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Tracheal mucosal damage after aspiration. A scanning electron Microscope study

J W Wynne, R Ramphal, C I Hood

    The American Review of Respiratory Disease
    |December 1, 1981
    PubMed
    Summary
    This summary is machine-generated.

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    Gastric content aspiration causes significant tracheal damage, even in small amounts. Lower pH and gastric juice components worsen injury and delay healing in the large airways.

    Area of Science:

    • Gastroenterology
    • Pulmonology
    • Toxicology

    Background:

    • Aspiration of gastric contents is a known cause of pneumonitis.
    • The specific effects of gastric aspiration on the large airways, particularly the trachea, are not well understood.

    Purpose of the Study:

    • To investigate the impact of varying gastric content compositions and pH levels on tracheal mucosa integrity and healing.
    • To assess the severity of tracheal damage induced by aspiration of saline, hydrochloric acid, and canine gastric juice in a mouse model.

    Main Methods:

    • 63 healthy A/J mice were divided into four groups and intratracheally instilled with sterile saline (pH 5.9), hydrochloric acid (pH 1.5), canine gastric juice (pH 1.5), or canine gastric juice (pH 5.9).
    • Tracheal tissues were examined using scanning electron microscopy at various time points (1, 6, 24, 48, 72 hours, and 7 days) post-aspiration.

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  • Lung inflammation was also assessed to determine the extent of associated pulmonary damage.

    • Main Results:

    • Aspiration of hydrochloric acid (pH 1.5) caused significant desquamation of the tracheal epithelium, with regeneration beginning at 3 days and complete recovery by 7 days.
    • Canine gastric juice (pH 1.5) induced similar but more delayed regenerative responses compared to hydrochloric acid.
    • Canine gastric juice (pH 5.9) resulted in milder desquamation and delayed regeneration, indicating that both acidity and gastric juice components contribute to tracheal injury.

    Conclusions:

    • Gastric contents cause substantial tracheal mucosal damage, independent of clinically significant pneumonia.
    • Lower pH levels of aspirated gastric contents exacerbate tracheal injury.
    • Components within gastric juice itself may impede the healing process of the tracheal mucosa.