Post-Op Atelectasis Flashcards
What is atelectasis?
A partial collapse of the small airways
How common is atelectasis?
The majority of post-op patients will develop some degree of atelectasis
What can atelectasis result in?
Abnormal alterations in lung function or compromise to the lungs immune defences
What is the pathophysiology of atelectasis?
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
Why does atelectasis presuppose patients to developing pulmonary complications?
Due to reduced airway expansion and subsequent accumulation of pulmonary secretions
What pulmonary complications are patients with atelectasis predisposed too?
- Hypoxaemia
- Reduced lung compliance
- Pulmonary infections
- Acute respiratory failure
What does the degree of lung tissue involved in atelectasis depend on?
The underlying cause
When are most cases of atelectasis seen?
In post-op period, typically developing within 24 hours of surgical intervention
What are the main risk factors for post-op atelectasis?
- Age
- Smoking
- Use of general anaesthetics
- Duration of surgery
- Pre-existing lung or neuromuscular disease
- Prolonged bed rest
- Poor post-op pain control
How will patients with post-op atelectasis present?
Varying degrees of respiratory compromise, with the most common clinical features being increased respiratory rate and reduced oxygen saturations
What may be found on examination in post-op atelectasis?
- Fine crackles over affected pulmonary tissue
- Reduced oxygen saturation
- Sometimes low-grade fever
How is a diagnosis of atelectasis usually made?
Normally clinical, especially in post-op patient who develops respiratory symptoms within 24 hours of surgery
What may be found on CXR in atelectasis?
Small areas of airway collapse
What can be done if CXR is inconclusive and warranting further investigation in post-op atelectasis?
CT
What is found on CT in atelectasis?
Airway collapse and reduced airway volume