Atelectasis

A health condition that provokes the collapse of the lung or a part of the lung (lobe) is called atelectasis. It usually occurs when alveoli (air sacs within the lungs) lose air. This is one of the common complications after surgery but other respiratory problems complications also can happen. These include cystic fibrosis, lung tumors, chest injuries, fluid in the lungs, and respiratory weakness. Atelectasis can also occur if you breathe in a foreign object. In people with lung conditions, atelectasis can make breathing hard. The treatment for this condition differs among people because it depends on the severity of the condition, other existing lung diseases, and which part of the lung has collapsed.

In addition, there is a difference between atelectasis and pneumothorax. The second condition occurs when the air leaks into the space between the chest wall and the lungs, leading to the collapse of the entire or a part of the lung. Commonly, pneumothorax is the cause of atelectasis.

Symptoms

People with atelectasis usually experience the following symptoms. For example:

Wheezing
Coughing
Rapid and weak breathing
Difficulty breathing

Immediately seek medical care if you experience breathing problems. However, there are different health conditions that can cause trouble breathing. That’s why you need to get the right diagnosis and treatment.

Causes

Sometimes, people experience obstructive atelectasis and it happens when a person has a blocked airway. However, pressure outside the lungs also can lead to atelectasis (nonobstructive atelectasis).

One of the most common atelectasis causes is general anesthesia (used often before the use of medications or surgery). Anesthesia causes regular patterns of breathing to change, which impacts the exchange of lung gases, leading the air sacs in the lungs to lose air. Approximately all people who experienced major surgery have atelectasis. Most commonly it happens after heart bypass surgery.

Check below some cases when airways become blocked:

Mucus plug – This is a buildup of phlegm or sputum in the airways. In most cases, it happens during or after surgery because you cannot cough. Moreover, medications administered during surgery cause you to breathe less deeply. As a result, mucus that moves out of the lungs can build up in the airways. Sometimes, suctioning the lungs can help to prevent buildup of the mucus. Furthermore, mucus plugs usually appear in children and people with cystic fibrosis or during a severe asthma attack.
Foreign objects – This condition occurs frequently in children who inhale an object into the lungs (such as a small toy or peanut).
Airway tumors – Narrowing of the airways can also happen due to certain growths (tumors) not necessarily cancerous.

Check below also some atelectasis causes caused by pressure from outside the lungs:

Pleural effusion – This is a disease that leads to a buildup of fluid in the space between the lungs and inside the chest wall.
Pneumonia – A lung infection that also can lead to atelectasis.
Injury – For example chest trauma, a car accident, or a fall can provoke avoiding deep breathing due to pain, which usually leads to lung squeezing.
Pneumothorax – A disease in which air starts leaking in the space between the chest wall and the lungs. It usually leads to the collapse of the lung.
Tumor – People who experience a large tumor against the lung put extra strain on the lungs forcing air out of it.
Scarring of the lung tissue – Scarring of the lung tissue usually occurs due to surgery, injuries, or lung diseases.

Risk Factors

The following factors may make you more prone to develop atelectasis. Examples include:

Lung disease (including bronchiectasis, cystic fibrosis, or asthma)
Recent surgery in the chest of the stomach region
Need for long-term bed rest without the possibility of changing positions
General anesthesia
Health conditions that provoke difficulty swallowing
Weak breathing muscles are often caused by spinal cord injury, muscular dystrophy, or other neuromuscular diseases.
Medications that cause weak breathing
Smoking
Injury or pain that makes it painful to cough (such as stomach pain or a broken rib)

Complications

Commonly, small areas of atelectasis can be treated, especially in adults. Check below some atelectasis complications:

Respiratory failure – If a person loses a lobe or an entire lung (especially in children or in people with severe lung disease) can be life-threatening.
Pneumonia – The risk of pneumonia continues until you get rid of atelectasis. Moreover, if you have mucus in a collapsed lung it may lead to infection.
Hypoxemia (low blood oxygen) – It may occur due to trouble breathing.

How to Prevent Atelectasis?

A blockage of the airways is one of the most common causes of atelectasis in children. To prevent this health problem it is advised to keep away small objects from your children.

A major surgery usually provokes this lung condition in adults. In case you are scheduled for surgery, you should consult with your doctor about preventive measures. In addition, some studies suggest that breathing exercises and regular muscle training can reduce the risk of atelectasis after surgery.

Diagnosis

Usually, healthcare professionals diagnose this condition by performing a physical examination and a plain chest X-ray. Sometimes, they can perform additional tests to determine the severity of the condition and rule out other diseases that provoke similar symptoms. For example:

CT (computerized tomography) scan – This test can be more accurate than X-ray at finding the type and cause of atelectasis.
Oximetry – This test measures the oxygen in the blood using a small device placed on one of the fingers. It helps to determine how severe atelectasis is.
Chest ultrasound – It uses sound waves to produce detailed images of the chest and inside structures. This test can determine the exact cause of atelectasis (such as pneumothorax, pleural effusion, or fluid buildup in the lungs).
Bronchoscopy – Doctors use a flexible and lighted tube during this test. Thereafter, it is placed down your throat to check for blockages (including mucus plugs, tumors, or foreign objects). Moreover, physicians can remove these blockages while performing bronchoscopy.

Treatment

The treatment is different among the patients because it depends on the cause, severity, and other factors. Commonly, mild forms of atelectasis do not require treatment and go away on their own. In some cases, medications that help to loosen and thin the mucus can help to get rid of this condition. However, if you experience atelectasis due to blockages, you may need surgery.

Chest Physical Therapy

This treatment option is also known as physiotherapy and involves a group of airway clearance techniques. This therapy helps to breathe deeply after surgery and extend a collapsed lung. Check below some techniques:

Deep breathing exercises using a special device (incentive spirometer). After that, you should cough deeply to clear out the lungs. This procedure helps to clear mucus from the lungs and return to their larger size.
To allow better draining of the mucus from the lungs, you can position the body so the head is lower than the chest.
Percussion is a technique that helps to lose the mucus from the collapsed region of the lung. It involves tapping on the chest. However, you can use mechanical devices to get rid of mucus. These include an air pulse vibrator vest, hand-held instruments, and others.

Surgery

Doctors sometimes recommend bronchoscopy. This is a surgery that helps to remove blockages that occur in the airway. In case you experience atelectasis due to tumors, you may need additional treatments along with surgery. These include chemotherapy, radiation therapy, and others.

Breathing Treatments

Sometimes, doctors may recommend a breathing tube or continuous positive airway pressure (CPAP) to improve weak cough and low oxygen levels (hypoxemia).

Frequently Asked Questions

Can atelectasis be life-threatening?

In case a person experiences large areas of atelectasis it may be life-threatening, especially in children or in someone with a serious lung disease.

What are the primary causes of atelectasis?

Commonly, people experience atelectasis due to a blockage of the airway (bronchus or bronchioles) or pressure on the lung. Discuss with your healthcare professional for more details.

Which form of atelectasis occurs most commonly?

Obstructive atelectasis is the most commonly diagnosed form of this condition. It happens when an obstruction occurs between the alveoli and trachea. Ask your doctor if you have additional questions.