Methods for Decreasing Risk of Aspiration Pneumonia in Critically Ill Patients

Background: Pneumonia is a significant clinical concern in critically ill hospitalized patients, leading to increase in the use of antibiotics, length of hospital stay, and the risk of mortality. Pneumonia caused by aspiration of gastric contents is of particular concern in patients who need mechanical ventilation and feeding through a nasogastric tube. Therefore, methods for decreasing the risk of aspiration are very important. Methods: This review article summarizes factors that might influence the development of aspiration pneumonia, such as the position of the patient's body or type of hospital bed, methods of feeding, medications administered, suctioning of subglottic secretions, and bacterial decontamination. Results: Elevating the head of the bed (45°), continuous subglottic suctioning, and oral decontamination seem to be effective in the prevention of aspiration pneumonia. (Journal of Parenteral and Enteral Nutrition 26:S58-S61, 2002)