The key difference between aspiration pneumonia and aspiration pneumonitis is that aspiration pneumonia is a condition due to pulmonary infection by aspiration of an infectious source, while aspiration pneumonitis is a condition due to an acute inflammation that occurs after chemical burns in the lung airways and lung parenchyma.
Aspiration is known as the inhalation of oropharyngeal or gastric contents into the larynx and the lower respiratory tract of the respiratory system. Several pulmonary conditions can occur after aspiration. Aspiration pneumonia and aspiration pneumonitis are two lung or pulmonary conditions that occur due to aspiration. Aspiration pneumonia is an infectious injury caused by the inhalation of oropharyngeal secretions that are colonized by pathogenic bacteria, whereas aspiration pneumonitis is a chemical injury caused by the inhalation of sterile gastric contents.
CONTENTS
1. Overview and Key Difference
2. What is Aspiration Pneumonia
3. What is Aspiration Pneumonitis (Mendelson syndrome)
4. Similarities – Aspiration Pneumonia and Aspiration Pneumonitis
5. Aspiration Pneumonia vs. Aspiration Pneumonitis in Tabular Form
6. Summary – Aspiration Pneumonia vs. Aspiration Pneumonitis
What is Aspiration Pneumonia?
Aspiration pneumonia is a condition that occurs due to breathing food or liquid into the airways or lungs instead of being swallowed. This is an infectious process since these foods or liquids are normally colonized by pathogenic bacteria, leading to inflammation and infection of the lungs and large airways. The risk factors for this condition include being less alert due to medications, coma, drinking large amounts of alcohol, taking illicit drugs, general anaesthesia, old age, poor gag reflex in people who are not alert, problems in swallowing, and being hospitalized. The symptoms of aspiration pneumonia are chest pain, coughing up foul-smelling phlegm, fever, fatigue, shortness of breath, wheezing, breath odour, excessive sweating, problems in swallowing, and confusion.
Figure 01: Aspiration Pneumonia
Aspiration pneumonia can be diagnosed through physical examination, arterial blood gas test, blood culture, bronchoscopy, complete blood test, X-ray, CT scan, sputum test, and swallowing test. Furthermore, aspiration pneumonia can be treated through a ventilator to assist breathing, antibiotics for infection, and feeding methods to reduce the risk of aspiration.
What is Aspiration Pneumonitis?
Aspiration pneumonitis is also known as Mendelson syndrome. It is due to chemically induced inflammation of the lungs as a result of aspiration of sterile gastric contents. The risk factors for this condition include people having residual gastric volume of greater than 25 ml and with pH of less than 2.5, people undergoing non-elective surgical procedures, having had light anaesthesia, having had acute or chronic, upper or lower GI pathology, obesity, taking opioid medication, having neurological disease, lithotomy position, difficulty in intubation, gastrointestinal reflux, and hiatal hernia. Moreover, the symptoms of this condition may include shortness of breath, low blood oxygen, rapid breathing, and clicking, bubbling, or rattling sounds in the lungs while breathing.
Aspiration pneumonitis can be diagnosed through physical examination, chest X-ray, and oxygen levels. Furthermore, treatment options for aspiration pneumonitis may include minimized further aspiration, secure airways (ETT) and suction until airways are cleared, empty stomach with NG tube, oxygen therapy, breathing assistance through a ventilator, chest physiotherapy, and corticosteroids to dampen down inflammation.
What are the Similarities Between Aspiration Pneumonia and Aspiration Pneumonitis?
- Aspiration pneumonia and aspiration pneumonitis are two lung or pulmonary conditions that occur due to aspiration.
- Both are critical conditions,
- Both may have similar symptoms, such as shortness of breath, chest pain, etc.
- They can be diagnosed through physical examinations and imaging tests.
- They are treated through breathing assistance and specific medications.
What is the Difference Between Aspiration Pneumonia and Aspiration Pneumonitis?
Aspiration pneumonia is a condition due to pulmonary infection by aspiration of an infectious source, while aspiration pneumonitis is a condition due to an acute inflammation that occurs after chemical burns in the lung airways and lung parenchyma. Thus, this is the key difference between aspiration pneumonia and aspiration pneumonitis.
Furthermore, the risk factors for aspiration pneumonia include being less alert due to medications, coma, drinking large amounts of alcohol, taking illicit drugs, general anesthesia, old age, poor gag reflex in people who are not alert, problems in swallowing, and being hospitalized. On the other hand, the risk factors for aspiration pneumonitis include people having a residual gastric volume of greater than 25ml and with a pH of less than 2.5, people having undergone a non-elective surgical procedure, having had light anaesthesia, having had acute or chronic, upper or lower GI pathology, obesity, taking opioid medication, having neurological disease, lithotomy position, difficulty in intubation, gastrointestinal reflux, and hiatal hernia.
The infographic below presents the differences between aspiration pneumonia and aspiration pneumonitis in tabular form for side-by-side comparison.
Summary – Aspiration Pneumonia vs. Aspiration Pneumonitis
Aspiration disorders include all conditions in which foreign substances are inhaled into the lungs or airways. These are crucial conditions as they restrict proper breathing. Aspiration pneumonia and aspiration pneumonitis are two lung or pulmonary conditions that occur due to aspiration. Aspiration pneumonia occurs when breathing in food or liquid into airways or lungs that are normally colonized by pathogenic bacteria. On the other hand, aspiration pneumonitis occurs due to chemically induced inflammation of the lungs as a result of aspiration of sterile gastric contents. So, this summarizes the difference between aspiration pneumonia and aspiration pneumonitis.
Reference:
1. “Aspiration Pneumonia: What It Is, Causes, Diagnosis, Treatment.” Cleveland Clinic.
2. Sethi, Sanjay. “Aspiration Pneumonitis and Pneumonia – Pulmonary Disorders.” MSD Manual Professional Edition, MSD Manuals.
Image Courtesy:
1. “Aspiration pneumonia201711-3264” By melvil – Own work (CC BY-SA 4.0) via Commons Wikimedia