Intensive Care Medicine (ICM) Practice Exam

Which of the following could lead to aspiration pneumonia in critically ill patients?

1. Enteral feeding

2. Parenteral nutrition

3. Oral medication

4. IV fluids

The correct answer is: Enteral feeding

Aspiration pneumonia is a type of lung infection that occurs when food, liquid, or other substances enter the airways and lungs, leading to inflammation and infection. In critically ill patients, enteral feeding is a significant risk factor for aspiration pneumonia. This is especially true when patients have impaired swallowing or reduced consciousness, which can happen due to their critical condition. When enteral feeding is administered, especially if the patient is in a supine position, there is a chance that the feeding can reflux into the esophagus and subsequently into the lungs. This can occur due to improper placement of feeding tubes, gastric distension, or dysphagia, which are common complications in critically ill patients. The nature of enteral feeds, often being thick and calorically dense, can also pose a greater risk for aspiration compared to other forms of nutrition. Hence, maintaining proper positioning, confirming tube placement, and monitoring for signs of aspiration are crucial when using enteral feeding to minimize the risk of aspiration pneumonia in critically ill patients. In contrast, parenteral nutrition, oral medications, and IV fluids typically do not pose the same risk of aspiration, as they bypass the gastrointestinal tract in different ways. Parenteral nutrition is delivered intravenously and directly nour