Atelectasis: Is an incomplete expansion
of lobules (clusters of alveoli) or lung segments may result in partial
or complete lung collapse. The collapsed tissue, unable to perform
gas exchange, allows unoxygenated blood to pass through it unchanged, producing
hypoxemia (deficient oxygenation of the blood). Atelectasis can be
present at birth (incomplete expansion of the lungs), or during adulthood
(from a collapsed lung). It may be chronic or acute.
It occurs to some degree in many patients undergoing upper abdominal or
thoracic surgery. Prognosis depends on prompt removal of any airway
obstruction, relief of hypoxia, and reexpansion of the collapsed lobule(s)
or lung(s).
Cause: Atelectasis may be the result from:
Bronchial occlusion by mucus plugs (common problem with
-Chronic obstructive pulmonary disease patient)
Bronchiectasis
Cystic fibrosis
Heavy smoking
Occlusion by foreign bodies
Bronchogenic carcinoma
Inflammatory lung disease
Idiopathic respiratory distress syndrome of the newborn (hyaline membrane
disease)
Oxygen toxicity
Pulmonary edema
Prolong immobility
CNS depression such as ; drug overdose
Any condition that inhibits full lung expansion or makes deep breathing
painful, such as; rib fractures, obesity, an abdominal surgical incisions
Symptoms:
Symptoms varies with the degree of hypoxia
Dyspnea (labored or difficulty breathing), may be mild and subside without
treatment if atelectasis involves only a small area of the lung. Severe if massive collapse occurs
Anxiety
Cyanosis
Diaphoresis
Decreased breath sounds
Dull sound on percussion if a large portion of the lung is collapsed
Peripheral circulatory collapse
Tachycardia
Substernal or intercostal retraction
Compensatory hyperinflation of unaffected areas of the lung
Mediastinal shift to the affected side
Treatment:
Incentive spirometry
Chest percussion
Postural drainage
Frequent coughing and deep-breathing exercise
If these measures fail, bronchoscopy may help remove secretions
Humidity and bronchodilators can improve mucociliary clearance and dilate
airways and are sometimes used with a nebulizer
Atelectasis secondary to an obstructing neoplasm may require surgery
or radiation therapy.
Postoperative thoracic or abdominal surgery patients require analgesics
to facilitate deep breathing, which minimizes the risk of atelectasis