WHAT YOU NEED TO KNOW:

What is aspiration pneumonia? Aspiration pneumonia is a lung infection that develops after you aspirate (inhale) food, liquid, or vomit into your lungs. You can also aspirate food or liquid from your stomach that backs up into your esophagus. 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
  
  
• A weakened immune system from age, diabetes, COPD, heart failure, or other health problems
  
  
• Smoking cigarettes
  
  
• Use of a feeding tube or ventilator that allows bacteria to travel to your lungs
  
  
• Surgery or radiation to treat cancer of the head or neck
  
  
• Poor oral hygiene, teeth that are missing, or dentures
  
  
• Alcoholism or IV drug use

What are the signs and symptoms of aspiration pneumonia?

• Fever
  
  
• Cough, which may or may not bring up mucus
  
  
• Sputum (spit) that is pink or frothy
  
  
• Bluish skin around your mouth or your fingertips
  
  
• Trouble swallowing
  
  
• Shortness of breath, rapid breathing, or noisy breathing
  
  
• Chest pain or a rapid heartbeat
  
  
• Confusion, fatigue, 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 healthcare provider 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:

• Blood tests are used to find out if your white blood cell count is high. This can be a sign of infection.
  
  
• A barium swallow may show if you have long-term swallowing problems. Your healthcare provider will watch you swallow different foods and liquids. You may be asked to drink a thick liquid called barium while healthcare providers take x-rays of your throat, esophagus, and lungs.
  
  
• A sputum culture may be tested for bacteria that can cause pneumonia. Your healthcare provider may ask you to cough mucus into a cup, or he may suction mucus from your throat.
  
  
• X-ray or CT pictures may show lung damage or an infection, such as swelling and fluid in your lungs. You may be given contrast liquid before the CT scan so your healthcare provider can see the pictures better. Tell your healthcare provider if you have ever had an allergic reaction to contrast liquid.

Which medicines are used to treat aspiration pneumonia?

• Antibiotics are given to treat pneumonia caused by bacteria. You may be given antibiotics as pills or through your IV.
  
  
• Steroids are given to reduce swelling.
  
  
• 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 healthcare provider before you take off the mask or oxygen tubing.

What can I do to prevent or manage aspiration pneumonia?

• Go to speech therapy as directed. A speech therapist can teach you exercises to strengthen the muscles you use to swallow.
  
  
• 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. 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.
  
  
• Do not take sedatives, or reduce how much you take. 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. Nicotine and other chemicals in cigarettes and cigars can cause lung damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.

When should I seek immediate care?

• You have chest pain.
  
  
• You are confused or cannot think clearly.
  
  
• You have more trouble breathing, or your breathing seems faster than normal.

When should I contact my healthcare provider?

• 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.

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.