A Mechanical Strategy for Preventing Perioperative Pulmonary Aspiration

Pulmonary aspiration of gastric contents is a rare but serious complication of impaired consciousness, such as during the induction of anesthesia, and is associated with significant morbidity and mortality. Despite numerous standard interventions, there is limited evidence that these strategies reliably prevent aspiration. Alginates are naturally derived polysaccharides that form a buoyant gel "raft" barrier in the stomach and have been used safely for decades to prevent acid reflux worldwide. However, according to the scientific literature, alginates have not been employed to potentially prevent pulmonary aspiration of gastric contents during induction of anesthesia and represent a promising new prophylactic option, serving as an ingestible physical barrier to esophageal reflux of stomach contents. With established safety and efficacy in the treatment of gastroesophageal reflux disease, alginates may offer an immediate, nonsystemic, inert, and safe reflux barrier to limit the risk of aspiration by physically inhibiting the regurgitation of gastric contents.