Atelectasis

Atelectasis is also known as closed lung or partial lung collapse since this disorder causes either total closure or partial collapse of the lobes of your lung. Tiny air sac of the lung becomes constricted (deflated) causing breathing problems. Certain diseases like lung tumors, severe asthma, and cystic fibrosis can lead to atelectasis. Deflated lobes of the lung can cause life threatening complications since it may lead to pneumonia or lung scarring. If it involves large portions of the lung it reduces considerable amount of oxygen supply to the body causing severe complications.

Symptoms :

Atelectasis can cause difficulty in breathing due to low level of oxygen in blood or shallow breathing. For some people it can cause persistent cough with fever. Often there may not be any obvious symptom if only small area of the lungs gets deflated. The above signs are present if large areas of lung are deflated.

Causes :

Two reasons can cause atelectasis. One is pressure from outside area can block the airway and the second is the air passage inside the lungs can get blocked. People who undergo any type of surgery (with anesthesia) can develop some form of atelectasis, since the given anesthesia can block or change the airflow inside the lungs. The alveoli (tiny sacs of the lungs) can accumulate extra gases and build up pressure inside leading to obstruction of airway.

Severe mucus can block the bronchial tubes causing atelectasis. This can happen during and after surgery since lungs cannot fully expand after surgery. You may not be able to cough out during surgery and even afterwards (at least for few days). This can lead to accumulation of mucus in the alveoli. Children may accidentally inhale small objects which may pass into their lungs causing deflation.

Certain diseases like severe fungal infections and TB can lead to partial lung collapse. Similarly any type of lung disease and lung cancer can block the airway. Any accidental injury can cause difficulty in taking a deep breath which may cause compression in the lungs. Pleural effusion, pneumonia, lung scarring and tumor can cause obstruction of airway inside the lungs. Severe asthma, cystic fibrosis and COPD are related to atelectasis.

Who are at risk?

Individual born prematurely (before the completion of full-term pregnancy) may not have his lungs fully developed. He is likely to develop difficulty in swallowing which can cause atelectasis. People with lung disease, people undergoing surgery, and people who cannot normally yawn or cough spontaneously may develop this problem. Children of age group 1-3 years may not be able to breathe deeply can develop atelectasis.

Complications :

Atelectasis or partial lung collapse can reduce the normal input of oxygen in the blood leading to hypoxemia. Lung deflation can lead to scarring of lungs making the person more prone to develop lung infection and respiratory problem.

Diagnosis :

Your doctor would request for chest X-ray initially to verify the presence of any foreign body in the lungs. Further investigation would be doing CT scan, ultrasound scan to detect atelectasis and also to check any fluid accumulation or presence of any tumor. Bronchoscopy or oximetry test may be done for some people.

Treatment :

Your doctor will decide the course of treatment based on the root cause of atelectasis. People who are undergoing surgery should learn some techniques of deep breathing so that the lungs can fully expand after collapse. Effective deep breathing exercises, coughing and clapping on your chest can help in clearing off any unwanted gas inside. You can try postural drainage by positioning your head below the chest level so that accumulated mucus will be drained easily.

If air block is due to presence of tumor, surgery will be done to remove it or chemotherapy is used to shrink the tumor. For some people, drugs like Foradil or serevent (bronchodilators) are given to open the airway fully so that lungs can expand normally. Mucus plug can be cleared using dornase Alfa in children who develop cystic fibrosis. For severe airway obstructions, bronchoscopy is done to remove the block.

Tips for Prevention :

• Children below 3 years should be monitored closely while eating and playing (with small toys) to prevent accidental swallowing.
• Quit smoking since it reduces the mucus production considerably.
• Practice breathing exercises and do it after surgery.
• In case you are confined to bed for long term, you can change your position frequently. Coughing helps to clear the mucus from the airways.