Thoracentesis

Thoracentesis or pleural fluid aspiration is a procedure that involves removal of fluid from the space between the lining of the pleura and the chest wall. Fluid is withdrawn with the aid of a needle passed through the skin of the chest wall into the pleural space. An analysis of the pleural effusion can indicate pulmonary embolism, hemothorax, pancreatitis, pneumonia, heart failure or thyroid disease. Thoracentesis can aid in relieving pressure caused by accumulation of excess pleural fluid. A chest x-ray is taken before and after the thoracentesis process. Do not move or cough while the diagnostic test is being conducted. Patients who have had lung surgery or lung disease such as emphysema may have difficulty with thoracentesis. Pneumothorax, pulmonary edema or respiratory distress are rare complications associated with thoracentesis. It is essential to keep the doctor posted of any medications such as blood thinners or known allergies.

Aspiration Pneumonia

Aspiration pneumonia occurs when gastric contents, vomit or food distillate into the lungs and cause inflammation of the lungs and bronchial tubes. The aspirated material is responsible for introducing bacteria that is not normally found in the lungs. Pus forms as a result of this infection. The infection can then spread to the blood and other areas of the body. It can bring on shock and acute respiratory distress syndrome. Sometimes it can cause pus to collect in the lungs. The severity of aspiration pneumonia depends on the volume and acidity of the aspirated contents. The effects of aspiration pneumonia can range from mechanical obstruction of airways to acute respiratory distress. Older persons or persons with altered mental status are more likely to face this emergency situation. Aspiration pneumonia is also a coincident risk of head trauma, acute stroke or metabolic derangement. Elderly hospitalized patients and those suffering from neurological diseases or gastroesophageal reflux are at increased risk of aspiration pneumonia.

Symptoms of aspiration pneumonia are fever and cough with foul-smelling or blood-stained mucus. Patients experience shortness of breath and chest pain. Increased heart rate and wheezing is also noticed. Aspiration pneumonia can be fatal if not attended to in time. Hospitalization may be required for management of the illness. Treatment measures vary depending on the severity of the pneumonia. Chest x-rays, blood culture and sputum culture can aid diagnosis and treatment. Swallowing studies are conducted on the patient to assess the swallowing function. Intravenous antibiotic medications are used to treat aspiration pneumonia. Articial breathing apparatus is used to aid the patient and keep the airways open. Oxygen therapy is also resorted to.

Epiglottitis

Epiglottitis is a serious condition that can affect children and adults. In children, epiglottitis can be life-threatening and usually manifests between 2 and 6 years. In adults, it is more likely to affect men than women. Earlier there were more number of pediatric epiglottitis cases. But with the introduction of the HIB vaccine, cases of children being affected by this condition has reduced. This condition occurs when the flap of cartillage found at the back of the tongue (epiglottis) swells can causes respiratory distress. The epiglottis serves to keep food from going into the trachea while swallowing. An inflamed epiglottis can result in swallowing problems and difficulty in breathing. The patient suffers fever and chills and may develop a bluish skin coloring (cyanosis). If the airways become totally obstructed, it can be fatal. Sore throat, difficulty in speaking and difficulty in swallowing and breathing are typical symptoms of epiglottitis that occur within a few hours. Persons affected by this condition tend to lean forward to breathe and appear restless.

Epiglottitis is believed to be caused by vrirus such as Streptococcus pneumoniae, Haemophilus parainfluenzae, varicella-zoster, herpes simplex virus type 1 and Staphylococcus aureus. Any damage to the epiglottis can also cause this condition. While mild cases of epiglottitis manifest as sore throat and pain while swallowing, acute cases can suffer severe respiratory distress or even a respiratory arrest. Physical examination and study of medical history is the first step towards diagnosing epiglottitis. X-ray of the neck and blood tests are also conducted. If there is severe discomfort and labored breathing, hospitalization may be necessary. Humified oxygen helps alleviate some of the distress while intravenous fluids keep the patient well hydrated. Antibiotics and corticosteroids are used to treat the condition. Intravenous (IV) antibiotics are adminstered to treat the infection.