Congestive pneumonia in stroke patients. Pneumonia during and after stroke: causes, consequences, prevention

Pneumonia after a stroke develops in 34-50% of all patients with brain damage. Most often, pneumonia during a stroke is a complication or concomitant disease. This condition dramatically worsens the patient’s condition and threatens his life. In 15% of cases of stroke followed by pneumonia, the death of patients was recorded, despite the treatment measures taken.

The occurrence of damage to the respiratory system

Stroke and pneumonia develop in a patient almost simultaneously.

Apoplexy along with pneumonia manifests itself in people in the presence of the following factors:

1. The patient is over 40 years old.
2. The person is overweight.
3. The patient had previously suffered from pneumonia and was diagnosed with cardiovascular diseases.
4. The patient is in a comatose state.
5. When being treated for a disease, a person was connected to a mechanical ventilation system for a long period.
6. In bedridden patients after a stroke during long-term hospitalization with adynamia, dangerous lesions of the respiratory system develop.
7. Some medications taken by stroke patients, such as H2 blockers, may cause symptoms of pneumonia.

After a stroke, inflammation in the respiratory system is most often recorded in bedridden patients. This occurs due to a sharp decrease in immunity.

The prognosis of the consequences of the development of pneumonia against the background of a stroke depends on the factors that caused the development of brain damage. Doctors distinguish 2 types of apoplexy of this kind.

The first type of disease is aspiration pneumonia. It develops due to various pieces of food entering the patient’s respiratory canals. In this case, the segment of the lung where these food fragments enter ceases to function normally, and bacteria that have penetrated this area provoke an inflammatory process.

Symptoms of aspiration pneumonia are similar to signs of poisoning or intoxication. First, a painful cough develops, and then the body temperature rises to 37-39°C

The danger increases if pieces of food enter the respiratory canals and block large bronchi. Then the person finds it difficult to cough due to severe pain.

The second type of damage to the respiratory system after a stroke is congestive (hypostatic) pneumonia. Most often, this type of lesion develops in bedridden patients. A long period of the body being in a horizontal position causes disruption of blood flow in the pulmonary circulation. Viscous fluid begins to accumulate in the organ, as ventilation deteriorates and the drainage system does not work well. Due to the accumulation of sputum, microbes spread, which provoke the development of purulent inflammation of the lung.

What can pneumonia lead to with brain damage?

It is necessary to treat damage to the respiratory system in a patient who is bedridden due to a stroke immediately after diagnosis. With timely early diagnosis of the disease, the patient's survival prognosis increases dramatically. The difficulty of making a correct diagnosis lies in the fact that the first pathological changes in the respiratory organs are often attributed to the consequences of brain damage.

A patient can easily become infected with pneumonia even in a hospital setting. For this, only pathogens (staphylococcus) and insufficient blood supply to the brain and respiratory organs are needed.

If signs of incipient pneumonia are detected in time, the patient is connected to a ventilator. He will remain in this state throughout the entire course of drug therapy. To determine the causes that led to damage to the respiratory system, doctors carry out differential diagnosis. The type of apoplexy and the type of causative agent of the inflammatory process in the lung are determined. This is necessary to select optimal therapy.

If adequate measures are not taken, the following complications will arise:

1. The patient experiences loss of respiratory function. It can be partial or complete. Therefore, the person is connected to a ventilator. It is necessary to supply the patient’s body with oxygen until complete recovery.
2. If pneumonia is not completely cured, then intoxication of the human body may develop. Such poisoning greatly affects the functioning of the cardiovascular system. Congestive pneumonia has no obvious symptoms and is difficult to diagnose using blood tests.
3. If a person develops undiagnosed congestive pneumonia as a result of a stroke, most often the patient dies. Half of people with stroke survive aspiration pneumonia.

It is recommended to take preventive measures to prevent subsequent complications. It should be taken into account that it is possible for stroke patients to develop bilateral pneumonia in the lungs while they are in hospital. This is the most dangerous complication, because the person loses consciousness and then develops a coma. Therefore, doctors must strictly monitor the condition of the patient’s respiratory system to take timely measures.

Prevention and treatment of pneumonia after stroke

Preventive measures to combat congestive pneumonia are designed to prevent the development of inflammatory processes in the patient’s respiratory system. To do this, doctors and orderlies carry out daily sanitation of the person and take him to physical therapy procedures. This reduces the pathogenic factor and leads to a sharp decrease in pathogenic flora in the patient’s upper respiratory canals.

An important component of preventive measures is compliance with all hygiene rules, since in most cases the appearance of symptoms of pneumonia in a patient during the treatment of a stroke is a consequence of failure to comply with the rules of asepsis and antisepsis by the hospital workers themselves.

Pneumonia can occur due to the use of connecting the patient to artificial ventilation equipment using old samples of breathing tubes. Therefore, it is recommended to use modern types of tracheotomy tubes, which do not allow the development of an inflammatory process.

If a respiratory tract disease develops after a stroke in an elderly person, then it is very difficult to cure the lesion, since the body of such a patient has practically no reserves. For such people, it is necessary to constantly adjust the course of therapy, because even if the doctor correctly carried out all the treatment measures, there is no guarantee that pneumonia will not appear again.

Treatment of people with the described complications comes down to combating various congestion in the respiratory system. At the same time, doctors relieve swelling of the patient’s brain structures.

For treatment, drugs from the diuretic group, mucolytic medications, and cardiotonics are used. The patient undergoes physiotherapy sessions and is prescribed breathing exercises. Treatment is carried out using antibacterial agents, and to achieve results, doctors adjust their use every 3 days.

Prognosis for successful elimination of pneumonia depends on the general condition of the person and the timely detection of damage to his respiratory system.

In contact with

One of the most dangerous complications in patients after acute cerebrovascular accident is pneumonia. According to statistics, in 50% of cases it occurs as a complication of ischemic stroke, in 35% - hemorrhagic, and in 45% - subarachnoid. In almost 15% of them, pneumonia is fatal.

The high incidence of post-stroke pneumonia is directly related to the fact that in patients severe forms of cerebral circulatory disorders lead to profound depression of consciousness and breathing, swallowing and cough reflexes. The situation is also aggravated by hemodynamic changes in the blood circulation of the lung tissue, weakened immunity, and a malfunction in the bronchial drainage system. All this contributes to an imbalance in the functioning of normal microflora and its displacement by pathogenic ones.

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

Factors that provoke this dangerous complication include:

1. Age 60 years and older.
2. Excess body weight.
3. The patient has been on mechanical ventilation for more than a week.
4. Prolonged static position, adynamia.
5. 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.

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. Impaired swallowing and the absence of a cough reflex give rise to the development of aspiration pneumonia.

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

At a later stage (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, and sputum does not come out.

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), and the initial condition of the patient. The rate of development of complications is also influenced by the location of the lesion in the brain.

Clinical manifestations

Diagnosing early pneumonia after a stroke is quite difficult.

Its symptoms are nonspecific, with signs similar to the primary pathology:

• Moderate fever.
• Respiratory rhythm disturbance.
• Lack of cough reflex.

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

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

Late pneumonia during stroke occurs with more severe symptoms:

• Fever up to 39–40 °C.
• Frequent attacks of chills.
• Discharge of purulent sputum.
• Wet wheezing.

The radiograph shows reduced transparency of the pulmonary field with delicate cloud-like infiltrates of small diameter (up to 3 cm).

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

If a complication is suspected, tomography and plain radiography of the chest organs are prescribed. To identify pathogenic microflora, sputum is collected from the patient.

Treatment program

Drug therapy must solve several important problems:

• Stop hypoxia as soon as possible.
• Prevent the development of pulmonary edema during stroke.
• Suppress and neutralize the infectious agent.
• Restore the drainage ability of the bronchi.
• Resume normal lung function.
• Increase immune defense.

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 cephalosporin group of I–III generations, which are combined with aminoglycosides and fluoroquinolones in the following combinations:

• Ceftazidime and respiratory fluoroquinolone.
• Amikacin and one of the antipseudomonas penicillins.
• Monotherapy with a fourth generation cephalosporin (Cefepime).
• Ceftazidime and Cefipime, Imopenem and fluoroquinolone of the second generation.

Treatment includes:

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

The following are prescribed as auxiliary procedures to improve expectoration:

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

The effectiveness of the treatment is checked 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 produced.
• Reduced leukocytosis in the blood.

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

Prevention

Pneumonia can be avoided if the patient is provided with proper care and a number of important procedures are performed.

To operate the diaphragm and eliminate stagnation, you need:

1. Regularly turn the patient over from the right side to the left 6-8 times a day, sit on the bed, and lie on his stomach.
2. Thorough cleansing of the oral cavity: teeth, tongue, gums from food debris.
3. Daily massage (3 to 5 times) of the upper third of the chest
4. Physiotherapy.
5. Inflating balloons, plastic bags, blowing air through a tube inserted into a container of water.
6. At home, alternating jars and mustard plasters is recommended.

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

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

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

Untreated pneumonia after a stroke is always fatal. If not treated in a timely manner, the disease can be complicated by an abscess, gangrene, exudative pleurisy or empyema.

When a person is seriously ill, he is constantly in bed. Regardless of age, he requires constant care. If you do not care for it correctly, complications may arise in parallel with the underlying disease. Congestive pneumonia in bedridden patients is a disease that occurs as a result of congestion in the body during prolonged bed rest.

What you need to know about pneumonia in bedridden patients

When a bedridden patient appears in a family, the life of this family changes. Often patients live out their last days in this situation. At this time, a person’s life depends on the care and attentiveness of a nurse. Good care in some cases can get the patient back on his feet, but bad care can shorten his life.

Typically, a bedridden patient is not able to roll over on his own. And if he is not helped with this, over time the body stagnates, problems with the heart, gastrointestinal tract, and lungs begin.

Pneumonia in bedridden patients occurs quite often and in most cases ends in death. This happens because the disease often occurs in a latent form, its symptoms are blurred, and the diagnosis may be made late.

A person who cares for a patient must be very attentive to his patient. Constantly monitor his general condition, mood and physical activity. Any changes must be recorded and reported to the doctor.

If the diagnosis is made early in the disease, the patient will have a chance of recovery. When the process is started, he has no chance not only to recover, but also to continue to live. This is especially dangerous in old age, when the body is worn out and no longer fights diseases. In this case, the prognosis is extremely unfavorable.

The mechanism of breathing and the causes of congestion

Prolonged immobilization of a sick person leads to stagnation of the blood of the small circulation passing through the lungs. During the breathing process, it is very important that the movements of the chest during inhalation and exhalation are harmonious. If the patient is constantly in a lying position, the amplitude of the chest is limited. The worse the patient's condition, the harder it is for him to breathe.

The act of breathing is a reflex regulated from the respiratory center, which is located in the brain:

• During inhalation, the chest should expand due to the movement of the diaphragm and external muscle contractions. This creates negative pressure in the chest, which leads to the filling of the alveoli with air entering the respiratory tract from the environment.
• At the same time, blood flow occurs in the pulmonary artery.
• Meeting in the alveoli, the air saturates the blood with oxygen, taking carbon dioxide from it. This is how gas exchange occurs, and after it exhalation should occur. It is possible due to internal muscle contractions and relaxation of the diaphragm.
• Pressure increases in the chest cavity, pushing air and blood out of the lungs. Foreign impurities in the form of dust, mucus and various microorganisms are removed from the lungs with air.

This is the breathing mechanism of a healthy person. In bedridden patients, the range of motion of the chest is limited, and respiratory movements do not occur fully. As a result, air and blood are not completely pushed out of the lungs, blood stagnates in the vessels, and mucus is retained in the lungs.

In most cases, this phenomenon develops in the body of an elderly person. This is due to the fact that old people already suffer from cardiovascular and pulmonary diseases. Being without active movement for a long time, an already worn-out body is most susceptible to stagnation.

Young people with weak cardiovascular systems and weakened immune systems are no less at risk.

People who have had surgery are also prone to developing pneumonia. Pain in the wound after surgery is the reason that the patient begins to breathe carefully, superficially. This causes stagnation. It is enough for an infection to appear, and problems begin in the lungs.

What is the danger of this pathology?

The disease is very dangerous. During it the following happens:

• Parts of the lungs in which fluid has sweated into the alveoli and lung tissue stop working during breathing. This is the danger of hypostatic pneumonia; a person begins to lack air.
• In addition, bedridden patients are not able to fully cough up sputum. As it accumulates, it clogs the bronchi, causing an even larger area of ​​the lungs to stop working.
• Then complications occur that affect the entire body. An inflammatory process begins in the lungs. It is caused by an infection that easily attaches to a weakened body.
• The waste products of bacteria begin to poison the patient’s body, affecting the heart and gastrointestinal tract. The patient's appetite decreases and he stops eating. Because of this, he does not receive the required amount of vitamins and proteins that he needs so much at this time.

In severe cases, exudative pleurisy and pericarditis develop. This is an effusion of inflammatory fluid into the pleural cavity and into the cardiac sac. This condition is very dangerous. Respiratory failure worsens further, and the heart, compressed by fluid, is unable to function properly.

Symptoms of pneumonia in bedridden patients

In immobilized patients, the symptoms of pneumonia differ from usual. High temperature rarely appears; more often it remains normal or low-grade.

For a bedridden person, congestive pneumonia is very insidious. Often it is disguised as symptoms of the disease due to which the patient is forced to stay in bed. For example, a patient with a stroke becomes a little more inhibited and inadequate than before. Or a patient with a fracture due to osteoporosis begins to complain that he has pain in his chest.

To notice these changes, the relatives of the sick person need to be very attentive. In most cases, neither the patient himself nor those who care for him notice this.

When specific signs indicating the presence of congestive pneumonia appear, it may already be too late to treat. It may appear like this:

• Initially, a dry cough occurs, which intensifies over time, and sputum begins to be discharged. It is mucopurulent, maybe with bloody streaks.
• But if the patient is elderly, he may not have a cough reflex. Then his breathing becomes difficult, heavy, due to the accumulation of phlegm in the lungs.
• Body temperature rises slightly. In bedridden patients, the body stops responding to pyrogenic substances that cause an increase in temperature.
• The patient begins to sweat heavily. If previously he could change his bed every few days, now his linen is damp after every time he sleeps.
• The patient becomes lethargic, apathetic, he loses interest in everything around him.
• He refuses to eat, feels nauseous, and may have vomiting and diarrhea.
• Increased heart rate and pain are observed in the heart and blood vessels.
• At rest, the patient experiences shortness of breath, breathing quickens to 20 per minute, and he lacks air. This indicates that part of the lungs has stopped working.

In severe cases of pneumonia, the patient's consciousness becomes confused. He sleeps a lot and stops waking up, does not answer questions or answers incoherently, his consciousness is depressed. In this case, breathing can be very rare or very frequent. In this condition, it is necessary to call an ambulance and send the person to the hospital. He needs resuscitation measures, otherwise he will not be able to survive this.

Diagnostics

The therapist may notice congestive pneumonia during auscultation. In the lower parts of the lungs, wheezing or pleural crepitus can be heard. The diagnosis is clarified based on the results of radiography. It can be carried out using a stationary X-ray machine, specially adapted for such patients. Some ambulances are equipped with them. But the safest thing to do is to place the patient in a hospital, where he will undergo all the necessary examinations and be provided with optimal care.

When pneumonia is detected, in order for the doctor to prescribe the correct treatment, it is necessary to find out what type of infection caused the disease and what the nature of the inflammation is. Therefore, two sputum tests are taken from the patient. One is sent to the bacteriological laboratory, the second to the clinical laboratory. The patient is also given:

• Ultrasound of the heart;
• electrocardiogram;
• General and biochemical blood test.

Pneumonia can develop rapidly. AND The sooner the diagnosis is made, the greater the chance of recovery. Otherwise, life expectancy with pneumonia in bedridden patients is very short, the count can go on for days.

Treatment

Congestive pneumonia is difficult to treat. The body of a bedridden patient is weakened by the underlying disease and is not able to fight the new disease. Therefore, he requires complex therapy:

• Having identified the causative agent of pneumonia, the doctor prescribes the drug that will act directly on it. For seriously ill patients, it is prescribed intravenously in the first days, then switched to tablets.
• Along with antibiotics, antifungal drugs are also prescribed, because pneumonia can be caused not only by bacteria, but also by fungi in the form of mold.
• In order to relieve the patient of congestion in the lungs and veins, diuretics are prescribed.
• If the patient has a cough reflex and is able to cough up, he is prescribed mucolytic and bronchodilator drugs to remove sputum.
• In the absence of a cough reflex, sputum is pumped out with a special apparatus.
• Patients in serious condition are placed in intensive care and connected to artificial ventilation.
• Attention is paid to the state of the cardiovascular system, and appropriate medications are prescribed.
• Vitamin therapy and immunostimulants are also prescribed.

It is very important to provide the patient with proper care during this period. He is admitted to the hospital, where he is monitored by medical staff. Relatives are allowed to care for seriously ill patients.

The patient must be turned over regularly to avoid new congestion. When the condition improves, it is recommended to carry out breathing exercises.

It is important that the patient eats well during this period. If he can chew food on his own, he is fed food rich in vitamins and proteins. If he is unconscious, food is given through a tube with ground foods. It is recommended to drink vitamin decoctions in large quantities.

Preventive measures

Prevention of pneumonia in bedridden patients involves proper and constant care. His body is fighting the disease and now it is important to prevent stagnation from occurring in it. Prevention includes a set of measures:

• Every two hours the patient is turned over to change his body position. He should be regularly turned on his stomach - this way the lungs are better cleansed.
• When the patient is on his stomach, he needs to wipe his back with camphor alcohol to avoid the development of bedsores and congestion in the lung area.
• At the same time, it is recommended to perform a relaxing massage on the back.
• Every day the patient must perform breathing exercises.
• The room where the sick person is lying must have an optimal air temperature. It must be regularly ventilated and cleaned. In this case, care must be taken to ensure that the patient does not enter the draft area.
• The patient must be dressed and covered in such a way that he is not hot or cold.
• Nutrition should be complete.
• A bedridden patient should be visited regularly by a doctor.

It is necessary to monitor the patient's temperature, blood pressure, respiration and heart rhythms. In case of deviations from the norm, you must inform your doctor.

Congestive pneumonia is a dangerous disease that claims the lives of many patients and ranks fourth in mortality among bedridden patients. But it can be cured if you notice it in time and take the necessary measures.

A stroke in itself is a serious disease that can easily make a person permanently disabled. What can we say when after one “blow” to health comes a second, no less serious one – pneumonia. The most common development is the congestive version of this disease, which is a complication of a previous stroke.

According to statistics, the incidence of pneumonia after a stroke ranges from 35 to 50%. In approximately 15% of complications, pneumonia causes death. It would seem that a person survived after one illness, but could not cope with the second. Any pneumonia during a stroke has its own reasons; it makes sense to understand them in more detail.

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

Elderly and senile people often experience pneumonia after a stroke. Their lung drainage function is normally impaired, and after a stroke there is virtually no sputum production, especially if the disease is severe. The risk of pneumonia increases significantly after a person turns 65 years old.

Excess weight in itself is a predisposing factor to 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 suffered from chronic forms of heart and lung disease before the stroke.

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

Development mechanism

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

• in a depressed consciousness 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 brain tissue damage, as well as the location where the hemorrhage or blockage of the vessel occurred. As a result, the function of draining mucus from the lungs is impaired in some patients. The cough reflex or the urge to cough is reduced or absent; it is this that is protective and promotes the discharge of sputum. Microorganisms are replaced by more aggressive ones that can cause disease. Then it’s just a matter of time and the disease does not keep itself waiting long, the inflammatory process develops rapidly.

Other factors

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

Symptoms of the disease

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

Some symptoms may be noticeable:

• the temperature rises moderately;
• breathing is impaired according to the type of pathological variant of Cheyne-Stokes or Kussmaul;
• as a result of a violation of the cough reflex, there is no sputum production;
• On auscultation, wheezing of various calibers is heard.

Features of aspiration pneumonia

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

With aspiration pneumonia, the manifestations resemble intoxication or poisoning. Initially, a cough is noticed, which is painful in nature. The hilar variant of aspiration pneumonia is difficult to diagnose. A high temperature develops and coughing becomes painful. A dangerous situation becomes when a large bronchial tube is blocked by pieces of food.

Symptoms of late variants

Diagnosis of the late version of the disease is much simpler. To make a correct diagnosis, your doctor will need certain symptoms. Among them it is worth noting:

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

Definitive diagnosis

In addition to symptoms, there are some standards for instrumental diagnosis of the problem. Initially, it is worth listening to the chest using a phonendoscope; if pneumonia is suspected, then an X-ray examination of the lungs is prescribed. In addition to stagnant phenomena, the most intense shading center will be clearly visible in the image.

Sputum or bronchial washings are subject to examination. This analysis will allow us to determine the type of pathogen, after which its individual sensitivity to antibacterial drugs is carried out. This analysis will subsequently allow the doctor to prescribe effective treatment.

Treatment

In case of pneumonia, which could be complicated by a stroke, measures are aimed at eliminating hypoxia as quickly as possible. The tissues must receive more oxygen, this is done through artificial ventilation or the use of oxygen pillows. It is necessary to pay attention that pulmonary edema is often associated, which is why prevention of this condition is carried out.

At the same time, treatment of the underlying disease is carried out, which is prescribed by a neurologist. 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 mandatory; they help reduce swelling and prevent pulmonary edema. Cardiac medications and expectorants are indicated. If there are problems with sputum discharge as a result of its viscosity, the doctor may prescribe medications to thin it.

Additionally

After the person’s condition has been stabilized due to a stroke, physiotherapy is recommended. Electrophoresis with potassium iodide is excellent for removing mucus. Exercise therapy under the guidance of an instructor is also indicated; it is mainly aimed at restoring breathing.

While still in bed, the doctor may recommend breathing exercises to the person. If the patient is able to breathe on his own, then he is recommended to inflate balloons in bed. Special drainage provisions are also used to promote the removal of mucus from the lungs. Massage in the acute period is undesirable, but in a mild form it helps remove mucus and is carried out by a massage therapist.

Prevent pneumonia

When there is an understanding of the mechanism of disease development, the development of the disease can be prevented. 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:

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

Prevention

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

Initially, it is worth ensuring a constant flow 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.

Oral hygiene is mandatory when a person is unable to cope with it himself; those who care for him help him. To prevent stagnation, the position in bed is changed every two hours. If the patient is in a normal condition, he is given a semi-lying position at an angle of 45 degrees.

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

As stroke symptoms regress, the person needs to be activated, first in bed, and then within the ward. This approach will prevent the accumulation of sputum and prevent congestion.