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Pneumonia, Aspiration

Eussra El-Magbri, MD and Adam Z. Tobias, MD, MPH, FACEP Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Pneumonia due to the misdirection of large volume of gastric bacteria into the lung parenchyma

  • Contrasts with typical pneumonia, which occurs by direct microinhalation of infectious p...

DIAGNOSIS

  • There is no “gold standard” test for aspiration pneumonia; radiologic, clinical, and bacteriologic criteria have all been used. Most instances of aspiration are not observed (2)[B].

  • Diagnosis...

TREATMENT

MEDICATION

  • Treatment guidelines are below, although final therapy choices will vary based on local susceptibility and resistance patterns.

  • Antibiotics are indicated for aspiration pneumonia an...

ONGOING CARE

DIET

  • NPO if reduced consciousness

  • Aggressive oral hygiene

  • Soft diet with thickened liquids

  • Encourage smaller bites.

  • Chin-down swallowing

  • Mechanical strategies

    • Elevated head 30 to 45 degrees when...

REFERENCES

1
Gomes GF, Pisani JC, Macedo ED, et al. The nasogastric feeding tube as a risk factor for aspiration and aspiration pneumonia. Curr Opin Clin Nutr Metab Care.  2003;6(3):327–333. [View...

ADDITIONAL READING

  • Gagnon DJ, Nielsen N, Fraser GL, et al. Prophylactic antibiotics are associated with a lower incidence of pneumonia in cardiac arrest survivors treated with targeted temperature man...

CODES

ICD10

  • J69.0 Pneumonitis due to inhalation of food and vomit

  • J69.8 Pneumonitis due to inhalation of other solids and liquids

  • J69.1 Pneumonitis due to inhalation of oils and essences

ICD9

  • 507.0 Pneumon...

CLINICAL PEARLS

  • Aspiration pneumonia is usually a clinical diagnosis.

  • Initial antibiotic treatment is empiric. Routine coverage of anaerobes is unnecessary in absence of specific risk factors.

  • Typical p...

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