Aspiration Pneumonia

Question 1

What is aspiration pneumonia?

Answer 1

It is a pulmonary inflammatory response due to inhalation or aspiration of liquid or particulate matter such as food or vomit.

• inflammation, swelling and pus
• stomach acid can cause chemical burn in the lungs

Question 2

Who are at risk of aspiration pneumonia?

Answer 2

• patients with altered mentation (recovering from anaesthetic or post ictel)
• esophageal disorders: megaesophagus, vomiting patients in weakened state, neurological patients with impaired gag reflex or swallow inability, post operative laryngeal paralysis animals
• force feeding
• Rapid eating

Question 3

Signs and symptoms of aspiration pneumonia

Answer 3

• Cough and fever
• Actue tachypnea, tachycardia
• Increased, decreased or adventitious lung sounds
• Fine to coarse crackles
• Wheezing
• Coughing or have a purulent discharge from nares
• progressive weakness and dyspnea
• Inappetence, cyanosis and collapse

Question 4

Diagnostics for aspiration pneumonia

Answer 4

• Thoracic radiographs
• will show changes 12-36hrs following aspiration
• interstitial or alveolar patterns, areas of consolidation, and evidence of alveolar infiltrates
• right middle lung lobe most commonly affected with right and left cranial lobes most common
• Airway washes (transtracheal or bronchoavelolar)
• suppurative inflammation
• Blood work
• neutrophilia
• hypoalbuminemia
• arterial: hypoxemia and elevated A-A gradient

Question 5

Treatment of aspiration pneumonia

Answer 5

If witnessed: immediate suction and lavage

If not witnessed: oxygen, antibiotics, IVF, nebulisation and coupage