Management of Aspiration and Pneumonia Following Stroke

Abstract

Aspiration has been associated with pneumonia following stroke and its detection and prevention are considered important in the management of stroke patients. Initially, a bedside assessment is conducted, especially in high-risk patients. However, clinical assessment may miss a substantial number of “silent” aspirators and therefore the videofluoroscopic modified barium swallow (VMBS) study is considered the “gold standard” for confirming the presence and extent of aspiration. Clinical indications for use of VMBS studies remain empirical and have never been scientifically validated. Treatment of known aspiration involves specialized diets and in more severe cases, nonoral feedings. Only a little quality scientific research demonstrates whether such treatments are effective or ineffective in preventing aspiration. An obvious need exists for further research into this area.