With micro-aspiration, this increases the likelihood of pathogenic organisms getting entry into the bronchial tree.
This change in gastric pH leads to a change in the gastric flora, which favors pathogenic organisms over the normal colonizers. The use of these agents for peptic ulcer prophylaxis is ubiquitous and changes the gastric pH to a less acidic environment. It is prudent to use this for patients that are not expected to be weaned from the ventilator early.Īnother important consideration is the widespread use of proton pump inhibitors in the intensive care unit (ICU) population. The use of endotracheal tubes with aspiration ports proximal to the cuff and connected to continuous suction have successfully decreased the risk of VAP but have not completely stopped its occurrence. It should be noted that the endotracheal tube cuff, or tracheostomy tube cuff, does not protect from micro-aspiration, even when properly inflated. Ventilated patients have significant disease states that may predispose them to a superimposed infection. However, micro-aspiration has been implicated in the pathogenesis of ventilator-associated pneumonia (VAP). Healthy people in the community can tolerate small aspiration events without significant sequelae. This activity describes the evaluation, diagnosis, and management of aspiration pneumonia and highlights the role of team-based interprofessional care for affected patients. It is difficult to determine the quality of the aspirate in most cases, and a combination of bacterial and chemical injury is common. In practice, it is prudent to treat a chemical pneumonitis with prophylactic antibiotics because a superimposed infection occurs in over 25 percent of cases. If partially digested gastric contents are aspirated along with some gastric acid, a mixture of chemical pneumonitis and inoculation of the lungs with potentially pathogenic organisms can occur.
However, if pure gastric secretions are aspirated, then a chemical pneumonitis is the result. If oropharyngeal secretions, orally ingested material, or partially digested gastric contents are aspirated, one would expect infectious pneumonia to develop. It is categorized based on the predominant material in the aspirate. Aspiration can have significant morbidity and mortality in certain circumstances. Aspiration is common, even in healthy patients.
0 kommentar(er)
