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Atelectasis

Overview

What is atelectasis?

The lungs are a pair of organs in your chest that take in air to deliver oxygen to your body. Atelectasis (pronounced at-uh-LEK-tuh-sis) is the term for a collapse of one or more areas in the lung.

When you breathe in, your lungs fill up with air. This air travels to air sacs in your lungs (alveoli), where the oxygen moves into your blood. The blood delivers the oxygen to organs and tissues throughout your body.

When air sacs become deflated because of atelectasis, they cannot inflate properly or take in enough air and oxygen. If enough of the lung is affected, your blood may not receive enough oxygen, which can cause health problems.

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Atelectasis often develops after surgery. It is not typically life-threatening, but in some cases, it needs to be treated quickly.

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Symptoms and Causes

What causes atelectasis?

Atelectasis has many causes. Any condition that makes it hard to take deep breaths or cough can lead to a collapse in the lung.

People may call atelectasis or other conditions a “collapsed lung.” Another condition that commonly causes a collapsed lung is pneumothorax. Pneumothorax is the presence of air between the lung and the chest wall, which can cause the lung to collapse.

Causes

  • Surgery: Surgery is the most common reason people develop atelectasis. Medicine to keep you asleep during surgery (anesthesia) can affect your ability to breathe normally or cough. Pain after surgery could make deep breaths painful. Continued shallow breathing because of the pain can lead to deflated air sacs.
  • Chest pressure: Pressure from outside the lungs can make deep breathing difficult. This type of pressure can come from a tumor or other growth, a deformed bone, or a tight brace or body cast. If the cause of the pressure is not clear, your doctor will do additional tests to identify its source.
  • Blocked airway: A blocked airway can also cause atelectasis. If air cannot get past the blockage, the affected part of the lung could collapse. Mucus or an inhaled object could cause a blockage.
  • Other lung conditions: Other medical conditions involving the lungs can also be associated with atelectasis. These disorders could include lung cancer, pneumonia, pleural effusions (fluid around the lungs) and respiratory distress syndrome (RDS).

What are the signs and symptoms of atelectasis?

If atelectasis affects only a small area of the lungs, you may not have any symptoms. But if it affects larger areas, the lungs cannot fill with enough air, and the oxygen level in your blood may go down. When this happens, uncomfortable symptoms can occur, including:

  • Trouble breathing (shortness of breath)
  • Increased heart rate
  • Coughing
  • Chest pain
  • Skin and lips turning blue
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Other conditions including asthma and emphysema can also cause chest pain and trouble breathing. If you experience these symptoms, you should see your doctor for the correct diagnosis and treatment.

Diagnosis and Tests

How is atelectasis diagnosed?

To diagnose atelectasis, doctors usually start with X-rays (a test that provides pictures of the inside of your chest). Another test called a computed tomography (CT) scan can provide more detailed pictures.

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In more severe cases, a doctor may use a procedure called a bronchoscopy to see inside your airway. In this test, the doctor sends a small tube called a bronchoscope down the throat to look for a blockage or other issue. The test is fairly painless. If a blockage is found, your doctor may be able to remove it during the procedure.

Management and Treatment

How is atelectasis treated?

Most cases of atelectasis get better without treatment. Your doctor will watch you carefully and advise you if you need to rest or make other changes until the lung re-inflates.

Treatment for more severe cases depends on the cause and extent of the collapse. The most common causes of atelectasis and their treatments include:

  • Surgery: Nurses or respiratory therapists will guide you in breathing exercises and sitting or standing upright as soon as possible after surgery.
  • Chest pressure: Using surgery or medicine, doctors can remove the source of the pressure.
  • Blocked airway: Usually, during a bronchoscopy, doctors will remove the blockage so you can breathe freely again.
  • Lung condition: Doctors may treat the condition with medicine or a procedure to relieve pressure on your lung.

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Prevention

Can atelectasis be prevented?

Deep breathing exercises and coughing after surgery can reduce your risk of developing atelectasis. If you smoke, you can lower your risk of developing the condition by quitting smoking before any operation. Many patients in the hospital are provided a device called an incentive spirometer which can encourage you to take deep breaths to prevent and treat atelectasis.

Outlook / Prognosis

What is the outlook for people with atelectasis?

Once the cause of the atelectasis is treated, most people recover quickly and have no serious lasting effects. In people who have a long-lasting (chronic) condition causing the atelectasis, further treatment may be needed if the condition returns.