Lungs and their performance can be compared to inflation and deflation of balloons. They work by getting filled up with air in a breathe-in situation and relax when air is let out. A blockage along the airway prevents normal intake into the lungs while a weakened region or hole allows air to escape, hence making it collapse just as a balloon would.
So, what is atelectasis(at-uh-LEK-tuh-sis)? It is a partial or complete collapse of your lung or a lobe of it. This condition develops when the small sacs of air known as alveoli inside the lungs get deflated. The atelectasis condition can be a probable complication of other issues of respiration such as inhaled foreign bodies, fluid present in lungs, lung tumors, cystic fibrosis, chest injuries and acute asthma.
Symptoms of Atelectasis
The symptoms of a lung that has collapse are diverse. They may be a number or all of the following:
- Decreasing levels of oxygen in the blood that make the person appear ashen or bluish with a potential of bringing on unusual hearth rhythms (also known as arrhythmias)
- Fever in the case of an infection
- Quick shallow breathing
- Acute pain on the affected region in a severe condition having a quick blockage
- Shock accompanied with severe decrease in blood pressure and a fast heart beat rate
- Extreme, sudden short breath in severe conditions
When the blockages occur gradually, there could be few noticeable or completely no symptoms. Symptoms that could occur in such a case may include short breath, an increased heart beat and a persistent hacking cough.
Pronounced atelectasismay occur when in hospital. Nevertheless, see a doctor immediately if you experience breathing difficulties. Other conditions other than atelectasis can lead to breathing challenges and need a correct diagnosis along with prompt treatment. If you face more difficulties in breathing, treat it as a matter of urgency and get medical attention.
Causes of Atelectasis
Atelectasis can be a result of four basic mechanisms. These are:
Airway blockage: Obstruction of the airway from the inside like through a foreign object breathed in alongside air or by a mucous plug may lead to this situation. It could also be a result of an external blockage through a lung cancer exerting pressure on the airway. These two situations lead to a collapse of a part of the lung. The broncioloalveolar carcinoma (BAC) lung cancer fills alveoli with tumors, leading to this condition.
Airway compression: This can be a result of a fluid or maybe some air surrounding the lungs commonly in a pneumothorax or a pleural effusion. It can also be a result of an aneurysm or enlargement of the heart, tumors like lymphomas, inflamed lymph nodes or through abdominal distention that leads to pressure exertion on lungs.
Adhesion: The alveoli are opened by something known as surfactant. In the absence of this substance, the lungs seemingly lose the needed surface tension and will ultimately collapse. This maybe well understood as the main cause of distress in new born babies. The lack of surfactant can also take place in adults with kidney failure, smoke inhalation and an adult respiratory distress syndrome.
Hypoventilation: An inability to have deep breaths can lead to a collapse of some fragment of a lung. It commonly occurs during surgery, particularly with normal anesthesia, and during shallow breathing caused by pain such as with a rib fracture. This condition is the main cause of the atelectasis problem.
The following are risk factors that could easily lead to atelectasis:
- Foreign items along the airway usually in children
- Tumors along the airway
- Long bed rest in one position
- Mucus stuck on the airway
- Shallow breathing particularly due to painful breathing
- Lung pressure due to fluid buildup between the lungs and the ribs usually known as pleural effusion
- Lung infections
Treatments for Atelectasis
Atelectasis treatment depends on its cause. If it is only a small portion affected on your lung, it may die out without medical attention. If there is a primary cause like a tumor, proper treatment would require removing or shrinking it through chemotherapy, surgery or radiation.
There are means that help individuals to take deep breaths following a surgery for purposes of re-expanding the already collapsed tissues of the lungs. It is important to learn the techniques used before carrying out the surgery. These include:
- Percussion or clapping on your chest over the collapsed region to loosen any mucus. You can also do mechanical clearance of mucus using such devices as a hand-held equipment or an air-pulse vibrator vest.
- Doing deep-breathing workouts (incentive spirometry).
- Putting your body in a position where the head rests lower than the chest, which is known as postural drainage. This makes it possible for mucus to drain efficiently from the base of your lungs.
- Additional oxygen can assist to relieve short breath experiences.
Medications can be applied in some cases as follows:
- To open up the lungs’ bronchial tubes for ease of breathing, inhaled bronchodilators such as Serevent and Foradil can be used.
- Thinning mucus along the airway can be made possible through acetylcysteine (acetadote) to ease coughing.
- Mucus plugs can also be cleared in children having cystic fibrosis through the use of Dornase Alfa (Pulmozyme). However, the role of this medical intervention is not well defined for atelectasisfor individuals who don’t have cystic fibrosis.
Surgery or Other Procedures
Your doctor could make a suggestion of removing the airway obstructions. This can be done through mucus suctioning or through bronchoscopy. Bronchoscopy makes use of a flexible tube that is normally threaded all the way down to your throat for clearing the airways. The use of constant positive pressure could be of great help in some individuals experiencing low levels of oxygen (commonly known as hypoxemia) following a surgery.
Prevention of Atelectasis
Prevention of lungs from collapsing is always of equal importance to treatment. A collapse of the lung can be avoided by the following:
- For people who usually smoke, they should quit for a period of about 6-8 weeks prior to the surgery.
- Following a surgery, the patients must take deep breathes, cough occasionally and move on immediately. Some exercises like changing body positions to help draining the lungs, or devices to enhance voluntary deep breathes can also be of great use.
- Patients suffering from a deformed chest or maybe a nerve condition causing shallow breathes could need breathing assistance. Constant positive pressure on the airway provides oxygen by a facemask or nose mask. This makes sure that airways don’t get collapsed even in between breath pauses. A mechanical ventilator would sometimes be needed.