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Ventilator-associated pneumonia (VAP) is a type of lung infection that occurs in people who are on mechanical ventilation breathing machines in hospitals. As such, VAP typically affects critically ill persons that are in an intensive care unit (ICU) and have been on a mechanical ventilator for at least 48 hours.
Most nosocomial respiratory infections are caused by so-called microaspiration of upper airway secretions, through inapparent aspiration, into the lower respiratory tract. Also, "macroaspirations" of esophageal or gastric material is known to result in HAP. Since it results from aspiration either type is called aspiration pneumonia. [1] [2] [3]
The risk of dangerous irregularities of the heart beat is increased. [ 6 ] [ 7 ] Hypercapnia also occurs when the breathing gas is contaminated with carbon dioxide, or respiratory gas exchange cannot keep up with the metabolic production of carbon dioxide, which can occur when gas density limits ventilation at high ambient pressures.
Aspiration pneumonia is typically diagnosed by a combination of clinical circumstances (people with risk factors for aspiration) and radiologic findings (an infiltrate in the proper location). [1] A chest x-ray is typically performed in cases where any pneumonia is suspected, including aspiration pneumonia. [18]
Aspiration can result in patient death through a variety of mechanisms. It is important to recognize and diagnose early in order to improve patient outcomes. Death from aspiration and aspiration-related syndromes is most common in elderly patients with known baseline risk factors, though it frequently goes unrecognized. [18]
The sooner the endotracheal tube is removed, the lower the risk of pneumonia, but if it is removed too early and has to be put back in, the risk of pneumonia rises. [39] People who are at risk for pulmonary aspiration (e.g. those with lowered level of consciousness due to head injuries) are especially likely to get pneumonia. [ 39 ]
The causes of upper airway obstructions can be acute or chronic. More acute causes of upper airway obstruction include foreign body aspiration, blunt trauma to the neck, infections, and swelling due to allergies or other inflammatory conditions. [3] In children, viral infections such as croup or epiglottitis are frequent causes. [4]
Doses as low as 10 ml orally have been reported to be potentially fatal, whereas some patients have survived the ingestion of 60 ml of petroleum distillates. A history of coughing or choking in association with vomiting strongly suggests aspiration and hydrocarbon pneumonia.