ASPIRATION PNEUMONIA 

Many people who have aspiration pneumonia also have other diseases that affect swallowing. This may slow down recovery and result in a longer recovery period. This may also be dependent on how much of the lung has been affected, the severity of the pneumonia, the type of causative bacteria, and any underlying medical condition that compromises the immune system or one’s ability to swallow.

 

What Is Aspiration Pneumonia?

This is a lung infection that is due to a relatively large amount of material such as (food, saliva, liquids or vomit) from the stomach or mouth, entering the lungs or by inhalation or aspiration of materials either from the stomach or externally into the oesophagus. It is largely involuntary and the aspiration or inhalation of these materials could also introduce bacteria into the lungs. When bacteria that can affect the lungs are introduced, healthy lungs may clear these by itself and when it doesn’t pneumonia can develop as a complication.

 

 

Signs and Symptoms

Signs and symptoms of aspiration pneumonia includes:

• Chest pain

• Fatigue

• Fever

• Shortness of breath

• Wheezing

• Breath odour

• Coughing up of phlegm (sputum) that has a pungently foul-smell and contains pus or blood

• Excessive sweating

• Bluish skin around the mouth or fingertips

• Trouble swallowing

• Loss of appetite or weight

 

What Causes Aspiration pneumonia? 

Aspiration pneumonia can occur when the immune system is compromised or impaired and the aspirated contents have a large dose of harmful bacteria. These bacteria may go on and infect the lungs because of the weakened immune system.

It is also caused by a defective swallowing mechanism often due to a neurological disease or as the result of an injury that directly affects swallowing or interferes with consciousness.

The possibility of bacteria to cause aspiration pneumonia, depends on:

  • The health of the individual
  • History of antibiotics use
  • Weakening of the immune system

Aspiration pneumonia can also occur if food or drink goes down the wrong way during swallowing. This is not necessarily a consequence of an irregular gag reflux and whether or not the individual swallows normally before occurrence.

 

Risk Factors for developing Aspiration pneumonia 

There is an increased risk for people older than 75, living in nursing homes or long-term care centres. This could be attributed to disease conditions associated with aging.

The following factors increase risks:

• Parkinson’s disease, Alzheimer disease, stroke or other diseases could weaken the muscles that helps in swallowing.

• Smoking cigarettes which may lead to chocking and aspiration.

• Intubation for feeding or ventilation can allow bacteria to travel down the lungs.

• Surgery or radiation to treat cancer of the head or neck.

• Weakened immune system caused by diabetes, autoimmune disorders or other health problems.

• Poor oral/dental hygiene.

• Swallowing dysfunctions.

• Heartburn (gastroesophageal reflux).

• Gastroesophageal reflux disease (GERD).

 

How Aspiration pneumonia is Diagnosed

A physician diagnosing aspiration pneumonia will look out for signs of pneumonia during physical examination. These signs which includes decreased airflow, rapid heart rate and crackling sound in the lung could help determine if there is pneumonia or not. Lung biopsy could also be used in the diagnosis of aspiration pneumonia, caused by aspiration of food particles.

Laboratory examinations may include:

• Chest x-ray

• Sputum culture

• Bronchoscopy

• Full Blood Count (FBC)

• Computed tomography (CT) Scan of the chest area

• Blood culture

• Arterial blood gas

 

Treatment of Aspiration pneumonia 

Treatment is typically with antibiotics, targeted at destroying the bacteria. For those with only chemical pneumonitis, antibiotics may not be required.

People with an irregular gas reflux and having trouble swallowing may need to stop taking food by mouth.

Supportive care such as supplemental oxygen, steroids to reduce lung swelling or help from breathing machine may be employed for cases where aspiration pneumonia leads to breathing problem.

Oxygen may be given through a tube mask placed over the nose and mouth or through small tubes placed in the nostrils for patients with low blood oxygen level.

It is important to note that if aspiration pneumonia is left untreated, it could become serious.

 

How to Prevent Aspiration pneumonia 

• Avoid behaviours that may lead to aspiration of materials such as excessive drinking.

• Take care when taking medications that may cause drowsiness and loss of motor controls.


References

Alkhawaja, Sana; Martin, Claudio; Butler, Ronald J.; Gwadry-Sridhar, Femida (2015-08-04). “Post-pyloric versus gastric tube feeding for preventing pneumonia and improving nutritional outcomes in critically ill adults”. The Cochrane Database of Systematic Reviews (8): CD008875. doi:10.1002/14651858.CD008875.pub2

DiBardino, DM;Wunderink, RG (February 2015). “Aspiration pneumonia: a review of modern trends”. Journal of critical care. 30 (1): 40–8.

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