Aspiration Pneumonia: Difference between revisions
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== Introduction == | == Introduction == | ||
Aspiration pneumonia (AP) is a common disease that frequently occurs in older patients, with many of these patients having a swallowing disability. Research is limited, but reveals that aspiration pneumonia contributes 5% to 15% of all community-acquired pneumonia. AP is frequently underdiagnosed as | Aspiration pneumonia (AP) is a common disease that frequently occurs in older patients, with many of these patients having a swallowing disability. Research is limited, but reveals that aspiration pneumonia contributes 5% to 15% of all community-acquired pneumonia. AP is frequently underdiagnosed as although easily diagnosed if overt aspiration events are witnessed, but often silent unobserved aspirations occurs making diagnosis of AP challenging. <ref>Almirall J, Boixeda R, de la Torre MC, [https://www.resmedjournal.com/article/S0954-6111(21)00191-8/fulltext#secsectitle0050 Torres A. Aspiration pneumonia: A renewed perspective and practical approach]. Respiratory Medicine. 2021 Aug 1;185:106485.Available:https://www.resmedjournal.com/article/S0954-6111(21)00191-8/fulltext#secsectitle0050 (accessed 12.11.2023)</ref> | ||
In pneumonia, microaspiration is the usual pathogenic mechanism, while “aspiration pneumonia” refers to the aspiration of a large amount of oropharyngeal or upper gastrointestinal content moving through the vocal cords and trachea into the lungs.<ref name=":0">Niederman MS, Cilloniz C. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9106188/ Aspiration pneumonia.] Revista Española de Quimioterapia. 2022;35(Suppl 1):73.Available:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9106188/ (accessed 12.11.2023)</ref> | In pneumonia, microaspiration is the usual pathogenic mechanism, while “aspiration pneumonia” refers to the aspiration of a large amount of oropharyngeal or upper gastrointestinal content moving through the vocal cords and trachea into the lungs. Put simply AP is an infection of the lungs caused by inhaling saliva, food, liquid, vomit and even small foreign objects.<ref name=":0">Niederman MS, Cilloniz C. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9106188/ Aspiration pneumonia.] Revista Española de Quimioterapia. 2022;35(Suppl 1):73.Available:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9106188/ (accessed 12.11.2023)</ref> | ||
== Pathogenesis == | |||
In normal healthy people, both the mucociliary mechanism and alveolar macrophages work to defend and protect the respiratory system from micro aspirations of oropharyngeal secretions. The pathological process of AP occurs when the the usual defence mechanisms fail in the predisposed person. Upon entry of fluids into the bronchi and alveolar space an anti-inflammatory reaction is triggered and the release of proinflammatory cytokines, tumor necrosis factor-alpha, and interleukins occur.<ref>Sanivarapu RR, Gibson J. [https://www.ncbi.nlm.nih.gov/books/NBK470459/ Aspiration pneumonia].Available:https://www.ncbi.nlm.nih.gov/books/NBK470459/ (accessed 12.11.2023)</ref> | |||
== Risk Factors == | == Risk Factors == | ||
Revision as of 04:04, 12 November 2023
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Introduction[edit | edit source]
Aspiration pneumonia (AP) is a common disease that frequently occurs in older patients, with many of these patients having a swallowing disability. Research is limited, but reveals that aspiration pneumonia contributes 5% to 15% of all community-acquired pneumonia. AP is frequently underdiagnosed as although easily diagnosed if overt aspiration events are witnessed, but often silent unobserved aspirations occurs making diagnosis of AP challenging. [1]
In pneumonia, microaspiration is the usual pathogenic mechanism, while “aspiration pneumonia” refers to the aspiration of a large amount of oropharyngeal or upper gastrointestinal content moving through the vocal cords and trachea into the lungs. Put simply AP is an infection of the lungs caused by inhaling saliva, food, liquid, vomit and even small foreign objects.[2]
Pathogenesis[edit | edit source]
In normal healthy people, both the mucociliary mechanism and alveolar macrophages work to defend and protect the respiratory system from micro aspirations of oropharyngeal secretions. The pathological process of AP occurs when the the usual defence mechanisms fail in the predisposed person. Upon entry of fluids into the bronchi and alveolar space an anti-inflammatory reaction is triggered and the release of proinflammatory cytokines, tumor necrosis factor-alpha, and interleukins occur.[3]
Risk Factors[edit | edit source]
Include:
- Impaired swallowing (dysphagia, chronic obstructive pulmonary disease, neurological diseases eg stroke or dementia, need of mechanical ventilation),
- Weakened cough reflex (medications, stroke, dementia, impaired consciousness and alcohol).
- Reduced consciousness (acute stroke, head injury, brain lesions, seizures and the effect of some agents that can induce impaired consciousness such as alcohol, drugs, anesthesia or sedatives),
- Greater likelyhood of gastric contents reaching the lung (reflux and tube feeding).[2]
Sub Heading 3[edit | edit source]
Resources[edit | edit source]
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References[edit | edit source]
- ↑ Almirall J, Boixeda R, de la Torre MC, Torres A. Aspiration pneumonia: A renewed perspective and practical approach. Respiratory Medicine. 2021 Aug 1;185:106485.Available:https://www.resmedjournal.com/article/S0954-6111(21)00191-8/fulltext#secsectitle0050 (accessed 12.11.2023)
- ↑ 2.0 2.1 Niederman MS, Cilloniz C. Aspiration pneumonia. Revista Española de Quimioterapia. 2022;35(Suppl 1):73.Available:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9106188/ (accessed 12.11.2023)
- ↑ Sanivarapu RR, Gibson J. Aspiration pneumonia.Available:https://www.ncbi.nlm.nih.gov/books/NBK470459/ (accessed 12.11.2023)
