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Atelectasis

Last updated: May 26, 2021

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Atelectasis is a loss of lung volume that may be caused by a variety of ventilation disorders, for instance, bronchial injury or an obstructive mass such as a tumor. It may be categorized as obstructive, nonobstructive, postoperative, or rounded. Clinical features depend on the severity and extent of atelectasis, ranging from no symptoms to respiratory distress. Physical examination reveals a dull note on percussion and diminished breathing sounds over the affected area. On x-ray, the atelectatic section of the lung appears condensed and, due to decreased lung volume, may extend to the surrounding tissue. This effect can lead to an elevated diaphragm and mediastinal shift to the affected side. Treatment depends on the underlying cause. Complications of atelectasis include pneumonia or, depending on the extent of disease, respiratory failure.

References:[1][2]

The risk of atelectasis after surgery can be avoided by prescribing opioids in doses that are sufficient for pain relief, as well as encouraging the use of incentive spirometry. At the same time, opioids should be used with caution due to their suppression on coughing. Smoking should be avoided 6–8 weeks prior to surgery.

References:[1][5][6]

We list the most important complications. The selection is not exhaustive.

  • Preoperative measures
    • Smoking cessation prior to elective surgery (6–8 weeks)
    • Physical therapy (e.g, breathing and aerobic exercises)
    • Treatment of poorly controlled asthma, symptomatic COPD, and respiratory chest infections.
  • Intraoperative ventilation with PEEP
  1. Atelectasis. http://www.merckmanuals.com/home/lung-and-airway-disorders/bronchiectasis-and-atelectasis/atelectasis. Updated: January 26, 2017. Accessed: January 26, 2017.
  2. Woodring JH, Reed JC. Types and mechanisms of pulmonary atelectasis. J Thorac Imaging. 1996; 11 (2): p.92-108.
  3. Proto AV, Tocino I. Radiographic manifestations of lobar collapse. Semin Roentgenol. 1980; 15 (2): p.117-173.
  4. Mironov AV, Pinchuk TP, Selina IE, Kosolapov DA. Emergency fiberoptic bronchoscopy for diagnostics and treatment of lung atelectasis [Article in Russian]. Anesteziol Reanimatol. 2013; 6 : p.51-54.
  5. Atelectasis. https://www.msdmanuals.com/professional/pulmonary-disorders/bronchiectasis-and-atelectasis/atelectasis. Updated: July 1, 2013. Accessed: January 26, 2017.
  6. Restrepo RD, Braverman J. Current challenges in the recognition, prevention and treatment of perioperative pulmonary atelectasis. Expert Review of Respiratory Medicine. 2014; 9 (1): p.97-107. doi: 10.1586/17476348.2015.996134 . | Open in Read by QxMD
  7. Schnapf BM. Pediatric Pulmonary Sequestration. In: Sharma GD, Pediatric Pulmonary Sequestration. New York, NY: WebMD. https://emedicine.medscape.com/article/1005815-overview. Updated: November 2, 2016. Accessed: January 26, 2017.