Aspiration pneumonia, also known as Mendelson's syndrome, is a chemical pneumonia caused by the entry of food and gastric juice or food into the respiratory tract and lungs. Aspiration pneumonia is usually caused by anaerobic bacteria and aerobic gram-negative bacteria, therefore treatment is based on the use of broad-spectrum antibiotics. Aspiration pneumonia occurs in people of all ages, but is most often diagnosed in children and the elderly.

Aspiration pneumonia( Mendelson's syndrome ) can develop in people of all ages, but is most often diagnosed in newborns, infants , young children and the elderly. Moreover, the following factors predispose to the development of aspiration pneumonia:

  • severe clinical condition of the patient, who is unconscious and usually hospitalized in the intensive care unit
  • reanimation
  • oesophageal diseases, dysphagia and gastroesophageal reflux disease are a significant risk factor for the development of Mendelson's syndrome. The lower esophageal sphincter is a muscle whose primary function is to prevent the stomach from refluxing food and gastric juice back into the esophagus. Disturbances in the functioning of this sphincter, reduction of its tone or neoplastic changes located in its vicinity cause gastroesophageal reflux and may lead to the aspiration of the food content.
  • emergency surgical operations, as they require general anesthesia and intubation (insertion of an endotracheal tube into the trachea using a laryngoscope) of an unprepared patient.
  • pregnancy and childbirth predispose to aspiration of food and the development of aspiration pneumonia, because physiologically the tension of the lower esophageal sphincter is reduced during pregnancy
  • prematurity - all newborns, but especially those born prematurely, are at risk of developing aspiration pneumonia due to an ineffective cough reflex. They can aspirate amniotic fluid or meconium during labor and choke on the mother's food during suckling
  • alcohol intoxication and loss of consciousness caused by alcohol abuse predispose to choking and aspiration of the contentalimentary tract to the respiratory tract
  • neurological diseases associated with the cough reflex disorder

Aspiration pneumonia: symptoms

The first clinical symptoms of aspiration pneumonia develop quite quickly, usually 2-12 hours after aspiration, so it is important to see a doctor after noticing the first symptoms of the disease.

The clinical picture of aspiration pneumonia does not differ much from that of typical pneumonia. The most characteristic symptoms of the disease are:

  • weakness
  • fever
  • chills
  • difficulty breathing
  • rapid breathing
  • cough
  • excessive amounts of secretion in the bronchi
  • cyanosis
  • pain in the chest when breathing in
  • tachycardia
  • drop in blood pressure

In newborns and infants, the symptoms of pneumonia are not specific and are easily overlooked. Sick children tend to be irritable, anxious, tearful and refuse to eat.

Aspiration pneumonia: diagnosis

Aspiration pneumonia is usually diagnosed on the basis of the patient's clinical symptoms, physical examination, and a well-rounded medical history.

Imaging diagnostics is helpful in determining the diagnosis, especially chest X-ray is important.

Changes in the lung parenchyma, inflammatory infiltrates, parenchymal thickening, as well as areas of airless pulmonary parenchyma (i.e. areas of atelectasis) can only be observed after some time of the disease.

Laboratory tests of blood show increased CRP values ​​and leukocytosis (increased number of white blood cells).

It is sometimes necessary to remove residual chyme or secretions from the respiratory tract using a bronchofiberoscope.

The procedure is usually performed under local anesthesia and consists in inserting a flexible endoscope through the nose or mouth into the patient's respiratory tract. The instrument ends with a camera, thanks to which the doctor can clearly see the light of the trachea and large bronchi.

Aspiration pneumonia: treatment

Treatment of aspiration pneumonia is performed in a hospital setting.

It is based on the administration of broad-spectrum antibiotics, mechanical suction of residual secretions from the bronchial tree (especially in unconscious or non-contact patients, who themselves do not cough effectively) and the use of oxygen therapy.

WIn some cases, it may be necessary to intubate the patient and turn on mechanical ventilation with a ventilator.

Aspiration pneumonia: complications

The following are the most common complications of aspiration pneumonia:

  • bacterial contamination
  • lung abscess
  • pulmonary edema
  • acute respiratory failure, which is a direct threat to the patient's life

Read also:

  • Pneumonia: causes, types, symptoms and complications
  • Pneumocystosis pneumonia (Pneumocystosis)
  • Interstitial pneumonia - symptoms, causes, treatment
  • SARS is atypical pneumonia
  • Bacterial pneumonia
  • Viral Pneumonia

Category:

Respiratory system