Atelectasis

What is it?

It is the collapse of part or the whole lung. That is, the blockage caused in part or entire lung  in the bronchial air passage of greater or lesser gauge (bronchus or bronchiole, respectively). The bronchi are tubes that give passage to the air, spreading it throughout the lungs which plays a vital role in Respiration process.

atelectasis

Causes of Atelectasis

Atelectasis may occur by different mechanisms.

The accumulation of bronchial secretions can block the passage of air, leading to partial or total collapse of the affected lung.
When some object inadvertently enters the air and reaches the bronchus, atelectasis may occur. This tends to happen more with the children, when they swallow a toy or other small object.
Lung tumors can grow within a bronchus or press it outwardly, causing, in some cases the total or partial atelectasis of the lungs.
Patients who undergo general anesthesia, which has some chronic lung disease or who are bedridden long time may eventually get affected by atelectasis.

In an adult, atelectasis is generally not a life-threatening situation, since parts of the lung that are not affected can compensate for loss of function of the affected area. Moreover, the same situation a baby or a small child can pose a threat to life.

Symptoms of Atelectasis

The symptoms associated with this condition may or may not be present . Depending mainly on the size of the affected area of the lungs and the presence or absence of concurrent diseases. Pulmonary atelectasis may be accompanied by chest pain, cough or difficulty in breathing.

Diagnosis of Atelectasis?

Through imaging tests such as X-ray or CT scan of the chest, the doctor can make the diagnosis. Atelectasis, physical examination of the patient, may be required in a minority of cases. This is because there must be a collapsed lung from a large area of the lung that result in changes in physical examination.

Bronchoscopy – examination observing the inside of the lungs through a device provided with flexible fiber optics and lenses – are able to detect the blockage of the air passage (bronchi) and its cause.

Treatment of Atelectasis

Treatment should be chosen according to the cause of atelectasis, aiming to expand again (“inflate”) lung.

In cases of accumulation of secretions, pulmonary physiotherapy to mobilize secretions and bronchoscopy for aspiration of these will be the most appropriate treatment.

Physical therapy may be used breathing exercises, tapping (small blows with fists in the lungs), postural drainage (placing the individual in a position that favors the removal of secretions), exercise and vibrators.

When there is any bacterial infection (by bacteria) associated with excess secretions, antibiotics should be given. Besides these, mucolytics (medications that facilitate the expectoration of the secretions) could be used in respiratory infections, either viral or bacterial.

In cases of foreign body in the airway (objects), bronchoscopy should be performed to do the removal. If not successful, surgery should be performed.

When the cause of atelectasis is a tumor, it’s treatment should cure it

How can it be Prevented?

Keep small objects away from children is a way of preventing atelectasis caused by foreign body. Likewise, parents should be cautious in choosing toys that should be appropriate to the child’s age.

Avoid long hours staying  in bed is also important for prevention of atelectasis, especially after surgery. In the same sense, physical therapy may also be needed. It can be used for the prevention of atelectasis.

Complications

Pneumonia is a complication that can develop within days of the onset of an atelectasis. Therefore, it is important to cure it before it become fata.

 

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