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Care
Published in Henry J. Woodford, Essential Geriatrics, 2022
The potential consequences of reduced swallow ability include malnutrition and difficulties taking oral medication. Aspiration is a term for food, drink, or saliva entering the airways, which can lead to aspiration pneumonia (see page 400). Aspiration usually provokes a cough but can occur without any obvious symptoms or signs, termed ‘silent aspiration'. A reduction in cough force can reduce the ability to clear airways of aspirated matter. Signs indicative of swallowing problems include pooling of food in the mouth, coughing or choking when eating, wet voice quality after eating, or recurrent chest infections.
The patient with acute gastrointestinal problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
Rebecca Maindonald, Adrian Jugdoyal
Aspiration pneumonia occurs if stomach contents are aspirated into the lungs. This can result in an acute lung injury which may be fatal. There is an increased risk of aspiration associated with a reduced level of consciousness, absent cough/gag reflexes, delayed gastric emptying, paralytic ileus or by simply having an enteral feeding tube in situ. Strategies to minimise the risk of aspiration include monitoring nasogastric aspirates, nursing patients upright (45%) and confirming and monitoring tube positioning.
Gastrointestinal system
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
In gastro-oesophageal reflux iron deficiency anaemia occurs due to reflux oesophagitis and bleeding. Aspiration pneumonia is due to the aspiration of stomach contents into the lungs. It tends to improve when the child adopts a sitting posture. Vomiting is usually effortless. Cisapride improves oesophageal sphincter tone and gastric motility which alleviate the vomiting. The incidence is increased in patients with cerebral palsy.
Profiles of oral microbiome associated with nasogastric tube feeding
Published in Journal of Oral Microbiology, 2023
Ding-Han Wang, Fa-Tzu Tsai, Hsi-Feng Tu, Cheng-Chieh Yang, Ming-Lun Hsu, Lin-Jack Huang, Chiu-Tzu Lin, Wun-Eng Hsu, Yu-Cheng Lin
Aspiration pneumonia, an acute condition caused by inhalation of oropharyngeal pathogens, poses major mortality risks to patients with NG tube as these patients often have impaired swallowing and cough reflux [15,16]. The presence of NG tube has been suggested to be associated with aspiration pneumonia, though the pathogen could originate from either oropharyngeal or gastric routes [17]. Aspiration pneumonia is most commonly treated with empiric antimicrobial therapy [18,19], which in many cases could be ineffective due to the lack of information on the causative bacteria. Moreover, aspiration pneumonia is often caused by anaerobes which are hard to culture, further complicating the identification of the causative pathogen [16]. Thus, systematic, culture-independent evaluation of pneumonia-associated oral microbes among long-term care patients could potentially provide information for better antibiotics treatment.
Effects of behavioural swallowing therapy in patients with Parkinson’s disease: A systematic review
Published in International Journal of Speech-Language Pathology, 2023
Both swallowing and coughing require highly coordinated sequences of structural movements with reconfiguration of the ventilator breathing pattern (Hegland, Okun, & Troche, 2014; Troche, Brandimore, Godoy,& Hegland, 2014). Atypical respiratory-swallow coordination, which is associated with dysphagia, is common in patients with PD. In consideration of the relationships amongst airway functions (including swallowing, coughing, and breathing), Curtis and Troche (2020) focussed on the respiratory-swallow coordination that is associated with swallowing. This group found that verbal cueing on the R-S pattern was an effective method to improve R-S coordination. As an extension of this study, RSCT by Curtis et al. (2020) introduced a skill-based treatment that emphasised the relationship between airway functions including swallowing, coughing, and breathing. Swallowing prevents material from entering the lower airway, whereas coughing helps to eject material from the lower airway, especially when penetration/aspiration (PA) occurs. Dysfunction in swallowing and coughing leads to pervasive and progressive impairments in a continuum of airway protective behaviours that can result in aspiration pneumonia (Pitts, Bolser, Rosenbek, Troche, & Sapienza, 2008; Troche et al., 2014). Therefore, the interventions included swallowing and cough training combined with breathing function. Swallowing improvement was then followed by an overall improvement in the airway functions in this study.
The Spectrum of Infections in Patients with Lung Cancer
Published in Cancer Investigation, 2023
Damla Serce Unat, Ozlem Ulusan Bagci, Omer Selim Unat, Sukran Kose, Ayse Caner
Aspiration pneumonia refers specifically to pneumonitis resulting from aspiration of oropharyngeal or gastric contents, which may contain bacteria, exogenous substances or be of low pH (29,30). Bacterial aspiration causes an active infection caused by inoculation of large amounts of bacteria into the lungs (31). In LC patients, involvement of the vagus or recurrent laryngeal nerve due to tumor invasion can cause vocal cord paralysis and glottal incompetence, resulting in dysphonia, dysphagia, and weak cough. Specially, recurrent laryngeal nerve injury is one of the most common complications associated with lung cancer surgery, leading to lethal consequences (6,30,32). Radiotherapy also causes glottal incompetence by reducing in ciliary functions. In addition, aspiration pneumonia was induced by brain metastases (33).