Everything You Need to Know About Aspiration Pneumonia

Aspiration pneumonia or inhalation pneumonia is the inflammation of the lungs that occurs as a result of inhalation of various substances. These substances include vomit, food, foreign bodies, and regurgitated gastric juices.

Aspiration of foreign objects can cause inflammation of the lungs, infection, or obstruction of the airways. Although aspiration pneumonia can occur quite often, it commonly produces minor symptoms. The severity of aspiration pneumonia depends on the following three factors:

1. The type of substance being aspirated or inhaled.
2. The specific organism present in the lungs.
3. The distribution of pneumonia within the lungs. 

Who is at risk of aspiration pneumonia?

Not everyone aspirate substances; only a certain group of people are at risk of aspiration. They are:

• People with an altered level of consciousness such as those with dementia, mental retardation, and under anesthesia.
• Stroke patients who have difficulty in swallowing (dysphagia). 
• People who experience chronic vomiting.
• People suffering from chronic gastroesophageal reflux disease.
• During dental procedures
• Patients with GI devices such as nasogastric tubes or respiratory devices such as endotracheal tubes.

Healthy people commonly aspirate small amounts of secretions, but the defense mechanism of the respiratory tract gets rid of the aspirated substances without causing any further problems.

What is the pathophysiology involved?

Aspiration pneumonia is a result from the aspiration of food or oral secretions that are usually toxic to the lungs. Oral anaerobes and gram-negative organisms are responsible for pneumonia when you aspirate food or oral secretions.

The Signs and Symptoms

The signs and symptoms of aspiration pneumonia is similar to that of a simple pneumonia, which include:

• Mild difficulty in breathing
• Fever
• Weight loss
• A cough productive of sputum
• Abnormal lung sounds such as crackles or rhonchi heard during the physical exam.

How is aspiration pneumonia diagnosed?

The initial diagnostic test for aspiration pneumonia is a chest X-ray. The chest X-ray will show infiltrates in the lung fields. Severe cases of pneumonia may show abscesses in the lungs. 

How is aspiration pneumonia managed?

After diagnosing aspiration pneumonia, your doctor will prescribe you antibiotics. The most commonly used antibiotic for the treatment of aspiration pneumonia is clindamycin, which is active against oral anaerobes and gram-negative organisms. Sometimes, in severe cases, if an abscess is found, surgical drainage is recommended. 

How can you prevent future episodes of aspiration pneumonia?

It is quite important that you learn how to prevent aspiration pneumonia as it can recur. This is especially true for bedridden patients. Therefore, practicing precautions to prevent aspiration pneumonia in the future is really important.

• Avoid oral feeds. Start the patient on a special diet.
• Elevate the head end of the bed to more than 30 degrees. This has proven to reduce the chances of aspiration.
• Maintain a good oral hygiene.
• Do not drink excessive water.