ATELECTASIS
INTRODUCTION
Atelectasis is a partial or complete collapse of the lung that reduces or stops the
exchange of gases. It can occur in one or both lungs, but is usually unilateral. The
severity of symptoms depends on how much of the lung is affected and how
quickly it develops. Some people with mild atelectasis may not experience any
symptoms
DEFINITION
Atelectasis is a complete or partial collapse of a lung or a section (lobe) of a lung.
OR
Atelectasis is a partial or complete collapse of the lung that reduces or stops the
exchange of gases
RISK FACTORS
✓ Older age
✓ Asthma
✓ COPD
✓ Smoking
✓ Had chest or abdominal surgery that requires medication to keep you relaxed or
asleep (anesthesia), preventing you from taking deep breaths.
✓ A condition that blocks the small airways (branches) in your lungs, preventing
normal lung expansion.
✓ A chest injury or rib fracture that causes severe pain. This may keep you from
being able to take deep breaths.
✓ Had smoke exposure.
ETIOLOGY
✓ Mucus plug. A buildup of mucus is common after surgery, in children, in
people with cystic fibrosis and during severe asthma attacks.
✓ Inhaled object. A lung blockage by an accidentally inhaled object is
particularly common in children, who often inhale small toy parts or foods.
✓ Fluid around the lungs (pleural effusion). Underlying illness (such as heart
disease) is usually the cause of pleural effusion.
✓ Air around the lungs (pneumothorax).
✓ Non-cancerous (benign) growths.
✓ Cancerous tumors.
✓ Lung scarring.
✓ Underlying illness. Conditions like chronic obstructive pulmonary
disease (COPD) or acute respiratory distress syndrome (ARDS) and
respiratory infections like COVID-19 or pneumonia can lead to atelectasis.
CLINICAL MANIFESTATIONS
• Trouble breathing/shortness of breath (dyspnea).
• Coughing.
• Chest pain.
• Rapid breathing (tachypnea).
• Skin and lips turning blue
• Low oxygen in the body
• Wheezing
PATHOPHYSIOLOGY
Reduced ventilation or blockage
ↆ
Obstruction of passage of air from and to alveoli
ↆ
Trapped alveolar air absorbed into blood stream
ↆ
Affected portion of alveoli becomes airless
ↆ
Atelectasis (Alveoli collapse)
DIAGNOSTIC EVALUATION
• History collection
• Physical examination
• CT Scan
• X.ray
• Pulse oximetry
• Ultrasound of the thorax
• Bronchoscopy
MEDICAL MANAGEMENT
✓ Deep breathing exercises (incentive spirometry).
✓ Removing obstructions in your lung (usually using bronchoscopy).
✓ Physical therapy to help promote expansion of your lungs.
✓ Inhaled medications to open up your airways (bronchodilators).
✓ Treatment of tumor or chronic lung conditions.
✓ Suctioning: A health care practitioner can suction the airway to relieve
blockages.
✓ Breathing tube or CPAP machine: A breathing tube or continuous positive
airway pressure (CPAP) machine may be used
SURGICAL MANAGEMENT
➢ Bronchoscopy
A doctor uses a flexible tube to clear blockages in the airways.
If a tumor is causing atelectasis, the tumor may be removed or shrunk
during the bronchoscopy.
➢ Surgery
If a tumor is blocking an airway, surgery may be used to relieve the
blockage.
NURSING MANAGEMENT
• Frequent turning, early mobilization
• Deep breathing exercises atleast every 2hrs
• Incentive spirometer
• Strategies to remove secretions, coughing exercises, suctioning, aerosol
therapy, chest physiotherapy
• Endotracheal intubation
• Mechanical ventilation
• Oxygen therapy
• Postural drainage and percussion
COMPLICATIONS
✓ Hypoxemia
✓ Pneumonia
✓ Respiratory Failure
