Subsegmental Atelectasis Treatment

by Kevin Pederson

Atelectasis is defined as the part or complete disintegration of the lung or lung lobe as a result of deflation of tiny air sacs (alveoli) in the lungs. Atelectasis is a common respiratory complication after a surgery. Atelectasis can be caused by several other disorders of the lungs such as lung fluids, cystic fibrosis and injuries.

Subsegmental atelectasis is defined as the decrease in the volume of the lung due to the impediment of the small or subsegmental bronchus. The condition appears as linear opacity in a chest radiograph. People suffering from respiratory tract infection, hypoventilation, and pulmonary embolism are generally affected with subsegmental atelectasis.

Symptoms


  • Low fever
  • Coughing
  • Shallow, fast breathing
  • Dyspnea (difficulty in breathing)

Causes


Atelectasis can occur due to a blocked airway (obstructive) or by the outside pressure on the lung (non-obstructive). The causes include the following.

  • Mucus Plug: The buildup of mucus in the airways, a common occurrence post surgery, is the foremost reason for the atelectasis. The lungs do not inflate to their maximum capacity following a surgery. The condition causes buildup of the secretions in the airways. Mucus plugs are also seen in people during an asthma attack. The condition is prevalent in patients with cystic fibrosis.
  • Tumor: An abnormal cyst or growth can result in the narrowing of the airways.
  • Foreign Body: The presence of foreign body in the lungs can cause subsegmental atelectasis. Children are likely to draw in small toys and edibles such as peanuts into their lungs.
  • Narrowing of Airways: Chronic infections like tuberculosis and fungal infections can constrict and damage the airways.
  • Pneumonia: The lung infection caused by pneumonia can cause atelectasis. The prolonged atelectasis in the lung can cause bronchiectasis, an abnormal widening of the airways.
  • Pleural Effusion: The accumulation of large quantities of fluid in the fluid filled space around the lungs can result in subsegmental atelectasis.
  • Chest Trauma: A fall, an accident or a severe injury can constrict and compress the lungs.
  • Pneumothorax: The presence of gas or air in the space between the chest wall and lungs can cause damage to the lungs.
  • Prolonged Bed Rest: The lack of movement after a surgery might cause the disorder in the lungs.

Diagnosis and Treatment


The diagnosis of the subsegmental atelectasis generally includes physical investigation, a chest X-ray, CT scan, ultrasound, and oximetry.

In some cases of subsegmental atelectasis, no treatment may be advised as the condition may subside on its own. Nonetheless, the treatment advised for the condition includes the following options.

Bronchoscopy:
A slender, flexible tube is inserted down the throat to locate and remove the blockages such as mucus plug, foreign body, and tumors in the airway.

Chest Physiotherapy: Physiotherapy techniques that involve deep breathing are incorporated to expand the collapsed lung. These techniques include

  • Clapping on the collapsed part of the chest to ease the mucus. Some mechanical devices such as handheld instruments or air pulse vibrator may be advised to facilitate mucus discharge.
  • Coughing
  • Deep breathing exercises
  • Postural drainage (correct positioning) for proper discharge of mucus from the lungs
Medication: The medication prescribed may include

  • Bronchodilators to expand the bronchial tubes
  • Domase alfa to drain the mucus build-up in children suffering from cystic fibrosis
  • Acetylcysteine to facilitate coughing and mucus discharge

Risk Factors


  • Lung disorders such as asthma, bronchietasis, cystic fibrosis
  • Chest surgery
  • Extended bed rest
  • General anesthesia
  • Inhalation of foreign objects by children
  • Obesity/old age
  • Shallow breathing
  • Premature birth (impaired development of lungs)

Complications


  • Respiratory failure
  • Lung damage (bronchiectasis)
  • Pneumonia
  • Hypoxemia (low oxygen levels)

Prevention


  • Quit smoking
  • Practice deep breathing techniques and exercises
  • Avoid small toys for children up to 3 years of age
  • Switch sides and positions in case of prolonged bed stay
Reference:
  1. www.ncbi.nlm.nih.gov


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