Acute aspiration

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 with risk factors for aspiration should undergo a bedside clinical exam before feeding.

Anesthesia-related aspiration of gastric contents can be prevented by identifying patients susceptible to vomiting and reflux, minimizing gastric contents before surgery, minimizing emetic stimuli, and avoiding complete loss of protective reflexes from oversedation.

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 neurologic deficits, infants, older patients (age >70 years), and debilitated patients with dysphagia may also aspirate barium sulfate during radiologic procedures, which can result in severe pneumonitis.

Aspiration is the inhalation of liquid or solid particles, particularly food, into the airways beyond the vocal cords.[1]Raghavendran K, Nemzek J, Napolitano LM, et al. Aspiration-induced lung injury. 2011 Apr;39(4):818-26. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3102154 http://www.ncbi.nlm.nih.gov/pubmed/21263315?tool=bestpractice.com It can be categorized as aspiration pneumonitis or aspiration pneumonia. Aspiration pneumonitis is a chemical injury after aspiration of gastric contents. Aspiration pneumonia is an infectious process secondary to aspiration of orogastric contents colonized with bacteria.[2]Marik PE. Aspiration pneumonitis and aspiration pneumonia. N Engl J Med. 2001 Mar 1;344(9):665-71. http://www.ncbi.nlm.nih.gov/pubmed/11228282?tool=bestpractice.com [1]Raghavendran K, Nemzek J, Napolitano LM, et al. Aspiration-induced lung injury. 2011 Apr;39(4):818-26. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3102154 http://www.ncbi.nlm.nih.gov/pubmed/21263315?tool=bestpractice.com This topic does not discuss the inhalation of foreign bodies.