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Atelectasis
Prepared by
Mr. Abhay Rajpoot
HOD (Dep. of Medical Surgical)
abhayrajpoot5591@gmail.com
DEFINITION
• Atelectasis is derived from the Greek words “ateles” and
“ektasis”, meaning incomplete expansion.
• Refers to closure or collapse of alveoli.
Cont…
• Atelectasis is also defined as diminished volume
affecting all or part of a lung.
commonly encountered• One of the most
abnormalities.
• It is usually unilateral
ETIOLOGY
• Atelectasis may be the result of a blocked airway
(obstructive) or of pressure from outside the lung (no
obstructive).
• Almost everyone who has surgery has some atelectasis
from anesthesia.
Obstructive Atelectasis
• Most common type
• Due to a physical blockage of airflow
• Obstruction can occur at the level of the larger or smaller
bronchus
Causes
• Mucus plug.
• Foreign body- Atelectasis is common in children who have inhaled
an object, such as a peanut or small toy part, into their lungs.
• Tumor in a major airway- An abnormal growth can narrow the
airway.
• Blood clot.
Obstructive Atelectasis
Non Obstructive Atelectasis
• When alveoli collapse due to factors acting via other mechanisms.
• Least common
Causes
• Injury- Chest trauma from a fall or car accident.
• Pleural effusion.
• Pneumonia- Different types of pneumonia, an infection of your
lungs, may temporarily cause atelectasis.
• Pneumothorax.
• Tumor- A large tumor can press against and deflate the lung.
RISK FACTORS
• Age — being younger than 5 or older than 60 years of age.
• Any condition that interferes with spontaneous coughing,
yawning and sighing.
• Lung disease, such as asthma in children, COPD,
bronchiectasis or cystic fibrosis.
• Premature birth.
• Recent abdominal or chest surgery.
• Recent general anesthesia.
• Respiratory muscle weakness, due to muscular dystrophy,
spinal cord injury or another neuromuscular condition.
• Any cause of shallow breathing
CLASSIFICATION OF ATELECTASIS
Based
Compression
Atelectasis
Adhesive
Atelectasis
on
Absorption
Atelectasis
Cicatrization
Atelectasis
characteristics
Relaxation
Atelectasis
Rounded
Atelectasis
Compression Atelectasis
•Compression atelectasis occurs from the lesion of the
thorax compresses the lungs.
•It takes place in congenital emphysema.
Absorption Atelectasis
• Refers to the condition where the reduction of
nitrogen concentration in the lungs causes a
collapse.
Relaxation Atelectasis
• Relaxation or passive atelectasis results when pleural
effusion or Pneumothorax eliminates contact between
parietal pleura and visceral pleura.
Adhesive Atelectasis
• Adhesive atelectasis results from surfactant deficiency.
This is observed particularly in acute respiratory distress
syndrome (ARDS).
Cicatrization Atelectasis
• It results from the severe scarring of the parenchyma and
caused by the necrotizing pneumonia.
Rounded Atelectasis
• Occurs as a consequence of diseases with chronic pleural
scarring, especially asbestos-related pleural disease and
TB.
CLASSIFICATION OF ATELECTASIS
Based on Onset
Acute Chronic
Cont…
recently• Acute: post operative settings, the lung has
collapsed and is primarily notable only for airlessness.
• Chronic: in COPD patient (insidious and slower in onset) In
chronic atelectasis, the affected area is often characterized
by infection, bronchiectasis, destruction, and scarring
(fibrosis).
Pathophysiology
Reduced alveolar ventilation or any typeof
blockage
impedes the passage of air to and from the
alveoli
trapped alveolar air is absorbed into bloodstream &
outside air cannot replace the absorbedair
Cont…
Following lung
injury there is
damaged type II
alveolar cells
Lack of production
or inactivation of
surfactant
As there will be
increased surface
tension of the
alveoli
Decreased alveolar
compliance & recoil
Resulting in
atelectasis
Clinical Manifestations
production, and
• Development – insidious
• Cough, sputum
• low-grade fever
• Dyspnea, tachycardia, tachypnea,
• pleural pain and central cyanosis
supine position and• Difficulty breathing in the
anxious
Diagnostic Measures
• Auscultation: Decreased breath sounds and crackles over
the affected area.
• Pulse oximetry (SpO2) less than 90%
• ABG Analysis
-Provides information about respiratory and metabolic
acid/base balance.
-Adequacy of oxygenation
Cont…
• Chest x-ray findings
-Sharply-defined opacity obscuring vessels without air-
bronchogram
-Volume loss resulting in displacement of diaphragm, fissures,
hili or mediastinum
Management
• Treatment of the underlying cause
a.) Bronchial Obstruction: due to secretions
• Nasotracheal & Oral Suctioning
Cont…
b.) Pleural Effusion Management
Cont…
Bronchoscopy
• Bronchoscopy: If airway obstruction is caused by a foreign
body, mucous plug, or tumor,
• Fiberoptic Bronchoscopy may be used to remove the
blockage and correct the obstruction.
Incentive Spirometry
• An incentive spirometry may be used to encourage deep
breathing exercises.
Cont…
Bronchodilators
• Bronchodilators medication may be given by the nebulizer.
These help expand the airways.
• Examples are Albuterol, Metaproterenol.
Chest Physiotherapy
• Postural drainage and chest percussion (Chest
physiotherapy) is helpful. This allows mucus to drain more
easily.
SURGICAL MANAGEMENT
• Surgical management: If atelectasis is chronic, it can be
difficult to get the lungs to re-expand.
- Removal of the involved part of the lung via LOBECTOMY
or segmental resection may then be needed.
Postoperative Atelectasis
Management
• Avoid narcotics as much as possible.
• Ambulation(if hemodynamically stable)
• Vigorous Chest
• physiotherapy
NURSING DIAGNOSIS
• Ineffective breathing pattern related to Excessive mucus
production.
• Impaired gas exchange related to Lung volume reduction.
• Activity intolerance related to weak body condition
secondary to increased respiratory effort.
• Acute pain related to lungs inflammation.
Cont…
• Anxiety related to hospitalization.
• Knowledge deficit related to lack of information about
the disease process, treatment procedures at the
hospital.
• Risk for fluid volume deficits related to fever, fluid loss
Atelectasis
Atelectasis
Atelectasis

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Atelectasis

  • 1. Atelectasis Prepared by Mr. Abhay Rajpoot HOD (Dep. of Medical Surgical) abhayrajpoot5591@gmail.com
  • 2. DEFINITION • Atelectasis is derived from the Greek words “ateles” and “ektasis”, meaning incomplete expansion. • Refers to closure or collapse of alveoli.
  • 3. Cont… • Atelectasis is also defined as diminished volume affecting all or part of a lung. commonly encountered• One of the most abnormalities. • It is usually unilateral
  • 4. ETIOLOGY • Atelectasis may be the result of a blocked airway (obstructive) or of pressure from outside the lung (no obstructive). • Almost everyone who has surgery has some atelectasis from anesthesia.
  • 5. Obstructive Atelectasis • Most common type • Due to a physical blockage of airflow • Obstruction can occur at the level of the larger or smaller bronchus Causes • Mucus plug. • Foreign body- Atelectasis is common in children who have inhaled an object, such as a peanut or small toy part, into their lungs. • Tumor in a major airway- An abnormal growth can narrow the airway. • Blood clot.
  • 7. Non Obstructive Atelectasis • When alveoli collapse due to factors acting via other mechanisms. • Least common Causes • Injury- Chest trauma from a fall or car accident. • Pleural effusion. • Pneumonia- Different types of pneumonia, an infection of your lungs, may temporarily cause atelectasis. • Pneumothorax. • Tumor- A large tumor can press against and deflate the lung.
  • 8. RISK FACTORS • Age — being younger than 5 or older than 60 years of age. • Any condition that interferes with spontaneous coughing, yawning and sighing. • Lung disease, such as asthma in children, COPD, bronchiectasis or cystic fibrosis. • Premature birth. • Recent abdominal or chest surgery. • Recent general anesthesia. • Respiratory muscle weakness, due to muscular dystrophy, spinal cord injury or another neuromuscular condition. • Any cause of shallow breathing
  • 10. Compression Atelectasis •Compression atelectasis occurs from the lesion of the thorax compresses the lungs. •It takes place in congenital emphysema.
  • 11. Absorption Atelectasis • Refers to the condition where the reduction of nitrogen concentration in the lungs causes a collapse.
  • 12. Relaxation Atelectasis • Relaxation or passive atelectasis results when pleural effusion or Pneumothorax eliminates contact between parietal pleura and visceral pleura.
  • 13. Adhesive Atelectasis • Adhesive atelectasis results from surfactant deficiency. This is observed particularly in acute respiratory distress syndrome (ARDS).
  • 14. Cicatrization Atelectasis • It results from the severe scarring of the parenchyma and caused by the necrotizing pneumonia.
  • 15. Rounded Atelectasis • Occurs as a consequence of diseases with chronic pleural scarring, especially asbestos-related pleural disease and TB.
  • 16. CLASSIFICATION OF ATELECTASIS Based on Onset Acute Chronic
  • 17. Cont… recently• Acute: post operative settings, the lung has collapsed and is primarily notable only for airlessness. • Chronic: in COPD patient (insidious and slower in onset) In chronic atelectasis, the affected area is often characterized by infection, bronchiectasis, destruction, and scarring (fibrosis).
  • 18. Pathophysiology Reduced alveolar ventilation or any typeof blockage impedes the passage of air to and from the alveoli trapped alveolar air is absorbed into bloodstream & outside air cannot replace the absorbedair
  • 19. Cont… Following lung injury there is damaged type II alveolar cells Lack of production or inactivation of surfactant As there will be increased surface tension of the alveoli Decreased alveolar compliance & recoil Resulting in atelectasis
  • 20. Clinical Manifestations production, and • Development – insidious • Cough, sputum • low-grade fever • Dyspnea, tachycardia, tachypnea, • pleural pain and central cyanosis supine position and• Difficulty breathing in the anxious
  • 21. Diagnostic Measures • Auscultation: Decreased breath sounds and crackles over the affected area. • Pulse oximetry (SpO2) less than 90% • ABG Analysis -Provides information about respiratory and metabolic acid/base balance. -Adequacy of oxygenation
  • 22. Cont… • Chest x-ray findings -Sharply-defined opacity obscuring vessels without air- bronchogram -Volume loss resulting in displacement of diaphragm, fissures, hili or mediastinum
  • 23. Management • Treatment of the underlying cause a.) Bronchial Obstruction: due to secretions • Nasotracheal & Oral Suctioning
  • 25. Cont… Bronchoscopy • Bronchoscopy: If airway obstruction is caused by a foreign body, mucous plug, or tumor, • Fiberoptic Bronchoscopy may be used to remove the blockage and correct the obstruction. Incentive Spirometry • An incentive spirometry may be used to encourage deep breathing exercises.
  • 26. Cont… Bronchodilators • Bronchodilators medication may be given by the nebulizer. These help expand the airways. • Examples are Albuterol, Metaproterenol. Chest Physiotherapy • Postural drainage and chest percussion (Chest physiotherapy) is helpful. This allows mucus to drain more easily.
  • 27. SURGICAL MANAGEMENT • Surgical management: If atelectasis is chronic, it can be difficult to get the lungs to re-expand. - Removal of the involved part of the lung via LOBECTOMY or segmental resection may then be needed.
  • 28. Postoperative Atelectasis Management • Avoid narcotics as much as possible. • Ambulation(if hemodynamically stable) • Vigorous Chest • physiotherapy
  • 29.
  • 30. NURSING DIAGNOSIS • Ineffective breathing pattern related to Excessive mucus production. • Impaired gas exchange related to Lung volume reduction. • Activity intolerance related to weak body condition secondary to increased respiratory effort. • Acute pain related to lungs inflammation.
  • 31. Cont… • Anxiety related to hospitalization. • Knowledge deficit related to lack of information about the disease process, treatment procedures at the hospital. • Risk for fluid volume deficits related to fever, fluid loss