Can Hospital Acquired Pneumonia be Prevented in Patients Who Gurgle?

Hospital inpatients who have gurgling sounds heard during speech or breathing have been
observed to have a higher risk of hospital acquired pneumonia. Patients who gurgle and who
consent to participation will be randomized to receive routine clinical management or
management to include measures employed to reduce risks of aspiration, namely, 1. head of
bed up (30 degrees or higher), 2. swallowing evaluation by speech therapist (and feeding
predicated on formal evaluation), 3. prompting managing physicians to reduce sedating
medications to minimal effective dose.