Summary

• The inhalation of foreign material into the airways beyond the vocal cords.
• Usually occurs in patients with altered level of consciousness, dysphagia, or impaired cough reflex.
• Patients suspected of having any risk factors for aspiration should undergo a complete neurological evaluation before feeding.
• Anaesthesia-related aspiration of gastric contents can be prevented by identifying patients susceptible to vomiting and reflux, minimising gastric contents before surgery, minimising emetic stimuli, and avoiding complete loss of protective reflexes from over-sedation.
• Antibiotics are not indicated early after aspiration of gastric contents, but they should be considered if the pneumonitis does not resolve after 48 hours.
• Patients with neurological deficits, infants, older patients (aged >70 years), and debilitated patients with dysphagia may also aspirate barium sulphate during radiological procedures, which can result in severe pneumonitis.