Tuesday, December 16, 2008

Aspiration Pneumonia

Aspiration pneumonia is an infection in the lungs that develops after foods, liquids, or stomach contents are accidentally inhaled.
Aspiration Pneumonia

Foods and liquids enter your mouth and travel down the esophagus into the stomach. Air enters your mouth or nose and goes down your airway (trachea) into your lungs. Lungs are only meant to be exposed to air. But foods, liquids, or vomited stomach contents may accidentally get into the airway and travel down to the lungs. This is called aspiration.
Generally, most people can cough to prevent foreign substances from being inhaled into the lungs. However, some people may not be able to protect their lungs with a good cough. This may happen when they are unconscious or if they have trouble swallowing foods or liquids. Once the foreign substances get into the lungs, they may cause an infection known as aspiration pneumonia. This is a potentially serious condition that requires care from your doctor.
Risk Factors
The following factors increase your chances of developing aspiration pneumonia. In general, elderly people with a history of lung disease or a stroke, a need for feeding assistance, or poor dentition are at highest risk. If you have any of these risk factors, tell your doctor:
• Loss of consciousness due to alcohol intake, seizures, stroke, etc.
• Impaired swallowing function due to poor dentition or a history of Parkinson’s disease, Lou Gehrig’s disease, stroke, etc.
• History of heartburn (also called gastroesophageal reflux disease or GERD)
• History of lung disease
If you experience any of these symptoms, do not assume it is due to aspiration pneumonia. These symptoms may be caused by other, less serious health conditions. If you experience any one of them, see your physician.
• Swallowing problems
• Frequent coughing, especially after eating and/or drinking
• Shortness of breath or loud breathing
• Rapid heart rate
• Fever
• Chest pain, especially when coughing
Your doctor will ask about your symptoms and medical history, and perform a physical exam. During the exam, your doctor will listen to your heart and lungs with a stethoscope. Tests may include the following:
• Chest x-ray – A chest x-ray will determine if there are infiltrates within either lung, which may be a sign of lung infection.
• Sputum culture – A sample of sputum (a mucous-like secretion from the lungs) may be tested to determine which antibiotic should be used for treatment.
• Bronchoscopy – A tube with a camera at the end may be inserted through the nose or mouth into the airway to obtain a sample of sputum and to view the airways of the lungs.
• Barium Swallow (Upper Gastrointestinal Study) – If you have swallowing problems, you may be asked to swallow barium contrast, which will show up on an x-ray of the lungs if aspiration has occurred.
Talk with your doctor about the best treatment plan for you. Treatment options include the following:
Antibiotics are used to treat aspiration pneumonia. Sometimes a person may need to go to the hospital to receive antibiotics directly into their veins through an IV (or intravenous catheter). In other cases, antibiotics taken by mouth may be used to treat the infection.
Breathing Assistance
Some people may have trouble breathing due to aspiration pneumonia. In severe cases, a person may be placed on a machine to help with breathing.
To help reduce your chances of getting aspiration pneumonia, take the following steps:
• Follow your doctor’s orders when fasting before any surgery. This lowers the chance that while under anesthesia you could vomit the contents of your stomach, which may enter your airway and lead to pneumonia.
• If you have a swallowing problem, a speech specialist may suggest you change the texture of your foods. You may need to thicken liquids or chop or puree solids. Perhaps in severe cases, you may need to avoid eating foods and drinking liquids by mouth. You may then need to have a tube placed into your stomach or small intestine for formula feedings.