Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- tosse crônica ou aguda
- febre
- dispneia
- sibilância
- estertores
Other diagnostic factors
- Laringoespasmo
Risk factors
- nível de consciência reduzido (escore na escala de coma de Glasgow <9)
- doença mais grave
- anestesia geral
- idade >70 anos
- sexo masculino
- trauma cranioencefálico
- doença cerebrovascular
- tubo endotraqueal ou de traqueostomia
- disfagia
- dificuldades nas vias aéreas
- refeição de bário
- doença do refluxo gastroesofágico
- tubos de alimentação
- posição supina
- retardo do esvaziamento gástrico
- obesidade
- medicamentos que reduzem o tônus dos esfíncteres esofágicos
Diagnostic tests
1st tests to order
- radiografia torácica
Tests to consider
- tomografia computadorizada (TC) do tórax
- broncoscopia com lavagem broncoalveolar
- Hemograma completo
- gasometria arterial
- hemocultura
- toracocentese
Treatment algorithm
pneumonite causada por aspiração de conteúdo gástrico
pneumonite devida à aspiração de bário
Contributors
Authors
Augustine Lee, MD
Professor of Medicine
Division of Pulmonary and Critical Care Medicine
Mayo Clinic Florida
Jacksonville
FL
Disclosures
AL declares that he has no competing interests.
Spencer Deleveaux, MBBS
Fellow
Division of Pulmonary and Critical Care Medicine
Mayo Clinic Florida
Jacksonville
FL
Disclosures
SD declares that he has no competing interests.
Acknowledgements
Dr Augustine Lee and Dr Spencer Deleveaux would like to gratefully acknowledge Dr Madison Macht, Dr Kamran Mahmood, Dr Scott Shofer, Dr Septimiu Murgu, and Dr Henri Colt, previous contributors to this topic.
Disclosures
MM, KM, SS, SM, and HC declare they have no competing interests.
Peer reviewers
Andrew Parfitt, MBBS, FFAEM
Clinical Director
Acute Medicine
Associate Medical Director
Consultant Emergency Medicine
Guy's and St Thomas' NHS Foundation Trust
Clinical Lead and Consultant
Accident and Emergency Medicine
St Thomas' Hospital
London
UK
Disclosures
AP declares that he has no competing interests.
Momen M. Wahidi, MD, MBA
Director
Interventional Pulmonology
Division of Pulmonary, Allergy, and Critical Care Medicine
Assistant Professor of Medicine
Duke University Medical Center
Durham
NC
Disclosures
MMW declares that he has no competing interests.
References
Key articles
Marik PE. Aspiration pneumonitis and aspiration pneumonia. N Engl J Med. 2001 Mar 1;344(9):665-71. Abstract
Smith Hammond CA, Goldstein LB. Cough and aspiration of food and liquids due to oral-pharyngeal dysphagia: ACCP evidence-based clinical practice guidelines. Chest. 2006 Jan;129(1 suppl):154S-68S.Full text Abstract
American Society of Anesthesiologists. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures - an updated report by the American Society of Anesthesiologists task force on preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration. Anesthesiology. 2017 Mar;126(3):376-93.Full text Abstract
Smith I, Kranke P, Murat I, et al. Perioperative fasting in adults and children: guidelines from the European Society of Anaesthesiology. Eur J Anaesthesiol. 2011 Aug;28(8):556-69.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Síndrome do desconforto respiratório agudo
- Exacerbação da asma
- Fibrose cística com exacerbação
More DifferentialsGuidelines
- ACR appropriateness criteria: dysphagia
More Guidelines
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