Aspiration in bronchoscopic practice

DOI: https://doi.org/10.29296/25877305-2022-02-10
Issue: 
2
Year: 
2022

M. Steiner(1, 2), MD; Yu. Biktagirov(2), Candidate of Medical Sciences; Professor A.
Zhestkov(2), MD; Professor E. Korymasov(2), MD; Professor E. Krivoshchekov(2), MD; Professor S. Babanov(2),
MD; N. Lavrentieva(2), Candidate of Medical Sciences; A. Kibardin(3) (1)Samara City Hospital Fourth
(2)Samara State Medical University (3)Railway Clinical Hospital at the Samara Station, OAO «RZhD», Samara

Frequency and variants of aspiration with gastric contents were studied on the basis of 13 328 (100%) primary bronchoscopies performed in patients with nonspecific non-tumor lung pathology. Aspiration into the lower airway with gastric contents was detected in 82 (0.616%) patients. In the majority of patients included in the study group, the clinic of aspiration was masked by the clinic of the underlying disease. Several variants of aspiration with gastric contents were proposed based on the results of the studies: simple aspiration with gastric contents, simple multiple aspiration with gastric contents, complex multiple aspiration with gastric contents and combined multiple aspiration with gastric contents. Maximum problems of visual bronchoscopic diagnosis are associated with simple aspiration of gastric contents, because the presence of gastric juice is often obscured by the presence of bronchial secretion. No correlation of specific lower respiratory tract aspiration variants by gastric contents with specific nosological forms of the leading non-tumor lung pathology was not identified.
Keywords: 
bronchoscopy
lower airways
aspiration with gastric contents

References: 
  1. Ovchinnikov A.A. Traheobronhoskopija: istorija i progress. Atmosfera: pul'monologija i allergologija. 2005; 1: 18–22 [Ovchinnikov A.A. Trakheobronkhoskopiya: istoriya i progress. Atmosfera. Pulmonologiia I allergologiya. 2005; 1: 18–22 (in Russ.)].
  2. Chernehovskaja N.E., Korzheva I.Ju., Mal'tseva I.M. i dr. Kliniko-endoskopicheskaja diagnostika inorodnyh tel bronhov. Pul'monologija. 2009; 2: 120–3 [Chernekhovskaya N.E., Korzheva I.Yu., Mal’tseva I.M. et al. Clinical and endoscopic detection of foreign bodies in bronchi. Pulmonologiya. 2009; 2: 120–3 (in Russ.)]. DOI: 10.18093/0869-0189-2009-2-120-123
  3. Aliev A.V. Istorija bronhoskopii. Dal'nevostochnyj meditsinskij zhurnal. 2011; 3: 121–4 [Aliyev A.V. The history of bronchoscopy. Dal’nevostochnyi meditsinskii zhurnal. 2011; 3: 121–4 (in Russ.)].
  4. Donnelly T.J., York E. Aspiratsija. Meditsina neotlozhnyh sostojanij (Ukraina). 2006; 5 (6) [Donnelly T.J., York E. Aspiratsiya. Meditsina neotlozhnykh sostoyanii. 2006; 5 (6) (in Russ.)]. URL: http://urgent.mif-ua.com/archive/issue-13520/
  5. Svistushkin V.M., Mustafaev D.M. Inorodnye tela v dyhatel'nyh putjah. RMZh. 2013; 33: 1681–5 [Svistushkin V.M., Mustafaev D.M. Inorodnye tela v dykhatel’nykh putyakh. RMJ. 2013; 33: 1681–5 (in Russ.)].
  6. Ali S.R., Mehta A.C. Alive in the Airways: Live Endobronchial Foreign Bodies. Chest. 2017; 151 (2): 481–91. DOI: 10.1016/j.chest.2016.10.041
  7. Shtejner M.L., Biktagirov Ju.I., Korymasov E.A. i dr. Inorodnye tela traheobronhial'nogo dereva: problemy vzrosloj praktiki. Prakticheskaja meditsina. 2017; 4 (105): 96–101 [Shteiner M.L., Biktagirov Yu.I., Korymasov E.A., et al. Foreign bodies in the tracheobronchial tree: practical issues in relation to adult patients. Practical Medicine. 2017; 4: 96–101 (in Russ.)].
  8. Marouf R., Hamraoui S., Alloubi I. A neglected bronchial foreign body for 23 years. Rev Mal Respir. 2019; 36 (8): 1002–7. DOI: 10.1016/j.rmr.2019.06.010
  9. Sehgal I.S., Dhooria S., Ram B. et al. Foreign Body Inhalation in the Adult Population: Experience of 25998 Bronchoscopies and Systematic Review of the Literature. Respir Care. 2015; 60 (10): 1438–48. DOI: 10.4187/respcare.03976
  10. Ali S.R., Mehta A.C. Alive in the Airways: Live Endobronchial Foreign Bodies. Chest. 2017; 151 (2): 481–91. DOI: 10.1016/j.chest.2016.10.041
  11. Paintal H., Kuschner W. Aspiration syndromes 10 clinical pearls every physicians should know. Int J Clin Pract. 2007; 61 (5): 846–52. DOI: 10.1111/j.1742-1241.2007.01300.x.
  12. Kumar S., Selim M.H., Caplan L.R. Medical complications after stroke. Lancet Neurol. 2010; 9: 105–18. DOI: 10.1016/S1474-4422(09)70266-2
  13. Gorenshtejn M.L. Problemy aspiratsii i stressornyh povrezhdenij pischevaritel'nogo kanala pri kriticheskih sostojanijah. Meditsina neotlozhnyh sostojanij (Ukraina). 2012; 5 (44): 88–9 [Gorenshtein M.L. Problemy aspiratsii i stressornykh povrezhdenii pishchevaritel’nogo kanala pri kriticheskikh sostoyaniyakh. Meditsina neotlozhnykh sostoyanii (Ukraina). 2012; 5 (44): 88–9 (in Russ.)].
  14. Shtejner M.L., Biktagirov Ju.I., Belousova T.V. Bronhoskopija v nevrologicheskoj praktike. Vrach. 2015; 4: 60–3 [Shteiner M., Biktagirov Yu., Belousova T. Bronchoscopy in neurological practice. Vrach. 2015; 4: 60–3 (in Russ.)].
  15. Sidorenko I.A., Pusev A.V. Kislotno-aspiratsionnyj sindrom: prichiny, klinika, lechenie, profilaktika. Nauchnyj al'manah. 2019; 3–3 (53): 171–3 [Sidorenko I.A., Pusev P.V. Acid aspiration syndrome: causes, clinic, treatment, prevention. Science Almanac. 2019; 3–3 (53): 171–3. (in Russ.)].
  16. Putintsev V.A., Vorob'eva A.A., Sundukov D.V. i dr. Aspiratsionnaja asfiksija dyhatel'nyh putej krov'ju i zheludochnym soderzhimym pri travmah i zabolevanijah. Kremlevskaja meditsina. Klinicheskij vestnik. 2019; 3: 165–8 [Putincev V.A. Vorobieva A.A., Sundukov D.V. et al. Aspiration of respiratory tract asphyxia with blood and gastric contents in case of injuries and diseases. clinical case and literature reference. Kremlin Medicine Journal. 2019; 3: 165–8 (in Russ.)]. DOI: 10.26269/f6ay-qe09
  17. Teramoto S. Novel preventive and therapeutic strategy for poststroke pneumonia. Expert Rev Neurother. 2009; 9: 1187–200. DOI: 10.1586/ern.09.72
  18. Hannawi Y., Hannawi B., Rao C.P.V. et al. Stroke-associated pneumonia: Major advances and obstacles. Cerebrovasc Dis. 2013; 35: 430–43. DOI: 10.1159/000350199
  19. Sorokin Ju.N. Narushenija glotanija pri insul'tah (1. Osobennosti klinicheskih projavlenij). Meditsina neotlozhnyh sostojanij (Ukraina). 2015; 3 (66): 135–8 [Sorokin Yu.N. Narusheniya glotaniya pri insul’takh (1. Osobennosti klinicheskikh proyavlenii). Meditsina neotlozhnykh sostoyanii (Ukraina). 2015; 3 (66): 135–8 (in Russ.)].
  20. Shifman E.M. Giperergicheskij aspiratsionnyj pnevmonit (sindrom Mendel'sona). Obschaja reanimatologija. 2006; 2 (6): 191–9 [Shifman Y.M. Hyperergic Aspiration Pneumonitis (Mendelson Syndrome). General Reanimatology. 2006; 2 (6): 191–9 (in Russ.)]. DOI: 10.15360/1813-9779-2006-6-191-199
  21. Vatanskaja I.Ju., Jartseva S.V., Kozlova N.V. Aspiratsionnye pnevmonii: nekotorye aspekty etiologii, patogeneza, diagnostiki i antibiotikoterapii. Ukraїns'kij zhurnal ekstremal'noї meditsini іmenі G.O. Mozhaєva. 2009; 10 (1): 111–21 [Vatanskaya I.Y., Yartseva S.V., Kozlova N.V. Aspiration pneumonias: some aspects of etiology, pathogenesis, diagnostics and antibiotic therapy. Ukraїns’kii zhurnal ekstremal’noї meditsini іmenі G.O. Mozhaєva. 2009; 10 (1): 111–21 (in Russ.)].
  22. Son Y.G., Shin J., Ryu H.G. Pneumonitis and pneumonia after aspiration. J Dent Anesth Pain Med. 2017; 17: 1–12. DOI: 10.17245/jdapm.2017.17.1.1
  23. Barkovskaja N.A., Vartanov V.Ja., Pichugin V.V. i dr. Aspiratsionnyj sindrom u ginekologicheskoj bol'noj (klinicheskoe nabljudenie). Tol'jatinskij meditsinskij konsilium. 2018; 1: 96–100 [Barkovskaya N.A., Vartanov V.Ya., Pichugin V.V. et al. Aspiration syndrome in a gynecological patient (clinical observation). Tol’yatinskii meditsinskii konsilium. 2018; 1: 96–100 (in Russ.)].
  24. Koh G.H., Kim S.H., Son H.J. et al. Pulmonary aspiration dukoloring intubation in a high-risk patient: A video clip and clinical implications. J Dent Anesth Pain Med. 2018; 18 (2): 111–4. DOI: 10.17245/jdapm. 2018.18.2.111
  25. Lemoine J.M. Les bronchites chronigues. Bronches. 1965; 15 (2): 129–42. DOI: 10.1159/000192011
  26. Lukomskij G.I., Shulutko M.L., Vinner M.G. i dr. Bronhopul'monologija. M.: Meditsina, 1982; 399 s. [Lukomskii G.I., Shulutko M.L., Vinner M.G., et al. Bronkhopulmonologiya [Bronhopulmonology]. M.: Meditsina, 1982; 399 (in Russ.)].