Atelectasis

Atelectasis

Atelectasis is a condition when the small air sacs in the lungs (alveoli) collapse and are not filled with air. Atelectasis is one of the causes of lung collapse and cannot expand.

Alveoli is where the exchange of oxygen and carbon dioxide occurs in the lungs. For this exchange to work properly, the alveoli must be filled with air. However, in atelectasis, the alveoli are not filled with air. As a result, there is no exchange of oxygen and carbon dioxide.

Atelectasis needs to be treated quickly, because it can cause a lack of oxygen supply to the body's organs . If left untreated, atelectasis can develop into a life-threatening illness.

Causes of Atelectasis

Atelectasis is often caused by an obstruction, either a tumor, a foreign body , or mucus, in the respiratory tract. The blockage (obstruction) can occur in the respiratory tract, namely the trachea, bronchi, and bronchioles.

Apart from being a result of blocked airways, atelectasis can also be caused by the following conditions:

  • Injury to the chest that causes severe pain when breathing
  • Scar tissue in the lungs, either due to injury, complications  of lung disease , or side effects of lung surgery
  • Lung infections, such as tuberculosis or  pneumonia
  • Pleural effusion , which is a buildup of fluid in the pleural lining
  • A chest tumor that presses on the lungs and blocks the airways
  • Pneumothorax , namely the accumulation of air in the pleural space

Atelectasis can also occur due to lack of surfactant in the alveolar walls. Surfactant is a substance that functions to keep the alveoli stable and expand. Lack of surfactant will cause the alveoli to collapse and not be able to re-expand. This condition is common in babies born prematurely .

In addition to some of the causes above, there are several factors that can increase a person's risk of experiencing atelectasis, including:

  • Aged
  • Recently had surgery on the chest or abdomen
  • Just had surgery using  general anesthesia
  • Taking certain medications that affect the respiratory system
  • Have  a smoking habit
  • Suffering from sleep disorders such as sleep apnea
  • Suffering from a respiratory disease, such as  chronic obstructive pulmonary disease , asthma,  bronchiectasis , or  cystic fibrosis
  • Experiencing an injury that causes pain and difficulty taking deep breaths, including  a broken rib
  • Suffering from obesity
  • Is pregnant

Symptoms of Atelectasis

At first, atelectasis does not cause any symptoms. Atelectasis will only cause symptoms if the damaged part of the lung is large enough and the body begins to experience a lack of oxygen. Symptoms of atelectasis that will arise are:

  • Cough and wheezing
  • Difficulty breathing
  • Rapid and shallow breaths
  • Chest pain right  or left, depending on the affected lung
  • Blueness of the skin, lips, and fingertips ( cyanosis )
  • Increased heart rate ( tachycardia )

Atelectasis that continues over time will cause a decrease in oxygen levels in the body (hypoxia) and a drastic drop in blood pressure. If the damaged part of the lung is getting wider, atelectasis can also trigger shock .

When to see a doctor

Immediately go to the emergency room if you experience symptoms like the one above. Early treatment will prevent complications and more severe lung damage.

If you suffer from conditions that increase your risk of atelectasis, such as recent surgery under general anesthesia, and you have asthma,  cystic fibrosis , or a broken rib, see your doctor for a check-up and follow-up according to  the doctor  's schedule.

Atelectasis Diagnosis

The doctor will ask about the patient's symptoms and medical history, including a history of chest surgery. After that, the doctor will examine the thorax  or chest using a stethoscope.

To confirm the diagnosis, the doctor will carry out the following supporting examinations:

  • Scanning with  X-rays  or  chest CT scans  , to determine the condition of the lungs
  • Bronchoscopy , to see the condition of the lungs, take tissue samples, or treat blockages in the airways
  • Tissue examination ( biopsy ), to detect abnormalities in lung tissue, including to detect tumors, cancer, or infections
  • Examination with an oximeter, to measure oxygen levels in the blood

Atelectasis Treatment

Mild atelectasis resolves on its own without treatment. However, if atelectasis is caused by certain conditions, the doctor will take action to treat the cause.

Treatment methods for dealing with atelectasis include:

Chest physiotherapy

In atelectasis caused by complications after surgery, the doctor will recommend  physiotherapy  to the patient to help the lungs expand and deflate normally. The therapies provided include:

  • Teach patients the correct cough technique, to help remove mucus from the respiratory tract
  • Teach the patient the technique of deep breathing, with the aid of incentive spirometry
  • Performing tapping or percussion therapy on the chest wall, either by hand or with an  air-pulse vibrator
  • Positioning the head lower than the body to help expel mucus

Operation

If atelectasis is caused by a mucus blockage in the airway, the doctor will suck out the mucus using a special tube. This can be done with a bronchoscope.

Bronchoscopy can also be used to remove foreign bodies that are stuck in the respiratory tract.

If the atelectasis is caused by a tumor or cancer, the doctor will perform surgery to remove the tissue. This surgery can be combined with chemotherapy and radiotherapy.

Drugs

To help treat and cure atelectasis, your doctor may give you the following medications:

  • Bronchodilators
    These drugs function to dilate the bronchi and encourage the release of mucus that is trapped in the respiratory tract. Examples of  bronchodilator drugs  that can be used are  salmeterol  or  theophylline .
  • Antibiotics
    Antibiotics can be given to treat atelectasis caused by a bacterial infection. Antibiotics that can be given generally have a broad spectrum, such as  cefuroxime  and  cefaclor .
  • Mucolytics Mucolytic
    drugs function to thin mucus in the respiratory tract so that it is easier to expel. Examples of mucolytic drugs that can be given are  N-acetylcysteine , guaifenesin, and alpha dornase.

Atelectasis complications

Untreated atelectasis can cause complications in the form of:

  • Hypoxemia , which is a condition of low oxygen levels in the blood
  • Pneumonia  or wet lung, which is inflammation caused by infection in the lungs
  • Bronchiectasis , which is a lung disease caused by permanent damage, thickening, and widening of the bronchial tubes
  • Respiratory failure , which is a condition when the respiratory system is unable to deliver oxygen and get rid of carbon dioxide

Prevention of Atelectasis

Atelectasis can be prevented by avoiding factors that increase the risk. Efforts that can be made include:

  • Quit smoking
  • Pay attention to the safety of the children's play area, including keeping objects that are at risk of entering the child's respiratory tract
  • Consult your doctor regularly if you have a disease or condition that can increase your risk of atelectasis
  • Undergoing physiotherapy after surgery on the chest or surgery under general anesthesia, according to the doctor's advice
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