ATELECTASIS

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ATELECTASIS

1. Definition:

Atelectasis (at-uh-LEK-tuh-sis) is a complete or partial collapse of the entire lung or area (lobe)
of the lung. It occurs when the tiny air sacs (alveoli) within the lung become deflated or possibly
filled with alveolar fluid.

Atelectasis is one of the most common breathing (respiratory) complications after surgery. It's
also a possible complication of other respiratory problems, including cystic fibrosis, lung
tumors, chest injuries, fluid in the lung and respiratory weakness. You may develop atelectasis if
you breathe in a foreign object.

Atelectasis can make breathing difficult, particularly if you already have lung disease. Treatment
depends on the cause and severity of the collapse.

2. Identify the causative agent

Atelectasis occurs from a blocked airway (obstructive) or pressure from outside the lung
(nonobstructive).

General anesthesia is a common cause of atelectasis. It changes your regular pattern of


breathing and affects the exchange of lung gases, which can cause the air sacs (alveoli) to
deflate. Nearly everyone who has major surgery develops some amount of atelectasis. It often
occurs after heart bypass surgery.

Obstructive atelectasis may be caused by many things, including:

 Mucus plug. A mucus plug is a buildup of mucus in your airways. It commonly occurs
during and after surgery because you can't cough. Drugs given during surgery make you
breathe less deeply, so normal secretions collect in the airways. Suctioning the lungs
during surgery helps clear them, but sometimes they still build up. Mucus plugs are also
common in children, people with cystic fibrosis and during severe asthma attacks.

 Foreign body. Atelectasis is common in children who have inhaled an object, such as a


peanut or small toy part, into their lungs.

 Tumor inside the airway. An abnormal growth can narrow the airway.

Possible causes of nonobstructive atelectasis include:


 Injury. Chest trauma — from a fall or car accident, for example — can cause you to
avoid taking deep breaths (due to the pain), which can result in compression of your
lungs.

 Pleural effusion. This condition involves the buildup of fluid between the tissues
(pleura) that line the lungs and the inside of the chest wall.

 Pneumonia. Various types of pneumonia, a lung infection, can cause atelectasis.

 Pneumothorax. Air leaks into the space between your lungs and chest wall, indirectly
causing some or all of a lung to collapse.

 Scarring of lung tissue. Scarring could be caused by injury, lung disease or surgery.

 Tumor. A large tumor can press against and deflate the lung, as opposed to blocking the
air passages.

3. Signs and Symptoms

There may be no obvious signs or symptoms of atelectasis. If you do have signs and symptoms,
they may include:

 Difficulty breathing

 Rapid, shallow breathing

 Wheezing

 Cough

4. Med and Nsg Management

Treating atelectasis depends on the underlying cause and how severe your symptoms
are.

If you’re having trouble breathing or feel like you’re not getting enough air, seek
immediate medical treatment.
You may need the assistance of a breathing machine until your lungs can recover and
the cause is treated. 

Nonsurgical treatment

Most cases of atelectasis don’t require surgery. Depending on the underlying cause,
your doctor might suggest one or a combination of these treatments:

 Chest physiotherapy. This involves moving your body into different positions and


using tapping motions, vibrations, or wearing a vibrating vest to help loosen and
drain mucus. It’s generally used for obstructive or postsurgical atelectasis. This
treatment is commonly used in people with cystic fibrosis as well. 
 Bronchoscopy. Your doctor can insert a small tube through your nose or mouth
into your lungs to remove a foreign object or clear a mucus plug. This can also be
used to remove a tissue sample from a mass so that your doctor can figure out
what is causing the problem.
 Breathing exercises. Exercises or devices, such as an incentive spirometer, that
force you to breathe in deeply and help to open up your alveoli. This is especially
useful for postsurgical atelectasis.
 Drainage. If your atelectasis is due to pneumothorax or pleural effusion, your
doctor may need to drain air or fluid from your chest. To remove fluid, they’ll
likely insert a needle through your back, between your ribs, and into the pocket
of fluid. To remove air, they may need to insert a plastic tube, called a chest tube,
to remove extra air or fluid. The chest tube may need to be left in for several days
in more severe cases.

Surgical treatment

In very rare cases, you may need to have a small area or lobe of your lung removed. This
is usually only done after trying all other options or in cases involving permanently
scarred lungs.
Reference:

https://www.mayoclinic.org/diseases-conditions/atelectasis/symptoms-causes/syc-20369684

https://www.healthline.com/health/atelectasis

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