[5] Atelectasis Flashcards
What is atelectasis?
Complete or partial collapse of a lung, or a lobe of a lung
Is atelectasis unilateral or bilateral?
Usually unilateral
What happens to the alveoli in atelectasis?
They deflate down to little or no volume
Where is atelectasis a common respiratory complication?
Common respiratory complication of surgery, however also a possible complication of other respiratory conditions
What are the risk factors for atelectasis?
- Age
- Any condition that interferes with spontaneous coughing, yawning, and sighing
- Immobility, e.g. bed rest
- Impaired swallowing function
- Lung disease
- Premature birth
- Recent abdominal or chest surgery
- Recent general anaesthesia
- Respiratory muscle weakness
- Any cause of shallow breathing
What age group is at increased risk of atelectasis?
Younger than 3 or older than 60
Give 4 examples of lung diseases that increase the risk of atelectasis
- COPD
- Asthma
- Bronchiectasis
- CF
What might cause respiratory muscle weakness?
- Muscular dystrophy
- Spinal cord injury
- Another neuromusclar condition
What might cause shallow breathing?
- Medications
- Mechanical limitations, e.g. abdominal pain, rib fracture
What causes atelectasis?
Can be the result of a blocked airway (obstructice) or pressure from outside (non-obstructive)
How common is atelectasis after surgery?
Almost everyone who has surgery has some atelectasis
Why is atlectasis so common after surgery?
Because it changes the regular pattern of breathing and the absorption of gases and presures, which may combine to cause some degree of alveolar collapse
Following which surgery is atelectasis particularly prominent?
Heart bypass surgery
What are the obstructive causes of atelectasis?
- Mucus plug
- Foreign body
- Narrowing of major airways from disease
- Tumour in major airway
- Blood clot
What is a mucus plug?
Accumulation of mucus in the airway
When do atelectasis commonly occur?
During and aftery surgery
Why does atelectasis commonly occur during and after surgery?
- Inability to cough
- Drugs given during surgery make the lungs inflate less than normal, so normal secretions collect in the airways
What can help reduce the chance of the formation of a mucus plug during surgery?
Sunctioning during surgery, however they may continue to build up afterwards
What conditions are mucus plugs common in?
- Cystic fibrosis
- Severe asthma attacks
What diseases might cause narrowing of the major airways?
Chronic infections, such as fungal infections and TB causing scarring
When can a blood clot cause atelectasis?
Only if there is significant bleeding into the lungs that can’t be coughed out
What are the non-obstructive causes of atelectasis?
- Chest trauma
- Pleural effusion
- Pneumonia
- Pneumothorax
- Scarring of lung tissue
- Tumour
How can chest trauma cause non-obstructive atelectasis?
It can cause the patient to avoid taking deep breaths, and so causes compression of the lungs
What can cause scarring of the lung tissue?
- Injury
- Lung disease
- Surgery
How can a tumour cause non-obstructive atelectasis?
A large tumour can press against and deflate the lung
What are the symptoms of atelectasis?
There may be no obvious signs or symptoms. If present, they may include;
- Dyspnoea
- Rapid, shallow breathing
- Coughing
How is atelectasis investigated?
- CXR
- Chest CT or bronchoscopy may be necessary if cause is not clinically apparent
What might the CXR show in atlectasis?
- Lung opacification
- Loss of lung volume
What is the treatment of atelectasis directed at?
Correcting the underlying cause
How might atelectasis caused by infection be treated?
Antibiotics
How might atelectasis caused by a foreign body be treated?
Removal by coughing, sunctioning, or broncoscopy
How is post-surgical atelectasis treated?
Physiotherapy
What is involved in physiotherapy for the treatment of post-surgical acelectasis?
- Focusing on deep breathing
- Encouraging coughing
- Walking
How is walking beneficial in atelectasis?
It improves lung inflation
What might people with chest deformities or neurological conditions that cause shallow breathing for long periods of time benefit from in atelectasis?
Mechanical devices that assist breathing
How can atelectasis be managed surgically?
In some cases, the affected part of the lung can be removed
