Aspiration Pneumonitis And Conjunctivitis And Pneumonia

Aspiration pneumonitis and -pneumonien be caused by the inhalation of toxic substances, usually of gastric contents into the lungs. Chemical pneumonitis, bacterial pneumonia, or airway obstruction may occur. The symptoms include coughing and dyspnea. The diagnosis is made based on the clinical findings and the chest x-ray findings. Treatment and prognosis differ depending on the aspirated substance.

Aspiration can cause an inflammatory response of the lung (chemical pneumonitis), infection (bacterial pneumonia or abscess overview of pneumonia (pneumonia)) or an airway obstruction. However, most Aspirationsereignisse more likely to cause mild symptoms or pneumonitis rather than infection or obstruction, and some patients aspirate without sequelae. Drowning is discussed drowning and airway obstruction is discussed overview of breathing: etiology.

Aspiration pneumonitis and -pneumonien be caused by the inhalation of toxic substances, usually of gastric contents into the lungs. Chemical pneumonitis, bacterial pneumonia, or airway obstruction may occur. The symptoms include coughing and dyspnea. The diagnosis is made based on the clinical findings and the chest x-ray findings. Treatment and prognosis differ depending on the aspirated substance. Aspiration can cause an inflammatory response of the lung (chemical pneumonitis), infection (bacterial pneumonia or abscess overview of pneumonia (pneumonia)) or an airway obstruction. However, most Aspirationsereignisse more likely to cause mild symptoms or pneumonitis rather than infection or obstruction, and some patients aspirate without sequelae. Drowning is discussed drowning and airway obstruction is discussed overview of breathing: etiology. Risk factors for snoring include impairment of cognition or the level of consciousness impaired swallowing (as occurs after a few strokes or other neurological disorders) vomiting GI devices and procedures (eg. As placement of a nasogastric tube) dental respirators and procedures (eg . B. placement of an endotracheal tube) Gastroesophageal reflux disease pathophysiology Chemical pneumonitis Many substances have a direct toxic effect on the lungs, or solve an inflammatory response in the event aspiration; Gastric acid is the most common of these substances aspirated, to the other substances include petroleum products (especially those of low viscosity, such as petroleum jelly) and oily laxatives (zwie mineral oil, castor oil and paraffin oil), all of which can trigger a lipoid pneumonia. Aspiration of gasoline and kerosene also leads to chemical pneumonitis (hydrocarbon poisoning). The stomach contents causes damage mainly by stomach acid, although food and other substances swallowed (eg., Activated carbon in the treatment of intoxications) in large quantities can also be damaging. Stomach acid causes a chemical burn of respiratory tract and lungs and leads to rapid bronchoconstriction, atelectasis, edema and alveolar hemorrhage. The disease can spontaneously – usually within a few days – formed back; or can develop into an ARDS. Sometimes bacterial super-infection occurs. The aspiration of oil or Vaseline causes exogenous lipoid pneumonia histologically characterized by chronic granulomatous inflammation with fibrosis ist.Aspirationspneumonie Healthy people commonly aspirate small amounts of oral secretions, but which are eliminated again usually of normal defense mechanisms without sequelae. The aspiration of larger amounts or aspiration in a patient with restricted pulmonary defense mechanisms often causes pneumonia and / or abscess (lung abscess). Elderly patients prone to aspiration due to conditions associated with age, the change awareness, such as the use of sedatives and diseases (eg. As neurological disorders, weakness). Empyema (etiology) also makes it difficult sometimes aspiration. Gram-negative enteric pathogens and oral anaerobes are the most common cause of aspiration pneumonia. Symptoms and signs The symptoms and complaints may be similar and include those of other pneumonia and abscesses Chronic weak dyspnea fever weight loss cough with putrid, foul-tasting sputum patients may be signs of poor oral hygiene have a caused by stomach contents chemical pneumonitis causes an acute dyspnea with cough that occasionally is productive of pink frothy sputum, tachypnea, tachycardia, fever, diffuse moist RG and wheezing. If oil or petroleum jelly are inhaled, pneumonia can be asymptomatic and discovered accidentally on chest x-ray images, or it can be as low fever, express gradual weight loss and damp RG. Diagnostic chest X-ray In aspiration pneumonia of chest x-ray shows an infiltrate often, but not exclusively, in dependent lung segments, d. H. in the superior or posterior lower lobe segment or the posterior upper lobe segment. In aspirationsbezogenen lung abscesses, the chest x-ray may show a cavitary lesion. A contrast-enhanced CT is in lung abscesses sensitive and specific, showing a nodule with liquid or with an air-liquid mirror. the thorax x-ray findings vary in patients with aspiration of oil or petroleum jelly; Consolidation, cavitation, interstitial or nodular infiltrates, pleural effusions, and other changes may be slow progressive. Sign persistent aspiration may be frequent throat clearing or moist-sounding cough after eating. Sometimes there are no signs, and a continuing aspiration is diagnosed via a modified barium Ösophagographie to exclude an underlying swallowing disorder. Treatment Antibiotics percutaneous or surgical drainage of abscesses does not respond to antibiotic therapy. Treatment is symptomatic and often includes supplementary O2 and artificial respiration. Antibiotics (a ?-lactam / ?-lactamase inhibitor or clindamycin) are often given to patients with proven or known aspiration of gastric contents, because of the difficulty to exclude bacterial infection as contributing or primary factor. However, if developed h no infiltrate after 48 to 72, the antibiotics can be stopped. Toxic substances should be avoided. Anecdotal reports suggest that systemic corticosteroids in patients with aspiration of oil or petroleum jelly may be advantageous. In aspiration pneumonia, the “Infectious Diseases Society of America (IDSA) guidelines” recommend a ?-lactam / ?-lactamase inhibitor, clindamycin or a carbapenem. Some examples include clindamycin 600 mg iv every 8 h (followed by 300 mg p.o. 4 times daily) and amoxicillin / clavulanate 875 mg i.v. every 12 h. The duration of treatment is usually 1 to 2 week (see also the Infectious Diseases Society of America Clinical Guideline on community-acquired pneumonia). A lung abscess is treated with antibiotics, and optionally with a surgical drain (lung abscess: treatment). Prevention strategies to avoid aspiration for the care and general clinical course important. avoiding oral diet and oral medications and a survey of the head end of the bed to> 30 degrees can help patients with impaired consciousness. Sedative drugs should be avoided. Patients with dysphagia (due to stroke or other neurological disorders) need special diets with textures to reduce the risk of aspiration. A speech therapist can teach specific strategies (refer to the chest, etc. head) to reduce the risk of aspiration may patients. In patients with severe dysphagia percutaneous gastrostomy or jejunostomy tube is often used, although it is not clear whether this strategy really reduces the risk of aspiration. Optimization of oral hygiene and regular care by a dentist can help to prevent the development of pneumonia or abscesses in patients who aspirate again. Important Points patients with aspiration pneumonia aspiration pneumonitis should be tested for an underlying swallowing disorder. Aspiration pneumonia should be treated with antibiotics; Treatment of aspiration pneumonitis is supportive in the first place. Secondary prevention of aspiration with different measures is a key component of care for the patients concerned. For more information Infectious Diseases Society of America Clinical Guideline on Community-Acquired Pneumonia

Health Life Media Team

Leave a Reply