Atelectasis is a complete or partial collapse of the entire lung or area (lobe) of the lung. It occurs when the tiny air sacs (alveoli) within the lung become deflated or possibly filled with alveolar fluid.
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
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.
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.
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