Aspiration pneumonia

Numerous biomarkers including serum procalcitonin have been studied to distinguish aspiration pneumonia from aspiration pneumonitis, without success.[58]El-Solh AA, Vora H, Knight PR 3rd, et al. Diagnostic use of serum procalcitonin levels in pulmonary aspiration syndromes. Crit Care Med. 2011 Jun;39(6):1251-6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3102149 http://www.ncbi.nlm.nih.gov/pubmed/21283001?tool=bestpractice.com Most patients respond to appropriate antibiotic coverage within 5 days. Prompt initiation of antibiotics may help prevent development of lung abscess or empyema. For uncomplicated aspiration pneumonia treated promptly with appropriate antibiotics, the patient is likely to make a full recovery. However, in the presence of feeding tube, swallowing dysfunction, poor oral hygiene, and other predisposing factors, the patient is at risk for recurrent aspiration pneumonia. Such predisposing factors should be corrected if at all possible.

Aspiration pneumonia often occurs in patients with poor overall health. Regardless of comorbidities and age, these patients have decreased long-term survival. Even with therapy for swallowing, patients with chronic aspiration are unlikely to improve their swallow, and are likely to have another episode of aspiration pneumonia. Depending on comorbidities and quality of life, and the frequency of occurrences of aspiration pneumonia, it may be reasonable to discuss with the patient or family about recognition of overall state of health, and goals of care. Some patients may choose to avoid gastrostomy tubes or endotracheal intubation, and choose to continue eating, acknowledging the increased risk of death.