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Aspiration pneumonia: A renewed perspective and practical approach

Aspiration pneumonia (AP) is a sub-type of community-acquired pneumonia (CAP) still poorly recognized especially in the absence of an aspiration event. A further difficulty is the differentiation between AP and aspiration pneumonitis. From a clinical perspective, AP is becoming increasingly relevant as a potential cause of severe and life-threatening respiratory infection among frail and very old patients, particularly among those with CAP requiring inpatient care. Moreover, AP is frequently underdiagnosed and a clear-cut definition of this pathological entity is lacking. There are different factors that increase the risk for aspiration, but other common factors influencing oral colonization…

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Articles of Interest

An Introduction to Aspiration Pneumonia

It is not uncommon for prophylactic antibiotics to be initiated after an aspiration event. A survey of critical-care providers found that nearly 80% initiated prophylactic antimicrobials at the time of a macroaspiration event.

Anaerobic Antibiotic Coverage in Aspiration Pneumonia and the Associated Benefits and Harms

Aspiration pneumonia is a bacterial lung infection that results from a large-volume aspiration of oropharyngeal and gastric contents.1 It accounts for 5% to 15% of community-acquired pneumonia (CAP)1 cases and is associated with high mortality.

Aspiration pneumonia

Although there are strategies for the prevention and management of patients with pneumonia that have been shown to be effective in older people with pneumonia, more research is needed on aspiration pneumonia, its risk factors and outcomes, especially since there are no specific criteria for its diagnosis and consequently, the studies on aspiration pneumonia include heterogeneous populations.

Pediatrics - Aspiration Pneumonia

These are guidelines only and not intended to replace clinical judgment. Modification of therapy may be indicated based on patient comorbidities, previous antibiotic therapy or infection history.

Resources

Anesthesia Key

Arterial hypoxemia, the hallmark sign of aspiration pneumonitis, is frequently the first sign of aspiration. Because the majority of aspiration incidents are asymptomatic or mildly symptomatic, unexplained hypoxemia occurring in otherwise healthy patients postoperatively may frequently be a vague sign of silent aspiration. Other signs to alert the anesthetist to the possibility of aspiration include tachypnea, dyspnea, tachycardia, hypertension, and cyanosis.

Radiopaedia

Aspiration may be clinically silent or present with dyspnea, cough, or fever. The clinical and radiographic features depend on the aspirated volume, pH, and chronicity.

StatPearls

The infectious pulmonary process that occurs after abnormal entry of fluids into the lower respiratory tract is termed aspiration pneumonia. The aspirated fluid can be oropharyngeal secretions or particulate matter or can also be gastric content.