Highlights & Basics
- Acute aspiration is the inhalation of foreign material into the airways beyond the vocal cords with variable manifestations that result in aspiration bronchiolitis, aspiration pneumonitis, aspiration pneumonia, and acute respiratory distress syndrome (ARDS).
- Usually occurs in patients with altered level of consciousness, dysphagia, or impaired cough reflex.
- Screening for dysphagia is recommended for patients at risk of, or following, aspiration (including all patients after an acute stroke).
- Clinical presentation and severity depends on the volume and type of the aspirated material as well as the host defenses, such as adequate cough reflex, intact mucociliary barrier, and respiratory reserve.
- Anesthesia-related aspiration of gastric contents can be prevented by identifying patients susceptible to vomiting and reflux, minimizing gastric contents before surgery, avoiding drugs that reduce gastric emptying, minimizing emetic stimuli, and avoiding complete loss of protective reflexes from oversedation.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
Bronchoscopy showing barium aspiration in a lung transplant patient in the right mainstem bronchus after a barium swallow study
Barium aspiration. A barium swallow was conducted in a 53-year-old woman. Imaging revealed hyperdense airway-centered material in the left lower lobe consistent with barium aspiration bronchiolitis. A tracheoesophageal fistula was confirmed
A. Portable upright chest x-ray before aspiration; B. Chest x-ray 1 hour after aspiration, showing bilateral diffuse alveolar infiltrates, worse at the bases on the right side
Lipoid pneumonia. A 77-year-old woman with dysphagia and achalasia following a stroke presented with recurrent lung infiltrates, including a persisting right middle lobe lesion. Hounsfield units (HU) measurement was -157, consistent with lipoid pneumonia. Comparative subcutaneous fat and aorta (blood/tissue) HU are shown
Citations
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