Post-Op Atelectasis Flashcards

1
Q

What is atelectasis?

A

A partial collapse of the small airways

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2
Q

How common is atelectasis?

A

The majority of post-op patients will develop some degree of atelectasis

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3
Q

What can atelectasis result in?

A

Abnormal alterations in lung function or compromise to the lungs immune defences

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4
Q

What is the pathophysiology of atelectasis?

A

Not fully understood, but current theories suggest that airway collapse is due to combination of airway compression, alveolar gas resorption intra-operatively, and impairment of surfactant production

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5
Q

Why does atelectasis presuppose patients to developing pulmonary complications?

A

Due to reduced airway expansion and subsequent accumulation of pulmonary secretions

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6
Q

What pulmonary complications are patients with atelectasis predisposed too?

A
  • Hypoxaemia
  • Reduced lung compliance
  • Pulmonary infections
  • Acute respiratory failure
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7
Q

What does the degree of lung tissue involved in atelectasis depend on?

A

The underlying cause

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8
Q

When are most cases of atelectasis seen?

A

In post-op period, typically developing within 24 hours of surgical intervention

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9
Q

What are the main risk factors for post-op atelectasis?

A
  • Age
  • Smoking
  • Use of general anaesthetics
  • Duration of surgery
  • Pre-existing lung or neuromuscular disease
  • Prolonged bed rest
  • Poor post-op pain control
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10
Q

How will patients with post-op atelectasis present?

A

Varying degrees of respiratory compromise, with the most common clinical features being increased respiratory rate and reduced oxygen saturations

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11
Q

What may be found on examination in post-op atelectasis?

A
  • Fine crackles over affected pulmonary tissue
  • Reduced oxygen saturation
  • Sometimes low-grade fever
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12
Q

How is a diagnosis of atelectasis usually made?

A

Normally clinical, especially in post-op patient who develops respiratory symptoms within 24 hours of surgery

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13
Q

What may be found on CXR in atelectasis?

A

Small areas of airway collapse

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14
Q

What can be done if CXR is inconclusive and warranting further investigation in post-op atelectasis?

A

CT

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15
Q

What is found on CT in atelectasis?

A

Airway collapse and reduced airway volume

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16
Q

What is the most effective treatment for post-op atelectasis?

A
  • Deep breathing exercises
  • Chest physio
  • Pain control
17
Q

Why are deep breathing exercises and chest physio important in post-op atelectasis?

A

Ensures airways are opened maximally and coughing can be performed effectively

18
Q

Why is pain control important in post-op atelectasis?

A

Allow patient to deep breathe

19
Q

What should be done if no significant improvement is seen following physiotherapy in post-op atelectasis?

A

Bronchoscopy to aid in suctioning out pulmonary secretions

20
Q

How can post-op atelectasis be prevented?

A

All patients who have undergone major surgery should be referred to receive chest physiotherapy as a preventative measure