Aspiration Pneumonia

What is Aspiration Pneumonia?

Pneumonia is a respiratory complication (infection) that causes swelling in the lungs. Aspiration Pneumonia is a condition that occurs when you inhale the gastric secretions of the oropharynx (the part of the pharynx that lies between the epiglottis and the soft palate). Although a small amount of the gastric content enters the respiratory tract, it may contain bacteria that can affect the lungs. The inhaled oropharyngeal contents stimulate the receptors for removal yet the patients are unable to remove it in this condition.

Causes

Aspiration pneumonia occurs when the defense mechanism of the body is impaired, and the contents carry bacteria into the lungs. The entry of oropharyngeal substances can lead to the following:

Swallowing Impairment

Swallowing is a complicated neuromuscular action that requires coordination of epiglottis, tongue, and pharynx. It is an automated phenomenon, but problems might arise within the Esophagus that can delay the mechanism and cause accidental inhalation. This condition is known as Silent Aspiration.

Sclerosis

This disease causes degeneration in the nervous system and leads to the alteration of regular functionalities like swallowing. Interference in the nervous system may lead to aspiration of food. The degeneration of nerve cells is responsible for the involuntary action.

Neurological Accident

An arterial rupture or blockage due to a head injury leads to the death of oxygen-starved cells in the brain. This condition usually arises due to a head injury and can lead to a loss of voluntary moments. Usual Inhaling and swallowing get impaired due to this arterial blockage, and this might cause aspiration.

Chemical Intoxication

Consumption of synthetic drugs and alcohol increases the toxicity in the nervous system. Chronic or acute consumption of these poisonous chemicals may impair the functioning of the brain. Therefore, it results in Pulmonary Inflammation due to the sudden inhalation of these drugs into the lungs accidentally.

Medical Complication

The adverse effects or complications of a medical treatment or surgery are known as Iatrogenic Artifacts. In this case, the condition arises due to operations using general anesthesia. Hence, this results in accidental inhalation of oropharyngeal secretions.

Weak Immune System

A poor immune system leads to improper swallowing reflexes resulting in aspiration.

Symptoms

Inhalation of fluids or food particles into the lungs can lead to the following conditions:

Chemical Pneumonia

The oropharyngeal secretions have toxic effects that cause inflammation of lungs. The condition in which the bronchiole walls experience intense swelling is known as bronchopneumonia.

Pulmonary Infection

This infection is a constant accumulation of mucus, food particles and saliva encouraging bacterial growth leading to a lung infection. Chronic inflammation of the airways is because of bacterial growth and causes lung abscess. The condition marks inflammation, destruction of tissues and collection of pus. Various types of bacteria leading to this condition are:

  • Haemophilus¬†influenza
  • Pseudomonas aeruginosa
  • Staphylococcus aureus
  • Streptococcus¬†pneumonia
  • Peptostreptococcus
  • Fusobacterium
  • Prevotella
  • Fusobacterium

Symptoms and common signs of these conditions include:

  • Fever
  • Vomiting
  • Nausea
  • Shortness of Breath
  • A dry and persistent cough
  • Loss of Appetite
  • Unregulated and unintentional weight loss
  • Irregular heart rate
  • Chest pain
  • Abnormal breathing
  • Sputum filled with pus
  • Discoloration due to reduced oxygen supply
  • Swallowing difficulty
  • Dizziness
  • Fatigue

Diagnosis

A doctor conducts a thorough physical examination to search for distinctive symptoms of the disease. Some major diagnostic tests are:

X-Ray

The upper right lobe is a prone site for infiltrating formation of alcohol-consuming patients. Radiography can spot the infiltration in the chest.

Blood Test

An elevation in the count of white blood cells indicates bacterial infection in pneumonia affected patient.

Sputum Culture

The test identifies and detects bacteria causing infection in the air passage and lungs. The sample of infected sputum is collected and sent for culture.

Neurological Assessment

The voluntary, involuntary and cognitive processes are examined to figure out underlying neurological complications causing the pulmonary condition.

Bronchoscopy

A bronchoscope is inserted through the nose or mouth into the air passage to identify foreign elements.

Imaging Techniques

CT scan and Ultrasonography of the chest helps to detect excess fluid in pleural layers and pulmonary infiltrates.

Barium Ingestion

The ingestion of barium sulfate to examine the gastrointestinal tract is a part of the diagnostic procedure. A fluoroscope imaging technique detects the presence of a swallowing disorder.

Thoracentesis

The fluid in the pleural cavity is tested to identify the cause of lung inflammation. Increased count of platelets and white blood cells indicate pulmonary infection.

Treatment

Tracheal Suctioning

The technique involves removal of aspirated contents from the trachea using a sterile suction machine. Such aspirated contents do not clear up by coughing. Removal of oropharyngeal contents from the lungs helps in restoring normal breathing.

Oxygen Supplementation

Deficiency of oxygen in the blood leads to brain damage. Adequate oxygen supply is given to the patient using a mask to prevent such instances. This procedure provides relief from the respiratory distress.

Chest Drainage

A plastic tube is inserted into the pleural cavity to remove the aspirates. This flexible tube is an emergency measure to protect the lungs and ensures proper drainage of aspirates.

Ventilation

A ventilator assists spontaneous breathing in acute distress syndrome. This life-saving device forces air into the trachea to avoid a respiratory collapse.

Medications

Intravenous and oral intake of antibiotics helps in treating the bacterial infection. Some of the prescribed antibiotics used as per severity are:

  • Azithromycin
  • Ceftriaxone
  • Levofloxacin
  • Moxifloxacin

Pathogens like Pseudomonas aeruginosa that invade the lungs require elimination using amoxicillin or clindamycin.

Prevention

  • Perform oral exercises to get rid of swallowing difficulties.
  • Position the head of the bed at 35-40 degree angle to reduce the risk of aspiration
  • Do not eat lying flat on your back
  • Take semi-solid food and chew properly to practice eating slowly
  • Adjust the position of chin downwards to swallow and ensure that no food enters the lungs
  • Maintain healthy dental hygiene to inhibit the bacterial growth
  • Avoid the use of sedatives to prevent oral dehydration

Conclusion

Medical professionals should schedule specific guidelines for the treatment of this disease. Involving microbial pathogens to prevent secondary infections requires sterile clinical settings. Patients suffering from breathing and swallowing disorders must consult a doctor on time. The absence of proper and effective treatment leads to fatal consequences.

References:

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