Risk factors for aspiration-induced lung injury:
(1) reduced level of consciousness
(1a) traumatic brain injury
(1b) alcohol or drug intoxication
(1c) encephalopathy
(1d) seizure disorder
(1e) stroke
(2) impaired or absent gag reflex
(2a) endotracheal intubation
(2b) bulbar paralysis
(3) gastrointestinal disorders
(3a) nasogastric intubation
(3b) esophageal motility disorder
(3c) gastroesophageal reflux disease (GERD)
(3d) gastroparesis
(3e) ileus
(3f) bowel obstruction
(3g) other causes of vomiting
(4) obesity
(5) labor (in pregnancy)
(6) medications
(6a) adrenergic drugs
(6b) anticholinergic agents
(6c) calcium channel blockers
(6d) nitrates
(6e) calcium channel blockers
(6f) sedatives
(6g) recent general anesthesia
The presence of a protected airway can reduce aspiration in patients with risk factors. However, problems with a protected airway can negate its benefit.
