Aspiration pneumonia is a common condition among patients on long term care. It occurs when a person inhales contents from their oropharynx or their stomach into the lower respiratory tract. Compared to the general population, persons who are on long term care are three times as likely to have this condition. We will look at some of the strategies that can be undertaken in aspiration pneumonia prevention.
The main factors that have been found to increase the risk of suffering the condition among patients in long term care include difficulty in swallowing (dysphagia), the use of certain medications among these patients and poor oral hygiene. Addressing these factors significantly helps to minimize the risk and reduce the morbidity associated with aspiration that include pneumonia, pneumonitis, abscess formation and obstruction. Pneumonia is likely to be encountered if the aspirated contents contain bacterial organisms.
It is estimated that close to 15% of adults have problems of swallowing, a known risk factor for aspiration. The problem appears to worsen with advancing age and increases 50% in patients aged 80 to 89 years. The physical and physiological changes that occur within the head and neck region as we age are responsible for this. Other conditions that may also contribute to the difficulty in swallowing include stroke, cerebral palsy, dementia and traumatic brain injury among others.
There are a number of things that can be done to help patients that have dysphagia. One of the most effective is to take them through posture changes and swallowing therapies. The main role of such therapies is to teach specific maneuvers that can be done to minimize the risk of aspirating. Another important intervention is dietary modification. The best form of diet for patients that are at high risk is that which has a honey-like viscosity. Tube feeding may be adopted but as a last resort.
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.
The contribution that is made by drugs as a risk factors is related to two main effects. One of the effects is that they increase the secretions and the other is that they inhibit the swallowing function. It is important that all the drugs being administered are evaluated to determine which among them will have these effects. Drugs that increase the risk of aspiration include proton pump inhibitors, antiemetics, muscle relaxants and sedatives.
There are a number of drugs that can be used to reduce the chance of aspirating gastric or oropharyngeal contents. One of the drugs that has been shown to be beneficial is the drug levodopa. This drug works by increasing the levels of dopamine, an important chemical in the swallowing function (maintains the tome in muscles used for swallowing). Enalapril and other angiotensin converting enzyme inhibitor drugs also reduce the risk due to their ability to reduce oral secretions.
Aspiration pneumonia is associated with severe morbidity especially if treatment is delayed. Although treatments for the condition exist, there should be greater emphasis on prevention. The team that is involved in prevention include nurses, physicians, swallowing therapists and physiotherapists among others.
The main factors that have been found to increase the risk of suffering the condition among patients in long term care include difficulty in swallowing (dysphagia), the use of certain medications among these patients and poor oral hygiene. Addressing these factors significantly helps to minimize the risk and reduce the morbidity associated with aspiration that include pneumonia, pneumonitis, abscess formation and obstruction. Pneumonia is likely to be encountered if the aspirated contents contain bacterial organisms.
It is estimated that close to 15% of adults have problems of swallowing, a known risk factor for aspiration. The problem appears to worsen with advancing age and increases 50% in patients aged 80 to 89 years. The physical and physiological changes that occur within the head and neck region as we age are responsible for this. Other conditions that may also contribute to the difficulty in swallowing include stroke, cerebral palsy, dementia and traumatic brain injury among others.
There are a number of things that can be done to help patients that have dysphagia. One of the most effective is to take them through posture changes and swallowing therapies. The main role of such therapies is to teach specific maneuvers that can be done to minimize the risk of aspirating. Another important intervention is dietary modification. The best form of diet for patients that are at high risk is that which has a honey-like viscosity. Tube feeding may be adopted but as a last resort.
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.
The contribution that is made by drugs as a risk factors is related to two main effects. One of the effects is that they increase the secretions and the other is that they inhibit the swallowing function. It is important that all the drugs being administered are evaluated to determine which among them will have these effects. Drugs that increase the risk of aspiration include proton pump inhibitors, antiemetics, muscle relaxants and sedatives.
There are a number of drugs that can be used to reduce the chance of aspirating gastric or oropharyngeal contents. One of the drugs that has been shown to be beneficial is the drug levodopa. This drug works by increasing the levels of dopamine, an important chemical in the swallowing function (maintains the tome in muscles used for swallowing). Enalapril and other angiotensin converting enzyme inhibitor drugs also reduce the risk due to their ability to reduce oral secretions.
Aspiration pneumonia is associated with severe morbidity especially if treatment is delayed. Although treatments for the condition exist, there should be greater emphasis on prevention. The team that is involved in prevention include nurses, physicians, swallowing therapists and physiotherapists among others.
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