Aspiration pneumonitis in palliative care

Aspiration pneumonitis may complicate an aspiration event, usually presenting within hours of the aspiration event with acute breathlessness, tachypnoea, tachycardia and fever.

Acute management of aspiration pneumonitis in palliative care includes:

• raising the head of the bed
• gently encouraging patients to clear sputum
• oxygen therapy, titrated to target oxygen saturation measured by pulse oximetry (SpO₂)
• symptomatic management of severe acute breathlessness
• considering bronchodilators for bronchospasm.

Patients who can cough and clear sputum often recover within 24 to 48 hours. However, some patients can develop aspiration pneumonia within a few days, and antibiotic therapy should be considered if consistent with the patient’s goals of care and preferences. See Pneumonia in palliative care, and What is aspiration pneumonia? in the Antibiotic guidelines.