202406151510
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Aspiration pneumonitis - Paed
- in children incidence 0.6 - 12 in 10,000
- majority of aspiration incidents NOT lead to patient harm
- aspiration of solid materials → asphyxia / death
- aspiration of clear fluid, regardless of acidity, will NOT
- real threat in children is hypoxia rather than aspiration
- Risk factors
- emergency surgery
- high ASA status
- gastrointestinal comorbid conditions
- laryngospasm
- NPO violation
- Difficult airway
- gastroesophageal reflux
- obesity
- ↑ IAP
also see Paediatric preoperative fasting
Gastric fluid content
- 'critical gastric volume'
- 0.4 → 0.8 → 1.25 → 1.5ml/kg
- laboratory study → NGT suctioning → Gastric ultrasound
- 0.4 → 0.8 → 1.25 → 1.5ml/kg
Aspiration also depends on other things
- lower oesophageal sphincter pressure
- anaesthesia level
- to avoid coughing / straining
- Difficult airway