Alveoli

Atelectasis

search

Atelectasis, Lobar Collapse

  • 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. 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
  • Symptoms
  • 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
  • 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