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KMID : 0365819710110010175
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Journal of Pusan Medical College
1971 Volume.11 No. 1 p.175 ~ p.196
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Experimental Study of Respiratory and Pathological Responses of the Lung following Instillation of Acid and Alkaline
Solution into the Trachea
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Abstract
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The object of this study was to examine the immediate respiratory responses as well as the pathological changes of the lung following the introduction of acid or alkaline solution into the bronchial tree.
Attention in this study was payed chiefly on the influence of variation in pH and volume of instilled acid or alkaline solution and its possible neutralization, and the prophylactic effects of hydrocortisone and sodium thiosulfate to aspiration pneumonitis.
The influences of bilateral cervical vagotomy and atropine administration to the sudden apnea appearing immediately following aspiration was also investigated.
The results were as follows:
1. A syndrome of sudden apnea was appeared immediately after instillation in all animals in which saline or sodium bicarbonate solution over 4cc/kg, and acid or alkaline solution over 3cc/kg was used, regardless of degree of pH.
2. Tachypnea was appeared immediately after instillation in all animals except those in which at a pH 1.50 hydrochloric acid was instilled.
3. Sudden apnea appearing immediately after instillation could be abolished with bilateral vagotomy but not with atropine.
4. The degree of pathological responses in the lung following instillation of acid or alkaline solution was found to be directly proportional to the acidity or alkalinity and volume of aspirated solutions.
5. Highly acid or alkaline solutions(pH 1.50 HCI or pH 12. 50 NaOH solution) produced more severe reactions such as pulmonary edema, hemorrhagic pneumonitis and de-epithelialization of bronchial mucosa. However, with HCI less acid than pH 2. 00 or NaOH less alkaline than pH 12.15 the main finding was interstitial pneumonitis with large macrophages.
6. Attempted endotracheal dilution or neutralization of low pH acid solution did not alter the usual reactions, but inversed the severity of the reaction,
7. Prophylactic hydrocortisone injection which was expected to decrease the extent of the lesions of aspiration pneumonitis. was not responded definitively..
8.. Prophylactic use of sodium thiosulfate was expected to be valuable as a prevenive agent in the pulmonary edema resulted from aspiration chemical pneumonitis.
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