Atelectasis

Aka: Atelectasis, Lobar Collapse

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II. Definitions

  1. Atelectasis
    1. Alveolar collapse of lung lobe or segment

III. 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

IV. Causes

  1. Focal Splinting of respiratory Muscle and chest wall movement (limited by pain)
    1. Post-operative change
    2. Rib Fracture or rib Contusion
  2. Airway obstruction
    1. Mucus plugging
    2. Foreign Body Aspiration
    3. Lung Mass

V. Symptoms

  1. Dyspnea
  2. Chest Pain

VI. 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

VII. Labs

  1. Complete Blood Count
    1. Leukocytosis

VIII. 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

IX. 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

X. References

  1. Broder (2021) Crit Dec Emerg Med 35(6): 12-3

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