Mechanism of development and diagnosis of aspiration pneumonia in patients with risk factors

• Published in: Terapevtic̆eskii arhiv Vol. 80; no. 3; p. 54
• Main Authors: Barkov, V A, Nechaev, V I, Vinogradova, V F
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) 2008
• Subjects: Adult; Aged; Alcoholism - complications; Alcoholism - diagnosis; Algorithms; Bronchoscopy - methods; Endoscopy, Gastrointestinal - methods; Esophageal pH Monitoring; Female; Gastritis - complications; Gastritis - diagnosis; Gastroesophageal Reflux - complications; Gastroesophageal Reflux - diagnosis; Humans; Incidence; Male; Middle Aged; Pneumonia, Aspiration - diagnosis; Pneumonia, Aspiration - epidemiology; Pneumonia, Aspiration - etiology; Risk Factors; Russia - epidemiology; Russia
• ISSN: 0040-3660

To optimize diagnosis of purulent lung destruction of aspiration genesis in patients with risk factors basing on algorithms.
A total of 235 patients with destructive aspiration pneumonia (AP) aged 32-70 years (207 males and 28 females) were examined (fibrobronchoscopy, esophagogastroscopy, 24-h pH-metry). Statistic processing was made with nonparametric methods (ANOVA/MANOVA).
Aspiration mechanism of pneumonia was established in 106 (47%) of 225 alcoholic patients and in 10 (4.2%) non-alcoholics. Basic damaging factors were contents of the stomach (52%), food from the mouth (15.6%), foreign bodies (33.9%). A diagnostic algorithm for AP is presented providing diagnosis of destructive AP variants.
Chronic alcoholism associated with ulcer, chronic gastritis, hepatitis/cirrhosis is a basic predictor of AP and purulent destruction of the lungs. Pulmonary symptoms are one of the masks of the gastroesophageal reflux disease (GERD). Refluxes are essential predictors allowing isolation of GERD-associated AP as a specific form of the disease. For verification of aspiration it is necessary to perform x-ray examination including fibrobronchoscopy, esophagogastroscopy, 24-h pH-metry. The proposed algorithm provides definite diagnosis of different variants of AP.