Aspiration Pneumonitis and Aspiration Pneumonia

Abstract

Aspiration is defined as the aspiration of gastric (aspiration pneumonitis) or oropharyngeal (aspiration pneumonia) contents into the larynx and the lower respiratory tract. The principal mechanisms are delay in gastric empting, gastric oversecretion, gastroesophageal reflux, laryngeal alteration. The main cause is the alteration of consciousness. The clinical consequences depend on the nature of the gastric or oropharyngeal aspirated secretions. Bacteriology is then either negative or positive for oropharyngeal flora, with a debatable role for the anaerobes. The treatment includes oxygenotherapy, mechanical ventilation if necessary and antimicrobial treatment. Preventive strategies include fast before a general anesthesia, a protocol for enteral feeding, and good oral hygiene.