How Is Pneumonia Diagnosed
Your doctor will ask you about your symptoms and do a physical exam. He or she may order a chest X-ray and a complete blood count . This is usually enough for your doctor to know if you have pneumonia. You may need more tests if you have bad symptoms, are an older adult, or have other health problems. In general, the sicker you are, the more tests you may need.
Your doctor may also test mucus from your lungs to find out if bacteria are causing your pneumonia. Finding out what is causing your pneumonia can help your doctor choose the best treatment for you. However, often the organism can’t be found and a broad-spectrum antibiotic may be given.
What Are The Risk Factors For Postoperative Pneumonia
There are a number of risk factors that can make someone more likely to develop postoperative pneumonia, including:
- Advanced age
- Reduced mobility
- Underlying comorbidity
Additionally, patients who are undergoing abdominal or thoracic surgery have a greater chance of developing postoperative pneumonia.
Spreading Pneumonia To Others
If your pneumonia is caused by a virus or bacteria, you may spread the infection to other people while you are contagious. How long you are contagious depends on what is causing the pneumonia and whether you get treatment. You may be contagious for several days to a week.
If you get antibiotics, you usually cannot spread the infection to others after a day of treatment.
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Risk Factors For Postoperative Pneumonia After Lung Cancer Surgery And Impact Of Pneumonia On Survival
Postoperative pneumonia is a common complication following lung cancer surgery.
Strong risk factors are advanced age, previous pneumonia, and chronic lung disease.
Modifiable risk factors include obesity, alcoholism and atrial fibrillation.
Thoracoscopic surgery is associated with lower pneumonia risk than open thoracotomy.
Pneumonia within 30 days predicts decreased survival within 31365 days and 15 years.
Signs And Symptoms Of Pneumonia After Surgery
Signs and symptoms of pneumonia after surgery may not be easy to detect. Sometimes, they are overlooked, and the diagnosis and treatment are delayed, resulting in a worse outcome. Here are some of the signs and symptoms that may be present:
- Fever: A fever may not always be present with pneumonia after surgery. However, it is important to think about pneumonia after surgery if you have a fever. It is important to get a chest x-ray to look for pneumonia if you have a fever within 48 to 72 hours of surgery.
- Cough with thick yellow phlegm
- Worsening confusion and disorientation
- Abnormal labs
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How Can You Prevent Pneumonia
Experts recommend immunization for children and adults. Children get the pneumococcal vaccine as part of their routine shots. If you are 65 or older or you have a long-term health problem, it’s a good idea to get a pneumococcal vaccine. It may not keep you from getting pneumonia. But if you do get pneumonia, you probably won’t be as sick. You can also get an influenza vaccine to prevent the flu, because sometimes people get pneumonia after having the flu.
You can also lower your chances of getting pneumonia by staying away from people who have the flu, respiratory symptoms, or chickenpox. You may get pneumonia after you have one of these illnesses. Wash your hands often. This helps prevent the spread of viruses and bacteria that may cause pneumonia.
How Long Is Lung Surgery Recovery
How long does it take to recover from lung surgery? Recovering from lung surgery generally takes most people anywhere from a few weeks to 3 months. Before you leave hospital, you’ll be given detailed instructions for exercise, medications, follow up appointments, ongoing wound care and resuming normal activities.
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What To Expect By Age And Health
Here is how age can affect your recovery from pneumonia:
- Infants under the age of 6 months are typically hospitalized for pneumonia out of an abundance of caution.
- Children over the age of 6 months are more likely to be treated at home, provided they are typically healthy.
- Older adults may take longer to bounce back from pneumonia since our immune system naturally weakens the older we get, especially if you have a preexisting health condition. Its also more common for the elderly and chronically ill to be hospitalized for pneumonia since the rate of complications and mortality increases for those over the age of 65.
What Are The Risk Factors For Pneumonia
While pneumonia can affect people of all ages, the following age groups face a greater risk:
- Infants who are two years old or younger
- Adults who are 65 years old or older
Several conditions place people at risk for pneumonia, as they often result in a weakened or suppressed immune system. These include:
- Conditions that require an organ, blood or marrow stem cell transplant
Other risk factors for pneumonia include:
- Abusing alcohol
- Exposure to some chemicals, toxic fumes or pollutants
- Smoking cigarettes
- Staying in a hospital intensive care unit, especially if using a ventilator
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What Causes Bacterial Pneumonia
Bacteria pneumonia is caused by bacteria that works its way into the lungs and then multiplies. It can occur on its own or develop after another illness, like a cold or the flu. People who have a higher risk for pneumonia may:
- have weakened immune systems
- have respiratory diseases
- be recovering from surgery
Doctors classify bacterial pneumonia based on whether it developed inside or outside a hospital.
Community-acquired pneumonia : This is the most common type of bacterial pneumonia. CAP occurs when you get an infection after exposure to bacterial agents outside of a healthcare setting. You can get CAP by breathing in respiratory droplets from coughs or sneezes, or by skin-to-skin contact.
Hospital-acquired pneumonia : HAP occurs within two to three days of exposure to germs in a medical setting, such as a hospital or doctors office. This is also called a nosocomial infection. This type of pneumonia is often more resistant to antibiotics and more is difficult to treat than CAP.
What Does Getting A Chest Infection Mean For My Recovery
If you get a post-operative chest infection, your discharge from hospital will be delayed by days or weeks.
Chest infections can have many complications. Fluid can build up in the lungs or infection can spread in the bloodstream to affect other organs in your body. Specific treatment is given for these on the ward or in the intensive care unit. If you are admitted to the intensive care unit, your recovery is likely to be very slow indeed.
Most people who get a post-operative chest infection go on to make a full recovery without long-term effects.
Some comments from patients:
‘My breathing meant I had to stay in bed, I couldn’t walk, I couldn’t eat because when I took the mask off, my breathing got harder and the oxygen levels in my blood dropped very low.’
‘My brother who had near enough the same type of surgery was out in a week but I was in just over a month.’
‘I didn’t expect it to be as bad as it was. I thought the antibiotics into my vein would clear me right up but I had to have three different types and the last one affected my kidneys which made me even sicker.’
Content used with permission from the Royal College of Anaesthetists website: Post-operative chest infection . Copyright for this leaflet is with the Royal College of Anaesthetists.
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An Effective Pilot Program
In the April 2010 Journal of the American College of Surgeons, my colleagues and I reported a study in which we tested a pilot pneumonia-prevention program to assess its effect on reducing the incidence of postoperative pneumonia in a hospital surgical ward. The pilot prevention program was designed and implemented based on an extensive literature review of risk reduction interventions. In the program, physicians and ward staff received education on preventing pneumonia. Other components of the program included:
Cough and deep-breathing exercises with incentive spirometer.Twice daily oral hygiene with chlorhexidine swabs.Ambulation with good pain control.Head-of-bed elevation to at least 30° and sitting up for all meals.
Quarterly staff meetings were also initiated to discuss the results of and compliance with the program. Pneumonia bundle documentation and computerized pneumonia-prevention order sets in the physician order entry system were also key components in the program.
How Common Is Aspiration Pneumonia
Aspiration of food or drink is a relatively common thing. Youve probably heard someone say that food “went down the wrong pipe, meaning that food or drink went toward your lungs instead of your stomach. When this happens, you probably coughed until you felt better.
When the same sort of thing happens to someone who isnt able to cough the food or drink out of their lungs, aspiration pneumonia may result.
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How Is Pneumonia Treated
When you get a pneumonia diagnosis, your doctor will work with you to develop a treatment plan. Treatment for pneumonia depends on the type of pneumonia you have, how sick you are feeling, your age, and whether you have other health conditions. The goals of treatment are to cure the infection and prevent complications. It is important to follow your treatment plan carefully until you are fully recovered.
Take any medications as prescribed by your doctor. If your pneumonia is caused by bacteria, you will be given an antibiotic. It is important to take all the antibiotic until it is gone, even though you will probably start to feel better in a couple of days. If you stop, you risk having the infection come back, and you increase the chances that the germs will be resistant to treatment in the future.
Typical antibiotics do not work against viruses. If you have viral pneumonia, your doctor may prescribe an antiviral medication to treat it. Sometimes, though, symptom management and rest are all that is needed.
Most people can manage their symptoms such as fever and cough at home by following these steps:
If your pneumonia is so severe that you are treated in the hospital, you may be given intravenous fluids and antibiotics, as well as oxygen therapy, and possibly other breathing treatments.
Why Is My Face Flushed The Day After Surgery
Flushing is seen frequently at induction of anaesthesia, is associated with anaesthetic agents such as thiopental and muscle relaxants, and is attributed to histamine release. The changes are generally confined to the neck and upper chest .The incidence of flushing on induction of anaesthesia in patients who
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Why Some People Develop Pneumonia After Surgery
In a condition when the delicate lung tissue becomes acutely infected, there exists the lung disease known as pneumonia. The infection may be caused by several kinds of bacteria and viruses. In battling the infection, the alveoli fill up with mucus, pus, white blood cells, and other liquids. This bodily response makes it difficult for oxygen to reach the bloodstream. It is through the bloodstream that the infection can spread to the entire body.
There are at least a couple reasons why pneumonia is a serious disease, with the first being that the presence of toxic substances in the blood is relatively great. The other reason is that a persons life is dependent on the continuous functioning of the lungs whether involved with disease or not, the lungs must function continuously day and night.
Some people who underwent surgery were found to have developed pneumonia. Indeed, why do some people develop pneumonia after surgery? A person can be vulnerable to pneumonia after going through serious surgery, when a machine may be required to assist breathing. The reason for this is that the machine may not expand the lungs completely. Additionally, the pain of a chest or abdominal incision may affect bodily responses that expand and clean the lungs . The use of painkillers, in some cases, adds to the problem.
1. Annals of Internal Medicine, Who Gets Pneumonia after Surgery? http://www.annals.org/cgi/content/full/135/10/S54
Everything You Need To Know About Postoperative Pneumonia
Medically reviewed by Dr. Nick Rosen, MD on December 28th, 2020
If youve been scheduled to undergo surgery, you probably want to know everything you can about the procedure, including what you can do to minimize the risk of any potential complications. One of these complications is the development of postoperative pneumonia. In fact, postoperative pneumonia is the third most common complication for all surgical procedures. To help you prepare for your upcoming procedure, weve compiled everything you need to know about this condition.
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How Serious Is It If I Get A Chest Infection
If you were previously healthy, you are very likely to recover fully from a post-operative chest infection. But rarely, people who were well before their surgery die from pneumonia afterwards. If you were not previously healthy and had long-standing lung disease or another long standing illness, then you are more likely to have a serious life-threatening post-operative chest infection. However, many people with previous lung disease recover after a post-operative chest infection. Your anaesthetist will be able to talk to you about the risks which apply to you.
Why Does Recovery Take So Long
Almost everyone who comes down with pneumonia will ask themselves or their healthcare provider at least once, Why does it take so long to recover from pneumonia? After all, you felt better within a few days of starting your antibiotic or, in some cases, steroid treatment. Like everything else in medicine, there are many reasons why it takes so long to recover.
When bacteria enters your body, your body goes into defense mode to remove it. Somewhere along the line, you start your antibiotics, and in a few days, you feel better. This improvement is because the bacteria has been dealt with. However, your body is now in cleanup mode, removing all the debrislike the mucus in your lungs.
Your body starts working overtime to clear out all the trash left behind. Your body is using multiple mechanisms to move the mucus out of your lungs. This movement is why you experience a productive cough.
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Risk Factors And The Prediction Model
Univariate analysis was used to analyze potential risk factors for the development of postoperative pneumonia and showed that many aspects, including demographics, comorbidities, cardiac anatomy and function, laboratory values, operative time, and blood transfusion, were significantly different between patients with and without postoperative pneumonia .
In the multivariate analysis, 13 independent risk factors for postoperative pneumonia were identified, including age > 60 years, hypertension, diabetes mellitus, smoking history, COPD, BMI 24 kg/m2, renal insufficiency, heart surgery history, NYHA class III-IV, preoperative anemia, hypoalbuminemia, CPB time > 120 minutes and blood transfusion . Odds ratios with corresponding 95% confidence intervals and assigned points are presented. A simplified point-based risk score used to predict the risk of postoperative pneumonia was then generated . There were 32 possible points in the composite risk index, with scores ranging from 0 to 27 in this study with a median of 9 . The predicted rate of postoperative pneumonia ranged from 0.61% for those with a score of 0, to 93.4% for those with a score of 32.
Table 2Figure 2Figure 3Table 3
Preventing Postoperative Pulmonary Complications
Using ERAS and I COUGH to improve outcomes.
- Postoperative pulmonary complications are costly and responsible for extended hospital stays and mortalities.
- Enhanced recovery after surgery are multimodal evidence-based guidelines aimed at reducing stress, decreasing recovery time, enhancing patient satisfaction, and optimizing functionality.
- I COUGH was designed to mitigate postoperative pneumonia and emphasize incentive spirometry, coughing and deep breathing, oral care, patient and family understanding, getting out of bed, and head of bed elevation.
Editors note: This is web exclusive is an early release article for an upcoming issue of the American Nurse Journal.
Alan Steely* is a 70-year-old man who weighs 205 pounds and has a body mass index of 31. Mr. Steely, who has a history of smoking cigarettes and obstructive sleep apnea , has returned to the medical/surgical unit for postoperative care after a colon resection for colon cancer. In addition to assessing his surgical wound, managing his pain, and monitoring his nasogastric drainage output, youre especially concerned about his respiratory status because of his BMI, smoking, and OSA history. His care plan calls for managing his postoperative care in accordance with enhanced recovery after surgery and I COUGH protocols, which your institution recently implemented.
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What Causes Pneumonia
Germs called bacteria or viruses usually cause pneumonia.
Pneumonia usually starts when you breathe the germs into your lungs. You may be more likely to get the disease after having a cold or influenza . These illnesses make it harder for your lungs to fight infection, so it is easier to get pneumonia. Having a long-term, or chronic, disease like asthma, heart disease, cancer, or diabetes also makes you more likely to get pneumonia.
What To Think About
In most cases pneumonia is a short-term, treatable illness. But frequent bouts of pneumonia can be a serious complication of a long-term illness, such as chronic obstructive pulmonary disease . If you have a severe long-term illness, it may be hard to treat your pneumonia, or you may choose not to treat it. You and your doctor should discuss this. This discussion may include information about how to create an advance care plan.
For more information, see:
There are a number of steps you can take to help prevent getting pneumonia.
- Stop smoking. You’re more likely to get pneumonia if you smoke.
- Avoid people who have infections that sometimes lead to pneumonia.
- Stay away from people who have colds, the flu, or other respiratory tract infections.
- If you haven’t had measles or chickenpox or if you didn’t get vaccines against these diseases, avoid people who have them.
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