What is Aspiration Pneumonia?
Aspiration is “the inhalation of oropharyngeal or gastric contents into the larynx and lower respiratory tract.”
Aspiration pneumonia is specific to the colonization of oropharyngeal material in the lungs.
The aspiration of gastric contents refers to a different condition condition called Aspiration Pneumonitis (which we aren’t involved in). An SLP could ID this on an assessment but is not treated the same way or in our scope of practice.
So, aspiration pneumonia is caused by bacteria from the oropharynx region getting into the lungs, festering, and developing into an infection.
Not just anyone can get aspiration pneumonia, you have to have a pre-existing situation occurring. The average person “aspirates” their own secretions and we don’t all get pneumonia.
How do you get Aspiration Pneumonia
- You have to be sick or compromised already. It doesn’t just manifest in a healthy person.
- ORAL CARE is key. If your oral cavity isn’t clean and healthy you will collect pathogens in your oral cavity.
- You have to aspirate. Under these conditions, you send pathogens into your lungs. Your immune system can’t handle it, so they fester and develop into Aspiration Pneumonia.
Aspiration pneumonia is often a side effect of dysphagia. You typically acquire it if you have something else going on. In this section we have a few topics that may be relevant to a diagnosis of aspiration pneumonia.
Risks beyond a diagnosis of dysphagia
Stroke, COPD, GI disease, CHF
Being in a nursing home, or anyone w/ a compromised immune system
Being bedridden, or dependent on assistance for movement and ADLs
Being on an plethora of medications
Use of suctioning
Feeding tube or a mechanically altered diet
Delirium or decreased alertness
Having a trach tube
A note about Feeding Tubes
Feeding tubes, or alternative means of feeding, may be necessary in some cases. SLPs may influence the decision to place a feeding tube. However, feeding tubes can cause further problems or compromise the patient’s health more. A feeding tube won’t prevent aspiration pneumonia if the patient is aspirating their own secretions. A feeding tube could also decrease oral care and thus increase the risk for aspiration pneumonia. Additionally, the tube can compromise the patient’s immune system which is another risk factor for aspiration pneumonia.
Signs and Symptoms
Cough (not always present)
Shortness of breath/difficulty breathing
Chest pain when breathing or coughing
Poor oral care, you look in their mouth or smell their breath and it doesn’t seem like a clean, pleasant place
These can be indicative of a variety of conditions so it’s important to seek further assessment to rule out or identify aspiration pneumonia as the root cause.
Your body's natural defense
Good oral care
A secondary cough
A strong immune system:
Specialized lung cells engulf, absorb, and transport fluid and food from the lungs.
A chemical reaction neutralizes acidic substances in the lungs.