Systematic review on the prevention of aspiration pneumonia in the elderly

Authors

DOI:

https://doi.org/10.56294/piii2023146

Keywords:

Pneumonia, Aspiration / prevention & control, Aspiration / mortality, Humans, Aged, Deglutition disorders

Abstract

Background: Pneumonia is a common respiratory infection. Macroaspiration, is the aspiration of a large oropharyngeal volume from the upper digestive tract. Dysphagia is the most significant of the risk factors for pneumonia and is extremely common in older people.

Material and methods: The study design was that of a systematic review of the literature, scientific articles were analyzed after making a selection after an exhaustive bibliographic search, with the objective of knowing the prevention measures to avoid or reduce the risk of pneumonia. macroaspiration in adults older than 65 years.

Results: Specific searches were carried out following the explained methodology, allowing the identification of 6 articles, after applying the inclusion and exclusion criteria. 2 articles were systematic review, 2 randomized clinical trials, a quasi-experimental quantitative study and a retrospective study.

Conclusion: Different approaches regarding the prevention of aspiration pneumonia in the elderly patient were analyzed. The main factors associated with aspiration pneumonia were two: dysphagia and poor oral hygiene. The importance of protecting the airway of the patient with dysphagia and poor oral hygiene is clear, it being important to diagnose dysphagia early in order to take preventive measures and avoid the complication of aspiration pneumonia

References

Torres A, Cilloniz C, Niederman MS, Menéndez R, Chalmers JD, Wunderink RG, van der Poll T. Pneumonia. Nat Rev Dis Primers. 2021 Apr 8;7(1):25. doi: 10.1038/s41572-021-00259-0. PMID: 33833230.

Niederman MS, Cilloniz C. Aspiration pneumonia. Rev Esp Quimioter. 2022 Apr;35 Suppl 1(Suppl 1):73-77. doi: 10.37201/req/s01.17.2022. Epub 2022 Apr 22. PMID: 35488832; PMCID: PMC9106188.

Luk JK, Chan DK. Preventing aspiration pneumonia in older people: do we have the 'know-how'? Hong Kong Med J. 2014 Oct;20(5):421-7. doi: 10.12809/hkmj144251. Epub 2014 Jul 4. PMID: 24993858.

Morley JE. Dysphagia and Aspiration. JAMDA 16 (2015) 631-634. doi: 10.1016/j.jamda.2015.05.022. PMID: 26212525

Tulunay-Ugur OE, Eibling D. Geriatric Dysphagia. Clin Geriatr Med. 2018 May;34(2):183-189. doi: 10.1016/j.cger.2018.01.007. PMID: 29661331.

Xu Z, Gu Y, Li J, Wang C, Wang R, Huang Y, Zhang J. Dysphagia and aspiration pneumonia in

elderly hospitalization stroke patients: Risk factors, cerebral infarction area comparison. J Back Musculoskelet Rehabil. 2019;32(1):85-91. doi: 10.3233/BMR-170801. PMID: 30223382.

Juan W, Zhen H, Yan-Ying F, Hui-Xian Y, Tao Z, Pei-Fen G, Jian-Tian H. A Comparative Study of Two Tube Feeding Methods in Patients with Dysphagia After Stroke: A Randomized Controlled Trial. J Stroke Cerebrovasc Dis. 2020 Mar;29(3):104602. doi: 10.1016/j.jstrokecerebrovasdis.2019.104602. Epub 2020 Jan 8. PMID: 31924485.

Okazaki T, Ebihara S, Mori T, Izumi S, Ebihara T. Association between sarcopenia and pneumonia in older people. Geriatr Gerontol Int. 2020 Jan;20(1):7-13. doi: 10.1111/ggi.13839. Epub 2019 Dec 6. PMID: 31808265

Scannapieco FA. Poor oral hygiene, oral microorganisms and aspiration pneumonia risk in older people in residential aged care: a systematic review. Dent Clin North Am. 2021 Apr;65(2):307-321. doi: 10.1016/j.cden.2020.11.006. Epub 2021 Jan 6. PMID: 33641755

Eltringham SA, Kilner K, Gee M, Sage K, Bray BD, Pownall S, Smith CJ. Impact of Dysphagia Assessment and Management on Risk of Stroke-Associated Pneumonia: A Systematic Review. Cerebrovasc Dis. 2018;46(3-4):99-107. doi: 10.1159/000492730. Epub 2018 Sep 10. PMID: 30199856.

Khadka S, Khan S, King A, Goldberg LR, Crocombe L, Bettiol S. Poor oral hygiene, oral microorganisms and aspiration pneumonia risk in older people in residential aged care: a systematic review. Age Ageing. 2021 Jan 8;50(1):81-87. doi: 10.1093/ageing/afaa102. PMID: 32677660.

Sole ML, Talbert S, Yan X, Penoyer D, Mehta D, Bennett M, Emery KP, Middleton A, Deaton L, Abomoelak B, Deb C. Impact of deep oropharyngeal suctioning on microaspiration, ventilator events, and clinical outcomes: A randomized clinical trial. J Adv Nurs. 2019 Nov;75(11):3045-3057. doi: 10.1111/jan.14142. Epub 2019 Aug 7. PMID: 31241194; PMCID: PMC8331062.

Morita A, Horiuchi A, Horiuchi I, Takada H. Effectiveness of Water Jelly Ingestion for Both Rehabilitation and Prevention of Aspiration Pneumonia in Elderly Patients With Moderate to Severe Dysphagia. J Clin Gastroenterol. 2022 Feb 1;56(2):e109-e113. doi: 10.1097/MCG.0000000000001493. PMID: 33471491; PMCID: PMC8754089.

Lee JS, Chui PY, Ma HM, Auyeung TW, Kng C, Law T, Ng LK, Tam KF, Tang WH, Chan BY, Tong MC, Wong KT, Yuen YH, Yuk KL, Kwok T. Does Low Dose Angiotensin Converting Enzyme Inhibitor Prevent Pneumonia in Older People With Neurologic Dysphagia--A Randomized Placebo-Controlled Trial. J Am Med Dir Assoc. 2015 Aug 1;16(8):702-7. doi: 10.1016/j.jamda.2015.05.009. Epub 2015 Jun 27. PMID: 26123256.

Seedat J, Penn C. Implementing oral care to reduce aspiration pneumonia amongst patients with dysphagia in a South African setting. S Afr J Commun Disord. 2016 Feb 16;63(1):102. doi: 10.4102/sajcd.v63i1.102. PMID: 26974243; PMCID: PMC8631170.

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Published

2023-11-10

How to Cite

1.
Takafashi Pereira S, Farias AD. Systematic review on the prevention of aspiration pneumonia in the elderly. SCT Proceedings in Interdisciplinary Insights and Innovations [Internet]. 2023 Nov. 10 [cited 2024 Dec. 3];1:146. Available from: https://proceedings.ageditor.ar/index.php/piii/article/view/70