DefinitionAtelectasis is the collapse of part or (much less commonly) all of a lung.See also: Pneumothorax
Alternative NamesPartial lung collapse
Causes, incidence, and risk factorsAtelectasis is caused by a blockage of the air passages (bronchus or bronchioles) or by pressure on the outside of the lung.It is common after surgery, or in patients who were in the hospital.Risk factors for developing atelectasis include:AnesthesiaForeign object in the airway (most common in children)Lung diseasesMucus that plugs the airwayPressure on the lung caused by a buildup of fluid between the ribs and the lungs (called a pleural effusion)Prolonged bed rest with few changes in positionShallow breathing (may be caused by painful breathing)Tumors that block an airway
SymptomsBreathing difficultyChest painCoughFever, low-grade, usually after surgery
Signs and testsBronchoscopyChest CT scanChest x-ray
TreatmentThe goal of treatment is to re-expand the collapsed lung tissue. If fluid is putting pressure on the lung, removing the fluid may allow the lung to expand.The following are treatments for atelectasis:Clap (percussion) on the chest to loosen mucus plugs in the airwayPerform deep breathing exercises (with the help of incentive spirometry devices)Remove or relieve any blockage in the airways by bronchoscopy or another procedure.Tilt the person so the head is lower than the chest (called postural drainage). This allows mucus to drain more easily.Treat a tumor or other condition, if there is oneTurn the person to lie on the healthy side, allowing the collapsed area of lung to re-expandUse aerosolized respiratory treatments (inhaled medications) to open the airwayUse other devices that help increase positive pressure in the airways and clear fluids (positive expiratory pressure [PEP] devices)
Expectations (prognosis)In an adult, atelectasis in a small area of the lung is usually not life threatening. The rest of the lung can make up for the collapsed area, bringing in enough oxygen for the body to function.Large areas of atelectases may be life threatening, especially in a baby or small child, or someone who has another lung disease or illness.The collapsed lung usually reinflates slowly if the blockage of the airway has been removed. However, some scarring or damage may remain.In general, the outlook depends on the underlying disease. For example, people with extensive cancer have a poor prognosis, while patients with simple atelectasis after elective surgery have good prognosis.
ComplicationsPneumonia may develop quickly after atelectasis in the affected part of the lung.
Calling your health care providerCall your health care provider if you develop symptoms of atelectasis.
PreventionEncourage movement and deep breathing in anyone who is bedridden for long periods.Keep small objects out of the reach of young children.Maintain deep breathing after anesthesia.
ReferencesO’Donnell AE. Bronchiectasis, atelectasis, cysts, and localized lung disorders. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 90.