pulmonary disorders
Aspiration Pneumonitis and Pneumonia
Prevention
Strategies to prevent aspiration are important to care and overall clinical outcome. For patients with decreased level of consciousness, avoidance of oral feeding and oral drugs and elevation of the head of the bed to > 30 degrees may help. Sedating drugs should be stopped. Patients with dysphagia (due to stroke or other neurologic conditions) have long been recommended to follow diets with specialized textures to attempt to reduce the risk of aspiration however there is little firm evidence that this is effective. A speech pathologist may be able to train patients in specific strategies (chin tuck, etc.) to reduce the risk of aspiration. For patients with severe dysphagia, a percutaneous gastrostomy or jejunostomy tube is often used, although it is not clear whether this strategy truly reduces the risk of aspiration because patients can still aspirate oral secretions and may have reflux of gastrostomy tube feedings. Optimization of oral hygiene and regular care by a dentist may help prevent development of pneumonia or abscess in patients who repeatedly aspirate. 