Aspiration Pneumonia

OVERVIEW OF ASPIRATION PNEUMONIA

Aspiration pneumonia is a complication of lung aspiration. Lung aspiration happens when food, saliva, stomach acid, or saliva is inhaled into the lungs. Food that is refluxed from the stomach to the esophagus can also get to the lungs and cause aspiration.

These inhaled substances may be contaminated with bacteria and will end up affecting the lungs. Healthy lungs can clear up the infection on their own but if they do not, a resultant complication is a pneumonia.

SYMPTOMS OF ASPIRATION PNEUMONIA

Those with aspiration pneumonia exhibit symptoms of poor oral hygiene and throat clearing or even a wet cough after eating. Additional symptoms of the condition include:

  • Chest pain
  • Shortness of breath
  • Wheezing
  • Cyanosis, meaning a blue discoloration of the skin
  • Fatigue
  • Cough, which may be with green sputum, blood, or foul smelling
  • Difficulty in swallowing
  • Bad breath
  • Excess sweating

Anyone experiencing these symptoms should speak to a doctor and inform them about any recent inhalation of food or liquids. Infants and the elderly should receive immediate medical attention and fast diagnosis.

Do not contemplate going to a doctor if you notice that you are coughing up colored sputum or your temperature is greater than 380C with any of the symptoms above.

CAUSES OF ASPIRATION PNEUMONIA

Aspiration pneumonia occurs when the lung defenses are impaired and the contents of aspiration contain a large number of bacteria.

Pneumonia can develop the following aspiration of food or drink ingested especially if it does not go down through the normal route-this can happen in very normal people who can swallow and have a good gag reflex. If so, one can prevent aspiration most of the time by coughing. Those with impairment in their coughing ability may not be able to do his. Coughing impairment may be caused by:

  • brain and nervous disorders
  • cancer of the throat
  • neuromuscular conditions such as myasthenia gravis or Parkinson’s disease
  • alcohol abuse or the use of illegal drugs
  • using  sedatives or anesthesia
  • a weak immune system
  • esophageal conditions
  • dental problems that affect chewing or swallowing

RISK FACTORS FOR ASPIRATION PNEUMONIA

Those who are at an increased risk of developing aspiration pneumonia include:

  • unconsciousness
  • lung disease
  • seizure
  • stroke
  • dental problems
  • dementia
  • impaired mental function
  • swallowing problems
  • some neurologic diseases
  • radiation therapy to the head and neck
  • gastro-esophageal reflux disease (GERD)
  • heartburn

DIAGNOSIS OF ASPIRATION PNEUMONIA

After a proper history taking on the likely causative factors and the symptoms being experienced, the doctor conducts a physical examination to look for the signs of pneumonia such as decreased airflow, fast heart rate, and a crackling sound in the lungs. The doctor will also run some tests to confirm the presence of pneumonia and these tests include:

  • chest X-ray
  • sputum culture
  • full blood count
  • arterial blood gas
  • blood culture
  • bronchoscopy
  • computed tomography (CT) scan of the chest region

Pneumonia is a serious condition and requires treatment. Some tests results will be made ready within 24 hours. Culture of the sputum and blood will take a longer time, about 3 to 5 days.

TREATMENT OF ASPIRATION PNEUMONIA

The treatment given will depend on the extent of severity of pneumonia, the patient’s health status, the presence of other co-morbidities, and hospital policies. Treating a severe form of pneumonia will not be an outpatient form of care but will need hospitalization. You may need to stop taking food by mouth if you have difficulty swallowing.

Antibiotics will be prescribed for the condition. The doctor will want to know the following before prescribing antibiotics:

  • Any recent hospitalization?
  • General health status
  • Any recent antibiotic use
  • Place of residence

Ensure that you are compliant with the antibiotics prescribed for the entire duration of prescription which may be within 1 to 2 weeks.

Supportive care may be needed if breathing problems are present. These treatment modalities include supplemental oxygen, steroid, or assisted ventilation. If it is a chronic aspiration, surgery may be necessary, depending on the cause. You may need surgery to place a feeding tube if you have swallowing difficulties that are unresponsive to treatment.

PREVENTION OF ASPIRATION PNEUMONIA

Tips for prevention

  • Do away with behaviors that can cause aspiration such as drinking excessively
  • Be careful when taking sedatives
  • Go for a dental check-up regularly

A swallowing evaluation can also be done by a swallowing therapist or a speech pathologist, as recommended. These people will work with you on different swallowing strategies and activities that will strengthen the muscles of the throat. A diet change may also be recommended.

Surgery risk: to reduce your chances of vomiting during anesthesia, be sure to follow the doctor’s orders on fasting.

LONG TERM OUTCOME

Majority of people who have aspiration pneumonia have other co-morbidities that interfere with swallowing. This will lead to an extended recovery period. The outcome depends on:

  • The extent of the lungs affected
  • The severity of pneumonia
  • The causative organism of the condition
  • Any medical problem that weakens the immune system or the ability to swallow

Pneumonia can cause long-lasting conditions such as lung abscess or a permanent scar formation in the lungs. Acute respiratory failure can also develop and it is life-threatening.

Those who are hospitalized but not staying in the intensive care unit are more likely to die when their condition is being complicated by aspiration pneumonia.

THINGS TO ALWAYS REMEMBER

Aspiration pneumonia is an infection of the lung that is caused by inhaling contents from the mouth or stomach. When left unattended, it can become very severe and fatal.Treatment is by administering antibiotics and supportive care for breathing.

The outcome of the condition depends on the health state prior to the event, the kind of foreign substance that is aspirated into the lungs and any other co-morbidity. 79 percent of people will recover from aspiration pneumonia. The 21 percent that dies are those who already have a preexisting condition that made them choose to have a do not resuscitate or do not intubate document.  Speak to a doctor immediately you have any symptoms of pneumonia, especially if the symptoms are in an elderly person or an infant. The doctor orders a test to check the health of the lungs and the swallowing ability.

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