Pulmonary aspiration

Abstract

It is apparent that appropriate management of pulmonary aspiration depends on a clear understanding of the pathophysiology associated with the aspirate. Pathologic processes induced by these events may be diverse and management must be individually determined. Aspiration of gastric acid may produce a fulminant and deadly form of pulmonary edema in which intubation, mechanical ventilation and sophisticated cardiopulmonary monitoring are required, but in which corticosteroids have no useful role. Bacterial pulmonary infection may follow gastric acid aspiration by several days, but is rarely a concurrent event. It is recommended that a subsequent infection be anticipated and the patient monitored in the interim as described above. Antibiotics should be administered only when infection is documented by appropriate changes in sputum Gram stain, fever, roentgenogram of the chest and peripheral leukocyte count.