Aspiration pneumonia
小结
定义
病史和体格检查
关键诊断因素
- cough
- dyspnea
其他诊断因素
- fever
- pleuritic chest pain
- tachypnea
- foul-smelling breath
- crepitations
- frothy or purulent sputum
- history of vomiting
危险因素
- chemoradiation for head and neck cancers
- altered mental status
- swallowing dysfunction
- gastrointestinal disease
- intubation or tracheostomy tube
- older age
- poor oral hygiene
- feeding tube
- recumbent position
诊断性检查
首要检查
- O2 saturation
- CXR
- CBC
- sputum Gram stain
- sputum culture
需考虑的检查
- point-of-care lung ultrasound
- ABG
- bronchoscopy
治疗流程
all patients
撰稿人
专家顾问
Michael J. Lanspa, MD, MS
Adjunct Associate Professor
Division of Pulmonary and Critical Care Medicine
Intermountain Medical Center
University of Utah
Salt Lake City
UT
利益声明
MJL declares that he has no competing interests.
鸣谢
Dr Michael J. Lanspa would like to gratefully acknowledge Dr Richard Kanner and Dr Krishna Sundar, previous contributors to this topic.
利益声明
DK and KS declare that they have no competing interests.
同行评议者
Toby Maher, MB, PhD, MRCP
Consultant Respiratory Physician
Department of Respiratory Medicine
Royal Brompton Hospital
London
UK
利益声明
TM has received research funding from the Wellcome Trust and GlaxoSmithKline. He has acted as a paid consultant to GSK, Actelion, and Respironies.
Feras Hawari, MD
Chief of Pulmonary and Critical Care
King Hussein Cancer Center
Amman
Jordan
利益声明
FH declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
Metlay JP, Waterer GW, Long AC, et al. Diagnosis and treatment of adults with community-acquired pneumonia. An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67.全文 摘要
American Society of Anesthesiologists. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: an updated report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration. Anesthesiology. 2017 Mar;126(3):376-93.全文 摘要
Kalil AC, Metersky ML, Klompas M, et al. Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis. 2016 Sep 1;63(5):e61-e111.全文 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Aspiration pneumonitis
- Atelectasis
- Pulmonary edema
更多 鉴别诊断指南
- Diagnosis and treatment of adults with community-acquired pneumonia
- Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures
更多 指南患者教育信息
Pneumonia
更多 患者教育信息
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