Atelectasis is the collapse or closure of the lungs caused by the absence of air in parts of the lung. It develops when alveoli become airless and collapse. Common causes include obstruction of the airways, diminished lung expansion, retained secretions, altered breathing patterns during anesthesia or sedation, and compression of the lungs. Symptoms may include cough, difficulty breathing, and low oxygen levels. Treatment focuses on removing obstructions and secretions through techniques like suctioning, chest physiotherapy, and bronchodilators to reinflate the lungs. More severe cases may require procedures like bronchoscopy or mechanical ventilation.

1. Atelectasis

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.

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.

5. Etiology
 Obstruction of an airway
 Diminished distention of alveoli

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.

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

21. Nursing diagnosis
 Ineffective breathing pattern related to
collapse of lung tissue
 Activity intolerance

22. Thank You