Atelectasis Flashcards
What is atelectasis?
Collapse or loss of lung volume
Describes an incomplete expansion of lung tissue, which may be congenital or acquired.
What is congenital atelectasis?
Due to incomplete expansion of the lungs
Can be classified into primary and secondary congenital atelectasis.
What is the most common cause of atelectasis?
Loss of air in lung tissue that was previously expanded
This results in the collapse of a lung or lung tissue.
What imaging technique is important for diagnosing atelectasis?
Plain chest radiography at end-inspiration
Multislice computed tomography may also be used when plain x-rays do not suffice.
What is the role of bronchography in atelectasis?
May be diagnostic in selected cases when combined with bronchoscopy
Used to show localized stenosis or bronchomalacia.
What are the pulmonary causes of atelectasis?
Obstruction of the bronchial lumen and increased surface tension of the fluid lining the respiratory tract and alveoli
These are the most common reasons for atelectasis.
What are extrapulmonary causes of atelectasis?
Compression of airways and lung tissue from outside the lung and weakness of respiratory muscles in neuromuscular disease.
What is primary atelectasis?
Due to lack of communication of the main bronchial tree with the affected parts of the lungs that have never been inflated.
What is secondary atelectasis?
May develop shortly after birth due to obstruction or compression of the bronchial lumen.
What are the Pores of Kohn?
Collateral communications between neighboring alveoli that help prevent atelectasis
They form at 3–4 years of age.
How does the solubility of trapped gases affect atelectasis?
Determines their absorption rate
For example, oxygen is absorbed within minutes, leading to faster atelectasis during high FiO2.
True or False: Muscular hypotonia in neuromuscular diseases can increase the risk of atelectasis.
True.
What clinical manifestations depend on in atelectasis?
Single or multiple lobes involved, size of atelectasis, underlying cause, age of the patient.
What is ‘middle-lobe syndrome’?
Atelectasis often located in the middle right lobe due to pulmonary infections
The right middle lobe bronchus has a smaller intraluminal diameter.
What are some physical examination findings in atelectasis?
Decreased expansion of the chest on the affected side, dullness to percussion, diminished or absent breath sounds, crackles.
How can intubation and mechanical ventilation affect oxygen saturation in atelectasis?
May cause temporary deterioration due to the abolition of protective vasoconstrictive reflex.
What is the most frequently used modality for diagnosing atelectasis?
Chest radiography.
What are some radiographic features of atelectasis?
Elevation of the diaphragm, narrowing of ipsilateral intercostal spaces, shift of the mediastinum and tracheal contours ipsilaterally.
What is the role of computed tomography (CT) in the diagnosis of atelectasis?
Reveals atelectasis not visible on chest x-ray and offers better understanding of lesions.
What is the advantage of magnetic resonance imaging (MRI) for atelectasis?
Provides excellent quality images in any plane and is a good alternative to CT in cooperative children.
What is the first-line treatment for atelectasis?
Chest physiotherapy
Its efficacy is not yet proven.
What is the role of broad-spectrum antibiotics in atelectasis treatment?
Used in children with long-standing right middle-lobe syndrome where bacterial colonization and infection are common.
What are routine prophylactic airway clearance techniques?
Incentive spirometry
Not recommended in hospitalized noncystic fibrosis patients except for those with neuromuscular illness.
What is the need for prospective RCT studies in the context of atelectasis?
To evaluate the effectiveness of physiotherapy techniques, use of mucolytic agents, and ventilation strategies.
