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Atelectasis

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Condition Detail

(Collapsed Lung)

Definition

Atelectasis is a condition where a portion of the lung has collapsed or is not able to completely expand. Normally, oxygen enters the body through the lungs. Carbon dioxide is released through the lungs. The lungs expand and contract to create the exchange of these gases. Atelectasis is not a disease, but a condition or sign that results from disease or abnormalities in the body.

The Lungs (Cut-away View)

Causes

Causes include:

Fluid in or around the lungs
Infection
Blockage of airways in the lungs due to tumors, mucus, or a foreign object
Compression, resulting from emphysema , an enlarged heart, or a tumor
Restricted chest movement, due to bone or muscle problems, or recent abdominal surgery
Scarring, as a result of radiation therapy , frequent infections, or disease
Injuries
Pneumothorax (leakage of air into the space surrounding the lungs)
Lung immaturity in premature babies

Risk Factors

Factors that increase your chance for atelectasis include:

Increased age
Premature birth
Lung diseases, such as:
- Asthma
- Lung cancer
- Emphysema
- Pulmonary edema
- Pneumothorax
- Pleural effusion
Weakened respiratory muscles
Smoking
Congestive heart failure
Obesity
Conditions that limit physical activity such as stroke , spinal cord injury, heart problems, trauma , or severe illness of any kind
Anesthesia , especially in patients who are obese or smoke
Injury to the chest wall

Symptoms

A collapsed lung may or may not cause symptoms. Small areas of collapse are less likely than larger areas to cause symptoms. Major atelectasis decreases the amount of oxygen available throughout the body.

Symptoms that may occur if a large area has collapsed include:

Rapid breathing
Shortness of breath
Taking shallow breaths
Coughing
Decreased chest movement during breathing
Mild fever
Rapid heart rate
Chest pain
Blueness of the lips or nails

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. This may include listening to your lungs for changes in the normal sounds.

Your doctor may need images of your lungs. This can be done with a chest x-ray .

Your doctor may need to examine your lungs and air passages. This can be done with a bronchoscopy .

Your doctor may also need to do additional tests to check your heart, blood vessels, and airways.

Treatment

Treatment focuses on treating the underlying cause and maintaining enough air supply. The collapsed lung usually expands after the underlying cause has been corrected. Atelectasis often resolves on its own without treatment.

Treatments include:

Physical Therapy

The therapist uses different techniques to help clear mucus from the lung. You will be positioned so that gravity helps secretions flow out of the body. When resting in bed, lie on the unaffected side to promote drainage from the lung area that has collapsed.

Respiratory Therapy

This may include any or all of the following:

Breathing masks or treatments to help keep your airways open
Incentive spirometry to help you learn to take deeper breaths
Suction to help remove secretions
A breathing machine, called a ventilator, if you are unable to breathe adequately on your own

Medication

Medications may include:

Drugs to open the airways
Drugs to treat the disease that caused the collapse
Antibiotics to treat an infection
Cardiac drugs to control heart disease
Inhalers and other drugs to manage asthma or emphysema
Oxygen, if you are having trouble breathing

Bronchoscopy

Bronchoscopy may be used to remove a foreign body or mucus that is blocking the airway.

Prevention

Measures to prevent atelectasis are related to the various causes. They include:

If you smoke, stop.
If you are obese, lose weight.
If you have a chronic lung or heart condition, follow your doctor's advice to manage the disease and limit complications.
After surgery, follow instructions for deep breathing, coughing, and turning. Ask for pain medication if discomfort is limiting movement or coughing.

RESOURCES

American Lung Association http://www.lungusa.org/

National Heart Lung and Blood Institute http://www.nhlbi.nih.gov/

CANADIAN RESOURCES

The Canadian Lung Association http://www.lung.ca/

Health Canada http://www.hc-sc.gc.ca

References

Behrman RE, et al. Nelson Textbook of Pediatrics . 18th ed. Philadelphia: Saunders, 2007.

Goldman L, Ausiello D, eds. Cecil Textbook of Internal Medicine . 23rd ed. Philadelphia: Saunders, 2008.

Mason, RJ et al. Murray & Nadel’s Textbook of Respiratory Medicine . 4th ed. Philadelphia: Saunders, 2007.

Revision Information

Reviewer: Brian Randall, MD
Review Date: 11/2012 -
Update Date: 11/26/2012 -

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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