Particulate matter or thick fluid may cause bronchial obstruction and ventilation-perfusion mismatch. Bacterial pneumonitis in this setting may be caused by a wide variety of pathogens ranging from preexisting oropharyngeal flora to nosocomial pathogens. The clinician must consider nosocomial infection if the patient is from a nursing home or has been hospitalized recently. Nosocomial cases number 800 per 100,000 hospital admissions per year. Empyema can occur in cases of inadequate antibiotic treatment.
Aspiration pneumonia is more common in males than in females.
As a guide to acute intervention with oxygen, bronchodilator therapy, continuous positive airway pressure ventilation, or intubation, ABG levels are considered in the presence of hypoxia to determine the extent of hypercarbia and acidosis. CBC analysis Determine the baseline hematocrit level and platelet count. Determine serum electrolytes, BUN, and creatinine levels to guide intravenous fluid therapy, especially in patients with a history of poor oral intake or recurrent episodes of emesis. Blood cultures may be used in baseline screening for potential bacteremia. Sputum culture and Gram staining can be used to screen for pathogenic infection and to guide appropriate antimicrobial therapy.