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Goal of Treatment
Treatment of aspiration pneumonia aims at treating any underlying conditions and
preventing further aspiration. Supportive measures may involve assisting
ventilation and oxygenation as needed, and consideration of antibiotics.

Clinical Considerations
Clinical Recognition
Children with neurologic impairment including altered consciousness and CNS
disorders that compromise normal swallowing or protective airway reflexes are at
risk for aspiration. This is particularly true for chronically impaired and
technology-dependent children, although healthy children who are transiently
depressed from acute neurologic deterioration, procedural sedation, or during or
after seizures can also aspirate. In addition, children with decreased esophageal or
intestinal motility or delayed gastric emptying are at increased risk of
regurgitation of stomach contents and therefore possible aspiration. Such
gastrointestinal dysmotility may be secondary to underlying disease, trauma, or
medications such as opiates or those with anticholinergic properties. Similarly,
anatomic narrowing or obstruction along the gastrointestinal tract can also
increase the risk of aspiration.
Triage
Patients with aspiration pneumonia may present with acute severe respiratory
distress, and, therefore, most will require prompt evaluation. Patients with chronic
aspiration often have a more insidious course, though may have an acute event or
intercurrent illness that results in more notable respiratory compromise prompting
evaluation.
Initial Assessment/H&P
The reported symptoms and physical findings in patients with aspiration
pneumonia are similar to patients with pulmonary infections resulting from more
typical bacterial or viral causes, and are further discussed in Chapter 94 Infectious
Disease Emergencies .
In cases of aspiration pneumonia, a brief latent period may occur before the

onset of respiratory signs and symptoms; more than 90% of patients are
symptomatic within 1 hour. Fever, tachypnea, and cough are frequent findings.
Hypoxia is also common, whereas apnea and shock are less likely but possible.
Sputum production is usually minimal.