Biomedical Center Martin and Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia.
Physiol Res. 2021 Dec 30;70(Suppl4):S567-S583. doi: 10.33549/physiolres.934767.
Aspiration is a common condition affecting healthy or sick patients which could create an acute or chronic inflammatory reaction in the lungs. Aspiration syndromes could be categorized according to a content entering the respiratory system into bacterial aspiration pneumonia with the gastric or oropharyngeal bacteria entering, aspiration chemical pneumonitis with bacteria-freegastric acid aspiration, or aspiration of a foreign body which causes an acute pulmonary emergency. There are differences in the clinical presentation of volume-dependent aspirations (microaspiration and macroaspiration): the higher is the volume of aspiration, the greater is the injury to the patient and more serious are the health consequences (with 70 % mortality rate for hospitalized patients). Aspiration syndromes can affect both the airways and pulmonary parenchyma, leading to acute lung injury, increased hospitalization rate and worse outcomes in critically ill patients. Impaired alveolar-capillary permeability, oedema formation, neutrophilic inflammatory response and pulmonary surfactant inactivation lead to reduced lung compliance and loss of aerated lung tissue and give rise to hypoxemia and respiratory failure. This review discusses the effect of aspiration events on the pulmonary tissue. The main focus is to distinguish the differences between bacterial and chemical pneumonia, their clinical presentation and symptoms, risk factors of developing the changes, possibilities of diagnostics and management as well as prevention of aspirations. Because of a risk of serious lung damage after the aspiration, pathophysiology and processes leading to lung tissue injury are discussed in detail. Data sources represent a systematic literature search using relevant medical subject headings.
吸入是一种常见的病症，可影响健康或患病患者，导致肺部发生急性或慢性炎症反应。吸入综合征可根据进入呼吸系统的内容物进行分类，包括细菌吸入性肺炎（胃或口咽细菌进入）、无菌胃酸吸入性化学性肺炎、或吸入异物导致急性肺部急症。在与容量相关的吸入（微吸入和大吸入）的临床表现上存在差异：吸入量越大，对患者的损伤越大，健康后果越严重（住院患者的死亡率为 70%）。吸入综合征可影响气道和肺实质，导致急性肺损伤、住院率增加和重症患者预后更差。肺泡毛细血管通透性受损、水肿形成、中性粒细胞炎症反应和肺表面活性物质失活导致肺顺应性降低和充气肺组织丧失，引起低氧血症和呼吸衰竭。本文讨论了吸入事件对肺部组织的影响。主要重点是区分细菌性和化学性肺炎之间的差异，及其临床表现和症状、发生变化的风险因素、诊断和管理的可能性以及预防吸入。由于吸入后可能导致严重的肺部损伤，因此详细讨论了导致肺组织损伤的病理生理学和过程。数据来源是使用相关医学主题词进行的系统文献检索。
