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Aspiration pneumonia is an inflammation of the lungs and bronchial tubes caused by inhaling foreign material, usually food, drink, vomit, or secretions from the mouth into the lungs. This may progress to form a collection of pus in the lungs (lung abscess). Aspiration pneumonia is a form of pneumonia that can develop when foreign material, such as food, liquid, vomit, or mucus, is accidentally inhaled into the lungs. This can happen when a person is unconscious or has a seizure or when a stroke has affected the person's ability to swallow.
Aspiration of foreign material (often the stomach contents) into the lung can be a result of disorders that affect normal swallowing, disorders of the esophagus (esophageal stricture, gastroesophageal reflux), or decreased or absent gag reflex (in unconscious, or semi-conscious individuals). Old age, dental problems, use of sedative drugs, anesthesia, coma, and excessive alcohol consumption are also causal or contributing factors. The response of the lungs depends upon the characteristics and amount of the aspirated substance. The more acidic the material, the greater the degree of lung injury, although this may not necessary lead to pneumonia. The injured lungs can become infected with multiple species of anaerobic bacteria or aerobic bacteria. A collection of pus may form in the lung. A protective membrane may form around the abscess.
This form of pneumonia is more common in people who have become weakened by illnesses that affect their ability to swallow or whose immune systems are impaired by disease or medications. People who have aspiration pneumonia are usually treated in a hospital with antibiotics. The usual site for an aspiration pneumonia is the right lung. Aspirated material will enter the lower lobes when the patient is standing. If the patient is supine then the aspirated material will enter the apical segment of the lower lobes or the posterior segment of the upper lobes.
Hospitalization may be required for management of the illness. Treatment measures vary depending on the severity of the pneumonia. Oxygen therapy and antibiotic medications are the standard treatments for aspiration pneumonia. Antibiotics are given through a vein. A ventilator, or artificial breathing machine, may be needed to keep an open airway and provide oxygen. The trachea may need suctioning to clear secretions and aspirated particles out of the airway.
The extent and severity of the condition often depends on the volume and acidity of the inoculum. Aspiration of a massive amount of gastric contents can produce acute respiratory distress occur within 1 hour. Mechanical obstruction of the airways may occur after aspiration of fluid or particulate matter. Tracheobronchial suction may be indicated for acute respiratory failure. However, most frequently, the size of the inoculum is small, and the course of the illness more insidious. Bacterial pneumonitis often is caused by oropharyngeal flora, but gram-negative bacilli and other nosocomial pathogens must be considered in nursing home residents or those recently hospitalized.
Microaspiration of bacteria after colonization of the oropharynx is the initial step in the pathogenesis of most cases of bacterial pneumonia. Traditionally, the term aspiration pneumonia has been reserved for cases in which the amount of aspirated oropharyngeal or gastric secretions or other exogenous material is large ("macroaspiration") and is associated with recognizable pulmonary sequelae. Aspiration pneumonia most often occurs in the presence of impairment of protective upper and lower airway reflexes in patients who have a decreased level of consciousness or central nervous system disease.
Aspiration Pneumonia Causes
Aspiration Pneumonia Symptoms
Aspiration Pneumonia Diagnosis
Aspiration Pneumonia Treatment
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