What is atelectasis?

By | 8 May 2021

Lung problems are one of the major disorders that negatively affect the health of the body. Various problems may occur in the lungs under certain conditions, especially in the hospital environment. To be informed about them and to take the necessary precautions; is extremely important for lung health. One of these conditions that threaten lung health is atelectasis.

What is atelectasis?

Atelectasis; is the situation in which a part of the whole of the lung goes out and loses the air inside and closes. It can develop as a result of a variety of anatomical or physiological conditions. Especially before long-term surgical procedures, the content of the air in the lung changes due to the gaseous anesthetic substances are taken by inhalation, causing the lungs to shrink. Therefore, atelectasis is quite common after surgical procedures.

How does atelectasis occur?

In normal breathing behavior, the air taken in spreads through the nasal cavity and windpipe to the bronchi and branches. In the end, the inhaled air reaches the air sacs called alveoli where gases such as oxygen in the air in the lung pass into the blood, and harmful gases are exchanged. Atelectasis is mentioned when these alveoli close or shrink due to various factors. It may be limited to a small part of the lung or may develop widely in the entire lung.

Pneumothorax condition characterized by the leakage of the air in the lung into the chest cavity due to various factors; it is different from atelectasis. Because the air escaping from the lung in the pneumothorax accumulates in another compartment and compresses the lung. In atelectasis, there is a lung area that cannot be ventilated. Since it cannot be ventilated, the area is closed and thus the lung shrinks. However; Pneumothorax can cause atelectasis due to external air compression.

What are the causes of atelectasis?

Depending on the mechanism of formation of atelectasis, the causes are divided into two:

OBSTRUCTIVE ATELECTASIA:
It is defined as the collapse of the lung region under the obstruction as a result of the obstruction of the airways by various factors. In this sense, conditions that can cause obstructive atelectasis are:

  • Foreign body aspiration
  • Mucus plugs in the airway
  • Tumors
  • Various anatomical problems (bone formations, abscess, cyst, etc.)

NON-OBSTRUCTIVE ATELECTASIA:
Non-obstructive atelectasis is mentioned when the lungs collapse despite the fully open airways. It is the most common type of atelectasis encountered in the clinic. In this context, the following factors can cause atelectasis:

  • Surgical operation: Due to the applications such as anesthetic agents applied before the surgery and oxygen delivery with the help of an oral machine; The natural breathing of the lung slows down and the cough reflex it shows against harmful substances from outside is suppressed. These two conditions result in the shrinkage of the lung alveoli. In the hospital environment, a strenuous breathing exercise device called a spirometer is given to prevent the development of postoperative atelectasis.
  • Pleural effusion: It is the accumulation of fluid in the space between the lung wall and the outer membrane of the lung due to the effect of various health problems such as heart failure or liver failure. Due to the filling of the cavity with fluid, the lung tissues are under pressure from the outside, unable to fill with enough air and deflate.
  • Pneumothorax: In some cases, damage to the lung tissue and leakage of air into the chest is called pneumothorax. In this case, as the air fills the chest cavity, the lung tissue shrinks. The stored air can compress the remaining lung tissues, forcing these tissues to atelectasis.
  • Damage to the lung: Injuries occur in the lung tissue with the effect of infections such as tuberculosis or harmful substances such as cigarette smoke and hard tissues are formed. These hard tissues can cause atelectasis by compressing the natural tissue of the lung.
  • Surfactant deficiency: Especially in babies born prematurely, the production of surfactant substance that prevents the closure of the alveoli is insufficient due to the inadequate development of the lungs. In this case, the lungs may close.

What are the symptoms of atelectasis?

Depending on the size of the closure that occurs in the lung tissue, the severity of the symptoms they cause varies in patients. While atelectasis that develops slowly in small lung tissue does not cause any symptoms; Life-threatening situations may arise in situations that affect the entire lung. However, atelectasis often causes the following symptoms in the clinic:

  • Shortness of breath: Air hunger may be felt due to the deflated lung segment.
  • Cough: Cough may develop depending on the obstructing airways that cause atelectasis or directly due to the part of the lung that closes.
  • Chest pain: Sudden chest pain may be felt during deep breathing or coughing.
  • Rapid breathing: Respiratory rate increases to satisfy air hunger.
  • Palpitation: As the amount of oxygen taken from the air decreases in parallel with the collapse of the lung, the heart rate increases and provides more effective delivery of the small amount of oxygen to the body.
  • Bruising: In proportion to the decrease in the amount of oxygen taken, the skin color starts to turn purple.
  • Fever: The closed lung section becomes infected by microorganisms over time and pneumonia develops. In this case, the general situation deteriorates and high fever is observed.
  • Sputum: Inflamed sputum production may be added to complaints as a result of pneumonia on atelectasis.

How is atelectasis diagnosed?

Atelectasis is suspected if there are underlying conditions that may cause atelectasis (recent surgery, presence of pneumothorax, etc.) in the presence of the above-mentioned symptoms in the patient. In this case, the diagnosis is confirmed by applying the following examinations to the patient:

  • Blood oxygen level is checked with an oximeter. For this, the oximeter is attached to the fingertip and lung function is evaluated according to the oxygen level on the monitor.
  • For more precise measurement, the oxygen level can be calculated in a blood sample taken from the artery.
  • The part of the lung with atelectasis can be detected by taking a direct chest radiograph.
  • Sections were taken on computed tomography allows for detailed examination of atelectasis and its causes.
  • Bronchoscopy; is the process of observing the airways and lung tissue with the help of a camera device. In this way, the causes of atelectasis can be determined precisely and therapeutic interventions can be performed at the same time.

What is done in the treatment of atelectasis?

Effective treatment of atelectasis depends on the correct detection of the health problem that causes this condition. When the agent is eliminated, the elimination of atelectasis becomes easier. While atelectasis is treated by eliminating the factor causing obstruction in the airway in obstructive atelectasis; In non-obstructive situations, it may be necessary to support the lung.

Accordingly, the approaches shown in treatment can be summarized as follows:

  • Chest physiotherapy; is applied to open the closed areas of the lungs and to remove the obstructions in the airways by applying various techniques such as vibration in different positions. It is particularly useful in obstructive causes and post-surgical atelectasis.
  • Bronchoscopy; is based on the principle of removing the factors causing clogging by applying direct intervention. In this way, planning can be made to prevent recurrence by making a definite diagnosis of the factor causing the obstruction.
  • Breathing exercises; Exercises based on strenuous breathing, such as spirometry, are very important to strengthen the respiratory muscles and prevent the alveoli from closing due to air loss.
  • Drainage; if atelectasis is due to the accumulation of various substances such as pneumothorax or pleural effusion; Atelectasis is resolved by draining the substance from the accumulated area by needle aspiration method. Underwater drainage may also be required in the case of pneumothorax.
  • Surgical; the area of ​​the lungs that rarely atelectasis does not fill with air again; It can be surgically removed to prevent more serious health problems, especially infection. Surgery is also used in the treatment of various anatomical problems such as tumors.

 

If you have symptoms that suggest atelectasis; You can apply to the nearest health institution to be evaluated by a specialist physician.

Wishing you healthy days.

 

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