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A.D.A.M. Medical Encyclopedia. Atlanta (GA): A.D.A.M.; 2011.

A.D.A.M. Medical Encyclopedia.

Atelectasis

Partial lung collapse

Last reviewed: September 15, 2010.

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

See also: Pneumothorax

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

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 tumor or 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

  1. 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.

Review Date: 9/15/2010.

Reviewed by: 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.

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What works?

  • Applying positive pressure at the end of each breath during anaesthesia for the prevention of mortality and postoperative pulmonary complications Applying positive pressure at the end of each breath during anaesthesia for the prevention of mortality and postoperative pulmonary complications
    Positive end‐expiratory pressure (PEEP) is a mechanical technique that is often used when ventilating an unconscious patient. The technique involves adding a quantity of pressure into the lungs at the end of each breath. The process of ventilating a patient causes a degree of deflation in the lungs; between breaths the lungs contain less air than usual. By adding positive pressure at that time, we aim to re‐inflate the airways. We know that PEEP can improve respiratory function during a general anaesthetic. We do not know whether patients who receive PEEP have a lower risk of postoperative mortality or respiratory complications, such as pneumonia. In this review, we aimed to assess the postoperative benefits and harms of using PEEP during general anaesthesia. After a search of the literature, we found eight randomized clinical trials (RCTs) involving 330 patients. Four trials reported mortality as an outcome. We pooled these data and found no difference between the group of patients who received PEEP and those who did not, but because of the small number of patients, and the fact that this outcome may be rare, these results did not allow us to make a conclusion about the effect of PEEP on mortality. There were two findings that suggested some benefit of PEEP. First, oxygenation was better on the day after surgery in the PEEP group. Second, radiological imaging showed less atelectasis (areas of collapsed lung) after surgery in the PEEP group. We did calculations to predict how many more patients would be needed in order to be able to make reliable conclusions about the application of PEEP on mortality. This number was 21,200. From the studies that we found, there was no suggestion that intraoperative PEEP causes harm. This finding is reassuring but, due to the small numbers, it is inconclusive. There is currently insufficient evidence to make conclusions about how intraoperative PEEP affects postoperative mortality and respiratory complications.
See all (8)...

Figures

  • Bronchoscopy.
    Lungs.
    Respiratory system.

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