Dependant Atelectasis

by Garreth Myers

Atelectasis is a term that has been derived from the Greek words ateles and ektasis, meaning incomplete and expansion. The definition of the term atelectasis means a partial or complete collapse of the lung leading to a diminished lung capacity. There are many different types of atelectasis. They are categorized as obstructive and non-obstructive atelectasis, depending on the underlying cause.

Of these different types of atelectasis, dependant atelectasis or gravity dependant atelectasis is a relatively benign form of atelectasis that usually requires no treatment. It is caused by small areas of your lung being unable to expand fully when you are lying down. The small portion of the lung that collapses under the influence of gravity usually re-expands on its own once you stand up or change your position. It is usually detected during a CT scan of the chest.

Certain persons are at a higher risk of developing this form of atelectasis. The risk factors include:
  • Anesthesia during surgery.
  • Diseases of the airways such as asthma, emphysema and chronic bronchitis. They result in a narrowing of the airways which tend to become blocked easily and make breathing difficult.
  • Lung tissue diseases that affect the structure of the lungs and make it unable to expand fully. They are usually caused by clotting, scarring or inflammation of the blood vessels and affect the lungs.
  • Prolonged bed rest without changing position for extended periods of time.
  • Shallow breathing as a result of trauma to the chest that causes painful breathing.
Since dependant atelectasis is usually a mild form of this condition, symptoms are usually not present. When present, symptoms will usually occur while lying down and may include:
  • Difficulty in breathing
  • Chest pain
  • Cough
This form of atelectasis is usually detected during a chest computerized tomography (CT) scan or a magnetic resonance imaging (MRI) scan. A CT scan uses x-rays to take detailed cross-sectional images of the chest and the lungs. In certain cases, a contrast dye may be injected prior to the scan to give a more detailed image that can help the doctor with the diagnosis.

As with any form of atelectasis, the goal of treatment is to re-expand the collapsed portion of the lung. Since dependant atelectasis only occurs under the influence of gravity while the person is lying down, it usually clears up on its own after the person changes position and does not require additional treatment. Treatment is usually confined to addressing the underlying condition that has caused the atelectasis to occur. Certain steps however, may be taken to provide symptomatic relief. These include:
  • Periodic changes of position while lying down.
  • Lying down on the healthy side will allow the collapsed portion to re-expand under the influence of gravity.
  • Performing deep breathing exercises. The doctor may suggest the use of incentive spirometry devices while performing these exercises.
  • If there is congestion of the bronchial passages, clapping on the chest areas may prevent the buildup of mucus plugs which can further aggravate the condition.
  • A bronchoscope may be used to clear the airways of any accumulated mucus if required.
The prognosis for those suffering from this form of atelectasis is good with the condition usually clearing up with a change in posture. The lungs are usually capable of making up for any minor loss of lung function and only further damage to the lungs by any underlying condition can make the condition worse.

References:
  1. http://www.umm.edu/ency/article/000065all.htm
  2. http://netwellness.uc.edu/question.cfm/56878.htm

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