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Atelectasis

Partial lung collapse

Atelectasis is the collapse of part or, much less commonly, all of a lung.

Causes

Atelectasis is caused by a blockage of the air passages (bronchus or bronchioles) or by pressure on the outside of the lung.

Atelectasis is not the same as another type of collapsed lung called pneumothorax, which occurs when air escapes from the lung. The air then fills the space outside of the lung, between the lung and chest wall.

Atelectasis is common after surgery or in people who were in the hospital.

Risk factors for developing atelectasis include:

  • Anesthesia
  • Use of a breathing tube
  • Foreign object in the airway (most common in children)
  • Lung diseases
  • Mucus that plugs the airway
  • Pressure on the lung caused by a buildup of fluid between the ribs and the lungs (called a pleural effusion)
  • Prolonged bed rest with few changes in position
  • Shallow breathing (may be caused by painful breathing)
  • Tumors that block an airway

Symptoms

Symptoms may include any of the following:

There are no symptoms if atelectasis is mild.

Exams and Tests

To confirm if you have atelectasis, the following tests will likely be done to view the lungs and airways:

Treatment

The goal of treatment is to re-expand the collapsed lung tissue. If fluid is putting pressure on the lung, removing the fluid may allow the lung to expand.

Treatments include one or more of the following:

  • Clap (percussion) on the chest to loosen mucus plugs in the airway.
  • Deep breathing exercises (with the help of incentive spirometry devices).
  • Remove or relieve any blockage in the airways by bronchoscopy.
  • Tilt the person so the head is lower than the chest (called postural drainage). This allows mucus to drain more easily.
  • Treat a tumor or other condition.
  • Turn the person to lie on the healthy side, allowing the collapsed area of lung to re-expand.
  • Use inhaled medicines to open the airway.
  • Use other devices that help increase positive pressure in the airways and clear fluids.

Outlook (Prognosis)

In an adult, atelectasis in a small area of the lung is usually not life threatening. The rest of the lung can make up for the collapsed area, bringing in enough oxygen for the body to function.

Large areas of atelectasis may be life threatening, often in a baby or small child, or in someone who has another lung disease or illness.

The collapsed lung usually reinflates slowly if the airway blockage has been removed. Scarring or damage may remain.

The outlook depends on the underlying disease. For example, people with extensive cancer often don't do well, while those with simple atelectasis after surgery have a very good outcome.

Possible Complications

Pneumonia may develop quickly after atelectasis in the affected part of the lung.

When to Contact a Medical Professional

Call your health care provider right away if you develop symptoms of atelectasis.

Prevention

To prevent atelectasis:

  • Encourage movement and deep breathing in anyone who is bedridden for long periods.
  • Keep small objects out of the reach of young children.
  • Maintain deep breathing after anesthesia.

References

O'Donnell AE. Bronchiectasis, atelectasis, cysts, and localized lung disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 90.

Rozenfeld RA. Atelectasis. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 408.

    • Bronchoscopy

      Bronchoscopy - illustration

      Bronchoscopy is a surgical technique for viewing the interior of the airways. Using sophisticated flexible fiber optic instruments, surgeons are able to explore the trachea, main stem bronchi, and some of the small bronchi. In children, this procedure may be used to remove foreign objects that have been inhaled. In adults, the procedure is most often used to take samples of (biopsy) suspicious lesions and for culturing specific areas in the lung.

      Bronchoscopy

      illustration

    • Lungs

      Lungs - illustration

      The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.

      Lungs

      illustration

    • Respiratory system

      Respiratory system - illustration

      Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.

      Respiratory system

      illustration

      • Bronchoscopy

        Bronchoscopy - illustration

        Bronchoscopy is a surgical technique for viewing the interior of the airways. Using sophisticated flexible fiber optic instruments, surgeons are able to explore the trachea, main stem bronchi, and some of the small bronchi. In children, this procedure may be used to remove foreign objects that have been inhaled. In adults, the procedure is most often used to take samples of (biopsy) suspicious lesions and for culturing specific areas in the lung.

        Bronchoscopy

        illustration

      • Lungs

        Lungs - illustration

        The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.

        Lungs

        illustration

      • Respiratory system

        Respiratory system - illustration

        Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.

        Respiratory system

        illustration

      Review Date: 8/21/2016

      Reviewed By: Denis Hadjiliadis, MD, MHS, Paul F. Harron, Jr. Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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