Aspiration pneumonia

Aspiration pneumonia

    * Introduction
    * Signs and symptoms
    * Diagnosis
    * Treatment
Is an aspiration pneumonia bronchopneumonia that develops due to entry of a foreign body in the bronchial tree, usually oral or gastric contents (food, saliva or nasal secretions). Depending on the acidity of aspiration pneumonia may develop chemical and bacterial pathogens, especially anaerobic bacteria leading to inflammation.
Aspiration pneumonia is commonly caused by ingestion of which is deficient in some forms of neurological disease (cerebral vascular attack) or when a person is intoxicated. One cause is iatrogenic during general anesthesia for surgery and patients are instructed to not eat anything for at least 4 hours before surgery.
If aspiration pneumonia is a true bacterial infection or a chemical process of inflammation remains a topic of debate. Both cases present with similar symptoms.
Aspiration pneumonia is typically diagnosed by a combination of clinical circumstances, radiological (right lower lobe pneumonia) and microbiological cultures. Some cases are caused by aspiration of food particles or other substances such as fragments of pills, being diagnosed by lung biopsy.
Pathogenesis and causes: Aspiration is the act of entry of foreign particles in the lungs, can cause a number of syndromes depending on the amount and nature of the material aspirated ferecventa aspiration and host factors that predispose patients to aspiration and change the answer. There are three types of natural causes three syndromes that causes pneumonic different. Aspiration of gastric acid cause chemical pneumonia. Aspiration of bacteria in oral and pharyngeal areas cause bacterial pneumonia. Aspiration of mineral oil or vegetable lipoida exogenous cause pneumonia, a rare form of pneumonia. In addition, a foreign body aspiration may cause acute respiratory emergency and in some cases predispose patients to bacterial pneumonia. Aspiration pneumonia include chemical and bacterial form, although the pathophysiology, clinical presentation, treatment and complications are different.
Aspiration during sleep is usually present in healthy patients. Not cause any disease because the material is sucked clean of alveolar macrophages and mucociliary action. Nature of the material aspirated, the volume of host defense and immune status are three important determinants of aspiration pneumonia.
Chemical pneumonia, also known as Mendelson's syndrome is due to parenchymal inflammatory reaction caused by a large volume of gastric contents irrespective of infection. If the pH of aspirated fluid is less than 2. 5 and the volume is more than 0. 3 ml / kg body weight it has a high potential to cause chemical pneumonia. Initial chemical burn is followed by inflammatory cell reaction favored the release of potent cytokines especially tumor necrosis factor alpha and you 8.
Bacterial pneumonia caused by aspiration may occur in community or hospital-nosocomial. In both cases anaerobic organisms alone or together with the microaerophilic plays an important role. nosocomial pneumonia caused by aspiration is common and serious pathogen involved in hospital is gained by colonization oropharyngeal flora: Staphylococcus, gram-negative bacteria). In anaerobic pneumonia pathogenesis is related to the large amount of anaerobic vacuum (in people with periodontal disease) and host factors (alcoholism) that suppress the cough, mucociliary cleaning and phagocytic efficiency. Selection and colonization of gram-negative organisms in the oropharynx, sedation, intubation of the patient's airways are important pathogenetic factors in nosocomial penuemonia.
Risk factors: Not all patients who develop aspiration pneumonia have a predisposition of the conditions listed below. Conditions associated with impaired consciousness u: -Alcoholism, drug overdose, seizures -Vascular stroke, head trauma, general anesthesia. Terms esophagus: -Dysphagia, strictures, neoplasms, diverticule -Tracheoesophageal fistula, gastroesophageal reflux disease / Neurological Diseases: Multiple-sclerosis, sementa, Parkinson's disease -Myasthenia gravis, pseudobulbara paralysis. Mechanical conditions: -Nasogastric tube, tracheostomy, upper gastrointestinal endoscopy -Bronchoscopy, or gastrostomy feeding tubes postpilorice.