Table 39.1.

Risk factors for pulmonary aspiration.

Risk factor	Clarification / Examples
Endotracheal intubation	The cuff does not prevent aspiration.
Decreased level of consciousness	GCS < 9, alcohol or drug overdose/withdrawal, excessive analgesics or sedatives, chemical paralysis
Neuromuscular disease and structural abnormalities of the aerodigestive tract	Diabetic gastroparesis, Parkinson’s disease, scleroderma, gastroesophageal reflux disease, esophageal cancer
Recent cerebrovascular accident	Within 4–6 weeks
Major intra-abdominal surgery	Less than 5 days postoperatively
Persistently high gastric residual volume (GRV)	GRV > 500 mL
Prolonger supine positioning	Spinal fractures
Persistent hyperglycemia	Blood glucose > 140 mg/dL

Modified from Metheny NA. Risk factors for aspiration. JPEN J Parenter Enteral Nutr 2002;26(Suppl 6):S26-S31.