Assessment of Aspiration-Induced lung Injuries among Acute Drug Poisoning Patients; Loghman Hakim Hospital, Poisoning center

Abstract

Background: Following pulmonary aspiration of gastric contents, a variety of conditions occurs ranging from the acute inflammatory response (aspiration pneumonitis) to an infectious process (aspiration pneumonia). They cause due to the failure of protecting mechanism of airway patency following poisoning toxicity. Methods: Patients with acute drug poisoning for assessment of aspiration-induced lung injury evaluated during the twelfth months. Results: 410 participants followed the study. Of those, 249 (61 %) were male and 161 (39%) female. They ranged between 17-55 years. The mode was 25-39 years with frequency of 38%. The mean±SD of age was 32.3±14.5 (Female 34% and Male 27% respectively). The mean age ±SD of females was lower than males (27.3±12.4 vs. 34.4±14.4 years old). An episode of vomiting was recorded positive in 62% (254) of patients. They were recorded by self-reported or witnessed by someone else within the first hours of poisoning. The chest radiograph abnormality was observed mostly in both lungs (45%, 185). They consisted of multifocal patchy infiltrates in lungs 44% (178), diffuse bilateral infiltration 35% (144), and bilateral perihilar consolidation 18% (72) and lobular consolidation 4% (16) mainly in both lung fields (45%, 185). Aspiration related pulmonary complications attributed to pneumonitis 43.5% (178) including ARDS 35% (144), pneumonia 18% (72), and lung abscess 4% (16). There was a significant relationship with vomiting (P=0. 04). Conclusion: Aspiration pulmonary abnormalities were the commonest lung manifestation of drug toxicities. Chest x-ray abnormalities associated with vomiting presentation are clues to finding pulmonary complications of acute drug toxicity.