| Mendelson's syndrome | |
|---|---|
| Specialty | Pneumonology |
Mendelson's syndrome, named in 1946 for American obstetrician and cardiologistCurtis Lester Mendelson, is a form ofchemical pneumonitis oraspiration pneumonitis caused byaspiration of stomach contents (principally gastric acid) duringanaesthesia inchildbirth. This complication of anaesthesia led, in part, to the longstandingnil per os (abbr. NPO; a Latin phrase meaning nothing by mouth) recommendation for women in labour.[1][2]
Mendelson's syndrome is characterised by abronchopulmonary reaction following aspiration of gastric contents during general anaesthesia due to abolition of thelaryngeal reflexes. The main clinical features are signs of generalhypoxia, two to five hours after anaesthesia. Such features may include cyanosis, dyspnea, fever, pulmonary wheeze, crepitant rales, rhonchi, andtachycardia with a low blood pressure. Decreasedarterial oxygen tension is also likely to be evident.Pulmonary edema can cause sudden death or death may occur later from pulmonary complications.[citation needed]
Historically it is said that a patient is at risk if they have:[3]
However these are indirect measurements and are not factors that directly influence aspiration risk.[3]
Patients with a high risk should have arapid sequence induction. High risk is defined as these factors:[3]
It is named forCurtis Mendelson.[4][5]
