Aspiration Pneumonia

TL;DR. Závažný plicní zánět po vdechnutí potravy, zvratků nebo žaludeční kyseliny; nutná okamžitá péče.

Cizí materiál mine hrtan a silně zánětlivě postihne plíce.

Co to je?

Chemical pneumonitis plus often bacterial pneumonia after inhaling food, vomit, or gastric acid. Airway protection fails (GI disease, neurology, larynx, anesthesia).

Příčiny a rizikové faktory

Almost always secondary. GI disorders >60% (megaesophagus ~26% leading). Neurologic ~18%, laryngeal ~13%; often multiple factors including recent anesthesia. Periodontal disease raises bacterial load.

Známky, na které dávat pozor

• Cough, respiratory distress, lethargy, fever, hypoxemia, crackles (common)
• Cyanosis, collapse, regurgitation, shock (occasional)

Ortopnoická poloha: natažený krk usnadňuje dýchání.

Jak veterináři diagnostikují

Auscultation (may be normal), thoracic radiographs (often right middle lobe), SpO₂, arterial blood gas, tracheal wash/culture, bronchoscopy if needed.

Možnosti léčby

Oxygen, IV fluids. Broad-spectrum antibiotics culture-guided. Glucocorticoids only with extreme caution for pure chemical pneumonitis. Nebulization and coupage when stable.

Prognóza

Favorable with early aggressive care (survival ~77–82% in referral settings); worse with ARDS/ventilation. Recurrence if cause uncontrolled.

Prevence

Megaesophagus: upright feeding. Pre-anesthetic fasting. Dental care. Investigate vomiting/regurgitation early.

Kdy volat veterináře

Grade-5 emergency: severe dyspnea, moist cough, blue mucous membranes, collapse, fever with apathy.

Zdroje

• Internal Medicine, 5th Edition, pages 357, 358.
• Small Animal Critical Care Medicine, 2nd Edition, pages 151, 152.

My highlights & notes

New note