Pulmonary aspiration: an update.

Pulmonary aspiration of foreign material occurs in many situations. The morbidity of pulmonary aspiration is astounding. even more staggering is the mortality of massive aspiration of gastric contents. Bewilderment exists among most physicians concerning the treatment of this lethal event. The use of corticosteroids in pulmonary aspiration has received much attention and no data exist to advocate their continued employment. Knowledge of the bacteriology of aspiration has resulted in more judicious use of antimicrobial agents. The most significant advance in the treatment of pulmonary aspiration has been the development of positive end-expiratory pressure as an adjunct to mechanical ventilation. Pulmonary aspiration in hospitalized patients is an entirely preventable disease. All physicians must be made aware of the multitude of instances in which aspiration may occur if any hope of averting this disaster exists.