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Goal of Treatment Treatment of aspiration pneumonia aims at treating any underlying conditions and preventing further aspiration Supportive measures may involve assisting ventilation and oxygenation as needed, and consideration of antibiotics Clinical Considerations Clinical Recognition Children with neurologic impairment including altered consciousness and CNS disorders that compromise normal swallowing or protective airway reflexes are at risk for aspiration This is particularly true for chronically impaired and technology-dependent children, although healthy children who are transiently depressed from acute neurologic deterioration, procedural sedation, or during or after seizures can also aspirate In addition, children with decreased esophageal or intestinal motility or delayed gastric emptying are at increased risk of regurgitation of stomach contents and therefore possible aspiration Such gastrointestinal dysmotility may be secondary to underlying disease, trauma, or medications such as opiates or those with anticholinergic properties Similarly, anatomic narrowing or obstruction along the gastrointestinal tract can also increase the risk of aspiration Triage Patients with aspiration pneumonia may present with acute severe respiratory distress, and, therefore, most will require prompt evaluation Patients with chronic aspiration often have a more insidious course, though may have an acute event or intercurrent illness that results in more notable respiratory compromise prompting evaluation Initial Assessment/H&P The reported symptoms and physical findings in patients with aspiration pneumonia are similar to patients with pulmonary infections resulting from more typical bacterial or viral causes, and are further discussed in Chapter 94 Infectious Disease Emergencies In cases of aspiration pneumonia, a brief latent period may occur before the onset of respiratory signs and symptoms; more than 90% of patients are symptomatic within hour Fever, tachypnea, and cough are frequent findings Hypoxia is also common, whereas apnea and shock are less likely but possible Sputum production is usually minimal
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