Atelectasis

Complete or partial collapse of a lung or a section (lobe) of a lung.Anaesthesia’s effect on the lungs causes almost everyone who undergoes surgery to have some atelectasis. Inhaled objects, asthma and other lung diseases and injuries can also cause atelectasis.

Essentials of Diagnosis:-
• Acute cases: Dyspnoea, tachycardia, cyanosis, chest pain, fever and hypoxaemia.
• Chronic cases: No symptoms, only diagnosed on X- ray.
• Important signs include retraction and immobility of chest on one side, displacement of mediastinum towards affected side, impaired percussion note on affected side with hyper resonance on healthy side,diminished to absent breath sounds on affected side.

• Radiological findings consistent with atelectasis are lobar or segmental density, often homogeneous with reduction in the size of the affected lobe. Tracheal deviation to affected side with elevation of dia-
phragm in massive atelectasis.

Investigation:-

-CXR

-CT CHEST PLAIN

-ECG

-BRONCHSCOPY

-ABG

Risk Factors for Atelectasis:-

Some people may be more likely than others to have atelectasis. Things that can raise your chances of it include:

  • Smoking
  • A long-term lung disease like COPD
  • Conditions that damage your nerves and muscles, such as a spinal cord injury or MUSCULAR DYSTROPHY.
  • An illness or injury that makes it harder to breathe or swallow
  • Medications that affect your breathing
  • Obesity
  • Using oxygen for a long time
  • Long-term bed rest
  • Older age


TREATMENT:-


-Oxygen inhalation.
-Relief of pain with low doses of Morphine or pethidine.

-Relief of obstruction:
i. Removal of foreign body by bronchoscopic manoeuvre.
ii. Removal of secretion by mucolytics (Brom- hexine), bronchodilators, postural drainage.
iii. Tracheal suction.
-Antibiotics to prevent infection in atelectic lung.Ampicillin 250-500 mg four times.
-Assisted ventilation: Tracheostomy may be
performed for the purpose of reducing the dead space and to facilitate aspiration of secretions. Inter- mittent positive pressure breathing greatly helps the seriously ill patient.
-In postoperative atelectasis the main treatment is induction of hyperventilation and stimulation of coughing.

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