Improving mortality outcomes in aspiration pneumonia: training, technology and teamwork

[摘要] Aspiration is the inhalation of oropharyngealor gastric content into the respiratory tract.1The consequent clinical pattern dependson the patient’s response, the quantity andfrequency of aspiration, and the presenceof pathogens. Two main clinical syndromesensue. First, aspiration pneumonitis fromchemical lung injury by sterile acidic gastriccontent, usually associated with patientswith a reduced conscious level,2 and aspiration pneumonia from inhalation of colonised oropharyngeal material resulting in aninflammatory response to the bacteria. Manyhealthy individuals aspirate small amounts,mainly when asleep, that are cleared by ciliarytransport, coughing and other lung defencesystems.3 Aspiration pneumonitis or pneumonia (AP) usually occurs when those mechanisms are impaired, for example, by cerebrovascular disease, or overwhelmed by aspiration at higher volume.1 4 Optimal care ofpatients at risk of AP requires a multidisciplinary team approach5 involving individualisedassessments and actions by doctors, nurses,speech and language therapists (SALTs),physiotherapists and others.

[学科分类] 药学

[关键词] quality improvement;mortality (standardized mortality ratios);geriatrics