Atelectasis

Definition
• Atelectasis is derived from the Greek
words
“ateles” and “ektasis”, meaning incomplete
expansion.

• Refers to closure or collapse of alveoli.

•Atelectasis and other conditions may also be
called “collapsed lung”. Atelectasis means that
lung sacs cannot inflate properly, which means
your blood may not be able to deliver oxygen to
organs and tissues.
 Diagnosis
To confirm the diagnosis or determine the type or severity of
atelectasis. They include:
•CT scan. Since a CT is a more sensitive technique than an X-ray, it may
sometimes help better detect the cause and type of atelectasis.
•Oximetry. This simple test uses a small device placed on one of your fingers to
measure your blood-oxygen level. It helps determine the severity of atelectasis.
•Ultrasound of the thorax. This noninvasive test can help tell the difference
between atelectasis, hardening and swelling of a lung due to fluid in the air sacs
(lung consolidation), and pleural effusion.
•Bronchoscopy. A flexible, lighted tube inserted down your throat allows your
doctor to see what may be causing a blockage, such as a mucus plug, tumor or
foreign body. This procedure may also be used to remove the blockages.
 RISK FACTORS
• Age- being younger than 5 or older than 60 years of
age.
• Any condition that interferes with spontaneous
coughing, yawning and sighing.
• Lung disease, such as asthma in children, COPD,
bronchiectasis or cystic fibrosis.
• Premature birth
• Recent general anesthesia
• Respiratory muscle weakness, due to muscular
dystrophy, spinal cord injury or another
neuromuscular condition.
• Any cause of shallow breathing
 Obstructive Atelectasis

• Most common type

• Due to a physical blockage of airflow
• Obstruction can occur at the level of the larger or smaller bronchus

Causes
• Mucus plug
• Foreign body- Atelectasis is common in children who have inhaled an
object, such as peanut or small toy part, into their lungs,
• Tumor in a major airway- an abnormal growth can narrow the airway.
• Blood clot.
 Non Obstructive Atelectasis
• When alveoli collapse due to factors acting via other
mechanisms.
• Least Common

Causes
• Injury- Chest trauma from a fall or car accident.
• Pleural effusion
• Pneumonia- Different types of pneumonia, an infection of
your lungs, may temporarily cause atelectasis
• Pneumothorax
• Tumor- a large tumor can press against and deflate the lung
 Classification of Atelectasis

• Acute: Post operative settings, The lung has

recently collapsed and is primarily notable
only for airlessness.

• Chronic: In COPD patient (insidious and

slower in onset) In chronic atelectasis, the
affected area is often characterized by
infection, Bronchiectasis, destruction, and
scarring (fibrosis).
 Classification of Atelectasis

Based on Characteristics
•Compression Atelectasis
•Cicatrization Atelectasis
•Adhesive Atelectasis
•Absorption Atelectasis
•Relaxation Atelectasis
•Rounded Atelectasis
 Compression Atelectasis
• Compression Atelectasis occurs from the
lesion of the thorax compresses the lungs.
• is secondary to increased pressure exerted on
the lung causing the alveoli to collapse. In
other words, there is a “decrease” transmural
pressure gradient (transmural pressure
gradient = alveolar pressure - intrapleural
pressure) across the alveolus resulting in
alveolar collapse.
 Cicatrization Atelectasis
• It results from the severe scarring of the
lung parenchyma and caused by the
necrotizing pneumonia.
 Absorption Atelectasis
• Refers to the condition where the
reduction of nitrogen concentration in
the lungs causes a collapse
 Adhesive Atelectasis
• Adhesive atelectasis results from
surfactant deficiency. This is observed
particularly in acute respiratory distress
syndrome (ARDS)
 Relaxation Atelectasis
• Relaxation or passive atelectasis results
when pleural effusion or Pneumothorax
eliminates contact between parietal
pleura and visceral pleura.
 Rounded Atelectasis
• Occurs as consequence of diseases with
chronic pleural scarring, especially
asbestos-related pleural disease and TB.
 Signs and Symptoms
This when happens, uncomfortable symptoms can
occur, including:

•Trouble breathing (shortness of breath)

•Increased heart rate
•Coughing
•Chest pain
•Skin and lips turning blue
•Other conditions including asthma and emphysema can also
cause chest pain and trouble breathing
 What causes atelectasis?
• 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.
Other Causes

•Surgery
•Chest pressure
•Blocked airway
•Other lung conditions
Treatment

Chest physiotherapy
Techniques that help you breathe deeply after surgery to re-
expand collapsed lung tissue are very important. These
techniques are best learned before surgery. They include:
•Performing deep-breathing exercises (incentive spirometry) and
using a device to assist with deep coughing may help remove
secretions and increase lung volume.
•Positioning your body so that your head is lower than your
chest (postural drainage). This allows mucus to drain better from
the bottom of your lungs.
•Tapping on your chest over the collapsed area to loosen mucus.
This technique is called percussion. You can also use mechanical
mucus-clearance devices, such as an air-pulse vibrator vest or a
hand-held instrument.
Surgery
•Removal of airway obstructions may be done by suctioning
mucus or by bronchoscopy. During bronchoscopy, the doctor
gently guides a flexible tube down your throat to clear your
airways.
•If a tumor is causing the atelectasis, treatment may involve
removal or shrinkage of the tumor with surgery, with or
without other cancer therapies (chemotherapy or radiation).

Breathing treatments
•In some cases, a breathing tube may be needed.
•Continuous positive airway pressure (CPAP) may be
helpful in some people who are too weak to cough and have
low oxygen levels (hypoxemia) after surgery.
 Nursing Interventions
• Encourage the patient to perform coughing and deep-
breathing exercises every 1 to 2 hours.
• Help the patient use an incentive spirometer to encourage
deep breathing.
• Gently reposition the patient often and help him walk as
soon as possible.
• Administer adequate analgesics to control pain.
• Humidify inspired air and encourage adequate fluid intake
to mobilize secretions.
• Use postural drainage and chest percussion to remove
secretions.
• Provide suctioning as needed for patients who are
intubated or unable to clear their own secretions.
• Administer sedatives with care because these medications
depress respirations and cough reflex.
• Offer ample reassurance and emotional support because the
patient’s limited breathing capacity may frighten him.
• Assess breath sounds and respiratory status frequently.
Report any changes immediately.
• Evaluate the patient’s ability to perform bronchial hygiene.
• Monitor pulse oximetry readings and ABG values for
evidence of hypoxia.
• Demonstrate comfort measures to promote relaxation and
conserve energy.
 Reference

https://www.slideshare.net/AbhayRajpoot3/atelectasis-241287775

https://www.mayoclinic.org/diseases-conditions/atelectasis/diagnosis-
treatment/drc-20369688

https://nursingfile.com/nursing-care-plan/nursing-interventions/nursing-
interventions-for-atelectasis.html