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BTS Clinical Statement
BTS clinical statement on aspiration pneumonia
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  1. A John Simpson1,2,
  2. Jamie-Leigh Allen3,
  3. Michelle Chatwin4,5,
  4. Hannah Crawford6,7,8,
  5. Joanna Elverson2,9,
  6. Victoria Ewan1,10,
  7. Julian Forton11,12,
  8. Ronan McMullan13,14,
  9. John Plevris15,16,
  10. Kate Renton3,17,
  11. Hilary Tedd2,
  12. Rhys Thomas1,2,
  13. Julian Legg3,18
  1. 1 Medical School, Newcastle University, Newcastle upon Tyne, UK
  2. 2 Newcastle upon Tyne NHS Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
  3. 3 Southampton Children’s Hospital, Southampton, UK
  4. 4 Royal Brompton Hospital, Guys and St Thomas’ NHS Foundation Trust, London, UK
  5. 5 National Hospital for Neurology and Neurosurgery, University College London NHS Foundation Trust, London, UK
  6. 6 Therapies, Tees, Esk and Wear Valleys NHS Foundation Trust, Darlington, UK
  7. 7 Teesside University, Middlesbrough, UK
  8. 8 University of Central Lancashire, Preston, UK
  9. 9 St Oswald’s Hospice, Newcastle upon Tyne, UK
  10. 10 South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
  11. 11 Noah’s Ark Children’s Hospital for Wales, Cardiff, UK
  12. 12 Cardiff University, Cardiff, UK
  13. 13 Queen’s University Belfast, Belfast, UK
  14. 14 Belfast Health and Social Care Trust, Belfast, UK
  15. 15 University of Edinburgh, Edinburgh, UK
  16. 16 Royal Infirmary of Edinburgh, Edinburgh, UK
  17. 17 Naomi House & Jacksplace Hospices for Children and Young Adults, Winchester, UK
  18. 18 NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Trust & University of Southampton, Southampton, UK
  1. Correspondence to Prof A John Simpson, Medical School, Newcastle University, Newcastle upon Tyne, UK; j.simpson{at}newcastle.ac.uk

https://doi.org/10.1136/thorax-2022-219699

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    Background, definitions, aims and scope of the clinical statement

    This BTS Clinical Statement seeks to provide practical clinical guidance on aspiration pneumonia (AP), through sections covering the relevant epidemiology, pathogenesis, prevention, diagnosis and management (including palliative care considerations where appropriate). Key clinical practice points appear at the end of each of these sections and are brought together in the highlighted summary below. Areas requiring important research to fill key knowledge gaps are highlighted in a separate section.

    The Statement arose because AP is disproportionately represented in people with a learning disability, in whom it is a major cause of death.1 The management of patients with community-acquired pneumonia (CAP) and learning disability is, therefore, the focus of a comprehensive parallel BTS Clinical Statement, in which learning disability is carefully defined.2 Despite this, however, most AP still occurs in people who do not have a learning disability. The existing literature on AP is of insufficient depth and quality to construct formal, comprehensive guidelines. For these reasons, the BTS proposed a Clinical Statement devoted to AP as a stand-alone document, but which specifically cross-references the sister Clinical Statement.2 All of the general preventive, diagnostic and management principles described in this document can be applied to people with a learning disability, and the reader is directed to the relevant page of the statement on community-acquired pneumonia in people with learning disability.2

    Importantly, this Clinical Statement seeks to complement the BTS Guidelines on CAP in adults3 and in children4 by giving an AP-specific context. However, readers should appreciate that the evidence base in the Guidelines has far stronger foundations than the evidence base for AP. As AP predominantly occurs in older adults, this Clinical Statement principally refers to practice in adults. However, we were eager to provide context specific to children, and subsections considering special considerations …

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