Atelectasis// Hindi animated

Atelectasis
It refers to closure or collapse of alveoli. It occurs when the alveoli cannot inflate properly and thus is not able to fill completely
Causes
Blockage of airways
Low Air Flow
Scarring Of Lungss
Increased pressure outside lungs
Risk Factors
Altered breathing pattern
Retained secretions
Pain
Alterations in small airway function
Prolonged Supine positioning
Increased abdominal pressure
Reduced lung volumes due to musculoskeletal / neurological disorders
Restrictive defects
Smoking
Long term bed rest
Obesity
Long term O2 therapy
Types
There are 3 main types of atelectasis
1) Compression atelectasis
2) Resorptive atelectasis
3) Contraction atelectasis
Others
1) Patchy atelectasis
2) Rounded atelectasis
3) Gravity dependent atelectasis
4) Subsegmental atelectasis
5) Bibasilar atelectasis
1) Compressive atelectasis
It is a form of atelectasis where there is Compression by any kind of fluid, air, blood or tumor from outside the alveoli. This usually occurs when the lung walls ie. the pleura is filled with these substances and the pressure outside the alveoli becomes more than the pressure inside the lungs, causing it to shut down
2) Resorptive/ Obstructive atelectasis
It occurs due to blockage or obstruction of the alveoli. Due to the blockage, no air can enter the alveoli and neither can the air inside the alveoli leave from there. Thus, some amount of air gets trapped inside the alveoli. This air gets reabsorped into the blood circulation leaving an empty
space which closes down without anything to keep it open.
3) Contraction atelectasis
Occurs as a rest of scars present in the lungs which does not allow complete expansion of the alveoli. It is like a contracture of the alveoli, which ultimately leads to the collapse of alveoli.
Symptoms
The sign and symptoms of this disorder is vague and includes
Difficulty breathing
Rapid shallow breathing
Cough
Cyanosis
Dizziness or fainting
Wheezing / cracking sound
Incomplete Chest expansion
Unilateral chest movement
Diagnosis
Diagnosis is done based on patient's risk for developing atelectasis, clinical examination and a chest xray. CT chest may be used to confirm the diagnosis as it accurately depicts the severity and involvement of lungs. Sometimes bronchoscopy, a procedure involving insertion of a camera attached tube into the Bronchi, may be done to visualise for any blockage such as mucus plug or foreign body. This blockage may be removed during the procedure itself to treat the patient.
Treatment
Mild form of obstructive atelectasis is treated with simple measures such as chest physiotherapy including chest percussion and postural drainage. Suctioning helps in removing secretions that obstructs airflow while nebulization with bronchodilators may help in throwing out the thick mucus and facilitating air movement into the alveoli. In some conditions where the obstruction is severe a bronchoscopy is done to remove the obstruction. Patient is encouraged to cough and do deep breathing exercises to facilitate alveoli expansion.
may be intubated and mechanical ventilation is provided to the patient.
Compression atelectasis due to pleural effusion where there is accumulation of fluid into the pleura, is treated with a procedure called thoracocentesis which helps in relieving the pressure onto the alveoli.
electasis may require tk be treated with surgery to remove or shrink the tumor.
The following methods helps in preventing atelectasis in patients.
Change patient's position frequently. A sitting position is preferred over supine or lying down position.
Post Operative patients are encouraged to ambulate as soon as possible to prevent accumulation of secretions into the airways.
Breathing technique and coughing is encouraged in patients at risk of atelectasis.
Incentive spirometry, a device in which patient blows is used to train the lungs and alveoli to expand fully.
Opioids and sedative medicines
Proper suctioning and chest physiotherapy helps in preventing accumulation of thick tenacious mucus.
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