2. Introduction
Atelectasis is defined as the collapse or closure of the
lung resulting in reduced or absent gas exchange. It
may affect part or all of one lung
Atelectasis is the collapse of alveoli or lung tissue.
It develops when the alveoli becomes airless from
absorption of their air without replacement of the air
with breathing.
3.
4. Contd…
Atelectasis may be acute or chronic
The most commonly described
atelectasis is acute atelectasis, which
occurs frequently in the postoperative
setting or in people who are
immobilized and have a shallow,
monotonous breathing pattern.
6. Contd
Airway foreign body
Extrinsic compression on an airway (eg,
compression due to an enlarged or aberrant vessel)
Enlarged lymph nodes that compress the airway
Masses in the chest that compress the airway or
alveoli
Cardiomegaly or enlarged pulmonary vessels that
compress adjacent airways
7. Etiology of atelectasis
Altered breathing patterns
Retained secretions
Pain, alterations in small airway function
Anesthesia or sedation
Increased abdominal pressure
Reduced lung volumes due to musculoskeletal
(Severe scoliosis) or neurologic disorders
Pain from upper abdominal surgery
8. Contd…
Restrictive defects, and specific surgical
procedures (eg, upper abdominal, thoracic, or
open heart surgery).
Persistent low lung volumes
Secretions or a mass obstructing or impeding
airflow and compression of lung tissue
Bronchospasm, airway secretions and
airway inflammation in patients with
asthma
Abnormal airway secretions in cystic fibrosis
9. Contd….
Abnormal airway clearance, such as with ciliary
dyskinesia syndrome
Airway foreign body
Excessive pressure on the lung tissue (pleural
effusion, pneumothorax, hemothorax)
Tumor growth within the thorax, or an elevated
diaphragm
10. Pathophysiology
Reduced alveolar ventilation or any type of blockage
Impedes the passage of air
The trapped alveolar air becomes absorbed into the
bloodstream, but outside air cannot replace the absorbed
air because of the blockage
Isolated portion of the lung becomes airless and the
alveoli collapse.
11. Excessive pressure on the lung tissue
Restricts normal lung expansion on inspiration
Becomes airless for prolong period
Alveolar colapse
12. Clinical Manifestations
Cough, sputum production, and low-grade fever.
Marked respiratory distress
Dyspnea, tachycardia,
Tachypnea, pleural pain, and central cyanosis
Difficulty breathing in the supine position
Anxious
13. Assessment and Diagnostic Findings
Chest x-ray : patchy infiltrates or consolidated
areas.
Pulse oximetry: (SpO2) (less than 90%) or a
(PaO2).
Physical examination: Decreased breath sounds
and crackles are heard over the affected area.
14.
15. Prevention
Frequent turning, early mobilization,
Strategies to expand the lungs and to manage
secretions.
Deep-breathing maneuvers (at least every 2 hours)
The use of incentive spirometry or voluntary deep
breathing
Directed cough, suctioning, aerosol nebulizer
treatments followed by chest physical therapy
Postural Drainage and chest percussion, or
bronchoscopy
16. Contd..
Change patient’s position frequently, especially
from supine to upright position, to promote
ventilation and prevent secretions from
accumulating.
Encourage early mobilization from bed to chair
followed by early ambulation.
Encourage appropriate deep breathing and
coughing to mobilize secretions and prevent
them from accumulating.
17. Contd…
Administer prescribed Opioids and sedatives
judiciously to prevent respiratory depression.
Perform postural drainage and chest percussion,
if indicated.
Institute suctioning to remove tracheobronchial
secretions, if indicated.
18. Management
The goal in treating the patient with atelectasis is to
improve ventilation and remove secretions
In patients who do not respond to first-line measures or
who cannot perform deep-breathing exercises, other
treatments such as positive expiratory pressure (PEP
therapy )
If the cause of atelectasis is bronchial obstruction
from secretions, the secretions must be removed by
coughing or suctioning to permit air to re-enter that
portion of the lung
19. Chest physical therapy (chest percussion and
postural drainage)
Nebulizer treatments with a bronchodilator
Medication or sodium bicarbonate may be used
to assist the patient in the expectoration of
secretions.
If respiratory care measures fail to remove the
obstruction, a bronchoscopy is performed.
Endotracheal intubation and mechanical
ventilation may be necessary for respiratory failure
20. Contd…
Thoracentesis, removal of the fluid by needle
aspiration, or insertion of a chest tube if cause is
compression
Bronchoscopy
