Atelectasis is a condition that describes a complete or partial collapse of the lung resulting in difficulty in breathing. Blockage of air tubes that leads to lungs cause atelectasis. The blockage may be inside or outside of the air tube. Plugs of mucus, a tumor, or an inhaled foreign object like a coin or food particle present inside the bronchus can block the air tubes, resulting in atelectasis. Sometimes, pressing of the lungs from outside such as a tumor, enlarged lymph nodes, and pressure from fluid in the chest cavity can cause blockage. Blockage of bronchiole results in the collapse of alveoli as the air in the alveoli beyond the blockage gets absorbed into the blood stream.
Injury, lung disease or surgery can cause scaring of lung tissues, and scar atelectasis may lead to interstitial lung disease. Atelectasis may also lead to scarring in the lungs. Atelectasis after surgery is a common occurrence as anesthesia is one of the common causes of atelectasis. Dynamics of air flow within the lungs gets changed by anesthesia, thereby changing the rate of exchange of gases and pressure. This results in mild collapse of air sac in the lungs causing atelectasis.
Abnormal healing response due to injury of the lung may result in the production of excess scar tissues that interferes with lung function. Scar atelectasis can also occur due to long-term exposure to toxins and bacterial, fungal, viral infections. In addition, drugs that are used to treat heart disease, chemotherapy and radiation drugs, psychiatric drugs, and even certain antibiotic drugs cause scar formation resulting in atelectasis scarring. Some health conditions such as rheumatoid arthritis, dermatomytosis, Sjogren’s syndrome, and scleroderma can also lead to scar formation.
Atelectasis can be caused by obstructive and non obstructive causes. Obstructive atelectasis can be caused by the blockages in the air passage. It includes mucus plugs, foreign bodies, narrowing of major airways due to disease, tumor in the airway, and blood clots in the airway. The possible causes of non-obstructive atelectasis include injury, pneumonia, pleural effusion, pneumothorax, scarring of lung tissue, tumors that press against the lung, etc.
In severe conditions, low oxygen levels, high blood pressure, respiratory failure, and right-side heart failure may develop. Chest X-ray, bronchoscopy, and chest CT scans are used to diagnose atelectasis.
If atelectasis develops due to blockages, treatment of atelectasis involves removal of blockages with surgery or radiation. Atelectasis that develops after surgery can be treated with chest physiotherapy. Coughing, clapping, and deep breathing exercises help to re-expand the collapsed lung tissue after surgery. It is best to learn these techniques before surgery. Shortness of breath can be relieved by supplementing oxygen.
Medications to open the bronchial tubes of the lungs like inhaled bronchodilators and medicines like acetadote to cough up mucus are also used in the treatment of atelectasis. Surgical procedures are done to remove airway obstructions.
Scar atelectasis is irreversible. However, if the scars are small and do not progress further, it can be well tolerated by treating the underlying condition causing the scar. Since the lungs are resilient, after removing the obstruction usually, a collapsed lung reinflates. Atelectasis in small area of the lung is not a life threatening problem. Small scar atelectasis will not cause further problems.
People who smoke can lower the risk of atelectasis by stopping smoking before surgery. In order to avoid atelectasis after surgery, patients should breathe deeply and cough regularly. Changing positions, breathing exercises, and using devices like incentive spirometry, patients can prevent atelectasis after surgery.
In order to prevent atelectasis in children, it is vital to keep choking hazards away from small children.
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