A retrospective survey of treatment and mortality in aspiration pneumonia.
A retrospective survey was conducted of all patients with severe aspiration pneumonitis requiring artificial ventilation in our Intensive Care Unit from 1982-1986 inclusive. Of 38 patients, 8 (21%) died. Five of these deaths were due to severe primary intracranial pathology, and occurred after complete or almost complete resolution of the pneumonitis. One death (2.5%) due to myocardial infarction was possibly related to aspiration, and 2 deaths (5%) were definitely related to aspiration. The 7.5% mortality related to aspiration is considerably lower than in previous clinical studies of severe aspiration pneumonia. There was only one death due to aspiration in patients under the age of 70. The mean arterial to alveolar oxygen tension ratio was 0.221, and the mean predicted mortality by apache II was 43%. Patients were managed with rapid intravascular volume restoration using crystalloid fluids, early ventilation, no steroids, and no immediate antibiotics. We conclude that with such management it is possible to achieve a low hospital mortality in severe aspiration pneumonia, particularly in young patients.
D000328:Adult; D000367:Age Factors; D000368:Aged; D002675:Child, Preschool; D003131:Combined Modality Therapy; D000077324:Crystalloid Solutions; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007552:Isotonic Solutions; D008297:Male; D010952:Plasma Substitutes / Q000008:administration & dosage / Q000627:therapeutic use; D011015:Pneumonia, Aspiration / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D011183:Postoperative Complications / Q000401:mortality; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012720:Severity of Illness Index
D000077324:Crystalloid Solutions; D007552:Isotonic Solutions; D010952:Plasma Substitutes