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Atelectasis

Definition

Atelectasis is the collapse of part or all of a lung.

See also: Pneumothorax

Alternative Names

Partial lung collapse

Causes

Atelectasis is caused by a blockage of the air passages (bronchus or bronchioles) or by pressure on the outside of the lung.

Risk factors for developing atelectasis include:

• Anesthesia
• Foreign object in the airway (most common in children)
• Lung diseases
• Mucus that plugs the airway
• Pressure on the lung caused by buildup of fluid between the ribs and the lungs
• Prolonged bed rest with few changes in position
• Shallow breathing
• Tumors that obstruct the airway may lead to atelectasis

Symptoms

• Breathing difficulty
• Chest pain
• Cough

Exams and Tests

• Bronchoscopy
• Chest x-ray

Treatment

The goal of treatment is to re-expand the collapsed lung tissue. If fluid is compressing the lung, removing the fluid may allow the lung to expand.

The following are treatments for atelectasis:

• Clap (percussion) on the chest to loosen mucus.
• Perform deep breathing exercises (incentive spirometry).
• Remove any obstruction by bronchoscopy or another procedure.
• Tilt the person so their head is lower than their chest (called postural drainage). This allows mucus to drain more easily.
• Treat a tumor or underlying condition, if there is one.
• Turn the person so they are lying on their healthy side, allowing the collapsed area of lung to re-expand.
• Use aerosolized respiratory treatments (inhaled medications) to open the airway.

Outlook (Prognosis)

In an adult, atelectasis in a small area of the lung is usually not life threatening. The rest of the lung can make up for the collapsed area, bringing in enough oxygen for the body to function.

Large atelectases may be life threatening, especially in a baby or small child, or someone who has another lung disease or illness.

The collapsed lung usually reinflates gradually once the obstruction has been removed. However, some scarring or damage may remain.

Possible Complications

Pneumonia may develop rapidly after atelectasis.

Massive atelectasis may result in the complete collapse of a lung.

When to Contact a Medical Professional

Call your health care provider if you develop symptoms of atelectasis.

Prevention

• Encourage movement and deep breathing in anyone who is bedridden for long periods.
• Keep small objects out of the reach of young children.
• Maintain deep breathing after anesthesia.

References

Mason RJ, Broaddus VC, Murray JF, Nadel JA. Mason, Murray & Nadel's Textbook of Respiratory Medicine. 4th ed. Philadelphia, Pa:Saunders; 2005.

Westerdahl E, Lindmark B, Eriksson T, Friberg O, Hedenstierna G, Tenling A. Deep-breathing exercises reduce atelectasis and improve pulmonary function after coronary artery bypass surgery. Chest. November 2005;128:3482-3488.

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