Pneumopathies d'inhalation

Aspiration is defined as the inhalation of oropharyngeal (aspiration pneumonia) or gastric (aspiration pneumonitis) contents into the larynx and the lower respiratory tract. It is related to four mechanisms that may be associated: delay in gastric emptying, increase of gastric secretions, gastroesophageal reflux, and laryngeal alteration. It mainly occurs in patients with alteration of consciousness. Clinical consequences may vary, depending on the type, the pH and the aspirated content volume. Bacteria isolated in patients with aspiration pneumonitis are originated from oropharyngeal contaminated flora. The role of anaerobic bacteria during aspiration pneumonia is strongly suggested, but debated. Most of the time recommended antimicrobial therapy includes anti-anaerobic antibiotic. Prevention strategies have been mainly studied in patients at risk of aspiration of gastric content undergoing anaesthesia.