[Mendelson's syndrome]

Mendelson's syndrome is discussed with a review of the literature and presentation of 27 personal cases studies. Accidental aspiration of gastric fluid occurs primarily during anesthesia, in cranial trauma victims, and in toxic coma patients. Tissue damage is proportional to the acidity and the quantity of aspirated fluid. The initial clinical manifestations are often serious, sometimes leading to acute respiratory distress syndrom with pulmonary edema. Frequent infectious complications, often with anaerobic microbes, are deciding factors in the prognosis. Artificial ventilation with positive pressure (sometimes continuous) is often necessary. Administration of corticosteroids at high doses is likely favorable. Prophylactic administration of antibiotics is initially directed against anaerobic agents. The prevention of this serious syndrome should be a primary concern of anesthesiologists and physicians treating comatous patients.