Aspiration of gastric fluids is an important cause of lung injury for patients in critical care. Raghavendran et al listed risk factors for aspiration-induced lung injury in the intensive care unit. The authors are from the University of Michigan and University of Buffalo, SUNY.


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.


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