A CASE OF MASSIVE ASPIRATION OF GASTRIC CONTENTS DURING OBSTETRIC ANAESTHESIA - TREATMENT BY TRACHEOSTOMY AND PROLONGED INTERMITTENT POSITIVE PRESSURE VENTILATION

Summary: A case is described of massive aspiration of liquid gastric contents into the lungs of an obstetric patient undergoing general anaesthesia. Pre-operative treatment with oral alkali to neutralize gastric acid did not prevent a severe reaction in the lungs. Treatment was by general supportive measures and long-term intermittent positive pressure ventilation via a tracheostomy. Great difficulty was experienced in ventilating the lungs because of their low compliance and the large physiological deadspace. Recovery was complicated by a severe reduction in pulmonary diffusing capacity and by the development of tracheal stenosis. The factors influencing the treatment and complications are discussed. © 1969 John Sherratt and Son Ltd.