RT Book, Section
A1 Daines, Cori L.
A2 Rudolph, Colin D.
A2 Rudolph, Abraham M.
A2 Lister, George E.
A2 First, Lewis R.
A2 Gershon, Anne A.
SR Print(0)
ID 7051223
T1 Chapter 511. Aspiration Syndromes
T2 Rudolph's Pediatrics, 22e
YR 2011
FD 2011
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-149723-7
LK accesspediatrics.mhmedical.com/content.aspx?aid=7051223
RD 2024/04/19
AB Pulmonary  aspiration  is  defined  as  the  passage  of  foreign  material  or  fluid  into  the  lungs  during  inspiration.  Although  food  or  gastric  contents  are  considered  the  main  culprits,  anything  from  saliva  to  plastic  toys  can  be  aspirated.  Aspiration  of  saliva  and  gastric  contents  can  occur  in  normal  individuals  silently,  especially  at  night.1,2  The  true  hazards  of  aspiration  were  not  reported  in  the  medical  literature  until  1946  when  Mendelson  described  the  clinical  and  pathologic  findings  in  obstetric  patients  who  aspirated  large-volume  gastric  contents.  He  described  the  “asthmalike”  symptoms  of  these  patients  and  then  showed  in  animal  models  that  acidic  material,  with  pH  less  than  2.5,  caused  inflammation,  damage,  and  desquamation  of  the  mucosa  in  the  lungs.3  Pathologic  aspiration  events  can  be  divided  into  2  main  categories:  acute  and  chronic.  The  acute  events  include  large-volume  aspiration  of  gastric  contents  or  other  fluid,  hydrocarbon  aspiration,  near-drowning,  and  foreign  body  aspiration.  The  chronic  events  include  recurrent,  small-volume  aspiration  of  saliva,  food,  upper  airway  secretions,  or  gastroesophageal  reflux.  Large-volume  aspiration  events  are  usually  witnessed  and  can  be  directly  addressed.  Recurrent  small-volume  aspirations  are  often  silent  and  more  difficult  to  diagnose  and  manage.  It  is  important  to  recognize  the  risk  factors  to  properly  diagnose  aspiration  (Table  511-1).