Atelectasis is a total or partial collapse of the lung. It is sometimes referred to as a "collapsed lung," although a collapsed lung can also signify a condition called a pneumothorax . Atelectasis is usually reversible and is not life threatening. However, if left untreated, it can lead to serious complications.
When atelectasis occurs, fresh air cannot reach the alveoli , the tiny balloon-shaped air sacs in the lungs where oxygen and carbon dioxide are exchanged. This leads to hypoxia when the body's organs and tissues do not receive enough oxygen.
Atelectasis can be acute, coming on suddenly in minutes, or chronic, developing over days or weeks. It can be caused by a variety of diseases, from lung damage to lung cancer.
Symptoms of atelectasis
Symptoms of atelectasis vary depending on the amount of lung destroyed and how quickly it develops. Atelectasis can cause minimal symptoms if it develops slowly or if it affects only a small part of the lung. If the condition develops rapidly or affects most of the lungs, it can be life-threatening and symptoms can be severe.
Atelectasis usually affects only one lung. However, it can also be bibasilar, which means that both lungs are affected, usually in the lower parts or lobes of the lungs.
Common symptoms include:
- Difficulty breathing (shortness of breath)
- Rapid, shallow breathing
- Persistent and persistent cough
- Sharp chest pain that worsens with deep breathing, usually on one side of the chest.
When to seek emergency help
Call 911 or seek emergency help if you have shortness of breath, chest pain, heart palpitations, rapid breathing, clammy skin, dizziness, or cyanosis (bluish discoloration of the skin, especially lips, chest, and tongue).
There are four main categories of atelectasis: postoperative, obstructive, non-obstructive, and round. Each of them is associated with certain diseases.
Hypoventilation is one of the most common causes of atelectasis, especially after breast surgery.
Hypoventilation is very slow or shallow breathing. When hypoventilation causes atelectasis, it is primarily due to abnormally low volume breathing (ie, shallow inhalation) rather than abnormally low rate. Just shallow breathing prevents air from entering the air sacs, increasing the likelihood that they will deflate and collapse.
During surgery, general anesthesia and muscle relaxants induce hypoventilation, increasing the risk of atelectasis. Postoperative torso or chest pain can also prevent you from taking deep breaths, which can lead to atelectasis.
Obstructive atelectasis is caused by a blockage in the airways. These blockages generally occur in the main airways: the trachea and bronchi . In obstructive atelectasis, airflow does not partially or completely reach the alveoli.
The most common causes of obstructive atelectasis include:
- Inhaled objects
- Mucous, thick and sticky plugs
- Tumors that cause a partial or complete blockage of the airways.
In non-obstructive atelectasis, pressure or damage to the lungs causes the alveoli to collapse.
The reasons include:
- Constriction : This is often caused by a pleural effusion , which is a collection of fluid in the space around the lungs that can cause the lung to collapse due to pressure. It can also be due to an enlarged heart, aneurysm, tumor, enlarged lymph nodes, or ascites (accumulation of fluid in the abdominal cavity).
- Trauma – A chest injury, such as a car accident, can put pressure on the lungs or cause pneumothorax, causing air to leak out of the lungs, making it difficult to inflate.
- Tumors : Bronchioloalveolar carcinoma is a type of lung cancer (now called a subtype of adenocarcinoma of the lung) that is known to cause tumors in the alveoli.
- Scar tissue . Lung diseases such as tuberculosis or inhaling harmful chemicals can lead to scar tissue in the lungs.
- Adhesions : Internal tissues and organs have a slippery surface that allows lung structures to easily slide over each other. Infection, cancer, or treatment of pleural effusion can cause adhesions in the pleural layers of the lungs, which can limit lung expansion and lead to atelectasis.
Rounded atelectasis is rare, but is often seen in asbestosis. With this type of atelectasis, part of the lung is swollen or bulging, which can sometimes give a false appearance of a tumor or cancer on x-rays.
Atelectasis is equally common in men and women, and the risk can increase with age.
Other factors that commonly contribute to atelectasis include:
- Obesity or pregnancy that can put pressure on the diaphragm.
- Of smoking
- Prolonged bed rest / immobility
- Rib fractures that can cause shallow breathing
- Anesthesia, sedatives, and opioids that slow down breathing.
If your healthcare provider suspects you have atelectasis, they will perform a physical exam. If you have a partial or complete lung collapse, your breath sounds may be silent or absent in the affected areas of the lung.
Your healthcare provider will also perform the percussion by striking your chest. The sound of tapping with the fingers in areas of atelectasis will be different from the sound of healthy areas of the lung.
Your healthcare provider may order additional tests, which may include:
Several complications can occur due to atelectasis:
- Infections caused by bacteria trapped in the collapsed area, which can lead to pneumonia or sepsis.
- Bronchiectasis is an abnormal dilation of the airways that causes secretions to accumulate in the affected area.
- Hypoxemia is a condition in which oxygen levels in the blood are low.
- Respiratory failure is a life-threatening condition in which the lungs cannot get enough oxygen to the blood.
Treatment of atelectasis aims to re-expand the lung to its normal size. The approaches may differ depending on the reason. In most cases, a combination of therapeutic approaches will be required.
Common therapies to relieve atelectasis include:
- Exercises for coughing and deep breathing.
- Suction of the airways to remove secretions.
- Percussion of the chest to break up thick secretions and cough them up.
- Postural drainage, which involves sitting or lying down in different positions to help drain mucus and secretions from the lungs.
- Positive pressure breathing therapy, in which air pressure is used to reopen the alveoli.
Other interventions performed by healthcare providers include:
- Pleural drainage may be necessary to treat pleural effusion.
- Bronchoscopy can be used to remove a foreign object that is causing an internal obstruction.
- Surgery may be done to remove a damaged part of the lung, remove a tumor, or relieve airway pressure.
Medications can also be used to treat atelectasis and include:
Breast surgery is the most common cause of atelectasis. To prevent postoperative atelectasis, your healthcare provider will recommend that you stop smoking before surgery if you smoke.
There are four things you should do after surgery to prevent atelectasis:
- Use an Incentive Spirometer – This is a simple medical device that you can use to measure the amount of air you breathe in and out, and to keep your lungs active. It is the most used device to prevent atelectasis.
- Deep Breathing – Do deep breathing exercises, paying special attention to long inhalation and controlled exhalation. Pain relievers may also be prescribed if breathing is particularly uncomfortable.
- Clean particles or phlegm : Try coughing to remove mucus or phlegm from your lungs.
- Moving : Change your posture, sit or move as much as your doctor allows.
Frequently asked questions
What is bibasilar atelectasis?
Bibasilar atelectasis is a partial or complete collapse of the small airways in the lower regions of both lungs.
How is atelectasis treated?
Treatment of atelectasis addresses the underlying cause and may include a combination of supplemental oxygen therapy, coughing and deep breathing exercises, medication, respiratory therapy, and medical or surgical procedures.
What is atelectasis?
The term atelectasis, literally translated from the Greek origin, means "imperfect propagation." It refers to the partial or complete collapse of the lungs and is generally treatable. If left untreated, it can lead to serious complications.
What Causes Atelectasis?
The main causes of atelectasis are shallow breathing (hypoventilation), airway obstruction, pressure compressing the lungs or airways, and lung damage.
Get the word of drug information
If you develop atelectasis, don't panic, this is an uncomfortable but treatable condition. Treatment varies depending on the underlying cause and severity of the atelectasis. If you are at risk, there are ways to prevent atelectasis. Preventive strategies include breathing exercises, and sometimes medications may also be necessary.