Atelectasis

Atelectasis refers to the partial or complete collapse of a part or the whole of the lung. It results from a reduction or absence of air in the alveoli.

• Commonly seen in post-operative patients, especially after thoracic or upper abdominal surgery.

• Can also occur in individuals of any age with various respiratory conditions.

• Obstructive (due to blockage):

  • Mucus plug
  • Tumour
  • Foreign body
• Non-obstructive:
  • Pleural effusion

• • Pneumothorax

• • Pulmonary oedema

• • Chest wall or pleural disease

• • Positional (e.g., bed-bound patients)

• • Reduced surfactant production (common in neonates)

• Symptoms can be absent in small areas of atelectasis.

• Dyspnoea (difficulty breathing)

• Pleuritic chest pain

• Cough

• Increased respiratory rate

• Chest X-ray: Areas of increased opacity; volume loss may be indicated by shift of the mediastinum, hemidiaphragm, or fissures towards the collapsed area.

• CT scan: Better resolution, especially for subtle or loculated atelectasis.

• Bronchoscopy: Useful for suspected obstructive causes like mucus plugs or tumours.

• Address the underlying cause.

• Physiotherapy:

  • Chest percussion

• • Deep breathing exercises

• • Incentive spirometry

• Positioning: Encourage post-operative patients to sit up and mobilise.

• Bronchodilators: For those with underlying reactive airway diseases.

• Supplemental Oxygen: To treat hypoxia if present.

• Pneumonia: Due to pooled secretions behind the obstruction.

• Respiratory failure: If extensive atelectasis or in combination with other lung diseases.