Aspiration Pneumonia

What is aspiration pneumonia?

Aspiration pneumonia is a lung infection that develops after you aspirate (inhale) food, liquid, or vomit into your lungs. If you are not able to cough up the aspirated material, bacteria can grow in your lungs and cause an infection.


What increases my risk for aspiration pneumonia?

Your risk is highest if you are older than 75 or live in a nursing home or long-term care center. You may become less active as you age, or you may be bedridden. You may not be able to swallow or cough well. The following also increase the risk for aspiration pneumonia:

  • The muscles that help you swallow are weakened by stroke, Alzheimer disease, or other diseases.

  • Your immune system is weakened by age, diabetes, COPD, heart failure, or other health problems.

  • You use a feeding tube or ventilator. These can be a gateway for bacteria to travel to your lungs.

  • You had surgery or radiation to treat cancer of the head or neck.

  • You have poor oral hygiene, have lost teeth, or wear dentures.

  • You have alcoholism, use IV drugs, or smoke cigarettes.

What are the signs and symptoms of aspiration pneumonia?

  • Cough, which may or may not bring up mucus

  • Trouble swallowing

  • Fever

  • Shortness of breath, rapid breathing, or noisy breathing

  • Chest pain

  • Confusion, unclear thinking, or changes in alertness

  • Voice changes such as gurgling and hoarseness

  • Loss of appetite or weight loss

How is aspiration pneumonia diagnosed?

It is common to aspirate but not know it. Your caregiver may diagnose aspiration pneumonia if you have symptoms and a history of swallowing problems. He will ask about your symptoms and when they started. He will look inside your mouth and down your throat, and listen to your heart and lungs. He will check your blood pressure, pulse, and blood oxygen level. He will ask you to speak and cough while he listens. Tell him about any health problems you have and any medications you use. Tell him if you smoke cigarettes or drink alcohol regularly. You may also need the following tests:

  • Chest x-ray: Caregivers use x-rays to look for signs of infection, such as swelling and fluid in your lungs.

  • Sputum culture: Your caregiver may ask you to cough mucus into a cup, or he may suction mucus from your throat. The mucus is tested for bacteria that can cause pneumonia.

  • Blood tests: Your blood may be tested to find out if your white blood cell count is high. This can be a sign of infection.

  • Neuro exam: Your caregiver will ask you questions to test your memory and level of alertness. He will check how your pupils react to light. He will ask you to grasp his hand. He may test your balance. These tests can help him find out if pneumonia or something else is affecting your brain and nervous system.

  • Bedside swallow or barium swallow: Your caregiver will watch you swallow different foods and liquids. You may be asked to drink a thick liquid called barium while caregivers take x-rays of your throat, esophagus, and lungs. These tests will show if you have long-term swallowing problems.

Which medicines are used to treat aspiration pneumonia?

  • Antibiotics: These are given to treat pneumonia caused by bacteria. You may be given antibiotics as pills or through your IV.

  • Steroids: Steroid medicine may help to open your air passages so you can breathe easier. Do not stop taking this medicine without your caregiver's OK. Stopping on your own can cause problems.

  • Oxygen: You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your caregiver before you take off the mask or oxygen tubing.

What are the risks of aspiration pneumonia?

If you continue to aspirate, you could have long-term inflammation of your lungs. This can cause you to get aspiration pneumonia again and again. Your lungs may slowly fail to pump enough oxygen into your blood. You could develop a blood infection called sepsis, or a lung abscess. This means part of your lung tissue begins to die. Any of the risks of aspiration pneumonia can be life-threatening.

How can aspiration pneumonia be prevented?

A speech-language pathologist can teach you exercises to strengthen the muscles you use to swallow. A dietitian, nurse, occupational therapist, or physical therapist may teach you what to eat and how to swallow safely. The following can help prevent aspiration pneumonia:

  • Sit up while you eat: Never eat while you are lying flat on your back. If you are bedridden, keep the head of your bed slightly up (at about a 30° to 45° angle) while you eat. Take small bites, eat slowly, and swallow with your chin down.

  • Eat thickened foods and drinks: A dietitian can teach you how to thicken your food so you have less trouble swallowing. Instead of a cup, drink liquids through a straw or sip them from a spoon.

  • Care for your teeth and mouth: Mouth care can help kill harmful bacteria in your mouth so you do not aspirate them. While you are sitting up, brush your teeth for 2 minutes daily after breakfast and again after dinner. Also brush your tongue. If you do not have teeth, gently brush your gums with a soft toothbrush. Dentures should be removed and cleaned with an electric toothbrush and water after breakfast and dinner. Soak dentures overnight in a cleaning solution. Visit a dentist regularly to have your teeth and gums cleaned.

  • Avoid or use fewer sedative medicines: These medicines increase the risk of aspiration because they dry out your mouth and make you drowsy. Use fewer antihistamine medicines because they also make your mouth dry.

  • Do not smoke: Smoking increases your risk for aspiration pneumonia.

When should I contact my caregiver?

Contact your caregiver if:

  • You have a fever.

  • Your symptoms are not better after 2 or 3 days of treatment.

  • You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • You aspirate or you see a person aspirate.

  • You are confused or cannot think clearly.

  • You have chest pain.

  • You have more trouble breathing or your breathing seems faster than normal.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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