Diseases

Atelectasis – Causes, Symptoms & Treatment

Atelectase

Atelectasis is a lung tissue that is devoid of air. This is not a disease in its own right, but rather a condition that results from another underlying disease. The symptoms can affect the entire lung, but in most cases circumscribed sections of the lung.

What is atelectasis?

In atelectasis, either part of the lung or the entire lung is emptied of air. Translated from the Greek, the term means “incomplete extension”. This condition particularly affects the air sacs (alveoli) in the lungs. These have a very important function, as this is where the oxygen exchange takes place. When the air sacs in the lungs collapse, that area is no longer available for oxygen exchange.

Therefore, atelectasis is a condition that needs to be taken seriously. Doctors distinguish between primary and congenital atelectasis. The acquired form is caused by another disease, while the congenital form only affects newborns or premature babies.

causes

The causes of congenital atelectasis are, for example, central nervous dysfunction, malformations or a lack of surfactant , which can occur in premature babies. Surfactant is a mixture of water, proteins and fats produced by the lungs, which serves to reduce the surface tension of the liquid layer in the alveoli so that expansion is possible. There are different forms of atelectasis:

  • In compression atelectasis, the collapsed area of ​​the lung is compressed and thus prevented from unfolding. This can be due to a number of reasons, such as a tumour , an injury to the lung or chest wall, a buildup of pus, water or blood, or swollen lymph nodes .
  • In contractile atelectasis, the lack of ventilation is caused by scarring of the lungs resulting from a lung disease such as tuberculosis .
  • In the case of microatelectasis, the blood supply to the lung tissue at the relevant point is too poor, which can happen in a shock situation, for example. As a result, it could not form enough surfactant. The surface tension of the liquid pulls the lungs together in the alveoli at this point.
  • Obstructive atelectasis (a subtype of resorption atelectasis) occurs when a branch of the lung is pinched off and the air trapped behind it is absorbed into the blood, such as by a tumor, an object that has been swallowed, or swollen lymph nodes.

Symptoms, Ailments & Signs

In the case of atelectasis, the lung function is restricted because gas exchange can no longer take place. This reduces the oxygen content in the blood. The body now tries to compensate for this condition. It speeds up breathing and increases heart rate . The skin sometimes turns bluish due to the reduced oxygen level .

The symptoms resulting from atelectasis depend, among other things, on the size of the affected lung section. Another role is played by whether the atelectasis developed acutely or gradually. Furthermore, the individual causes shape the symptoms. If atelectasis occurs suddenly, for example due to a blocked airway, there is severe shortness of breath and, in some cases, sharp pains in the chest.

Slowly developing atelectasis, affecting only small areas of the lungs, causes only mild symptoms. These include shortness of breath and getting out of breath more quickly, especially during exertion. Large collapsed areas of the lungs, on the other hand, can lead to circulatory shock , in which blood pressure drops sharply and the heart beats very quickly.

Symptoms of congenital atelectasis often appear shortly after birth or in the first hours of life. The skin of affected premature babies turns bluish. They also breathe rapidly, with the areas between the ribs and above the breastbone contracting as you inhale and the nostrils moving more.

Diagnosis & History

The doctor usually suspects it based on the typical symptoms that indicate atelectasis. In most cases, the underlying disease also leads to the assumption that there is a pulmonary dysfunction. A premature baby is generally expected to have breathing problems. Therefore, the baby’s breathing, skin color, heart rate, muscle tension and reflexes are carefully observed immediately after birth.

The still immature lung is one of the most common reasons for complications. The X-ray examination confirms the diagnosis. The degree of immature lungs can also be determined. In the case of acquired atelectasis, it is important to identify the underlying disease. This is done through an anamnesis (detailed discussion with the person concerned) in order to ask him or her about the symptoms and known diseases. The lungs are then listened to.

If there is atelectasis, the breath sounds are weakened. A muffled sound is heard when tapping the chest with the fingers. The additional X-ray examination again secures the final diagnosis. Depending on the cause, for example a lung tumor, fluid or bruising in the chest , further examinations such as a blood test , computer or magnetic resonance imaging follow .

complications

Atelectasis has a variety of causes and can lead to a variety of complications. On the one hand, atelectasis can lead to inflammation of the lungs (pneumonia). In the worst cases, this inflammation can spread over the entire body and thus lead to blood poisoning or sepsis. Sepsis can degenerate into septic shock.

This leads to a sharp drop in blood pressure, which leads to a lack of blood supply to various organs. This can lead to failure of these organs. The lungs and kidneys are particularly susceptible. Furthermore, the risk of edema forming is increased.

This accumulation of water in the lungs can become chronic and scarring (fibrosis) of the lung tissue can occur. As a result, the lungs can no longer expand properly, the affected person can hardly breathe and has shortness of breath. The body’s oxygen supply is no longer guaranteed, and so-called central cyanosis occurs.

In addition, the pulmonary vessels are constricted by the atelectasis, which can lead to a strain on the right heart, which can be weakened as a result. As the disease progresses, the right heart enlarges (right ventricular hypertrophy) and possibly fails in the same heart ( right ventricular failure ). Those affected are severely restricted in their quality of life and suffer a decrease in performance.

When should you go to the doctor?

Suspicion of atelectasis is a reason for an immediate visit to the doctor. A number of warning signs can be used to determine whether it is the syndrome. Typical symptoms are breathing difficulties, stabbing pains in the chest and an accelerated heart rate. Any of these symptoms should be evaluated by a medical professional to rule out a serious cause or to diagnose the syndrome.

Medical advice is required at the latest when typical symptoms (circulatory problems, a strong feeling of tightness in the chest, a very high heart rate, etc.) appear. Patients with congenital atelectasis should consult their general practitioner regularly . The same applies here: contact the emergency doctor at the first symptoms of an acute syndrome .

If atelectasis is detected and treated early, serious consequences can be reliably avoided. If lung damage has already occurred and the patient collapses, first aid measures must be taken. Treatment by the emergency services must be immediate to avoid serious consequences such as cor pulmonale or pneumonia of the lungs.

Treatment & Therapy

The treatment of atelectasis depends primarily on the causes. The aim is to restore lung function and to ensure that the body is supplied with sufficient oxygen. In the case of a lung tumor, the tumor is usually removed by surgery. Pneumothorax , where air has entered the space between the ribs and causes a section of the lung to collapse, sometimes requires surgery.

Mild forms, on the other hand, often do not require treatment. If there is a foreign body in the airways, it must be removed. If there is a mucus plug, suction is performed. In the case of congenital atelectasis, which is usually based on insufficient lung maturity, the lack of surfactant must be compensated for by giving the premature baby the substance as a drug. If the breathing problems are very pronounced, the baby is artificially ventilated.

Outlook & Forecast

The prognosis of atelectasis depends on the underlying disease. If there is a foreign body in the lungs or airways, there is a good chance of recovery in most cases. The foreign bodies can be removed in one operation and breathing is possible again without being injured. This depends on the size of the foreign body and the tissue it has damaged.

The healing path of pneumonia, on the other hand, is more extensive. In addition to drug or inpatient treatment, it can have a fatal course. If it is not possible to supply the organism with sufficient oxygen, there is a risk of further complications that have a negative impact on the overall prognosis.

Heart problems can occur, which can lead to an acute health situation. In the event of a heart attack or stroke , the patient is at risk of lifelong impairments due to paralysis or functional disorders. In addition, there is also the risk of premature death. In the case of persistent functional disorders of the lungs, artificial ventilation may be required.

If lung activity cannot be restored to the extent required, the patient can only be cured by means of an organ transplant. This is associated with numerous challenges and involves a long road to recovery. If it is successful, everyday life must be adapted to the changed conditions. Nevertheless, it is possible to be largely symptom-free for many years.

prevention

Acquired atelectasis cannot be prevented, only partially counteracted. Pregnant women who suspect a premature birth are given a drug that promotes the maturation of the unborn child’s lungs. Attempts are also made to delay the birth by using anti-convulsants.

aftercare

The extent to which follow-up care is necessary depends on the underlying disease. In principle, however, no immunity builds up even after healing. The complexity of the causes allows a renewed infection. If the typical symptoms occur, doctors order an X-ray for diagnosis. A tap on the chest can also sometimes provide clarity.

If the initial illness causes foreign bodies in the lungs or airways and no tissue was damaged during treatment, there is no follow-up care. The patient is discharged and does not have to fear any further consequences. In many other cases, however, aftercare is of great importance.

Then the lungs are usually so extensively attacked that normal everyday life is no longer possible. Those affected can hardly cope with even small loads. Since a final cure can only be achieved with a lung transplant, help is needed in private and professional everyday life.

Follow-up care aims to prevent complications by any means necessary. Because atelectasis can be acquired or congenital, treatment methods need to be adjusted. Patients whose causes are not resolved require long-term treatment. The symptoms can often be cured with the help of medication. Regular visits to the doctor are then necessary.

You can do that yourself

Individuals suffering from atelectasis require comprehensive medical treatment. An operation is usually necessary, which can be supported by those affected by rest and compliance with other medical requirements.

In addition, it must be ensured that the medication is optimally adjusted. Well-adjusted medication is important, especially when administering painkillers, in order to relieve the patient’s symptoms and thereby also positively influence the healing process. If unusual symptoms appear, the doctor must be informed.

Extensive treatment is often not required for mild forms of alectasis. It is usually sufficient to remove the foreign body from the airways and not to overexert the lungs for a few days or weeks. Congenital alectasis must be clarified by the pediatrician . Parents should keep a close eye on the affected child and make sure they are getting enough air.

In the case of severe breathing problems, intensive care treatment is required in any case. Since this is also a significant burden for the parents, therapeutic support should be obtained. The doctor in charge can often put you in touch with a self-help group. Parents can talk to other people there.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.