Beck-Schimmer B Bonvini JM 2011 Aspiration is defined as the inhalation of oropharyngeal or gastric contents into the lower respiratory tract. Upon injury, epithelial cells and alveolar macrophages secrete chemical mediators, attracting and activating neutrophils, which in turn release proteases and reactive oxygen species, degrading the alveolocapillary unit. Aspiration can lead to a range of diseases such as infectious pneumonia, chemical pneumonitis or respiratory distress syndrome with significant morbidity and mortality. It occurs in approximately 3-10 per 10 000 operations with an increased incidence in obstetric and paediatric anaesthesia. Patients are most at risk during induction of anaesthesia and extubation, in particular in emergency situations. The likelihood of significant aspiration can be reduced by fasting, pharmacological intervention and correct anaesthetic management using a rapid sequence induction. Treatment of acid aspiration is by suctioning after witnessed aspiration; antibiotics are indicated in patients with aspiration pneumonia only. Steroids are not proven to improve outcome or reduce mortality. Patients with acute lung injury requiring mechanical ventilation should be ventilated using lung protective strategies with low tidal volumes and low plateau pressure values, attempting to limit peak lung distension and end-expiratory collapse. https://sonar.ch/global/documents/211651 eng info:eu-repo/semantics/altIdentifier/doi/10.1097/EJA.0b013e32834205a8 info:eu-repo/semantics/altIdentifier/pmid/21157355 European journal of anaesthesiology. - 2011 Acute Lung Injury Anesthesia, Obstetrical Animals Child Female Humans Incidence Postoperative Complications Pregnancy Reactive Oxygen Species Respiration, Artificial Respiratory Aspiration Risk Factors Bronchoaspiration: incidence, consequences and management. http://purl.org/coar/resource_type/c_6501