Four anesthetized rabbits given intratracheal injections of hydrochloric acid, pH 1.5, 2 ml/kg, were killed 4 h later. A fifth rabbit was an untreated control. Each lung had a few red-brown patches of compression atelectasis. Microscopically, treated lungs had a severe exudative necrotizing bronchitis, bronchiolitis, and alveolitis. There was also intra-alveolar hemorrhage and edema. Electron microscopy showed folds, projections and focal swellings of type I cells lining affected alveoli. A morphometric study showed 69% of parenchyma to be normal, 26% edematous and 5% hemorrhagic. In the airways 58% of the epithelium was damaged.
References
1.
AlexanderI. G. S.:
The ultrastructure of the pulmonary alveolar vessels in Mendelson's (acid pulmonary aspiration) syndrome.Br. J. Anaesth.40:
408–414(1968)
2.
AweW. C.FletcherW. S.JacobS. W.:
The pathophysiology of aspiration pneumonitis.Surgery60:
232–239(1966)
3.
de BoerJ.BiewengaT. J.KuipersH. A.den OtterG.:
The effects of aspirated and swallowed water in drowning: sea-water and fresh-water experiments on rats and dogs.Anesthesiology32:
51–59(1970)
HalmagyiD. F. J.:
Lung changes and incidence of respiratory arrest in rats after aspiration of sea and fresh water.J. appl. Physiol.16:
41–44(1961)
10.
IronsE. E.ApfelbachC. W.:
Aspiration bronchopneumonia with special reference to aspiration of stomach content.J. Am. med. Ass.115:
584–587(1940)
11.
MendelsonC. L.:
The aspiration of stomach contents into the lungs during obstetric anesthesia.Am. J. Obstet. Gynec.52:
191–205(1946)
12.
ModellJ. H.:
The pathophysiology and treatment of drowning.Acta anaesth. scand.12:
suppl. 29,
pp. 263–271(1968)
13.
NopanitayaW.GambillT. G.BrinkhousK. M.:
Fresh water drowning. Pulmonary ultrastructure and systemic fibrinolysis.Archs Path.98:
361–366(1974)
14.
ReidbordH. E.:
An electron microscopic study of the alveolar-capillary wall following intratracheal administration of saline and water.Am. J. Path.50:
275–289(1967)
15.
ReidbordH. E.SpitzW. U.:
Ultrastructural alterations in rat lungs. Changes after intratracheal perfusion with freshwater and seawater.Archs Path.81:
103–111(1966)
16.
TaylorG.Pryse-DaviesJ.:
Evaluation of endotracheal steroid therapy in acid pulmonary aspiration syndrome (Mendelson's syndrome).Anesthesiology29:
17–21(1968)
17.
TeabeautJ. R.:
Aspiration of gastric contents. An experimental study.Am. J. Path.28:
51–67(1952)
18.
WambergK.ZeskovB.:
Experimental studies on the course and treatment of aspiration pneumonia.Anesth. Analg.45:
230–236(1966)