Alveoli

Atelectasis

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Atelectasis, Lobar Collapse

  • See Also
  1. Atelectasis on Chest XRay
  • Definitions
  1. Atelectasis
    1. Alveolar collapse of lung lobe or segment
  • Pathophysiology
  1. Bronchial obstruction results in Lobar Collapse
    1. Implies lack of collateral ventilation
  2. Air distal to obstruction reabsorbed in 4-24 hours
    1. Reabsorption is faster with Supplemental Oxygen
  • Causes
  1. Obstructive Atelectasis (Bronchial Obstruction)
    1. Lung Mass
    2. Mucus plugging
    3. Foreign Body Aspiration
  2. Compression Atelectasis (alveolar compression)
    1. Pneumothorax
    2. Pleural Effusion
  3. Traction Atalectasis (lung scarring distorts alveoli)
    1. Chronic lung fibrosis
    2. Severe Pneumonia
  4. Relaxation Atelectasis (passive Atelectasis)
    1. Focal Splinting of respiratory Muscle and chest wall movement (limited by pain)
    2. Post-operative change
    3. Rib Fracture or rib Contusion
  • Symptoms
  1. Dyspnea
  2. Chest Pain
  • Signs
  1. Fever is not caused by atelectesis
    1. Both atelectesis and fever are a result of the same triggers (e.g. major surgery)
  2. Affected lung side or lobe
    1. Diminished respiratory movements
    2. Diminished breath sounds
    3. Dullness to percussion
  3. Tracheal displacement toward affected side
  • Labs
  1. Complete Blood Count
    1. Leukocytosis
  • Imaging
  1. See Atelectasis on Chest XRay
  2. Chest XRay
    1. Lung opacity in affected area
    2. Shifted mediastinum to affected side
    3. Elevated diaphragm on affected side
  3. Chest CT
    1. Definitive imaging of obstructive lesions
  • Management
  1. Incentive Spirometry
  2. Relieve obstruction (e.g. Lung Mass, Foreign Body Aspiration, mucus plugging)
  3. Analgesics or Regional Anesthesia if Splinting due to pain
    1. See Rib Fracture
  • References
  1. Broder (2021) Crit Dec Emerg Med 35(6): 12-3