Aspiration pneumonia is a common complication among persons that are on long term care but may also occur in any other person. The condition is encountered when an individual inhales food contents either from the oropharynx or from the stomach. These contents end up in the lower respiratory tract. The incidence of the condition is at least three times as common in persons on long term care as it is in the general population. There a number of things one can do in aspiration pneumonia prevention.
There are a number of factors that predispose to this type of pneumonia among the patients that are on long term care. These include dysphagia (difficulty in swallowing), poor oral hygiene and certain medications. Prevention focuses on dealing with each of these risk factors. Other than aspiration pneumonia, other syndromes that may result from this event include pneumonitis, obstruction and abscess formation. Pneumonia sets in when the contents that have been aspirated contain bacteria.
About 15% of adults are believed to have difficulties in swallowing, dysphagia. This means that they are at a significantly high risk of aspiration. The incidence has been shown to increase with advancing age. The incidence of dysphagia is about 50% among patients that are 80 to 89 years. This is mainly brought about by the anatomical and physiological changes that occur as we advance in age. Other conditions that may also contribute include cerebral palsy, dementia, traumatic brain injury and stroke among others.
There are several interventions that can be undertaken as measures to help patients with dysphagia. Swallowing therapy is one of the most effective. In this form of therapy, the patient is taught to engage in certain maneuvers that will help reduce the risk of aspirating. Dietary modification is another intervention that can be considered. Lighter viscosity diet can be more easily aspirated than honey-like viscosity. The third option that can be tried is tube feeding.
Another area in which prevention can be effected is in oral hygiene. It has been shown through research that about 70% of patients having long term care having poor oral hygiene. This puts them at an increased risk of aspirating oropharyngeal contents that are infected with bacteria. To reduce the risk, they need to be assisted regularly to clean their teeth and to also have dental examinations.
Most patients that are on long term care receive multiple drugs. Some of these medications grossly inhibit the swallowing function. Healthcare providers need to consider all the drugs that are given and whenever possible replace those that are likely to predispose to aspiration. Examples of medications that are known to increase the risk include proton pump inhibitors, sedatives, hypnotics, muscle relaxants and antiemetics.
Drugs may also have a useful function as regards the reduction of aspiration risk. These benefits may be conferred through reduced secretions or enhanced swallowing. Levodopa, a drug used in treating Parkinsonism, is among those that improve the swallowing function by maintaining the tone of muscles used in swallowing. Enalapril and other angiotensin enzyme converting enzyme inhibitors work by reducing secretions.
Aspiration pneumonia is a major cause of morbidity among patients in long term care. Although it can be treated by use of antibiotics, the general recommendation is that greater emphasis should be placed on prevention. This should be done by a multidisciplinary team that includes a physician, nurses, swallowing therapists and physiotherapists.
There are a number of factors that predispose to this type of pneumonia among the patients that are on long term care. These include dysphagia (difficulty in swallowing), poor oral hygiene and certain medications. Prevention focuses on dealing with each of these risk factors. Other than aspiration pneumonia, other syndromes that may result from this event include pneumonitis, obstruction and abscess formation. Pneumonia sets in when the contents that have been aspirated contain bacteria.
About 15% of adults are believed to have difficulties in swallowing, dysphagia. This means that they are at a significantly high risk of aspiration. The incidence has been shown to increase with advancing age. The incidence of dysphagia is about 50% among patients that are 80 to 89 years. This is mainly brought about by the anatomical and physiological changes that occur as we advance in age. Other conditions that may also contribute include cerebral palsy, dementia, traumatic brain injury and stroke among others.
There are several interventions that can be undertaken as measures to help patients with dysphagia. Swallowing therapy is one of the most effective. In this form of therapy, the patient is taught to engage in certain maneuvers that will help reduce the risk of aspirating. Dietary modification is another intervention that can be considered. Lighter viscosity diet can be more easily aspirated than honey-like viscosity. The third option that can be tried is tube feeding.
Another area in which prevention can be effected is in oral hygiene. It has been shown through research that about 70% of patients having long term care having poor oral hygiene. This puts them at an increased risk of aspirating oropharyngeal contents that are infected with bacteria. To reduce the risk, they need to be assisted regularly to clean their teeth and to also have dental examinations.
Most patients that are on long term care receive multiple drugs. Some of these medications grossly inhibit the swallowing function. Healthcare providers need to consider all the drugs that are given and whenever possible replace those that are likely to predispose to aspiration. Examples of medications that are known to increase the risk include proton pump inhibitors, sedatives, hypnotics, muscle relaxants and antiemetics.
Drugs may also have a useful function as regards the reduction of aspiration risk. These benefits may be conferred through reduced secretions or enhanced swallowing. Levodopa, a drug used in treating Parkinsonism, is among those that improve the swallowing function by maintaining the tone of muscles used in swallowing. Enalapril and other angiotensin enzyme converting enzyme inhibitors work by reducing secretions.
Aspiration pneumonia is a major cause of morbidity among patients in long term care. Although it can be treated by use of antibiotics, the general recommendation is that greater emphasis should be placed on prevention. This should be done by a multidisciplinary team that includes a physician, nurses, swallowing therapists and physiotherapists.
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