Aspiration pneumonia occurs when food, saliva, liquids, or vomit is breathed into the lungs or airways leading to the lungs. There has not been any literature published to demonstrate that tube feeding reduces the incidence of aspiration pneumonia. Furthermore, studies have been published that show a high occurrence of aspiration pneumonia with patients who have been tube fed. This is most likely due to aspiration of saliva, which contains the bacteria found in the mouth.
The only significant risk factor was a history of a previous episode of pneumonia. No association was found with age, mental status or continuous versus intermittent method of infusion of feeding formula.
Interventions for those found to be at risk should focus on supporting the immune system. For example, here are some tips to help prevent aspiration pneumonia:
Encourage frequent brushing of the teeth.
Food and fluid intake at meals and between-meal snacks that limit bulk intake.
Treat GI conditions that may hinder absorption of nutrients.
Decrease medications that promote anorexia, dry mouth, diuresis, dysphagia, or lethargy,
or those that alter gustatory sensation (e.g., diuretics, antihistamines, antidepressants,
antipsychotics, and anticholinergics).
Avoid NPO restrictions whenever possible.
Mobility and positioning while eating and while in bed are 24-hour concerns. Be up in a
chair for all meals and for 30 to 60 minutes after meals; use an upright position for all food,
beverage, and medication presentations; elevate the head of the bed at all times for those
receiving tube feedings; and encourage sedentary residents to stand, walk, or propel their
Aspiration pneumonia does not have a single cause. In fact, a chain of events begins with
major medical stress followed by altered immune response, rapid growth of oral bacteria,
and aspiration of oropharyngeal secretions; these events conclude with pneumonia. This
illness also does not resolve by means of a single intervention. Those at risk of developing
aspiration pneumonia often remain at risk to varying degrees, depending on fluctuations
in their heath and nutritional status. Preventing aspiration pneumonia demands constant