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Aspiration Pneumonia

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1. Aspiration pneumonia

Aspiration pneumonia Aspiration pneumonia - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Aspiration pneumonia Last reviewed: February 2019 Last updated: January 2018 Summary Diagnosis is based on clinical signs or symptoms of pneumonia in a person with a history or risk factors for aspiration. Sputum or tracheal Gram stain reveals mixed flora. Infection usually involves the dependent lung lobe. Complications (...) of disease include lung abscess and empyema. Definition Aspiration pneumonia results from inhalation of oropharyngeal contents into the lower airways that leads to lung injury and resultant bacterial infection. It commonly occurs in patients with altered mental status who have an impaired gag or swallowing reflex. The bacteriology and presentation of aspiration pneumonia have changed over the past five decades. Older studies characterised an anaerobic pleuropulmonary syndrome, with necrotising pneumonia

2018 BMJ Best Practice

3. Aspiration Pneumonia: a Shadow in Post-Bariatric Patient : Correlation between aspiration and minigrastric bypass. (Abstract)

Aspiration Pneumonia: a Shadow in Post-Bariatric Patient : Correlation between aspiration and minigrastric bypass. The number of post-bariatric surgical procedures is increasing in time. Post-bariatric patients must be carefully evaluated preoperatively, and they must be considered a particular group of patients in plastic surgery. Aspiration is an occurrence in surgical patients that can cause transient pneumonitis but, in some cases, it can progress to severe clinical acute lung injury (...) or in acute respiratory distress syndrome. The aim of this research is to underline a correlation between one anastomosis bypass-minigastric bypass (OAGB-MGB) and biliar or gastric aspiration.We performed an analysis of literature and a systematic review of our post-bariatric patients who underwent body contouring procedures which required general anaesthesia from 2013 to 2018 and divided them in two groups: OAGB-MGB group and other bariatric procedures in order to compare the rate of aspiration/pneumonia

2019 Obesity Surgery

4. Anesthesia Assistance in Outpatient Colonoscopy and Risk of Aspiration Pneumonia, Bowel Perforation, and Splenic Injury (Abstract)

Anesthesia Assistance in Outpatient Colonoscopy and Risk of Aspiration Pneumonia, Bowel Perforation, and Splenic Injury The increase in use of anesthesia assistance (AA) to achieve deep sedation with propofol during colonoscopy has significantly increased colonoscopy costs without evidence for increased quality and with possible harm. We investigated the effects of AA on colonoscopy complications, specifically bowel perforation, aspiration pneumonia, and splenic injury.In a population-based (...) cohort study using administrative databases, we studied adults in Ontario, Canada undergoing outpatient colonoscopy from 2005 through 2012. Patient, endoscopist, institution, and procedure factors were derived. The primary outcome was bowel perforation, defined using a validated algorithm. Secondary outcomes were splenic injury and aspiration pneumonia. Using a matched propensity score approach, we matched persons who had colonoscopy with AA (1:1) with those who did not. We used logistic regression

2018 EvidenceUpdates

5. Variation in the Diagnosis of Aspiration Pneumonia and Association with Hospital Pneumonia Outcomes. (Abstract)

Variation in the Diagnosis of Aspiration Pneumonia and Association with Hospital Pneumonia Outcomes. National efforts to compare hospital outcomes for patients with pneumonia may be biased by hospital differences in diagnosis and coding of aspiration pneumonia, a condition that has traditionally been excluded from pneumonia outcome measures.To evaluate the rationale and impact of including patients with aspiration pneumonia in hospital mortality and readmission measures.Using Medicare fee (...) -for-service claims for patients 65 years and older from July 2012 to June 2015, we characterized the proportion of hospitals' patients with pneumonia diagnosed with aspiration pneumonia, calculated hospital-specific risk-standardized rates of 30-day mortality and readmission for patients with pneumonia, analyzed the association between aspiration pneumonia coding frequency and these rates, and recalculated these rates including patients with aspiration pneumonia.A total of 1,101,892 patients from 4,263

2018 Annals of the American Thoracic Society

6. Best practices for preventing aspiration pneumonia in hospital patients

Best practices for preventing aspiration pneumonia in hospital patients Best practices for preventing aspiration pneumonia in hospital patients Best practices for preventing aspiration pneumonia in hospital patients Mitchell, MD, Coniglio, MS, Posencheg, MA, Umscheid, CA Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Mitchell, MD (...) , Coniglio, MS, Posencheg, MA, Umscheid, CA. Best practices for preventing aspiration pneumonia in hospital patients. Philadelphia: Center for Evidence-based Practice (CEP). 2016 Final publication URL Indexing Status Subject indexing assigned by CRD MeSH Humans; Inpatients; Pneumonia, Aspiration Language Published English Country of organisation United States English summary An English language summary is available. Address for correspondence Center for Evidence-based Practice, University of Pennsylvania

2016 Health Technology Assessment (HTA) Database.

7. Video-fluoroscopic swallowing study scale for predicting aspiration pneumonia in Parkinson's disease. Full Text available with Trip Pro

Video-fluoroscopic swallowing study scale for predicting aspiration pneumonia in Parkinson's disease. A number of video-fluoroscopic swallowing study (VFSS) abnormalities have been reported in patients with Parkinson's disease (PD). However, the most crucial finding of subsequent aspiration pneumonia has not been validated fully. We conducted a retrospective and case-control study to determine the clinically significant VFSS findings in this population, and to propose a practical scale (...) for predicting aspiration pneumonia in patients with PD.We enrolled 184 PD patients who underwent VFSS because of suspected dysphagia. The patients who developed aspiration pneumonia within six months of the VFSS were assigned as cases and the patients without aspiration pneumonia at six months were designated as controls. Logistic regression analysis was performed to determine the prognostic VFSS features based on the data of swallowing 3 mL of jelly, which were used to make a PD VFSS scale (PDVFS

2018 PLoS ONE

8. Long-Term Mortality and Prognostic Factors in Aspiration Pneumonia. Full Text available with Trip Pro

Long-Term Mortality and Prognostic Factors in Aspiration Pneumonia. Aspiration pneumonia is a leading cause of death among older patients; however, little is known about the long-term mortality in aspiration pneumonia. The purpose of this study was to evaluate long-term mortality and its associated factors in patients with aspiration pneumonia.Retrospective cohort study.In total, 550 patients with aspiration pneumonia (median age: 78.0 years, 66.4% male) with compatible clinical symptoms (...) mortality of male sex [hazard ratio (HR) 1.533, P = .003], low body mass index (HR 0.934, P = .002), hypoalbuminemia, anemia (0.973, P = .032), and mechanical ventilation (HR 2.052, P < .001), which were also independent prognostic factors for 5-year mortality. During the follow-up period, 133 (24.2%) patients experienced recurrent aspiration pneumonia. However, Kaplan-Meier analysis showed no significant differences in survival curves between patients with single and recurrent aspiration pneumonia (P

2019 Journal of the American Medical Directors Association

9. The utility of endotracheal aspirate bacteriology in identifying mechanically ventilated patients at risk for ventilator associated pneumonia: a single-center prospective observational study. Full Text available with Trip Pro

The utility of endotracheal aspirate bacteriology in identifying mechanically ventilated patients at risk for ventilator associated pneumonia: a single-center prospective observational study. Ventilator-associated pneumonia (VAP) is a well-known, life-threatening disease that persists despite preventative measures and approved antibiotic therapies. This prospective observational study investigated bacterial airway colonization, and whether its detection and quantification in the endotracheal (...) aspirate (ETA) is useful for identifying mechanically ventilated ICU patients who are at risk of developing VAP.240 patients admitted to 3 ICUs at the Lahey Hospital and Medical Center (Burlington, MA) between June 2014 and June 2015 and mechanically ventilated for > 2 days were included. ETA samples and clinical data were collected. Airway colonization was assessed, and subsequently categorized into "heavy" and "light" by semi-quantitative microbiological analysis of ETAs. VAP was diagnosed

2019 BMC Infectious Diseases

10. Pilot study for risk assessment of aspiration pneumonia based on oral bacteria levels and serum biomarkers. Full Text available with Trip Pro

Pilot study for risk assessment of aspiration pneumonia based on oral bacteria levels and serum biomarkers. Aspiration pneumonia is a serious problem among elderly patients; it is caused by many risk factors including dysphagia, poor oral hygiene, malnutrition, and sedative medications. The aim of this study was to define a convenient procedure to objectively evaluate the risk of aspiration pneumonia in the clinical setting.This prospective study included an aspiration pneumonia (AP) group (...) , a community-acquired pneumonia (CAP) group, and a control (Con) group (patients hospitalized for lung cancer chemotherapy). We used the Oral Health Assessment Tool (OHAT), which assesses oral hygiene, and evaluated performance status, body mass index, serum albumin levels, substance P values in plasma, and oral bacterial counts.The oral health as assessed by the OHAT of the aspiration pneumonia group was significantly impaired compared with that of the CAP group and the control (5.13 ± 0.18, 4.40 ± 0.26

2019 BMC Infectious Diseases

11. Cefepime vs. meropenem for moderate-to-severe pneumonia in patients at risk for aspiration: An open-label, randomized study. (Abstract)

Cefepime vs. meropenem for moderate-to-severe pneumonia in patients at risk for aspiration: An open-label, randomized study. Treatment of aspiration pneumonia is an important problem due to aging of populations worldwide. However, the effectiveness of cefepime in aspiration pneumonia has not yet been evaluated.To compare the clinical efficacy and safety of cefepime and meropenem in patients with moderate-to-severe aspiration pneumonia.In this open-label, randomized study, either cefepime 1 g (...) or meropenem 0.5 g was administered intravenously every 8 h to patients with moderate-to-severe community-acquired or nursing-home acquired pneumonia at risk for aspiration for an average of 10.5 days. The primary outcome was the clinical response rate at the end of treatment (EOT) in the validated per-protocol (VPP)-population. Secondary outcomes were clinical response during treatment (days 4 and 7) and at the end of study (EOS) in the VPP-population, and survival at day 30 in the modified intention

2019 Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy Controlled trial quality: uncertain

12. A Double-Blind Randomized Controlled Trial to Determine the Preventive Effect of Hangekobokuto on Aspiration Pneumonia in Patients Undergoing Cardiovascular Surgery. Full Text available with Trip Pro

A Double-Blind Randomized Controlled Trial to Determine the Preventive Effect of Hangekobokuto on Aspiration Pneumonia in Patients Undergoing Cardiovascular Surgery. This study aimed to assess whether hangekobokuto (HKT) can prevent aspiration pneumonia in patients undergoing cardiovascular surgery.We performed a single-center, double-blinded, randomized, placebo-controlled study of HKT in patients undergoing cardiovascular surgery. JPS HKT extract granule (JPS-16) was used as HKT. The primary (...) endpoint was defined as the prevention of postoperative aspiration pneumonia. The secondary endpoints included complete recovery from swallowing and coughing disorders.Between August 2014 and August 2015, a total of 34 patients were registered in this study. The rate of subjects with postoperative aspiration pneumonia was significantly lower in the HKT group than in the placebo group (p = 0.017). In high-risk patients for aspiration pneumonia, the rate was significantly lower in the HKT group than

2019 Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia Controlled trial quality: predicted high

13. Aspiration Pneumonia in Older Adults. Full Text available with Trip Pro

Aspiration Pneumonia in Older Adults. Aspiration pneumonia refers to an infection of the lung parenchyma in an individual that has inhaled a bolus of endogenous flora that overwhelms the natural defenses of the respiratory system. While there are not universally agreed upon criteria, the diagnosis can be made in patients with the appropriate risk factors and clinical scenario, in addition to a radiographic or an ultrasonographic image of pneumonia in the typical dependent lung segment (...) . Treatment options for aspiration pneumonia vary based on the site of acquisition (community-acquired aspiration pneumonia [CAAP] versus healthcare-associated aspiration pneumonia [HCAAP]), the risk for multidrug-resistant (MDR) organisms, and severity of illness. Hospitalized CAAP patients without severe illness and with no risk for MDR organisms or Pseudomonas aeruginosa (PA) can be treated with standard inpatient community-acquired pneumonia therapy covering anaerobes. Patients with CAAP and either

2019 Journal of Hospital Medicine

14. Aspiration pneumonia and pneumonitis: a spectrum of infectious/noninfectious diseases affecting the lung. (Abstract)

Aspiration pneumonia and pneumonitis: a spectrum of infectious/noninfectious diseases affecting the lung. Our purpose is to describe aspiration pneumonia/pneumonitis as a spectrum of infectious/noninfectious diseases affecting the lung. We summarize diagnosis, risk factors, treatment, and strategies for prevention of aspiration.Aspiration is present in normal individuals, and disease manifestation depends on the chemical characteristics, frequency, and volume of inoculum. Anaerobes, though (...) present, are no longer the predominant microbes isolated in aspiration pneumonia. Targets for preventing aspiration including improved oral hygiene and positional feeding have had mixed results. Patients diagnosed by clinicians with aspiration pneumonia experience greater morbidity and mortality than patients with community-acquired pneumonia.Aspiration pneumonia and pneumonitis are part of the pneumonia continuum and share similarities in pathophysiology, microbiology, and treatment. Modern

2019 Current Opinion in Infectious Diseases

15. Different clinical predictors of aspiration pneumonia in dysphagic stroke patients related to stroke lesion: A STROBE-complaint retrospective study. Full Text available with Trip Pro

Different clinical predictors of aspiration pneumonia in dysphagic stroke patients related to stroke lesion: A STROBE-complaint retrospective study. Although stroke is one of the most common causes of dysphagia, no studies have investigated the radionuclide salivagram as a predictor of aspiration pneumonia in patients with stroke. In addition, few researches on the risk factors of aspiration pneumonia in patients with subacute and chronic stroke undergoing rehabilitation in the rehabilitation (...) unit have been rarely conducted. In this study, therefore, we investigated whether a radionuclide salivagram could predict aspiration pneumonia, and tried to find other clinical factors that may be helpful in predicting aspiration pneumonia in stroke patients undergoing rehabilitation in the rehabilitation department.From March 2013 and January 2018, a retrospective review of the medical records of 1182 subacute and chronic stroke patients who were admitted to rehabilitation department (South Korea

2018 Medicine

16. Observations from a pediatric dysphagia clinic: Characteristics of children at risk of aspiration pneumonia. (Abstract)

Observations from a pediatric dysphagia clinic: Characteristics of children at risk of aspiration pneumonia. The clinical variables that are predictive of aspiration pneumonia are not clear in the pediatric population. This study was conducted in order to identify the demographic, clinical, and radiological risk factors for the development of aspiration pneumonia in children referred to the dysphagia clinic.A retrospective analysis of medical records of 88 children referred to the dysphagia (...) clinic who had undergone videofluroscopic swallow study (VFSS).Oropharyngeal dysphagia was found in 61.3% (54 of 88). Incidence of aspiration pneumonia was 39.8% (35 of 88).Respiratory symptoms such as cough, choking, excessive secretions, and pharyngeal dysmotility other than aspiration in VFSS were not predictors of pneumonia. Infants and children with laryngotracheal anomalies, demonstrable aspiration in VFSS, and major cardiac illness are at risk of presenting with aspiration pneumonia. Whether

2018 Laryngoscope

17. Clinical features, bacteriology of endotracheal aspirates and treatment outcomes of patients with chronic obstructive pulmonary disease and community-acquired pneumonia in an intensive care unit in Taiwan with an emphasis on eosinophilia versus non-eosino Full Text available with Trip Pro

Clinical features, bacteriology of endotracheal aspirates and treatment outcomes of patients with chronic obstructive pulmonary disease and community-acquired pneumonia in an intensive care unit in Taiwan with an emphasis on eosinophilia versus non-eosino The clinical implications of blood eosinophil level in patients with chronic obstructive pulmonary disease (COPD) and community-acquired pneumonia (CAP) requiring invasive mechanical ventilation (IMV) and intensive care unit (ICU) admission (...) . The bacteriology of endotracheal aspirates showed that Pseudomonas aeruginosa and other gram-negative bacilli were the most common organisms in all study groups. Participants with an EP >2% had a shorter ICU length of stay (OR=12.13, p=0.001) than those with an EP ≤2%, while an AEC >300 cells/µL was not associated with any in-ICUoutcomes.The results of this study have significant clinical implications and should be considered when making treatment decisions for the management of patients with COPD and CAP

2018 BMJ open

18. A novel semi‐solidifying liquid formula via the nasogastric route to maintain enteral nutrition in the event of recurrent aspiration pneumonia: A case report Full Text available with Trip Pro

A novel semi‐solidifying liquid formula via the nasogastric route to maintain enteral nutrition in the event of recurrent aspiration pneumonia: A case report Recurrent aspiration pneumonia can impede the continuation of enteral nutrition. Semi-solid feeds have been demonstrated to reduce the incidence of aspiration pneumonia but are difficult to administer via the nasogastric tube. A novel semi-solidifying enteral formula may be used instead to avoid the occurrence of severe gastroesophageal

2018 Clinical Case Reports

19. Incidence of aspiration pneumonia during hospitalization in Japanese hospitalized cases did not increase whereas concern factors were exacerbated in a time-dependent manner: analysis of Diagnosis Procedure Combination (DPC) data Full Text available with Trip Pro

Incidence of aspiration pneumonia during hospitalization in Japanese hospitalized cases did not increase whereas concern factors were exacerbated in a time-dependent manner: analysis of Diagnosis Procedure Combination (DPC) data This study aimed i) to investigate about items with high relevance for aspiration pneumonia during hospitalization among cases evaluated using Diagnosis Procedure Combination data, and ii) to determine whether the concern factors for aspiration pneumonia during (...) hospitalization were exacerbated with the trend of the time. The Diagnosis Procedure Combination data were gathered from 2010 through to 2015 with 63,390 cases at Saga University Hospital. The occurrence of concern factors of aspiration pneumonia during hospitalization were compared in the two time periods set (2010-2012 and 2013-2015). The concern factors included: male, age, dysphagia at admission and during hospitalization, use and days in the emergency care unit or high care unit, use of the intensive

2018 Journal of clinical biochemistry and nutrition

20. Asymptomatic dysphagia causing recurrent aspiration pneumonia Full Text available with Trip Pro

Asymptomatic dysphagia causing recurrent aspiration pneumonia 52-year-old male patient with known bipolar disorder and innate cerebral palsy causing widespread spasticity problems. Treated for 2 years with antidepressants and electroconvulsive therapy. He repeatedly presented with-and was treated for-pneumonia resulting in more than 20 episodes of hospital admission. He underwent numerous examinations until a diagnosis of dysphagia was established using video fluoroscopic swallowing examination (...) (modified barium swallow). Eventually, as all other treatment regimens had proven effortless, percutaneous gastrostomy feeding tube was inserted and intensive training with a specialised occupational therapist was started. This treatment regimen caused the recurrent episodes of pneumonia to vanish. It is important to acknowledge that otherwise silent dysphagia may cause recurrent pneumonia.© BMJ Publishing Group Limited 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights

2018 BMJ case reports

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