Pulmonary aspiration risk factors

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Risk Factors

As a rule of thumb, any condition which compromises a patient's level of consciousness and/or gag reflex is a risk factor for pulmonary aspiration.

Causes of unconsciousness where aspiration may occur include trauma (especially head injuries), poisoning (including drug/alcohol overdose), general anaesthetics, and diseases or metabolic conditions.

Gastroesophageal reflux, a full stomach, pregnancy, and obesity all increase the risk of aspiration in the semiconscious.

Normally fasting for six hours before elective surgery is enough to empty the stomach. Severe injuries can slow the movement of digesta from the stomach and through the duodenum.

Acute alcohol poisoning is a relatively common cause of severe pulmonary aspiration as the alcohol renders the victim unconscious and can induce vomiting. Patients with neurological conditions may also aspirate food or drink.

During labor, early respiratory movements by the baby facilitate filling of alveolar ducts and alveolar lumens with elements of amniotic fluid: amniotic cells, squamous and squamous cells from fetal skin, lanugo, meconium. Reduced inflammatory infiltrate (neutrophils) and capillary congestion is present.


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