What is Atelectasis?

Atelectasis a complete or partial collapse of the entire lung or area (lobe) of the lung. It occurs when the tiny air sacs (alveoli) within the lung become deflated or possibly filled with alveolar fluid.

Atelectasis is one of the most common breathing (respiratory) complications after surgery. It’s also a possible complication of other respiratory problems, including cystic fibrosis, lung tumours, chest injuries, fluid in the lung and respiratory weakness. You may develop atelectasis if you breathe in a foreign object.

Atelectasis can make breathing difficult, particularly if you already have lung disease. Treatment depends on the cause and severity of the collapse.

What Causes Atelectasis?

Atelectasis occurs from a blocked airway (obstructive) or pressure from outside the lung (nonobstructive).

Possible causes of Atelectasis include:

  • General anaesthesia
  • Poor post-operative pain control (resulting in shallow breathing)
  • Mucus Plugging – it commonly occurs during and after surgery because you can’t cough.
  • Foreign Body – common in children
  • Tumour inside the airway
  • Injury – chest trauma may cause you to avoid taking a deep breath (due to pain), which can result in compression of your lungs
  • Pleural effusion – Buildup of fluid between the tissues that line the lungs
  • Pneumonia
  • Pneumothorax – Collapse of partial or all of the lung
  • Scarring of lung tissue – caused by injury, lung disease or surgery

Other Factors which may cause atelectasis include:

  • Older age
  • Smoking
  • Any condition that makes it difficult to swallow
  • Prolonged bed rest (espe4cially with limited position change)
  • Pre-existing Lung disease, such as asthma, COPD, bronchiectasis or cystic fibrosis
  • Recent abdominal or chest surgery
  • Weak breathing (respiratory) muscles due to muscular dystrophy, spinal cord injury or another neuromuscular condition
  • Medications that may cause shallow breathing
  • Pain or injury that may make it painful to cough or cause shallow breathing, including stomach pain or rib fracture

What are the symptoms of atelectasis?

Patients with atelectasis will present with varying degrees of respiratory compromise.

If you do have signs and symptoms, they may include:

  • Difficulty breathing
  • Rapid, shallow breathing
  • Wheezing
  • Cough

How is Atelectasis diagnosed?

A doctor’s examination and plain chest X-ray may be all that is needed to diagnose atelectasis. However, other tests may be done 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.
  • 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 non – invasive 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.
  • A flexible, lighted tube inserted down your throat allows your doctor to see what may be causing a blockage, such as a mucus plug, tumour or foreign body. This procedure may also be used to remove the blockages.

Management of Atelectasis

Respiratory Physiotherapy

The most effective treatments for atelectasis are deep breathing exercises and chest physiotherapy. This ensures that the airways are opened maximally and coughing can be performed effectively.

Pain control

To enable the patient to deep breath and cough effectively to clear secretions

Surgery

Removal of airway obstructions may be done by suctioning mucus or by bronchoscopy if no significant improvement following physiotherapy.

Continuous Positive Airway Pressure

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.

What would physiotherapy treatment for Atelectasis involve?

At Respiratory Physiotherapy Ireland, our physiotherapists will ensure you receive specialised treatment for your atelectasis. Following a detailed assessment and depending on the cause of your atelectasis, a personalised treatment plan may include the following:

  • Secretion clearance:
    • Active Cycle of Breathing
    • Autogenic Drainage
    • Positive Expiratory Pressure (PEP)
    • Oscillating positive expiratory pressure
    • Effective / productive coughing techniques.
    • Supported coughing techniques (if required secondary to pain, fear, anxiety)
    • Postural drainage in sitting and lying.
    • Manual techniques, including percussion and vibrations
  • Breathing techniques:
    • Deep Breathing exercises – performing deep-breathing exercises using an incentive spirometry may help remove secretions and increase lung volume. 
  • Education and Advice:
    • Illness cause and prevention
    • Medication management
    • Mobility and exercise

It will be important to note that the respiratory physiotherapy we apply should be closely incorporated with other health care professional’s management of the client’s needs.

Summary

Atelectasis is reversible collapse of lung tissue with loss of volume. Treatment of atelectasis depends on the underlying cause with the aim of re-expanding the lung to its normal size. Respiratory physiotherapy has a major role to play in the treatment of atelectasis.

At respiratory physiotherapy Ireland, our physiotherapists can provide specialised therapy and treatment techniques to manage your symptoms and best level of function.

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+353 86 105 5791

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