Aspiration Pneumonia Syndromes
| Inoculum | Effects on airway and lungs | Clinical features | Management |
|---|---|---|---|
| Acid | Chemical pneumonitis | Acute dyspnoea, tachypnoea, possible cyanosis, bronchospasm, fever, pink frothy sputum, infiltrates in one or both lower lobes, hypoxaemia | Positive-pressure breathing, IV fluids, tracheal suction |
| Oropharyngeal bacteria | Bacterial infection | Usually insidious onset; cough, fever, purulent sputum, infiltrate involving dependent pulmonary segment or lobe, with or without cavitation | Antibiotic therapy (Table 63.1) |
| Inert fluids | Mechanical obstruction, reflex airway closure | Acute dyspnoea, cyanosis, pulmonary oedema | Tracheal suction, intermittent positive-pressure breathing with oxygen, bronchodilator |
| Particulate matter | Mechanical obstruction | Dependent on level of obstruction, ranging from acute apnoea to chronic cough with or without recurrent infections | Extraction of particulate matter, antibiotic therapy (Table 63.1) |