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Query: UMLS:C0032290 (aspiration pneumonia)
 2,291 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Aspiration is the leading cause of pneumonia in the intensive care unit and the most serious complication of enteral tube feeding (ETF). Although aspiration is common, the clinical consequences are variable because of differences in nature of the aspirated material and individual host responses. A number of defense mechanisms normally present in the upper aerodigestive system that protect against aspiration become compromised by clinical events that occur frequently in the critical care setting, subjecting the patient to increased risk. The true incidence of aspiration has been difficult to determine in the past because of vague definitions, poor assessment monitors, and varying levels of clinical recognition. Standardization of terminology is an important step in helping to define the problem, design appropriate research studies, and develop strategies to reduce risk. Traditional clinical monitors of glucose oxidase strips and blue food coloring (BFC) should no longer be used. A modified approach to use of gastric residual volumes and identification of clinical factors that predispose to aspiration allow for risk stratification and an algorhythm approach to the management of the critically ill patient on ETF. Although the patient with confirmed aspiration should be monitored for clinical consequences and receive supportive pulmonary care, ETF may be continued when accompanied by appropriate steps to reduce risk of further aspiration. Management strategies for treating aspiration pneumonia are based on degree of diagnostic certainty, time of onset, and host factors.
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PMID:North American Summit on Aspiration in the Critically Ill Patient: consensus statement. 1240 28

While aspiration is a fairly common event for critically ill patients on enteral tube feeding, progression to aspiration pneumonia is difficult to predict due to variation in host factors and characteristics of the aspirate material. Aspiration of oropharyngeal secretions is of equal if not greater importance than aspiration of gastric contents. Monitors for aspiration such as glucose oxidase, blue food coloring, and gastric residual volumes are insensitive and unreliable. A number of clinical risk factors can be identified at the bedside. A variety of management strategies may be used in the intensive care unit to reduce risk of aspiration, while efforts continue to provide sufficient volume of enteral nutrients.
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PMID:Critical care nutrition: reducing the risk of aspiration. 1261 Aug 49