Oropharyngeal aspiration is an important etiologic factor leading to pneumonia in the elderly. The incidence of cerebrovascular and degenerative neurologic diseases increase with aging, and these disorders are associated with dysphagia and an impaired cough reflex with the increased likelihood of oropharyngeal aspiration.Author:
Paul E. Marik, Danielle KaplanCited by:
In a 2013 study, it was calculated that 21% of cases involving aspiration pneumonia culminated in death within 30 days.
What happens when you aspirate ? Aspiration means you’re breathing foreign objects into your airways. Usually, it’s food, saliva, or stomach contents when you swallow, vomit, or experience heartburn. This is common in older adults, infants, and people who have trouble swallowing or controlling their tongue.
Aspiration pneumonia can cause severe complications, especially if a person waits too long to go to the doctor. The infection may progress quickly and spread to other areas of the body. It may also spread to the bloodstream, which is especially dangerous . Pockets or abscesses may form in the lungs.
Mortality estimates for aspiration pneumonia vary. At least 5 percent of people who are hospitalized for aspiration will die. Among those with other complications, such as emphysema, the mortality rate rises to 20 percent or higher. Among geriatric populations, mortality skyrockets.
Recently, the effectiveness of rehabilitative management including physical, pulmonary, and dysphagia rehabilitation for aspiration pneumonia was reported. Several studies showed that early rehabilitation was associated with reduced mortality and early hospital discharge after aspiration pneumonia .
Some people may need to be hospitalized . Treatment depends on how severe the pneumonia is and how ill the person is before the aspiration (chronic illness). Sometimes a ventilator (breathing machine) is needed to support breathing. You will likely receive antibiotics.
Symptoms of chemical pneumonitis include sudden shortness of breath and a cough that develops within minutes or hours. Other symptoms may include fever and pink frothy sputum. In less severe cases, the symptoms of aspiration pneumonia may occur a day or two after inhalation of the toxin.
Pulmonary aspiration is when you inhale food, stomach acid, or saliva into your lungs. You can also aspirate food that travels back up from your stomach to your esophagus. All of these things may carry bacteria that affect your lungs. Healthy lungs can clear up on their own .
For people aspiration pneumonia, a doctor may prescribe antibiotics to help clear the infection. When aspiration results from a medical condition, such as a stroke, speech therapy may help to improve a person’s swallowing reflex and lower their risk of aspiration .
Aspiration pneumonia should be treated with antibiotics; treatment of aspiration pneumonitis is primarily supportive. Secondary prevention of aspiration using various measures is a key component of care for affected patients.
The choice of antibiotics for community-acquired aspiration pneumonia is ampicillin-sulbactam , or a combination of metronidazole and amoxicillin can be used. In patients with penicillin allergy, clindamycin is preferred.
Among people hospitalized with pneumonia , about 10% are due to aspiration . It occurs more often in older people, especially those in nursing homes. Both sexes are equally affected.
It is now recognized that many common community-acquired and hospital-acquired pneumonias result from small-volume aspiration of more virulent pathogens from the oral cavity or nasopharynx, such as Streptococcus pneumoniae,Haemophilus influenza, Staphylococcus aureus, and gram-negative bacteria.
Pneumonia is an infection of the lungs that can be serious in older adults . In the U.S., nearly 250,000 people are hospitalized with pneumonia each year, and about 50,000 die from the disease, according to the Centers for Disease Control and Prevention (CDC). Seniors are at high risk for complications and death.