Nasogastric tube feeding is a cause of aspiration pneumonia in ventilated patients

Abstract

complaints were diagnosed with bronchitis. This resulted in a more frequent use of inhaled steroids and bronchodilators in Dutch children as compared with German children [2].We cannot exclude the fact that a possible geographically heterogeneous worldwide Chlamydia pneumoniae pandemic could contribute to changes in asthma prevalences in different countries. However, it seems unlikely to us that this would be the sole explanation, as not all asthmatics (established or newly diagnosed) have C. pneumoniae present in bronchoalveolar lavage fluid. Moreover, the widespread use of (macrolide) antibiotics has not prevented a clear increase in asthma prevalence. On the contrary, it seems that a decrease in hospitalisation and mortality is strongly associated with an increase in the use of inhaled steroids [3], and there is no indication that this is associated with the use of antibiotics.However, it is certainly worthwhile to pay attention to the socalled Chlamydia-asthma theory proposed by D.L. Hahn and to investigate the presence of Chlamydia pneumoniae or other infectious organisms in new asthma patients.

Predicting Hospital-Acquired Infections by Scoring System with Simple Parameters

“…NG tube feeding is known to be a significant cause of aspiration pneumonia in critical patients due to the gastroesophageal reflux of bacteriologically contaminated gastric contents and subsequent microaspiration of these contents to the lower airways. The NG tube in ventilated patients is partially responsible for reflux and has been recognized as a risk factor for nosocomial pneumonia [33], [34].…”

Complications related to feeding tube placement

“…Twenty of the 182 patients who received gastric feedings throughout the 3-day study period had two or more gastric residual volumes of at least 200 ml; three-quarters of these patients were identified as frequent aspirators. The mere presence of a nasogastric tube is a frequently cited risk factor for aspiration [27].…”

Aspiration pneumonia

“…This means that, as a rule, hospital‐acquired aspiration pneumonia should be considered to occur without any relationship to ingestion of food. Even fasting or the placement of a gastric fistula do not provide absolute protection against pneumonia 9–12 . This is because upper airway reflexes decrease during the night, and sleep, sedatives and psychotropic agents not only inhibit swallowing reflexes to cause silent aspiration, but also represent factors exacerbating dysphagia.…”