Preparations 

Aspiration pneumonia stroke. Lower and upper limbs. What are the causes of the disease

Pneumonia in stroke is the leading cause of death in patients with stroke. Immediately after a stroke, every fourth patient, and within a month, every eighth begins pneumonia. What are the causes, symptoms, prognosis and treatment for this diagnosis?

Reasons for development

Due to a stroke, left without oxygen for a while, certain areas of the brain are affected. Because of this, there may be a violation of the functions of blood flow in the pulmonary circle, dysfunction of the diaphragm and the drainage system of the lungs.

All this, as well as a depressed immune system, allows sputum to accumulate in the lungs and airways, causing inflammation and creating a favorable environment for the reproduction of pathogenic microorganisms.

The position of the patient lying on his back and the absence of a productive cough accelerates the dynamics of the disease, which makes expectoration of sputum almost impossible.

Patients at risk:

These are not all the causes of foci of inflammation in the lungs. Thus, cases of bacterial infection of patients after the use of invasive methods of resuscitation, poor disinfection of air conditioners and humidifiers, and also in the absence of the necessary patient care are not uncommon.

But even in the presence of any of the above factors, timely preventive measures can prevent the development of pneumonia. But it can be difficult to recognize the clinical picture, as well as to make a prognosis of the course of the disease.

Symptoms and diagnosis

It is almost impossible to notice the manifestations of pneumonia in the early form (which occurred in the first 72 hours after a stroke). This is due to such a disturbed general condition after a stroke that the clinical picture of pneumonia is quite blurred and difficult to diagnose.

But there are still some typical symptoms:

  • a slight increase in overall body temperature;
  • wheezing and nonspecific sounds (gurgling, gurgling) when breathing;
  • obvious changes in the tissues of the lungs on x-ray;
  • In blood tests, as a rule, there is an increase in the level of leukocytes.

Cough in most cases is absent or mild and ineffective.

But with a late form of pneumonia (the onset occurs on days 14-30), the symptoms are more pronounced:


At the slightest suspicion of the occurrence of pneumonia, the patient is taken a sputum sample to identify the pathogen, and the doctor will also recommend an x-ray examination (computed tomography or traditional plain chest x-ray).

If it is possible to notice signs of pneumonia in the early stages, then timely treatment started gives hope for a positive prognosis.

If the use of x-rays is not possible due to the severe course of the underlying disease, then the diagnosis is established on the basis of general symptoms, as well as available laboratory data. After confirming the diagnosis and prescribing treatment, a blood test is collected daily and a number of other general studies are performed to monitor the dynamics of the disease.

Treatment

The appointment of drug therapy should occur immediately after the diagnosis is confirmed. Antibiotics with a broad spectrum of activity are used at the beginning of treatment, and after the pathogen and its resistance to drugs are accurately established, the prescription of drugs may change.

The most common causes of inflammation are:

  • gram-negative microflora;
  • fungal infection;
  • Pseudomonas aeruginosa;
  • anaerobic bacteria.

Depending on the type of pathogenic microflora, treatment can take from 10 to 45 days.

At the same time, they are not limited to the appointment of monotherapy (that is, only one drug). Usually, expectorants, sputum-thinning, diuretic drugs, as well as drugs that excite the cough center (if the patient's condition allows it) are added to the main drug.

If pneumonia was caused by food entering the pulmonary tract, vomiting, or a swallowing reflex is impaired due to a stroke, then food is administered to the patient directly into the stomach through a probe. But at the same time, a prerequisite is the treatment of the mouth and teeth several times a day with antimicrobial solutions.

In severe cases, with a large amount of accumulated sputum, it may be necessary to remove it by invasive methods (using a long needle and syringe) using local anesthesia. This procedure can be repeated several times until the condition improves.

All drugs in the first days are administered mainly intravenously, and then gradually move to oral administration.

Also, along with drug therapy, additional procedures are carried out to increase the effectiveness of coughing and expectoration of secreted mucus:

  • special vibration massage by manual or hardware method;
  • breathing exercises;
  • changing the position of the patient every 2.5-3 hours.

In modern methods of treatment, it is possible to use immunomodulating drugs, as well as agents that promote detoxification.

Supportive procedures also include physiotherapy with the use of bronchodilators.

With adequate and timely treatment, the prognosis is quite favorable. But the older the person, the less chance for a positive outcome. So, according to statistics, every 10 cases of pneumonia after a stroke in elderly people ends in death.

How to avoid pneumonia?

Proper and meticulous care of a stroke patient can reduce the risk of pneumonia.


Exercise should begin immediately after the permission of the doctor, so the cough will become more productive, and blood circulation in the small circle will improve significantly. It is this approach that is one of the most effective methods of preventing and eliminating congestion after pneumonia.

According to medical data, the main danger for patients who are in a state of ischemic stroke or after it is pneumonia. Pneumonia in stroke develops in 30-60% of patients, and in 10-15% of cases is the cause of death.

Why does pneumonia occur?

The high incidence of pneumonia in these patients is due to several factors. Patients with severe ischemic stroke have extensive brain damage. As a result of the oppressed consciousness, the protective mechanisms of the body get lost. The brain ceases to control the work of internal systems and organs, ceases to regulate the flow of important biochemical processes. But what is especially fatal with such a lesion is that the body loses its ability to heal itself.

The imbalance of the entire system contributes to the weakening of the immune system and the rapid development of pneumonia during a stroke or after it. The impetus for the occurrence of pneumonia are violations in the work of the respiratory system, in particular:

  • Failure of swallowing and cough reflexes
  • Decrease in the rate of blood microcirculation in the bronchi
  • Cut off the supply of nutrients and oxygen to the respiratory system
  • Violation of the functioning of the drainage system of the bronchi
  • Displacement of normal microflora by pathogenic, contributing to the development of infection.

It aggravates the condition of a patient with an ischemic stroke or after it a forced permanent lying position. As a result, the diaphragm, which helps the lungs pump blood, ceases to function. The fluid accumulating in the lungs becomes a breeding ground for the development of pathogenic microorganisms and then pneumonia.

What contributes to pneumonia

Factors that accelerate the development of pneumonia after ischemic stroke include:

  • Old age (over 65 years old)
  • Long-term (more than 7 days) artificial lung ventilation
  • Overweight patient
  • Chronic cardiovascular diseases
  • Pathologies of the respiratory system
  • hyperglycemia
  • Uremia
  • Long stay in the hospital
  • Lying state
  • Taking certain medications.

Difficulties in diagnosis

Even today, with the availability of modern equipment, it is extremely difficult to diagnose pneumonia in patients with ischemic stroke in time. The main difficulty lies in the fact that the symptoms of inflammation in the early stages of a stroke are often mistaken for signs of an underlying disease. A delayed diagnosis of pneumonia leads to the fact that by the time the diagnosis is made, the disease has already taken a severe form or caused complications.

It is much easier to determine the inflammation that has arisen against the background of an improvement in the condition of the underlying disease. In this case, the picture is clearer, and doctors quickly navigate the diagnosis. In a severe stroke, the symptoms of pneumonia tend to be more vague and therefore difficult to identify.

How does pneumonia develop?

Patients admitted to the hospital with ischemic stroke most often develop hospital-acquired pneumonia. That is, pneumonia manifests itself a few days after a stay in a medical facility. This does not include patients with pneumonia who at the time of admission already had lung lesions or the infection was in the incubation period.

Early pneumonia develops on 2-3 days of being in the hospital. The reason for its development are violations in the regulation of the central nervous system.

The disease is manifested by fever, the appearance of wheezing during breathing, shortness of breath. Cough is usually absent due to inhibition of the cough reflex. The occurrence and severity of complications depends on which part of the brain is affected and how severely.

Late pneumonia develops after 2-6 weeks in the hospital. It is provoked by hypostatic processes arising from the supine position. The normal circulation of blood in the small pulmonary circle is disturbed, fluid accumulates in the lungs. The disease is difficult to diagnose, and as a result of delay in treatment, death can occur.

Symptoms of pneumonia are manifested in the form of high fever, cough, wheezing in the bronchi. Their severity depends on the patient's condition, his immunity and the stage of the disease. When determining the disease, doctors are guided by the presence / absence of fever (temperature rise to 38 ° or decrease to 36 °), the number of leukocytes in the blood, the development of purulent processes in the trachea, and changes in the gas composition of the blood.

Laboratory and X-ray studies are used to make a diagnosis.

Treatment of pneumonia

The main directions of therapy:

  • Suppression of the inflammatory process
  • Neutralization of infection
  • Prevention of cerebral edema
  • Restoration of the drainage function of the bronchi
  • Resuming normal lung function
  • Immunity Boost
  • Prevention or treatment of complications.

To suppress the inflammatory process, drugs with antibacterial action are primarily prescribed. The appointment is made based on the patient's condition, determining the type of pathogen, its resistance to drugs, the presence or absence of an allergic reaction in the patient, concomitant diseases.

Unfortunately, even in the presence of well-equipped laboratories, it is possible to immediately determine the cause of the disease only in 50-60% of cases. The situation is complicated not only by the presence of several pathogens, but also by their resistance to drugs that has developed in hospital conditions. But in order to prevent the aggravation of the disease and the development of complications, it is extremely important to correctly and timely prescribe drugs.

The effectiveness of the treatment is checked after 1-5 days using laboratory or microbiological studies, and, if necessary, the treatment regimen is adjusted. The performance indicators are:

  • Temperature drop
  • Decreased amount of purulent sputum
  • Decreased leukocytosis
  • Slow down or stop the inflammatory process.

Further appointment is made on the basis of the data obtained from the previous treatment. The duration of the use of antibiotics can take from 5 days to one and a half months - depending on the type of pathogen, the severity of the patient's condition.

To improve the patient's condition, it is of great importance to take measures to improve the drainage function of the lungs. To do this, drugs with expectorant and mucolytic effects are prescribed, physiotherapy is carried out: massage, breathing exercises.

In a severe form of the disease, patients undergo plasma transfusion, and detoxification therapy is prescribed.

Methods for preventing pneumonia after a stroke

To prevent the development of pneumonia in patients with ischemic stroke, it is necessary:

Provide fresh air: ventilate the room more often, taking the necessary precautions to prevent hypothermia of the patient.

Perform oral hygiene. This will prevent the development of infection. If the patient is not able to independently carry out the procedures, you will need to help him with this.

Frequent change of position: it will be necessary to turn the patient every two hours to ensure normal air movement and reduce congestion.

If the patient's condition allows, he needs to provide a semi-recumbent position (at an angle of 45 °) - it will improve ventilation of the lungs.

Therapeutic massage is necessary to improve the separation and release of sputum. The session is held three times a day.

Breathing exercises. To restore the functions of the respiratory system, inflating balloons or children's toys helps a lot. The procedure is recommended to be carried out as often as possible, one and a half hours after eating.

Banks or mustard plasters.

Early activation of the victim. Doctors recommend stimulating the patient to do breathing exercises, and if possible, roll over on their own, take a sitting position. The start of rehabilitation exercises is determined by the doctor, based on the patient's condition.

The prognosis for treating pneumonia in people with or after a stroke depends on many factors. Of great importance is the prevention of the disease, timely diagnosis, proper treatment.

Pneumonia after a stroke is one of the most frequent and dangerous complications. It is pneumonia that develops in patients most often. According to medical statistics, the disease is formed immediately in the first post-stroke week in every 4th victim and after two to four weeks - in every 8th patient. At the same time, the form of cerebrovascular accident - hemorrhagic or ischemic - does not affect the occurrence of pneumonia.

Causes of pneumonia after a stroke

A stroke causes damage to certain parts of the brain. This can provoke a violation of blood circulation in the pulmonary circle, as well as the functioning of the drainage system of the lungs.

Against the background of suppression of immune defense, fluid accumulates in the lung tissues and lower respiratory tract, which becomes a suitable environment for the reproduction of pathogenic microflora.

Important! The accelerated development of post-stroke pneumonia is explained by the patient's low mobility. Prolonged lying on the back and unproductive (without sputum discharge) cough lead to the accumulation of sputum and the formation of the disease.

The provoking factors are:

  • the presence of chronic diseases, accompanied by a decrease in immune defense;
  • elderly age;
  • pathology of the oral cavity and nasopharynx;
  • obesity;
  • systemic diseases;
  • prolonged stay on artificial lung ventilation (longer than 6 days);
  • long-term immobility;
  • problems with the work of the respiratory system or the pulmonary circulation.

The cause of the development of the bacterial form of pneumonia are:

  • infection of the victim during the period of invasive resuscitation;
  • poor-quality disinfection of air conditioners;
  • poor patient care.

Appearance mechanism

Paralysis of the respiratory muscles makes it difficult to remove pulmonary sputum. As a result of the development of congestion, the patient develops pneumonia.

Prolonged stay in a horizontal position, low mobility cause stagnation of blood in the pulmonary circulation (ICC) and the release of blood plasma outside the blood vessels. Filling the lung alveoli with liquid contents (exudate) disrupts the normal passage of gas exchange processes, and the presence of pathogenic microflora initiates the development of local inflammation.

During the period of the patient being unconscious, it is possible that vomit or gastric juice enters the lungs. In this case, a person develops an aspiration form of pneumonia, i.e., resulting from the penetration of liquids or foreign bodies into the lungs.

Symptoms

It is very difficult to recognize the development of unilateral or bilateral pneumonia that has formed during the first three to seven days after a stroke. This is due to a significant violation of the general condition of the patient. The clinical picture of the disease is strongly blurred, which makes it difficult to diagnose.

Important! The development of early inflammation of the lungs is due to violations of the respiratory process as a result of a malfunction of the respiratory center.

But there are certain symptoms. This:

  • a slight rise in overall body temperature or its fall below 36 degrees;
  • hoarse breathing;
  • modifications in the lung tissues, identified during the passage of radiography;
  • increase in the number of leukocytes in the blood.

Cough, which is one of the likely signs of pneumonia, most often does not develop. Sometimes it is present, but almost always ineffective (sputum discharge does not occur).

Late pneumonia, which forms on the 14-30th day after the stroke, develops against the background of stagnation of blood in the pulmonary circulation. The symptoms of the disease in this case are more pronounced.

The patient has:

  • an increase in body temperature to significant levels;
  • chills;
  • cough;
  • the content of purulent impurities in the separated sputum;
  • a significant increase in the number of blood leukocytes;
  • pain in the chest, aggravated in the process of breathing;
  • dyspnea.

If pneumonia is suspected, a sputum sample is taken. The study of biomaterial helps to identify the causative agent of pathology. If necessary, a chest x-ray is ordered.

Important! Diagnosis of pneumonia in the early stages allows you to start treatment and improves the prognosis of the outcome of the disease.

Treatment

Therapeutic tactics depend on many factors. This:

  • patient's age;
  • the causes of the disease;
  • duration;
  • type of pathogen;
  • the severity of the general condition;
  • severity of neurological disorders;
  • accompanying illnesses.

Treatment of pneumonia after a stroke includes the following items:

  • taking drugs from the group of antibiotics;
  • support of the patient's respiratory function;
  • prevention of the development of edema of the tissues of the brain and lungs;
  • stimulation of the drainage function of the bronchi;
  • symptomatic treatment;
  • taking detoxifiers, antioxidants, immunomodulators;
  • physiotherapy exercises, massage, physiotherapy procedures.

Important! To start taking antibiotics, you do not need to wait for the results of a bacteriological study of bronchial discharge.

Immediately after confirming the diagnosis, the patient is prescribed antibiotics. If necessary, the selected drug and the scheme of its administration can be adjusted after receiving the results of bacteriological analysis of pulmonary separable.

The choice of antibiotic is influenced by the period of development of pneumonia, since the causative agents of the disease in each case are different:

  • treatment of early-onset pneumonia is carried out with the help of "Ceftriaxone" and "Ampicillin";
  • therapy of late pneumonia involves an integrated approach - the patient simultaneously receives several drugs;
  • to eliminate the aspiration format of pneumonia, "Metronidazole", "Clindamycin" are used.

To improve respiratory function, the patient is prescribed oxygen therapy. If necessary, a person is connected to a ventilator. In both cases, the blood gas composition normalizes, which favorably affects the course of metabolic processes.

To stimulate drainage functions, drugs from the groups of bronchodilators, mucolytics and bronchodilators are prescribed, in particular, Eufillin, Bromhexine, Acetylcysteine. But treatment is carried out only if the patient breathes on his own and is not in a coma. In the case of forced ventilation, the bronchi are cleared of accumulated sputum automatically.

The patient must be prescribed immunomodulators, immunoglobulins, as well as the introduction of specially prepared plasma.

The duration of therapy for pneumonia in the post-stroke period is determined by the patient's leading doctor or resuscitator, if the patient is in the hospital. The criteria are the dynamics of the patient's condition, the results of laboratory tests and instrumental techniques.

In the absence of treatment of pneumonia after a stroke that developed in bedridden patients, the disease ends with the death of the patient. A weakened immune defense is unable to destroy the infection.

With delayed therapy or incorrectly chosen tactics, a person can develop serious complications. The consequences of the disease can be:

  • formation of a lung abscess;
  • gangrenous lesions of the lung tissues;
  • exudative form of pleurisy - damage to the pleura, accompanied by filling its cavity with fluids of various origins;
  • empyema of the lungs - a secondary pathology characterized by the filling of the pleural cavity with purulent masses;
  • pneumosclerosis - pathology is accompanied by the replacement of lung tissues with connective tissues;
  • infectious-toxic shock;
  • multiple organ failure - a pathological condition accompanied by a violation / complete lack of functionality of more than two organs or body systems.

Prevention of pneumonia in a bedridden patient

Therapy of inflammation against the background of an extensive stroke that has occurred is quite difficult. That is why, after transporting the victim to a medical facility, a number of measures are taken to prevent the development of the disease. These include:

  • lifting the upper body of the patient - the bed in the head area always remains raised;
  • turning the body of the patient several times during the day and night;
  • daily sanitation of the nasopharynx;
  • physiotherapy;
  • compliance with the rules of asepsis and antisepsis;
  • the use of individual tracheostomy when connecting the victim to the ventilator;
  • chest massage;
  • early activation - the implementation of passive movements is recommended from the second day;
  • respiratory exercise.

The appearance of the primary symptoms of the disease is a reason for an urgent consultation with a doctor, since missed time and late therapy significantly worsen the prognosis.

Forecast

Predicting the outcome of post-stroke pneumonia is difficult. This is due to many factors. The leading ones should be called preventive measures, timely diagnosis and adequate therapy for the current state of the patient. Effective treatment significantly reduces the risk of death, increasing the patient's chances for a full recovery.

The age of the patient also plays an equally important role in predicting: the older the patient, the less chance doctors give. According to statistics, out of 10 elderly patients who have had a stroke, 1 patient dies.

Pneumonia that developed in the post-stroke period requires close attention, as it threatens the patient's life. Late diagnosis of pathology and lack of medical support can lead to death.

Pneumonia after a stroke is a common complication that is diagnosed in 50% of cases. In 10-15% of the consequences of pneumonia in the elderly are fatal.

Clinical picture

Factors contributing to the development of pneumonia after a stroke:

  • age (over 65 years);
  • excess weight;
  • chronic diseases of the lungs and heart;
  • prolonged weakness, hospitalization and mechanical ventilation (more than 7 days);
  • the use of H2-blockers;
  • oppression of consciousness.

Reasons for the development of the disease:

  • respiratory failure;
  • change in blood flow in the ICC.

Experts identify the following symptoms of the disease:

  • defeat of the GM;
  • violation of the drainage functions of the lungs;
  • cough.
Staphylococcus aureus is the causative agent of pneumonia.

Common causative agents of the disease are:

  • golden staphylococcus aureus;
  • coli;
  • klebsiella;
  • Pseudomonas aeruginosa.

What to do if the first signs of pneumonia appear after a stroke, it is recommended to ask a doctor. Treatment is prescribed taking into account the type of pneumonia:

  • early;
  • late.

The disease is diagnosed 2-3 days after hospitalization. The patient's central nervous system regulation is disturbed, edema appears in the lungs. The forecast depends on localization of the center. Late pneumonia (2-6 weeks) develops against the background of hypostatic processes. She is difficult to diagnose. Complications of the disease can lead to death.

Signs of pneumonia are manifested in the form of high body temperature, pathology of cough, wheezing. How long the temperature lasts in an adult depends on the severity of the course of pneumonia. Main clinical and laboratory parameters:

  • fever;
  • blood leukocytosis;
  • purulent process in the trachea.

To detect focal changes, an X-ray examination of the lungs is performed. To make an accurate diagnosis, experts consider the 4 signs described above.

Therapy Methods

Treatment of pneumonia after a severe stroke is aimed at suppressing the infectious process, stopping cerebral edema, and fighting inflammation. After the diagnosis is made, antibacterial agents (from various groups) are used. After 5 days, the course of therapy is adjusted taking into account the reaction of the body, the type of pathogen identified, the sensitivity of the virus to chemotherapy.

In the video you can see about the treatment of pneumonia at home and in the hospital.

The patient is prescribed mucolytics, diuretics, cardiotonic drugs, expectorants. It is recommended to carry out physiotherapy, do breathing exercises. If the patient has urinary incontinence, then bladder catheterization is performed. Prevention of inflammation of this system consists in strict observance of the rules of personal hygiene, washing the bladder, passing a bacteriological analysis of urine. In men, the catheter is fixed to the abdomen. The inflammatory process is treated with antibiotics.

If the blood vessels are clogged with blood clots, an additional examination of the patient will be required. A similar phenomenon is observed as a result of prolonged immobility and the active phase of rheumatism. For prevention, experts recommend early passive and active movements.

In a severe course of the disease, integumentary tissues may die. If this process penetrates deep, the wound becomes infected, the body becomes infected. Prevention of bedsores is to regularly change the position of the body (1 time in 2 hours). The skin is treated with warm camphor alcohol. If pneumonia disrupted the work of the large intestine, you will need to follow a diet. The diet includes fiber and dairy products. For constipation, take a laxative. Drink up to 2 liters of fluid per day.

The video provides information on the prevention of pneumonia in a patient with a stroke, the main exercises and movements in a bedridden patient:

To prevent pneumonia after a stroke, it is recommended:

  • sanitation of the nasopharynx;
  • physiotherapy;
  • hygiene;
  • compliance with the rules of antiseptics;
  • use of a tracheotomy tube.

You can not take antibacterial drugs to prevent pneumonia.

Navigation

Stroke is a dangerous neurological pathology that entails brain damage and a lot of serious consequences, one of which is congestive pneumonia.

The development of this kind of pathological process, according to various sources, is diagnosed in 30-60% of patients who have had a stroke. The risk of getting pneumonia increases in the elderly and senile, with about 10-12% of such cases becoming fatal. To counter this problem, it is necessary to understand the mechanism of development of "post-stroke pneumonia", the causes, symptoms and methods of treating the pathology.

Strokes - their relationship with congestive pneumonia

A stroke, that is, an acute violation of blood circulation in the brain, leads to severe brain damage, followed by disorders of many vital human functions.

The mechanism of development of ischemic and hemorrhagic stroke

organism. Depending on in which part of the brain the stroke was localized and what was the extent of the lesions, the brain centers responsible for the functioning of the respiratory system may be affected.

If during a stroke the part of the brain in which the respiratory center is located was affected, the supply of nerve impulses to the receptors of muscle fibers in the lungs is disrupted, congestive pneumonia begins.

In clinical practice, there are two main types of strokes, after which congestive pneumonia can begin:

  • Ischemic - complete or partial obstruction of a vessel in the brain, due to its blockage. At the same time, blood ceases to flow in the required quantities to certain areas of the brain, causing tissue damage and related complications.
  • Hemorrhagic - this type of stroke is less common and at the same time is the most dangerous, since we are talking about a violation of the integrity of the vessel, rupture of its wall, followed by cerebral hemorrhage. The danger lies not only in the fact that blood stops flowing to a certain area of ​​​​the main organ, there is a high risk of complications due to increased intracranial pressure, the appearance of a hematoma, etc.

How and why does pneumonia develop after a stroke?

Pneumonia, also known as pneumonia, is a respiratory disease in which an inflammatory process develops in the lung tissues. In most cases, the disease is infectious.

Congestive pneumonia is a slightly different type of pathology, which is characterized by stagnation of fluid or blood masses in the lungs and bronchi. The fact that, after a stroke, nerve activity and communication with the receptors of the muscle fibers of the respiratory organs is disturbed, increases the likelihood of developing congestive pneumonia.

We are talking about the fact that damage to the part of the brain responsible for the respiratory process leads to a disorder of respiratory functions. A person ceases to control the process of inhalation and exhalation, the cough reflex is dulled, the excretion of sputum stops, fluid begins to accumulate in the lungs. These are the main conditions for the occurrence of congestive pneumonia.

Given these factors, congestive pneumonia in bedridden patients develops much more often and faster, especially if the patient has remained unconscious for a long time and is then bedridden. In itself, the horizontal position, if it persists for an excessively long time, contributes to stagnant processes, filling the lung alveoli with exudate.

Another reason related to the main ones is that during and after a stroke, the chance of involuntary reflux of vomit and gastric juice into the lungs increases, which leads to the rapid development of inflammation of the lung tissues. This process is also more often observed in bedridden patients due to the forced horizontal position of the body.


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Factors in the development of post-stroke pneumonia

Taking into account the complications after a stroke mentioned above and the increased likelihood of developing congestive processes, a number of factors can be identified that contribute to the development of congestive pneumonia:

  • The risk zone is headed by the elderly (usually over 60-65 years). The fact is that it is among the elderly that the likelihood of a stroke is highest. In addition, in old age, the body copes much worse with any shocks, and the development of stagnant processes is aggravated, we can say that there is a predisposition to this. For the same reasons, pneumonia after a stroke among the elderly is more often fatal than usual;
  • At the second stage in the incidence of congestive pneumonia are people who have had any form of pneumonia in the past, as well as those who have chronic diseases associated with the lungs and respiratory system. Those most at risk are asthmatics and patients with tuberculosis;
  • Congestive pneumonia is much more likely to occur in people who are obese. The deposition of excess fat masses in itself causes enormous harm to the functioning of organs and the whole organism as a whole. Obesity increases the chance of developing a stroke, and after that it also increases the chances of developing pneumonia and congestive processes;
  • As mentioned earlier, in a recumbent patient, congestive pneumonia develops with an increased degree of probability. For this reason, those bedridden patients who are in an unconscious state (coma) are at risk.
  • Often after a stroke, pneumonia develops in people with diseases of the cardiovascular system and heart defects;
  • Functional disorders provoked by a stroke (failure of cough or swallowing reflexes, pathologies of blood microcirculation in the bronchi or disorders of the drainage system in the same department) entail the development of stagnant processes that lead to pneumonia.

In a bedridden patient after a stroke, congestive pneumonia develops with an increased degree of probability.

This list can be continued for quite a long time, supplementing the replacement of the healthy microflora of the respiratory organs with pathogenic ones, taking H2-blockers, as well as other "heavy" drugs.

About why the temperature rises with stroke, you will learn from

Signs of congestive pneumonia

Recognizing post-stroke pneumonia in a bedridden patient is not so difficult, but the process of making a diagnosis becomes more complicated at times if the patient is in a coma, because in this case, many symptoms do not make themselves felt.

In general, to detect the disease, one should pay attention to the following clinical signs:

  • With inflammation of a stagnant nature, subfebrile temperature is observed in 90% of cases, rarely the thermometer readings exceed 38 degrees of mercury;
  • Difficulty breathing is present, which is especially noticeable at the moments of inspiration, there is also shortness of breath;
  • The previous clinical sign is confirmed by listening to the chest. This symptom is often accompanied by wheezing or whistling sounds on inspiration and expiration;
  • Cough is one of the main symptoms of pneumonia. It is initially dry, then becomes moist with copious expectoration. Recognition of this symptom is difficult if the patient has no cough reflex after a stroke or is in a coma;
  • Pain in the chest area is noted, they are aggravated by inhalation or with increased physical exertion, for example, climbing stairs;
  • Congestive pneumonia is accompanied by a general deterioration, weakness throughout the body, patients complain of systematic fatigue, drowsiness;
  • In some cases, excessive sweating appears in the history taking. It is important to understand that sweating increases regardless of physical activity, season or indoor climate.

Diagnostics

Due to the fact that some symptoms may be blurred or indicate any other complications after a stroke, certain diagnostic measures are required to make an accurate diagnosis and start adequate treatment:

  • First of all, blood is taken from the patient for general and biochemical analysis, followed by determination of the level of leukocytes, ESR, detection of inflammatory proteins, etc.;
  • In addition, it is important to take a sputum sample for analysis in order to conduct a bacteriological study. If congestive pneumonia is diagnosed, the results of this analysis will also help in the selection of drugs;
  • The implementation of radiography will allow to detect foci of the inflammatory process in the lung tissues, to establish the localization and extent of the lesion;
  • In some cases, bronchoscopy, CT and MRI are also required.

Treatment

Taking into account the fact that congestive pneumonia often develops after a severe stroke, when complications affect not only the lungs, but also other organs and systems, treatment is often very complicated, and the prognosis for recovery is unfavorable.

In such cases, efficiency and an integrated approach to treatment are important:

  • Taking antibiotics;
  • Anti-inflammatory drugs for stopping the inflammatory process;
  • The patient is prescribed a mucolytic drug that helps to eliminate sputum;
  • The most important aspect of therapy is the prevention or suppression of cerebral edema;
  • Immunotherapy is also carried out, including vitamin complexes to enhance the body's defenses;
  • Congestive pneumonia requires improved drainage functions. In cases where the patient is unconscious, artificial aspiration of stagnant contents may be required;
  • In addition to the general course of treatment, a special massage, physiotherapy exercises, etc. are prescribed.

Such a dangerous complication after a stroke is stopped only with the participation of a neuropathologist and a pulmonologist, often in a hospital setting. Sometimes even after the stabilization of the patient and the onset of improvement, a long course of rehabilitation may be required.

Drawing conclusions

Strokes are the cause of almost 70% of all deaths in the world. Seven out of ten people die due to blocked arteries in the brain. And the very first and main sign of blockage of blood vessels is a headache!

Blockage of blood vessels results in a disease under the well-known name "hypertension", here are just some of its symptoms:

  • Headache
  • Increased heart rate
  • Black dots before the eyes (flies)
  • Apathy, irritability, drowsiness
  • blurred vision
  • sweating
  • Chronic fatigue
  • swelling of the face
  • Numbness and chills in fingers
  • Pressure surges
Attention! If you notice at least 2 symptoms in yourself, this is a serious reason to think!

The only remedy that has given a significant result ...