A child with aspiration may present with clear-cut acute lung injury from massive or highly toxic substance aspiration, mechanical obstruction of large- or intermediate-sized airways, infectious complications of aspiration, or recurrent small-volume aspiration. Generally, the diagnosis of massive, acute aspiration is straightforward. The major diagnostic challenges involve those patients in whom aspiration is (or should be) suspected but not obvious. Initially, this requires recognition and, if possible, treatment of underlying predisposing disorders. Although there are many tests available to help with the diagnosis of aspiration, none is both highly sensitive and specific. The clinician must decide that if aspiration is occurring, is it with swallowing, gastroesophageal reflux, or both. In addition, it is necessary to determine if aspiration is the most likely cause of lung injury or specific symptoms, often a process of exclusion. Thus, often a combination of tests may be necessary. Clinical suspicion and judgment remain major determinants of when to intervene on a child's behalf for treatment of suspected aspiration.
- Gastroesophageal reflux
- Lung injury
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Critical Care and Intensive Care Medicine