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Recent Advances in Chest Medicine |

Aspiration-Related Pulmonary SyndromesAspiration-Related Pulmonary Syndromes

Xiaowen Hu, MD; Joyce S. Lee, MD; Paolo T. Pianosi, MD, FCCP; Jay H. Ryu, MD, FCCP
Author and Funding Information

From the Department of Respiratory Disease (Dr Hu), Anhui Provincial Hospital, Hefei, China; the Department of Medicine (Dr Lee), University of California, San Francisco, CA; and Pediatric Pulmonology (Dr Pianosi), Department of Pediatric and Adolescent Medicine, and the Division of Pulmonary and Critical Care Medicine (Dr Ryu), Mayo Clinic, Rochester, MN.

CORRESPONDENCE TO: Jay H. Ryu, MD, FCCP, Division of Pulmonary and Critical Care Medicine, Gonda 18 S, Mayo Clinic, 200 First St SW, Rochester, MN 55905; e-mail: ryu.jay@mayo.edu


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;147(3):815-823. doi:10.1378/chest.14-1049
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Aspiration of foreign matter into the airways and lungs can cause a wide spectrum of pulmonary disorders with various presentations. The type of syndrome resulting from aspiration depends on the quantity and nature of the aspirated material, the chronicity, and the host responses. Aspiration is most likely to occur in subjects with a decreased level of consciousness, compromised airway defense mechanisms, dysphagia, gastroesophageal reflux, and recurrent vomiting. These aspiration-related syndromes can be categorized into airway disorders, including vocal cord dysfunction, large airway obstruction with a foreign body, bronchiectasis, bronchoconstriction, and diffuse aspiration bronchiolitis, or parenchymal disorders, including aspiration pneumonitis, aspiration pneumonia, and exogenous lipoid pneumonia. In idiopathic pulmonary fibrosis, aspiration has been implicated in disease progression and acute exacerbation. Aspiration may increase the risk of bronchiolitis obliterans syndrome in patients who have undergone a lung transplant. Accumulating evidence suggests that a causative role for aspiration is often unsuspected in patients presenting with aspiration-related pulmonary diseases; thus, many cases go undiagnosed. Herein, we discuss the broadening spectrum of these pulmonary syndromes with a focus on presenting features and diagnostic aspects.

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