Atelectasis and Fever

by Rachel Bhan


Atelectasis can be described as failure of the lung to inflate or expand fully. There are several factors that may cause this problem, some of which include tumors in the respiratory passages, blockage in the airways, lung infections or diseases, shallow breathing, cigarette smoke exposure and so on. Most people who have been through a surgery in which general anesthesia was used have suffered from some form of atelectasis. This medical problem may affect the entire lung or a single sub-segment of the lung. The collapse of lung tissue because of the depressant effects of anesthetic medication is often referred to as postoperative atelectasis. This problem constitutes of around 90% of all post-surgery pulmonary complications.

At times, people do not even realize that they are suffering from atelectasis, as this condition can be asymptomatic. However, if the signs and symptoms are present, they usually include -

  • Breathing difficulties
  • Elevated heartbeat
  • Chest pain
  • Cough (not a prominent one though)

People who have atelectasis also suffer from a low grade fever in some cases. Postoperative fever is a very common occurrence in people who have recently undergone a surgical procedure. Around 40% to 50% of surgical patients develop fever after a surgery but of this, only a small percent is because of an infection. In case there is no infection detected, atelectasis is regarded as the underlying cause of the fever. However, in the last few years, this theory has been refuted by medical researchers who claim that atelectasis does not cause postoperative fever. They add that there is no clinical evidence to support this dogma.

In a 2-day study conducted on 100 cardiac surgery patients, with daily chest radiographs and continuous temperature measurements, it was observed that the incidence of fever reduced progressively, whereas the incidences of atelectasis were higher. This showed that there is no correlation between atelectasis and fever. Of course, atelectasis and fever do occur simultaneously quite frequently after a surgery, though their concurrence is more likely to be coincidental, instead of casual. Researchers also claim that when fever is present after a surgery, it is not because of atelectasis. However, more studies need to be conducted to gauge the exact contribution of lung collapse in postoperative fever.

There are many other factors that could be responsible for a patient suffering from fever after a surgery. These include -

  • Acute cholecystitis
  • Blood product reactions
  • Catheter-related sepsis
  • Deep vein thrombosis
  • Drug fever
  • Infection in the surgical site
  • Intra-abdominal abscess
  • Intravenous line infections
  • Leaking anastomosis
  • Pulmonary causes like aspiration, pneumonia and pulmonary embolism
  • Systemic bacteremia
  • Urinary tract infections

At times, postoperative fever could be a manifestation of a more serious medical complication. Unfortunately, it is not always possible to identify the exact cause of fever after a surgery.

While atelectasis may not necessarily lead to fever, it should be checked and treated by a doctor as soon as possible. Some of the complications that may arise due to a deflated lung include -

  • Hypoxemia or low levels of oxygen in the blood, since atelectasis has an adverse effect on the lung’s ability to get air into the alveoli
  • Scarring which may remain even after the lung gets re-inflated. This may further lead to bronchiectasis
  • Respiratory failure

Fortunately, the risks of atelectasis can be reduced by following a few simple steps -

  • Quitting the habit of smoking and avoiding any exposure to cigarette smoke
  • Practicing deep breathing exercises
  • Changing positions frequently, during bed rest

In case atelectasis occurs in spite of following the preventative measures mentioned below, it is absolutely essential to consult a doctor immediately.

References


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