Pneumonia of bedridden patients after stroke treatment. Pneumonia in patients with severe stroke. How to protect yourself from congestive pneumonia after a stroke

03.03.2020

Mom after a stroke, the left side is paralyzed, does not speak, swallowing functions are present, we cannot chew. After discharge with a urinary catheter, cystitis began, the catheter was removed. They took Augmentin and Ciprofloxacin for 5 days. We also take Ramilong plus 1 time per day, Digoxin 0.25 half a tablet per day, Magnecard and Dialtiazem 1 per day and Encephabol 3 times a day. Now wheezing has begun, the temperature is 37.4 - 36.9. coughing when rolling over. Should I start giving an expectorant and continue drinking Augmentin?

Answer

Hello. There are several reasons for coughing after a stroke:

foreign body (food) in the respiratory tract;
respiratory tract infection with weakened immunity: inflammation in the nose, larynx, trachea, bronchi and lungs with the penetration of pathogenic viruses and bacteria;
allergic reactions due to the specific microflora of the room: dust, animal hair and other aggressive agents;
the side effect of drugs to lower blood pressure with concomitant disorders of the cardiovascular system after a stroke (for example, Magnecard can cause bronchospasm);
development of pneumonia with prolonged lack of physical activity.

It is important to understand that stagnation of blood in the pulmonary (small) circulation will develop pneumonia. Prolonged lying without movement reduces the amplitude of chest oscillations during inhalation and exhalation. Therefore, at first, there will be no full breath and the supply of oxygen to the body will decrease. Then the patient will not be able to fully exhale the air and remove the accumulation of carbon dioxide, particles of dust, mucus and microorganisms from the lungs. In older people, pneumonia develops very quickly.

As for the antibiotic Augmentin, only your doctor can prescribe or cancel it. Perhaps he will prescribe another antibiotic: an intravenous infusion of cephalosporins: Claforan or Fortum. May prescribe injections of ceftriaxone with lidocaine (1%). If pneumonia takes on an infectious and inflammatory form, then Sumammed is prescribed in tablets (500 mg for 3 days), powder or lyophilisate.

Macrolides are often prescribed: Erythromycin, Azithromycin, etc. If the cough causes pain, anti-inflammatory drugs are injected intramuscularly: Diclofenac or Ibuprofen. With a dry cough, treatment is prescribed with Herbion, Libeksin, Stopusin, etc. The patient may need artificial ventilation and oxygen therapy (oxygen therapy), as well as to strengthen the immune system - tinctures of ginseng, aralia, rosea rhodiola, eleutherococcus extract, vitamins.

To alleviate the patient's condition and restore physical activity, stop coughing, it is necessary:

ventilate the room regularly 2-3 times a day;
sanitize the oral cavity;
create patient mobility: turn, put an additional pillow under the back;
massage the chest to prevent congestion in the lungs and bronchi;
massage the patient's body to activate blood circulation and prevent pressure sores;
develop the paralyzed side of the body and massage to restore motor function.

In agreement with the doctor, you can give for a stroke and coughing decoctions for expectoration from such plants as elecampane tall, veronica, violet tricolor, primrose (primrose), sweet clover, dewdrop, blue scent blue. Plants have anti-inflammatory and bronchodilatory effects: oregano and St. John's wort, wild rosemary, calendula, peppermint, chamomile, coltsfoot, eucalyptus and sage. And also: plantain, horseradish, meadowsweet, thyme, fennel and motherwort.

It is useful to give after a stroke and with the development of pneumonia, a decoction of dark raisins: after crushing in a blender, raisins (0.5 tbsp) are poured with boiling water (1 tbsp) and placed in a bath under a lid for 10 minutes. You need to give 1.5 glasses a day.

Fig milk relieves the symptoms of pneumonia: 1 tbsp. milk will need 3 dried figs. The mixture is put on a quiet fire and simmer for half an hour. Give patients 2 tbsp. per day.

Aromatic oils of eucalyptus and rosemary are suitable for improving breathing with pneumonia and coughing, increasing the patency of the bronchi and lung capacity. To strengthen the immune system - oils of geranium, fern, myrtle, lemon, chlorophytum. The following oils can be used as an antiseptic: sage, anise or eucalyptus, mustard, lavender or clove, mint and cypress, fir and cedar, pine and cinnamon, lemon, rosemary and thyme. When your mom can do inhalation, then 10 drops of antiseptic oils are added to 1 liter of hot water.

A stroke in itself is a serious illness that can easily turn a person into a disabled bed. Needless to say, when after one "blow" to health follows a second, no less serious - pneumonia. Most often, a stagnant variant of this disease develops, which is a complication of a previous stroke.

According to statistics, the incidence of pneumonia after a stroke is 35 to 50%. In about 15% of complications, pneumonia is the cause of death. It would seem that the person survived after one illness, but could not cope with the second. Any pneumonia in stroke has its reasons, it makes sense to deal with them in more detail.

Any disease, including pneumonia after a stroke, has its causes and risk factors. Such knowledge will help prevent complications and prevent their occurrence in principle.

Often people of the elderly and senile age face pneumonia after a stroke. They normally have impaired drainage function of the lungs, and after a stroke, sputum separation is practically absent, especially if the disease is severe. The risk of pneumonia increases significantly after a person turns 65.

Excess weight in itself is a predisposing factor for the development of stroke. In the case of a complication in the form of pneumonia, the chances are much higher. Pneumonia can occur in people who, before the stroke, suffered from chronic forms of heart and lung disease.

After a stroke, a person can often be in a coma, this contributes to the development of congestion in the lungs. The reason for this condition is a violation or complete absence of sputum outflow. A similar condition occurs with prolonged artificial ventilation of the lungs, which is carried out in the absence of spontaneous breathing. Often a week is enough for pneumonia to develop. Sometimes, even in consciousness, the patient is on bed rest, which contributes to stagnant processes in the pulmonary system.

Development mechanism

It's no secret that the prognosis after a stroke is often sad. There are some reasons that trigger the pathological mechanism of the development of the disease. They consist of:

in an oppressed mind for a certain time;
central respiratory dysfunction;
lack of active movements;
impaired blood supply to the lungs.

The degree of damage depends on the massiveness of the damage to the brain tissue, as well as the place where the hemorrhage or blockage of the vessel occurred. As a result, in some patients, the function of sputum drainage from the lungs is impaired. Reduces or absent the cough reflex or the urge to cough, it is he who is protective and promotes the discharge of sputum. The microorganisms are replaced by more aggressive ones that can cause disease. Further, it is just a matter of time and the disease does not keep itself waiting long, the inflammatory process develops rapidly.

Other factors

But not always artificial ventilation of the pulmonary system after a stroke is the cause of the development of the disease. Often, an infection joins, which is constantly in the hospital, especially in the intensive care unit. Also, the level of immune defense decreases, the body is unable to resist infection.

Symptoms of the disease

It can be very difficult to diagnose pneumonia after a stroke, even at the present stage of development of medicine. The problem remains open to future generations of doctors. It is the difficult diagnosis that is the factor that contributes to the mortality of a person. In general, the manifestations can be easily veiled by the primary disease.

Some symptoms can turn on themselves:

the temperature rises moderately;
breathing is disturbed by the type of pathological variant of Cheyne-Stokes or Kussmaul;
as a result of a violation of the cough reflex, there is no sputum separation;
on auscultation, rales of various sizes are heard.

Features of aspiration pneumonia

This variant develops as a result of food particles entering the respiratory tract. After this, the segment of the lung ceases to perform its function normally, and the bacteria that are there rapidly develop.

With aspiration pneumonia, the manifestations resemble intoxication or poisoning. Initially, a cough that is painful in nature draws on itself. The root variant of aspiration pneumonia is difficult to diagnose. High temperature joins, coughing becomes painful. A dangerous option is the situation when a large bronchus is blocked by pieces of food.

Symptoms of late variants

Diagnosis of the late variant of the disease is much easier. Your doctor will need certain symptoms to make a correct diagnosis. Among them it is worth noting:

rapidly developing fever, numbers above 38 degrees;
in a blood test, an increased number of leukocytes is of interest;
pus is present in sputum or discharge from the trachea;
the x-ray clearly shows pathological changes in the lung tissue.

Final diagnosis

In addition to symptoms, there are some standards for instrumental diagnosis of the problem. Initially, it is worth listening to the chest with a phonendoscope, if there is a suspicion of pneumonia, then an X-ray examination of the lungs is prescribed. In addition to stagnant phenomena, the image will clearly show the most intense focus of shading.

Sputum or bronchial lavage is subject to examination. This analysis will make it possible to establish the type of pathogen, after which its individual sensitivity to antibacterial drugs is carried out. This analysis will further allow the doctor to prescribe an effective treatment.

Treatment

In case of pneumonia, which could be complicated by a stroke, measures are aimed at the speedy elimination of hypoxia. The tissues must receive more oxygen, this is done with the help of artificial ventilation or the use of oxygen bags. It is necessary to pay attention to the fact that pulmonary edema often joins, which is why prevention of this condition is also carried out.

In parallel, the treatment of the underlying disease is carried out, which is prescribed by a neuropathologist. After establishing the type of pathogen and its sensitivity to antibiotics, appropriate drugs are used. Before this analysis, broad-spectrum antibacterial drugs are indicated. The dose of the antibiotic is selected individually, but, as a rule, they are used in large quantities.

Diuretics are used without fail, they help reduce edema and prevent pulmonary edema. Cardiac drugs and expectorants are indicated. If there is a problem with mucus as a result of its viscosity, your doctor may prescribe medications to thin it.

Additionally

After stabilization of the state for a stroke, physiotherapy is recommended for a person. Electrophoresis with potassium iodide is excellent for sputum removal. Exercise therapy under the guidance of an instructor is also shown; it is mainly aimed at restoring breathing.

While still in bed, the doctor may recommend breathing exercises for a person. If the patient is able to breathe on his own, then in bed he is advised to inflate balloons. Special drainage positions are also used to help drain mucus from the lungs. Massage in the acute period is undesirable, but in a mild form it helps to remove phlegm and is performed by a masseur.

Prevent pneumonia

When there is an understanding of the mechanism of development of the disease, it is possible to prevent the development of the disease. Based on this, certain preventive measures have been developed, the observance of which will reduce the risk of developing the disease. An approximate list of them can be presented as follows:

It is worth reducing the pathogenic factor, because the risk of developing the disease largely depends on medical workers, the quality of their performance. In the intensive care unit, in addition to the treatment of instruments and surfaces, the bronchial tree must be sanitized.
It is required to carefully observe the rules of hygiene, including personal. Medical professionals should adhere to the rules of asepsis and antiseptics.
The tube that is used for ventilation of the lungs must be used for individual use and after use is processed and disposed of. The same applies to the rest of the instruments that may come into contact with the human respiratory system.

Prophylaxis

There are some things you can do to prevent pneumonia from developing after a person has a stroke. Some moments will require efforts from the caregiver and staff, but then they will fully justify themselves.

Initially, it is worth providing a constant supply of fresh air. This can be done by ventilating the room, but with certain precautions to prevent hypothermia. A person should be covered with a blanket, and in the cold season several.

It is imperative that oral hygiene is carried out when a person is unable to cope with it himself, those who care for him help him. To prevent stagnation, the position in bed changes every two hours. In the normal state of the patient, he is given a semi-recumbent position at an angle of 45 degrees.

Additionally, breathing exercises are shown, which are carried out no earlier than an hour and a half after the last meal. It is useful to inflate baby balloons. Additionally, a special massage is carried out for about three sessions throughout the day.

As the symptomatology of a person's stroke regresses, it is necessary to activate, first in bed, and then within the ward. This approach will prevent the accumulation of phlegm and prevent congestion.

Pneumonia in stroke occupies a leading place in the list of causes of death in patients with cerebrovascular accident. 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

As a result of a stroke, being left without oxygen for a while, some areas of the brain are affected. Because of this, a violation of the functions of blood flow in the pulmonary circle, dysfunction of the diaphragm and the drainage system of the lungs can occur.

All this, as well as a suppressed immune system, makes it possible for the secreted sputum to accumulate in the lungs and respiratory tract, causing inflammation and creating a favorable environment for the reproduction of pathogenic microorganisms.

The dynamics of the disease is accelerated by the position of the patient lying on his back and the absence of a productive cough, which makes it almost impossible to cough up sputum.

Patients are at risk:

These are not all the reasons for the occurrence of foci of inflammation in the lungs. So, there are frequent cases of bacterial infection of patients after using invasive resuscitation methods, poor disinfection of air conditioners and humidifiers, as well as in the absence of the necessary patient care.

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

Symptoms and diagnostics

It is almost impossible to notice the manifestations of pneumonia in the early form (which arose 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:

slight increase in overall body temperature;
wheezing and non-specific sounds (gurgling, gurgling) when breathing;
obvious changes in the tissues of the lungs on radiography;
in blood tests, as a rule, an increase in the level of leukocytes is observed.

Cough in most cases is absent, or mild and ineffective.

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

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

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

If the use of an X-ray is impossible due to the severe course of the underlying disease, then the diagnosis is established on the basis of general symptoms, as well as the available laboratory data. After confirming the diagnosis and prescribing treatment, a blood test and a number of other general studies are collected daily to monitor the dynamics of the disease.

Treatment

The appointment of drug therapy should occur immediately after the diagnosis is confirmed. At the beginning of treatment, antibiotics with a wide spectrum of action are used, and after the pathogen and its resistance to drugs are precisely determined, 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, phlegm-thinning, diuretics, and drugs that stimulate the cough center (if the patient's condition allows it) are added to the main drug.

If pneumonia is caused by ingestion of food, vomiting into the pulmonary tract, or as a result of a stroke, the swallowing reflex is impaired, then the food is injected directly into the patient's stomach through a tube. 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 performed several times until the condition improves.

All drugs in the first days are administered mainly intravenously, and then gradually switch 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 bronchodilators.

With adequate and timely treatment, the prognosis is quite favorable. But the older the person is, the less chance of 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 careful caring for a stroke patient can reduce the risk of pneumonia.

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

In almost 15% of them, pneumonia is fatal.

The reasons for the development of complications

The high rate of post-stroke pneumonia is directly related to the fact that in patients, severe forms of cerebrovascular accident lead to deep depression of consciousness and respiration, swallowing and cough reflexes. The situation is aggravated by hemodynamic changes in the blood circulation of the lung tissue, weakened immunity, failure in the drainage system of the bronchi. All this contributes to an imbalance in the work of normal microflora and its displacement to pathogenic.

The overwhelming majority of patients, entering the intensive care unit or the intensive care unit, receive the so-called hospital pneumonia, which develops in the first two days from the onset of the acute period of cerebrovascular accident.

The factors provoking this dangerous complication include:

Age 60 and over.
Overweight.
Stay of the patient for more than a week on artificial ventilation.
Prolonged static position, weakness.
History of chronic cardiovascular and pulmonary pathology, uremia and hyperglycemia.

The risk group for the development of complications also includes patients with a reduced level of immune defense and with acute and chronic diseases of the nasopharynx and oral cavity.

The mechanism of development of complications

Early pneumonia after stroke can occur in cases of bacterial infection due to insufficient disinfection of equipment, invasive procedures (debridement, fibrobronchoscopy) or lack of proper care. In bedridden patients, after a stroke, particles of food or vomit enter the upper respiratory tract. A disturbed swallowing act and the absence of a cough reflex give an impetus to the development of aspiration pneumonia.

But the main cause of the complication is the stagnation of fluid in the lungs due to the shutdown of the diaphragm. A favorable environment is created for the development of pathogenic flora and, as a result, pneumonia with pulmonary edema in stroke.

At a later date (period from 2 to 6 weeks), inflammation is provoked by hypostatic processes: the patient lies on his back for a long time, there is no productive cough, sputum does not go away.

Each case of congestive pneumonia has its own characteristics and clinical course, which depend on the type of pathogen (gram-negative flora, staphylococcus, fungal infection, Pseudomonas aeruginosa, anaerobes), the initial state of the patient. The rate of development of complications is also affected by the localization of the focus in the brain.

Clinical manifestations

Diagnosing early pneumonia after a stroke is difficult.

Its symptomatology is nonspecific, in terms of signs it is similar to the primary pathology:

Moderate fever.
Respiratory rhythm disorder.
Lack of cough reflex.

The main clinical and laboratory indicators of the development of pneumonia are:

The increased content of leukocytes in the blood.
Purulent discharge from the trachea.
Pathological changes on x-rays.
Wheezing, gurgling or bubbling sounds when breathing.

Late pneumonia with stroke passes with more pronounced symptoms:

Fever up to 39-40 ° C.
Frequent attacks of chills.
Discharge of purulent sputum.
Moist wheezing.

On the roentgenogram, the transparency of the pulmonary field is reduced with delicate cloudy infiltrates of small diameter (up to 3 cm).

If a specialist diagnoses inflammation at the initial stage, timely started therapy gives a positive prognosis.

If a complication is suspected, tomography, plain chest x-ray are prescribed. To identify pathogenic microflora from the patient, sputum is taken.

Treatment program

Drug therapy must solve several important problems:

Stop hypoxia as soon as possible.
Prevent the development of pulmonary edema in stroke.
Suppress and neutralize the infectious agent.
Restore the drainage capacity of the bronchi.
Resume normal lung function.
Boost immune defenses.

Drug therapy with broad-spectrum antibacterial drugs is prescribed immediately after confirmation of the diagnosis and lasts from 10 to 40 days. The program includes antibiotics of the I – III generation cephalosporin group, which are combined with aminoglycosides and fluoroquinolones in the following combinations:

Respiratory ceftazidime and fluoroquinolone.
Amikacin and one of the antipseudomonal penicillins.
Monotherapy with IV generation cephalosporin (Cefepim).
Ceftazidime and Cefipim, Imopenem and II generation fluoroquinolone.

Treatment includes:

Diuretics
Cardiotonics.
Mucolytics.
Drugs that stimulate the cough center.
Immunomodulators.
Detoxification agents
Native or fresh frozen plasma.

As auxiliary procedures to improve expectoration, the following are prescribed:

Oxygen therapy.
Manual or vibration massage course.
Breathing exercises.
Physiotherapy with bronchodilators.

The effectiveness of the treatment is tested approximately on the fifth day. Indicators of positive dynamics and stopping the inflammatory process:

Temperature reduced to normal values.
Reducing the amount of purulent sputum secreted.
Reduced blood leukocytosis.

Adequate and timely therapy gives a favorable prognosis for cure. But in older patients, the chances of recovery are reduced: every tenth case of acute cerebrovascular accident, accompanied by pneumonia, ends in death.

Prophylaxis

Lung inflammation can be avoided if the patient is provided with proper care with a range of important procedures.

For the diaphragm to work and eliminate stagnation, you need:

Regular turning of the patient from the right side to the left side 6-8 times a day, sitting on the bed, laying on the stomach.
Thorough cleaning of the oral cavity: teeth, tongue, gums from food debris.
Daily massage (3 to 5 times) of the upper third of the chest
Physiotherapy.
Inflation of balls, plastic bags, blowing out air through a tube inserted into a container with water.
At home, it is recommended to alternate cans and mustard plasters.

The patient should lie on a special functional bed with the head end raised by 30–60 °. The room should be regularly ventilated and equipped with a humidifier.

Medical and service personnel must strictly follow the rules of hygiene, all equipment and care products are carefully treated with disinfecting solutions.

The patient weakened by the disease should be protected from any contact with the infection.

Untreated pneumonia after a stroke is always fatal. In case of untimely treatment, the disease can be complicated by an abscess, gangrene, exudative pleurisy or empyema.

Causes of pneumonia after stroke and prevention

Pneumonia after a stroke is a fairly common and unpleasant complication that occurs in 50% of cases of cerebrovascular accident. It is pneumonia that becomes one of the main causes of death in patients who have suffered a cerebral stroke. In order to prevent the development of this complication, as well as to quickly restore the normal functioning of the body, it is necessary to know the causes of pneumonia, as well as its symptoms, which make it possible to identify the development of the disease in time.

What are the causes of the onset of the disease

There are many risk factors that contribute to the development of inflammation in the lung cavity after the transfer of impaired blood circulation in the brain.

These factors include:

the onset of a stroke over the age of 65;
increased weight;
chronic heart pathologies;
oppression of consciousness;
carrying out artificial ventilation of the lungs to the patient, which lasts more than 7 days;
prolonged lying, immobilized position;
taking H2 blockers as a treatment.

The following reasons have an effect on the appearance of pneumonia after a stroke:

The causative agents of this disease are most often:

klebsiella;
intestinal and Pseudomonas aeruginosa;
Staphylococcus aureus.

Doctors distinguish 2 types of pneumonia, which differ in the causes of their occurrence and characteristic symptoms:

Aspiration pneumonia. This condition occurs as a result of the ingress of small constituents of food into the upper respiratory tract, which leads to the cessation of the work of the affected part of the lung tissue. Microorganisms in them cause inflammation. The main symptoms of this type of pneumonia resemble intoxication, which is characterized by a severe cough. Worst of all, when bits of food trapped in the respiratory system block the area of large bronchi. As a result, it is very difficult for the patient to cough, and after a few days, pneumonia with a high fever occurs.
Congestive pneumonia. This type of disease is mainly diagnosed in bedridden patients, since the constant presence in this position causes serious circulatory disorders of the lungs. As a result of this, ventilation of the lungs is aggravated, and the release of sputum is difficult.

The prognosis of pneumonia directly depends on the cause that caused the development of the disease.

Symptoms and diagnosis of the disease

When an early or first form of pneumonia develops within 72 hours after the onset of a stroke, it is difficult to notice the symptoms of this complication. This can be explained by the serious condition of the patient after circulatory disorders in the brain, which causes a blurred clinical picture.

However, you can still distinguish several symptoms of an early form of pneumonia:

slight increase in body temperature;
changes in lung tissue that are clearly visible on an x-ray;
wheezing, bubbling and gurgling sounds when breathing;
an increase in the number of leukocytes in the blood;
mild cough, which is often absent from the victim.

A late and advanced form of pneumonia develops within 2-6 weeks after the onset of a stroke and if this complication is not treated, it can be fatal.

The main symptoms of this stage:

chills and increased body temperature 38-39.5 degrees;
purulent sputum;
coughing may occur;
a significant increase in the level of leukocytes in the blood.

If there is a suspicion of pneumonia, the doctor prescribes sputum tests for the patient, which will determine the presence of the pathogen. In addition, the patient is recommended to examine the chest, which is carried out using an X-ray.

If it is possible to timely establish the presence of pneumonia even at the initial stage of its development, then the treatment started on time allows us to hope for positive results.

Danger of pneumonia after stroke

It is worth knowing that it is quite easy to catch pneumonia in the hospital. For this, it is enough that the human body is struck by staphylococcus, and the development of a stroke also occurs.

In this case, it is not easy to avoid the appearance of pneumonia, since as a result of this disease, blood circulation is impaired.

In the absence of effective treatment, the patient may develop the following unpleasant consequences:

Intoxication - an incompletely cured disease leads to gradual and health-threatening poisoning, which immediately affects the work of the heart muscle.
Loss of respiratory function - in order to cope with the situation, the patient needs to install a device for ventilation of the lungs, which complicates the patient's rehabilitation, because in order to restore health, it is necessary to ensure a normal supply of oxygen.
Death - Lack of treatment or ineffective therapy for pneumonia often leads to the death of the patient.

In order to prevent the development of complications, the patient receives medication. In addition, the patient undergoes additional techniques that increase the process of expectoration of exfoliated sputum.

These activities include:

breathing exercises;
special manual massage;
turning the patient over every 3-4 hours.

Preventive actions

Proper and timely care of a stroke survivor can reduce the risk of pneumonia.

the headboard should be raised at an angle of 30 degrees;
alternate coups from one side to another at least 7 times a day;
high-quality cleaning of the water that the patient drinks;
massage or kneading the back to induce a cough and increase the quality of expectoration;
brushing your teeth and caring for the oral cavity;
high-quality hygiene;
care of medical items;
airing the hospital room, which will reduce the number of microbes in the air.

Immediately after discharging it hurts, he should begin to exercise, which will improve cough and quickly remove phlegm. Correct adherence to the doctor's advice will help you quickly restore your body and your own health, as well as avoid complications.

What to do if pneumonia occurs after a stroke

Pneumonia after a stroke is a frequent and dangerous complication that occurs in half of all patients who have had severe cerebrovascular accident. The success of therapy depends on a timely diagnosis and an accurate determination of the cause of the pathology. The inflammatory process in the lungs develops against the background of a disturbed blood gas composition. A stroke affects the functionality of all organs and systems, especially the respiratory organs, the control center of which is located in the brain stem.

Development mechanism

Stroke pneumonia occurs in bedridden patients due to impaired breathing quality. The loss of quality control of inhalation and exhalation leads to congestion in the lungs, in addition, the weakened body is unable to fight the many bacteria and microorganisms that can provoke pneumonia.

It can be:

enterobacter and klebsiella;
coli or Pseudomonas aeruginosa;
staphylococcus aureus.

Exudate accumulated in the alveoli, difficult sputum discharge, the release of white and red blood cells lead to disruption of gas exchange, and long-term immobility becomes the cause of the development of stagnation in the pulmonary circulation. Pathogenic microorganisms actively multiply and contribute to the onset of the inflammatory process.

Another reason for the onset of the inflammatory process in the lungs is the penetration of juice from the stomach or even particles of vomit into them at the moment when the patient is unconscious after apoplexy.

This is aspiration pneumonia, which occurs due to the termination of the functionality of a certain area of the lung tissue. Self-regulation and self-defense of the body of a patient who has suffered an apoplectic stroke are impaired.

In most cases, patients do not have a cough reflex, phlegm accumulates in the respiratory tract, in which pathogenic bacteria and microorganisms multiply. In this case, several days are enough for the development of inflammation in the lungs.

Another type of pneumonia is congestive pneumonia. It manifests itself in patients who have lost the ability to move and remain in one (lying, horizontal) position for a long time. Even regular massage does not help restore normal blood flow. Congestion and impaired blood supply to the lungs lead to an inflammatory process.

Often in the acute period of the disease, the patient needs artificial ventilation, which also contributes to the onset of pneumonia, but the most significant causes are changes in blood flow and impaired functionality of muscles, including those supporting breathing.

Diagnostics and the most striking symptoms

Pneumonia after stroke is suspected when, a few days after the stroke:

the temperature rises slightly and keeps without falling;
breathing becomes shallow, frequent and difficult;
both on inhalation and on exhalation, pronounced wheezing and bubbling are heard;
inhalation is especially difficult;
shortness of breath is clearly audible in a motionless patient;
a dry, tearing cough after a couple of days turns into a wet one, and streaks of blood are visible in the sputum;
despite the abundant content of sputum in the bronchi and lungs, the cough is either weak or absent at all.

The danger of the disease lies in the fact that early pneumonia proceeds against the background of pronounced symptoms of the underlying disease and it is not always possible to diagnose it in a timely manner. Early pneumonia is accompanied not only by a rise, but also by a decrease in body temperature to 35 ° due to a violation of the functionality of the center of thermoregulation in the brain.

In order to confirm the preliminary diagnosis, a detailed examination will be required, including:

A blood test that determines the number of leukocytes and the erythrocyte sedimentation rate. The white blood cell count can be markedly reduced due to the reaction to brain damage.
X-ray, which can detect changes in the lung tissue. Such foci are not always visible on the images at once, therefore, the examination is carried out several times and in several projections.
Blood biochemistry shows disruptions in gas and acid-base balance. With the help of this study, a protein of the inflammatory process is detected in the blood.
Sputum culture.
Bronchoscopy.
CT scan.

Therapeutic measures and prevention

Inflammation of the lungs that occurs after a stroke requires a special approach. Taking into account the serious condition of patients, forced recumbency, minimal mobility or its complete absence, treatment tactics are selected taking into account the severity of the condition and the patient's age, the presence of concomitant diseases and the severity of disorders from the nervous system.

For effective treatment, the doctor may prescribe:

antibiotics;
medicines to maintain respiratory function;
means for preventing the development of cerebral edema;
medicines that improve the drainage function of the bronchi.

There is also the so-called symptomatic therapy, which includes taking medications that have analgesic effects, support the heart muscle, and relieve a painful cough. The goal of therapy is not only to eliminate the causes of the inflammatory process, but also to remove intoxication, support and increase immunity.

Along with drug treatment, the performance of therapeutic exercises by patients, massage sessions, and physiotherapy procedures is of great importance. As for the appointment of antibacterial drugs, there is no need to wait for the results of the sputum test. Stasis after a doctor has diagnosed pneumonia after a stroke, patients are prescribed antibiotic therapy.

After apoplexy, pneumonia can be avoided by taking care of the simple rules of patient care:

The head end of the bed should be raised.
The position of the patient must be changed at least 4 times a day.
At least twice (in the morning and in the evening) during water procedures and rubdowns, rub the skin on the patient's back with camphor alcohol.
Massage the chest every day (if necessary, do a cupping massage).

Because of what pneumonia is formed after a stroke, what is dangerous and how is it treated

Stroke is primarily dangerous complications caused by an acute lack of blood supply to the brain. One of the most common consequences of a hemorrhagic or ischemic attack is the development of congestion.

Why does pneumonia occur with a stroke?

Stroke and pneumonia go hand in hand and occur in almost half of patients with brain damage. There are several factors that increase the likelihood of developing apoplexy:

Most often, pneumonia after a stroke develops in bedridden patients. But, apoplexy can also occur in patients who have retained some motor functions.

Types of pneumonia in stroke

The prognosis of the consequences of pneumonia after a stroke depends on what caused the disorder. According to the ICD, there are two main types of apoplexy.

Aspiration pneumonia - develops as a result of food pieces entering the respiratory tract of a person. As a result, the affected segment of the lung tissue stops working. Bacteria in the airways provoke inflammation.

Signs of aspiration pneumonia have manifestations similar to intoxication or poisoning of the body. The first symptom is an excruciating cough. The most difficult to diagnose is radicular pneumonia, since the inflammation spreads to the paramedystial space.

It is most dangerous when large bronchi overlap with pieces of food. It hurts the patient to cough, and over time, pneumonia develops with a temperature.

The accumulation of a viscous and thick liquid contributes to the spread of pathogenic bacteria and the development of purulent pneumonia of the lungs.

In both cases, violations lead to the need to connect to a ventilator during the entire period of drug therapy.

Why is pneumonia dangerous in stroke

Treatment of congestive pneumonia in bedridden patients with a stroke does not always begin in a timely manner. Early diagnosis of lung damage improves the prognosis of therapy. The difficulty in determining pathological changes often lies in the fact that the first signs of stagnation are mistakenly attributed to the consequences of a stroke.

Full or partial loss of respiratory function - connection to a ventilator is required, rehabilitation of the patient is difficult, since a normal supply of oxygen to the body is necessary for recovery.

Signs of intoxication from congestive pneumonia do not have pronounced manifestations and are not determined using clinical blood tests. Leukocytosis is either completely absent, or observed to an insignificant degree.

Treatment of pneumonia in bedridden patients after a stroke is difficult due to the severe condition of the body. An important part of traditional therapy is the use of preventive measures or the prevention of complications from brain damage.

How to prevent post-stroke pneumonia

Understanding the clinic of congestive pneumonia and its pathogenesis made it possible to envisage a number of preventive measures designed to prevent the development of the inflammatory process. The following preventive measures are required:

Pathogen reduction - Prevention of pneumonia depends largely on the efforts of the hospital's medical and maintenance staff to provide the necessary conditions to reduce the unfavorable flora of the upper respiratory tract. Daily sanitation and physiotherapy are provided.

How can pneumonia after a stroke be cured?

Pneumonia, as a complication after a stroke in the elderly, is difficult to treat due to the almost complete absence of the body's own reserves to fight the disease. The course of therapy has to be adjusted several times. Even a competently performed treatment does not guarantee that secondary pneumonia will not develop over time.

Relief of cerebral edema.

To achieve the tasks, they use: diuretics, cardiotonics, mucolytics, physiotherapy and breathing exercises. A course of antibiotic therapy is required, with drug adjustments every 72 hours.

Features of pneumonia as complications after stroke

Reasons for development

The dynamics of the disease is accelerated by the position of the patient lying on his back and the absence of a productive cough, which makes it almost impossible to cough up sputum.

Patients are at risk:

people with a reduced level of immunity (kidney disease, liver disease, heart disease, etc.);
those who have crossed the age threshold of 65;
in the presence of chronic or acute diseases of the oral cavity, nasopharynx;
overweight;
in the presence of systemic diseases;
if the ventilation of the lungs by the apparatus method was carried out for more than 6-8 days;
with immobility of the patient for a long time;
if, due to a stroke, there is difficulty in breathing or in the bloodstream in a small circle.

Symptoms and diagnostics

But there are still some typical symptoms:

slight increase in overall body temperature;
wheezing and non-specific sounds (gurgling, gurgling) when breathing;
obvious changes in the tissues of the lungs on radiography;
in blood tests, as a rule, an increase in the level of leukocytes is observed.

Cough in most cases is absent, or mild and ineffective.

But with a late form of pneumonia (you have to wear it), the symptoms are more pronounced:

temperature indicators increase to 38-39.5 0 С;
chills are observed;
cough may be present;
sputum becomes purulent;
pronounced leukocytosis is found in the blood.

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

Having studied the methods of Olga Markovich in the treatment of strokes, as well as the restoration of speech functions, memory and the removal of constant headaches and tingling in the heart, we decided to offer it to your attention.

Treatment

The most common causes of inflammation are:

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

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

To restore the body after a stroke, our readers use a new technique discovered by Elena Malysheva based on medicinal herbs and natural ingredients - the Collection of Father George. The collection of Father George helps to improve the swallowing reflex, restores damaged cells in the brain, speech and memory. And also carries out the prevention of recurrent strokes.

All drugs in the first days are administered mainly intravenously, and then gradually switch 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 bronchodilators.

How to avoid pneumonia?

Proper and careful caring for a stroke patient can reduce the risk of pneumonia.

coups alternately on each side 5-7 times a day;
sanitation of the oral cavity, as well as brushing your teeth after eating;
massage of the upper back to induce cough and effective expectoration;
setting the headboard at an angle;
fairly frequent ventilation of the room to reduce the number of germs in the inhaled air;
additional purification of used water;
thorough personal hygiene of medical personnel, timely disinfection of tracheostomy tubes, humidifiers, etc.

Do you think that it is impossible to restore body functions after a stroke? Judging by the fact that you are now reading these lines, victory in the fight against the consequences of the disease is not on your side. It should be noted that the earlier rehabilitation begins, the greater the chance to recover completely. And the likelihood of returning to an active life increases many times over if you recover under the supervision of the specialists of the rehabilitation center.

Read better what Elena Malysheva says about this. Read better what Elena Malysheva says about this. For several years I suffered from the consequences of STROKE - severe headaches, dizziness, heart palpitations, chronic fatigue, pressure surges, shortness of breath even with the slightest physical exertion. Endless tests, visits to doctors, pills did not solve my problems. BUT thanks to a simple recipe, headaches went away, shortness of breath and heart problems disappeared, blood pressure returned to normal, memory and vision improved. I feel healthy, full of strength and energy. Now my doctor is wondering how it is. Here is a link to the article. Here is a link to the article.

Stroke and pneumonia - worse than you can imagine

Risk factors

Any disease, including pneumonia after a stroke, has its causes and risk factors. Such knowledge will help prevent complications and prevent their occurrence in principle.

Development mechanism

It's no secret that the prognosis after a stroke is often sad. There are some reasons that trigger the pathological mechanism of the development of the disease. They consist of:

in an oppressed mind for a certain time;
central respiratory dysfunction;
lack of active movements;
impaired blood supply to the lungs.

Other factors

Symptoms of the disease

Some symptoms can turn on themselves:

the temperature rises moderately;
breathing is disturbed by the type of pathological variant of Cheyne-Stokes or Kussmaul;
as a result of a violation of the cough reflex, there is no sputum separation;
on auscultation, rales of various sizes are heard.

Features of aspiration pneumonia

Symptoms of late variants

Diagnosis of the late variant of the disease is much easier. Your doctor will need certain symptoms to make a correct diagnosis. Among them it is worth noting:

rapidly developing fever, numbers above 38 degrees;
in a blood test, an increased number of leukocytes is of interest;
pus is present in sputum or discharge from the trachea;
the x-ray clearly shows pathological changes in the lung tissue.

Final diagnosis

Treatment

Diuretics are used without fail, they help reduce edema and prevent pulmonary edema. Cardiac drugs and expectorants are indicated. If there is a problem with mucus as a result of its viscosity, your doctor may prescribe medications to thin it.

Additionally

Prevent pneumonia

When there is an understanding of the mechanism of development of the disease, it is possible to prevent the development of the disease. Based on this, certain preventive measures have been developed, the observance of which will reduce the risk of developing the disease. An approximate list of them can be presented as follows:

It is worth reducing the pathogenic factor, because the risk of developing the disease largely depends on medical workers, the quality of their performance. In the intensive care unit, in addition to the treatment of instruments and surfaces, the bronchial tree must be sanitized.
It is required to carefully observe the rules of hygiene, including personal. Medical professionals should adhere to the rules of asepsis and antiseptics.
The tube that is used for ventilation of the lungs must be used for individual use and after use is processed and disposed of. The same applies to the rest of the instruments that may come into contact with the human respiratory system.

Prophylaxis

Initially, it is worth providing a constant supply of fresh air. This can be done by ventilating the room, but with certain precautions to prevent hypothermia. A person should be covered with a blanket, and in the cold season several.

What to do with pneumonia after a stroke?

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

Clinical picture

Factors contributing to the development of pneumonia after stroke:

age (over 65);
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.

The reasons for the development of the disease:

Experts identify the following symptoms of the disease:

defeat of 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:

staphylococcus aureus;
colibacillus;
klebsiella;
Pseudomonas aeruginosa.

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

The disease is diagnosed 2-3 days after hospitalization. The patient has impaired regulation of the central nervous system, edema appears in the lungs. The prognosis depends on the localization of the focus. Late pneumonia (2-6 weeks) develops against the background of hypostatic processes. It is difficult to diagnose. Complications of the disease can be fatal.

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

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

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 are used (from various groups). After 5 days, the course of therapy is adjusted taking into account the reaction of the body, the identified type of pathogen, the sensitivity of the virus to chemotherapy.

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

The patient is prescribed mucolytics, diuretics, cardiotonics, expectorants. It is recommended to carry out physiotherapy, do breathing exercises. If the patient has urinary incontinence, bladder catheterization is performed. Prevention of inflammation of this system consists in strict adherence to the rules of personal hygiene, washing the bladder, and 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 an 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 deeply, then the wound becomes infected, the body becomes infected. Prevention of pressure sores consists in regular changes in body position (1 time in 2 hours). The skin is treated with warm camphor alcohol. If the work of the large intestine is disrupted during pneumonia, you will need to follow a diet. The diet includes fiber and dairy products. For constipation, take a laxative. You need to drink up to 2 liters of liquid per day.

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

For the prevention of pneumonia after a stroke, it is recommended:

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

Do not take antibacterial drugs to prevent pneumonia.

Pneumonia during and after stroke

Why does pneumonia occur?

The high incidence of pneumonia in these patients is explained by several factors. In patients with severe ischemic stroke, extensive brain damage occurs. As a result of the oppressed consciousness, the protective mechanisms of the body go astray. The brain ceases to control the work of internal systems and organs, stops regulating the course of important biochemical processes. But what is especially destructive with such a lesion is that the body loses its ability to heal itself.

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

Failure of swallowing and coughing reflexes
Decrease in the rate of microcirculation of blood in the bronchi
Interruption of the supply of nutrients and oxygen to the respiratory system
Dysfunction of the bronchial drainage system
Displacement of normal pathogenic microflora, contributing to the development of infection.

Aggravates the condition of the patient with ischemic stroke or after it, the forced constant 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:

Advanced age (over 65)
Long-term (more than 7 days) artificial lung ventilation
Overweight patient
Chronic cardiovascular disease
Respiratory pathology
Hyperglycemia
Uremia
Long hospital stay
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 on 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 the underlying disease. The belated determination of pneumonia leads to the fact that by the time of diagnosis, 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 with the underlying ailment. In this case, the picture is clearer, and doctors are quicker to navigate the diagnosis. In severe strokes, the symptoms of pneumonia are usually more subtle and therefore difficult to identify.

How does pneumonia develop

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

Early pneumonia develops within 2-3 days of being in the hospital. Its development is caused by violations in the regulation of the central nervous system.

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

Late pneumonia develops after 2-6 weeks of hospitalization. It is provoked by hypostatic processes arising from a lying position. Normal blood circulation in the small pulmonary circle is disrupted, fluid accumulates in the lungs. The disease is difficult to diagnose and can be fatal as a result of delay in treatment.

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 (an increase in temperature to 38 ° or a 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.

Pneumonia treatment

The main directions of therapy:

Suppression of the inflammatory process
Neutralizing infection
Preventing cerebral edema
Restoration of the drainage function of the bronchi
Resumption of normal lung function
Boost immunity
Prevention or treatment of complications.

To suppress the inflammatory process, drugs with an antibacterial effect are primarily prescribed. The appointment is made based on the patient's condition, determining the type of causative agent of the disease, 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 establish the exact cause of the disease only in% of cases. The situation is complicated not only by the presence of several pathogens, but also by their resistance to drugs, which has developed in a hospital setting. 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 therapy scheme is adjusted. Performance indicators are:

Decrease in temperature
Reducing the amount of sputum secreted with pus
Decreased leukocytosis
Slowing down or stopping the inflammatory process.

Further appointment is made on the basis of the data obtained from the previous treatment. The duration of antibiotic use 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. For this, drugs with expectorant and mucolytic effects are prescribed, physiotherapy procedures are carried out: massage, breathing exercises.

In case of a severe form of the disease, patients undergo a 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 an influx of fresh air: ventilate the room more often, taking the necessary precautions to prevent hypothermia of the patient.

Perform oral hygiene. This will prevent the infection from developing. If the patient is not able to carry out the procedures on his own, you will need to help him with this.

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

If the patient's condition allows, it is necessary for him to provide a reclining position (at an angle of 45 °) - it will improve ventilation of the lungs.

Massage therapy is necessary to improve the separation and release of phlegm. The session is held three times a day.

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

Banks or mustard plasters.

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

The prognosis for treating pneumonia in people with or after stroke depends on many factors. Prevention of the disease, timely diagnosis, and proper treatment are of great importance.

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Stroke is a serious disease characterized by an acute disturbance of blood circulation in the structures of the brain. Such a violation occurs quite quickly, but the treatment and rehabilitation of patients takes a lot of time and effort, both for the patient himself and those caring for him. Stroke often results in permanent disability in patients. Unfortunately, mortality from stroke is also high. After a stroke, the patient may be immobilized for a sufficiently long period of time, or his physical activity will be minimized.

What to do if a patient has a cough after a stroke. Let's try to understand the situation and find out what causes of cough after a stroke are the same as in a person who has not suffered from this condition, and what reasons are associated exclusively with the disease.

It should be noted that patients after a stroke have a weakened immune system, therefore, respiratory tract infections find fertile soil in their bodies. Numerous pathogenic viruses, bacteria can cause inflammatory processes in various respiratory organs (nasal cavity, larynx, trachea, bronchi, lungs).

Such patients are also susceptible to various allergic reactions, and since most of them have to spend a lot of time in a confined space, the allergic cough of such patients can be caused by the specific microflora of the room, dust, animal hair and other aggressive agents.

Very often, a spontaneous cough in a patient who has had a stroke occurs as a result of a foreign body entering the respiratory tract. This is due to the fact that as a result of the disease, a violation of the coordination of movements, as well as other functions of the body, can be observed, and those elementary actions that were not difficult and were reflexive before the disease can be inhibited or completely absent.

Stroke in most cases occurs against the background of hypertension, then sometimes a cough after a stroke can occur as a side effect of taking pharmacological drugs that lower blood pressure, such as: Enalapril, Captopril, Ramipril and their analogues (the so-called ACE inhibitors). Cough from drugs of this pharmacological group occurs more often in patients with disorders of the heart and blood vessels, which include patients after a stroke.

The condition of the patient who has not restored motor activity requires special attention. Such patients should be carefully cared for, which consists primarily in:

in regular (at least twice a day) ventilation of the room;
sanitation of the oral cavity on their own or with the help;
creating at least minimal mobility of the patient. If the patient is not able to roll over on his own, he needs to help or turn him over;
in chest massage to prevent pulmonary congestion;
breathing exercises, including inflation of balloons.

All these measures will help to avoid or reduce the risk of pressure sores and congestive pneumonia.

Congestive pneumonia occurs in bedridden patients as a result of stagnation of blood in the small (pulmonary) circulation. When lying for a long time, the amplitude of oscillations of the chest during inhalation-exhalation is limited, which first leads to the absence of a full-fledged entrance, which means that it limits the supply of oxygen to the body, and then to the absence of a full-fledged outlet, which does not allow completely removing accumulated carbon dioxide from the lungs. dust particles, mucus, microorganisms. In such a situation, the prerequisites are created for stagnation of blood in the lungs and a violation of the excretion of mucus. Against this background, congestive pneumonia can develop quite quickly, especially in the elderly.

Symptoms and Signs

If a bed patient has a cough after a stroke, do not delay the examination, this is a very serious symptom. Be sure to consult a doctor and do not self-medicate. Any pneumonia requires medical treatment, and a stroke is a factor that aggravates the course of the disease.

A cough with congestive pneumonia is accompanied by symptoms such as:

shortness of breath;
wheezing;
hard breathing;
fever (often to subfebrile);
weakness.

Diagnosis - congestive pneumonia

Early diagnosis is often difficult due to disorders caused by the stroke itself, such as shortness of breath and shortness of breath. The more time has passed from the onset of the primary illness to pneumonia, the easier it is to establish a diagnosis.

Ultrasound and X-ray will help to accurately establish the diagnosis and begin treatment on time. When establishing a diagnosis, it is advisable to conduct a general and biochemical blood test. An increased number of leukocytes, an accelerated erythrocyte sedimentation rate, and an increased amount of reactive inflammatory proteins will indicate the presence of an inflammatory process.

Microscopy of sputum and its bacteriological culture will help not only to identify bacteria-causative agents of the disease, but also to select antibiotics for effective and gentle treatment.

Treatment for congestive pneumonia

Treatment of congestive pneumonia is carried out with medication, taking into account the patient's condition. The main directions of treatment:

fighting bacterial infection;
control of ventilation of the lungs;
improved blood supply to the lungs;
reduction of puffiness.

For treatment, an expanded range of pharmacological drugs is used, in addition to antibiotics, to combat bacterial infection, expectorant drugs are used to improve sputum discharge, diuretics, immunomodulators, cardiac glycosides.

Physiotherapeutic procedures give a good effect in the treatment of congestive pneumonia:

oxygen therapy;
chest and back massage;
inhalation;

So oxygen therapy has a beneficial effect on gas exchange in the lungs, heart, and normalizes the electrical activity of the cerebral cortex.

Massages stimulate blood flow and relieve inflammation and swelling.
Inhalation is carried out using herbal infusions, essential oils.

Therapeutic gymnastics can be carried out exclusively when the patient is in a satisfactory condition, but with its beginning it is not necessary to delay. Any permitted activity will benefit the stroke patient.

Folk remedies to help

From the folk remedies for the treatment of pneumonia, you can recommend drinking thyme decoctions. The infusion is prepared at the rate of: two teaspoons of dry herbs per 0.5 liters of boiling water. The broth is taken four times a day before meals, half a glass. For the treatment of cough, you can prepare an infusion of viburnum and honey. The medicine is taken over three times a day. Drinking plenty of rosehip and raspberry infusions will also help cure congestive pneumonia.

The measures for the treatment of congestive pneumonia can also include the setting of mustard plasters and compresses, but only after consultation with the attending physician.

In conclusion, we note that patients who have suffered a stroke can also become infected with viral infections, leading to laryngitis, tracheitis, bronchitis, sinusitis, in which cough also occurs.