lung and airway disorders
Aspiration Pneumonia and Chemical Pneumonitis
Aspiration Pneumonia
Tiny particles from the mouth frequently dribble or are inhaled (aspirated) into the airways. Usually they are cleared out by normal defense mechanisms (such as coughing) before they can get into the lungs and cause inflammation or infection. When such particles are not cleared (because of impaired defense mechanisms and/or because the volume of aspirated material is large), aspiration pneumonia can develop. Material aspirated from the mouth and throat is more likely to contain bacteria, which can cause bacterial pneumonia. Material aspirated from the stomach is usually very acidic and can severely damage the lungs even before infection develops. People who are especially at risk of aspiration pneumonia include people who Are older Are debilitated Have trouble swallowing (as may happen due to a stroke) Are intoxicated by alcohol or drugs Are unconscious due to anesthesia, sedative drugs, or a medical condition Are vomiting Have undergone dental, respiratory, or digestive procedures Have Gastroesophageal Reflux Disease (GERD) None Symptoms of aspiration pneumonia do not begin for at least a day or two. The most common symptom is Cough The cough produces sputum (thick or discolored mucus). The sputum soon smells foul. Other symptoms of aspiration pneumonia include Fever Shortness of breath (dyspnea) Chest discomfort Doctors usually make the diagnosis of aspiration pneumonia based on finding signs or symptoms in people who have any of the risk factors described above. A chest x-ray confirms the diagnosis of pneumonia. If the x-ray shows an abnormality in certain portions of the lungs, such as the bottom of the lungs (a common location for aspirated material), aspiration is more likely to be the cause. Treatment of aspiration pneumonia requires antibiotics. Many antibiotics, includingclindamycin,amoxicillin/clavulanate,ampicillin/sulbactam, and imipenem, can be used. For people who have conditions that increase their risk of aspiration, doctors may stop or reduce the dosage of drugs that cause sedation. Raising the head of the bed slightly to prevent food, liquid, or acid in the stomach from moving up into the throat and then down into the lungs and consuming specific food textures or thickened liquids also help reduce the risk of aspiration. A speech pathologist may teach the person specific swallowing techniques (for example, swallowing while tucking the chin toward the chest) to further reduce the risk of aspiration. 