Management of exogenous lipoid pneumonia after fuel aspiration: a single-center experience

Congying SONG; Ping WANG; Yuanqiang LU

doi:10.1631/jzus.B2500270

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Research Article | Updated：2025-12-31

Management of exogenous lipoid pneumonia after fuel aspiration: a single-center experience
Management of exogenous lipoid pneumonia after fuel aspiration: a single-center experience
燃料误吸继发外源性类脂性肺炎的临床管理策略：单中心诊疗经验总结
Journal of Zhejiang University-SCIENCE B Vol. 26, Issue 12, Pages: 1233-1244(2025)
Affiliations：

1.Department of Emergency Medicine, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, China
2.Zhejiang Key Laboratory for Diagnosis and Treatment of Physic-chemical and Aging-related Injuries, Hangzhou 310003, China
Funds：
DOI：10.1631/jzus.B2500270
CLC：
CSTR：
Received：05 June 2025，

Revised：2025-10-16，

Published：31 December 2025
Accepted：

宋聪颖,王萍,陆远强.燃料误吸继发外源性类脂性肺炎的临床管理策略：单中心诊疗经验总结[J].浙江大学学报（英文版）（B辑：生物医学和生物技术）,2025,26(12):1233-1244.

Congying SONG, Ping WANG, Yuanqiang LU. Management of exogenous lipoid pneumonia after fuel aspiration: a single-center experience[J]. Journal of Zhejiang University-SCIENCE B, 2025, 26(12): 1233-1244.
宋聪颖,王萍,陆远强.燃料误吸继发外源性类脂性肺炎的临床管理策略：单中心诊疗经验总结[J].浙江大学学报（英文版）（B辑：生物医学和生物技术）,2025,26(12):1233-1244. DOI： 10.1631/jzus.B2500270.

Congying SONG, Ping WANG, Yuanqiang LU. Management of exogenous lipoid pneumonia after fuel aspiration: a single-center experience[J]. Journal of Zhejiang University-SCIENCE B, 2025, 26(12): 1233-1244. DOI： 10.1631/jzus.B2500270.

摘要

外源性类脂性肺炎是一种由碳氢化合物误吸引起的罕见但严重的肺部疾病。本研究旨在总结单中心收治的燃料误吸所致肺炎病例，为临床工作者提供参考。本研究收集和分析了11例燃料误吸所致肺炎患者的临床资料及转归，并详细描述了4例代表性病例，总结其临床特点和管理策略。结果显示，几乎所有患者均出现咳嗽和呼吸困难，其中呼吸困难与胸痛最为常见。影像学上，90.9%的患者表现为双下肺野受累，半数患者出现肺实变。在治疗方面，1例发生不可逆肺损伤的患者接受了体外膜肺氧合（ECMO）支持及肺移植手术，其余患者主要接受了氧疗、抗生素、糖皮质激素及其他支持治疗。抗生素与糖皮质激素是最常用的治疗手段，支气管肺泡灌洗（BAL）虽有助于清除刺激物，但其应用亦因相关风险需谨慎评估。最终所有患者均获得良好转归。本研究提示，外源性类脂性肺炎对患者健康危害显著，低氧血症是其常见表现。综上，以抗生素、糖皮质激素及呼吸支持为主的综合支持治疗是主要治疗方式，BAL的应用需严格把握指征，ECMO可作为恢复或肺移植前的关键桥梁支持，及时有效的治疗通常能使患者获得良好预后。

Abstract

Exogenous lipoid pneumonia (ELP) following hydrocarbon aspiration is an unusual but severe condition. This study aimed to summarize the cases of pneumonitis following fuel aspiration from a single center to serve as a useful reference for clinicians in the future. The clinical courses and outcomes of 11 patients with pneumonitis following fuel aspiration were collected and presented. Among them

four representative cases were described in detail to summarize the management experience of this disease

and these cases were analyzed to better understand the clinical features and management strategies of hydrocarbon pneumonitis following fuel aspiration. Almost all patients were found to present with cough and dyspnea

and the most common symptoms were dyspnea and chest pain. A high proportion (90.9%) of patients presented with bilateral lower pulmonary field involvement

and half of the patients showed pneumonic consolidation. One patient with irreversible lung injury received extracorporeal membrane oxygenation (ECMO) and a lung transplant. The other patients received oxygen support

antibiotics

steroids

and other supportive care. Antibiotics and steroids were the most commonly used treatments. While bronchoalveolar lavage (BAL) was beneficial for removing irritants

its utility could also be reduced due to significant risks. Finally

all patients had favorable outcomes. In conclusion

ELP was definitely harmful to patients’ health

and hypoxemia was common among these patients. Supportive care

including antibiotics

steroids

and respiratory support

was the main treatment modality. It is recommended that the decision to employ BAL is made selectively. ECMO serves as a critical bridge to recovery or transplantation

and patients with timely and efficient treatment usually have a positive outcome.

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references

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Related Institution

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