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Atelectasis

Last reviewed by Dr. Raj MD on January 12th, 2022.

What is Atelectasis?

This is a medical condition that is characterized by the full or partial collapse of your lung. When this happens a person will have impairment of the ability to breathe deeply. Many times this medical condition will occur in people who do not have enough pulmonary surfactant. This is the material that reduces the surface tension of their alveoli so that they do not collapse when you breathe out. Many physicians do not feel this is a disease but is better classified as a secondary lung condition which in turn can cause other serious lung diseases and problems.

Atelectasis Symptoms

If just a small number of your alveoli are affected there may not be any detectable symptoms. If it starts to grow quickly you may start to notice a serious shortness of breath.

Other symptoms can include:

  • Oxygen saturation becomes less
  • Cannot take deep breaths
  • An increase in your heart rate if you cannot breathe deeply.
  • Cough
  • Pleural effusion
  • Fever

If a person is suffering from an acute condition of atelectasis they may notice that their skin has a bluish color but this is a rare symptom. You may also develop a lung infection if it is not treated for a long period of time.

Atelectasis Causes

Although there are many different reasons for this happening basically atelectasis affects the tiny air sacs that line the lung which are called alveoli. These little sacs are extremely flexible. This allows them to inflate to take in oxygen and then deflate as the oxygen is pushed through the blood rich tissues of your lungs so it can be carried to other parts of your body. If your alveoli cannot inflate there is a chance that your lung will start to collapse which in turn will prevent your lung from inflating with air. This is restricting the supply of oxygen that is available to you.

Some of the causes can include:

  • Surgery – this is one of the most common causes which is why after surgery your airway is carefully monitored. If you are a smoker and going to have surgery it is advisable to stop smoking six to eight weeks before you have your surgery because if you do not it puts you at a greater risk for getting atelectasis.
  • Trauma to your lungs
  • Buildup of mucus
  • Obstruction such as a tumor or foreign object.
  • Congenital – this happens when a baby is born and does not have the ability to inflate one or both of their lungs. This is normally seen in babies that are born premature because their bodies are not completely developed. This is also referred to as infant respiratory distress syndrome. It can also happen in babies with a genetic condition that causes them to have surfactant production reduced.
  • Swollen lymph nodes
  • Compressed airways – this can happen because of having a small chest wall, a neuromuscular disease, chest deformities, neurological disorders, or severe asthma attacks.
  • Smoking
  • Lung problems such as emphysema or COPD

Diagnosis

In order to treat atelectasis correctly it is important to know what the cause is. In order to find out the cause the physician will normally order chest x-rays to be taken. In order to confirm the cause the physician may also have a bronchoscopy done after the chest x-ray is taken.

Treatment

As there are many different causes for atelectasis the treatment that is done will depend on what the cause is. The main focus of any treatment is to make sure that you have enough oxygen, which is a vital requirement for your body, before the physician can find the exact cause. This medical condition does need to be treated because if it is not it can be fatal but in adults it is usually not life-threatening because only a small part of your lung is normally affected. In children younger than ten years of age it is a different story. Because their bronchial tubes are very narrow atelectasis can be critical for them. If a large part of your lung is affected you could have lung damage even after it has been treated.

Some of the different treatments that can be used include:

  • Congenital atelectasis – the treatment involves giving medication to help their lungs build up surfactant while a ventilator helps to inflate their lungs, helping the baby to breathe easier.
  • Entire lung collapsed – ventilators may be used to breathe for you.
  • Blockages of foreign objects – using suction to clear the blockages so you can breathe easier and allowing the alveoli to inflate by themselves.
  • Trauma or tumor – surgery may need to be done to correct the problem. If it is a tumor they may also need to use chemotherapy or radiation to get rid of it completely.
  • Mucus blocking the air passages – many time the physician will give you a medication to thin out the mucus so they can get rid of it. One of the medications that are often used is acetylcysteine. You may also need to use percussion on your chest to loose the mucus. The physician may also suggest that when you lay down your head is lower than your chest to get it to drain out. This procedure is called postural drainage. The physician may also choose to suck the mucus out and/or have you cough to loosen the mucus.
  • Buildup of fluid – sometimes you can get fluid buildup between your lungs and your ribcage or around your lungs. When this happens the fluid will be drained out.
  • Compressed airways – this can happen when you have a severe asthma attack or even when you have anesthesia. There are many different ways this cause can be treated. To help open up your bronchial tubes you may be given medication called bronchodilators to inhale. You may also be instructed to do incentive spirometry, which is deep breathing exercises.
  • Partial lung collapse – the physician could have you lay on the side of the lung that is not damaged so the other lung that has collapsed has less pressure on it, making it easier to expand.
  • Infection of your windpipe – you will most likely need to have an artificial windpipe replace your infected one and have it regulated by a mechanical ventilator.

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