Practical points in understanding aspiration. Aspiration during anesthesia: a computer-aided study of 185,358 anaesthetics. Clinical significance of pulmonary aspiration during the perioperative period. Drug Intelligence & Clinical Pharmacy: the Annals of Pharmacoterapy. Aspiration pneumonitis: risk factors and management of the critically ill patient. Jejum prГ©-operatГіrio: validade de critГ©rios. Potential risks and preventive measures for pulmonary aspiration: new concepts in preoperative fasting guidelines. CONCLUSIONS: In all studied cases, forty to fifty minutes were not enough for gastric emptying after contrast administration and even stomach aspiration trough gastric tube has resulted in significant residual liquid. In two of them remarkable gastric liquid content remained even after stomach aspiration. Four anesthetized children have also presented gastric liquid residual 40-50 minutes after contrast administration through gastric tube. Two conscious children presented expressive gastric liquid residual 50 and 45 minutes, respectively, after oral contrast ingestion. CASES REPORT: Participated in this study 6 children undergoing abdominal tomography. Six patients submitted to abdominal tomography were evaluated concerning gastric emptying by tomographic slices in stomach topography to establish whether residual liquid contents remain in that organ after contrast administration. This practice means increased anesthesia duration and leads to issues about the possibility of gastric emptying in less than one hour. General anesthesia induction or sedation after contrast ingestion may pose substantial risk for gastric contents bronchoaspiration, so contrast administration by gastric tube is often used after tracheal intubation, since time elapsed for emptying gastric contrast is unknown. Tomography imaging with digestive tract contrast requires special care for children below five years of age requiring general anesthesia or sedation to assure immobility during the procedure. Palavras-chaveД«ACKGROUND AND OBJECTIVES: Pulmonary injury due to gastric contents aspiration is a complication related to airway protective reflexes loss. CONCLUSГ•ES: Nos casos observados, o perГodo de 40 a 50 minutos foi insuficiente para o esvaziamento do estГґmago, apГіs a administraГ§ГЈo de soluГ§ГЈo contrastante e mesmo a sucГ§ГЈo do conteГєdo por sonda nasogГЎstrica resultou em permanГЄncia de significante volume residual lГquido. Em duas destas persistiu apreciГЎvel resГduo lГquido no estГґmago, mesmo apГіs a aspiraГ§ГЈo do conteГєdo pela sonda.

Quatro, submetidas Г anestesia geral, tambГ©m apresentaram resГduo lГquido gГЎstrico decorridos 40 a 50 minutos da administraГ§ГЈo de contraste via sonda oro/nasogГЎstrica. Duas, nГЈo anestesiadas, apresentaram expressivo resГduo lГquido gГЎstrico decorridos 50 e 45 minutos, respectivamente, da ingestГЈo de contraste. RELATO DOS CASOS: Foram avaliadas seis crianГ§as submetidas Г tomografia contrastada do abdГґmen. Seis casos de pacientes submetidos Г tomografia de abdГґmen foram avaliados quanto ao esvaziamento gГЎstrico por meio da realizaГ§ГЈo de cortes tomogrГЎficos na topografia do estГґmago, com o objetivo de determinar a presenГ§a ou ausГЄncia de conteГєdo residual lГquido nesse ГіrgГЈo, apГіs a administraГ§ГЈo da soluГ§ГЈo de contraste. Esta conduta representa aumento do tempo de anestesia, o que resulta em constante questionamento sobre a possibilidade de esvaziamento do conteГєdo gГЎstrico em tempo inferior a uma hora. Isto faz com que se opte por administrar o contraste por sonda gГЎstrica apГіs a intubaГ§ГЈo traqueal, uma vez que nГЈo se conhece o tempo de esvaziamento gГЎstrico apГіs utilizaГ§ГЈo de soluГ§ГЈo contrastante. A induГ§ГЈo da anestesia ou sedaГ§ГЈo, apГіs ingestГЈo da soluГ§ГЈo de contraste pode trazer risco substancial para a broncoaspiraГ§ГЈo do conteГєdo gГЎstrico. Neste contexto, a realizaГ§ГЈo de exames tomogrГЎficos que incluem a contrastaГ§ГЈo do trato digestivo exige particular atenГ§ГЈo em crianГ§as abaixo de cinco anos, que necessitam anestesia geral ou sedaГ§ГЈo para assegurar imobilidade durante o procedimento.

JUSTIFICATIVA E OBJETIVOS: A lesГЈo pulmonar secundГЎria Г aspiraГ§ГЈo do conteГєdo gГЎstrico Г© complicaГ§ГЈo associada Г perda dos reflexos protetores das vias aГ©reas.

Tomografia pulmonar con contraste