Atelectasis

Answer 1

Definition

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

See also: Pneumothorax

Alternative Names

Partial lung collapse

Causes, incidence, and risk factors

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

Signs 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 tumoror 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.

Expectations (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.

Complications

Pneumonia may develop rapidly after atelectasis.

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

Calling your health care provider

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.

Answer 2

Definition

Atelectasis is the collapse of part or (much less commonly) all of a lung.

See also: Pneumothorax

Alternative Names

Partial lung collapse

Causes, incidence, and risk factors

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

It is common after surgery, or in patients who were in the hospital.

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 a buildup of fluid between the ribs and the lungs (called a pleural effusion)
• Prolonged bed rest with few changes in position
• Shallow breathing (may be caused by painful breathing)
• Tumors that block an airway

Symptoms

• Breathing difficulty
• Chest pain
• Cough

Signs and tests

• Bronchoscopy
• Chest CT scan
• Chest x-ray

Treatment

The goal of treatment is to re-expand the collapsed lung tissue. If fluid is putting pressure on 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 plugs in the airway
• Perform deep breathing exercises (with the help of incentive spirometry devices)
• Remove or relieve any blockage by bronchoscopy or another procedure.
• Tilt the person so the head is lower than the chest (called postural drainage). This allows mucus to drain more easily.
• Treat a tumoror other condition, if there is one
• Turn the person to lie on the healthy side, allowing the collapsed area of lung to re-expand
• Use aerosolized respiratory treatments (inhaled medications) to open the airway
• Use other devices that help increase positive pressure in the airways and clear fluids (positive and expiratory pressure [PEP] devices)

Expectations (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 areas of 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 slowly if the blockage of the airway has been removed. However, some scarring or damage may remain.

Complications

Pneumonia may develop quickly after atelectasis in the affected part of the lung.

Calling your health care provider

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

Barker AF. Bronchiectasis, atelactasis, cysts, and localized lung disorders. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 90.

Reviewed By

Review Date: 09/15/2010

David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Denis Hadjiliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.