Other conditions besides atelectasis can cause shortness of breath, and most cases require accurate diagnosis and prompt treatment.
Atelectasis - complete or partial collapse of the lung is a possible complication of many breathing problems. Mucus in the airways after surgery, cystic fibrosis, external aspiration, severe asthma, and chest trauma are among the common causes of atelectasis.
Unlike pneumothorax, which is air between the chest wall and lungs, atelectasis develops when the alveolar air sacs in the lungs deflate.
The amount of collapsed lung tissue can vary depending on the cause. The signs and symptoms of atelectasis also vary from the underlying cause and the extent of lung tissue involvement. Atelectasis can be serious because it impairs the exchange of oxygen and carbon dioxide in the lungs. Treatment depends on the cause and severity of the atelectasis.
Depending on the severity of the atelectasis, there may be no obvious signs or symptoms. If you experience signs and symptoms, they may include:
Shortness of breath.
Rapid shallow breathing.
Significant atelectasis can occur during the hospital stay. However, see your doctor right away if you have trouble breathing. Other conditions besides atelectasis can cause shortness of breath, and most require accurate diagnosis and prompt treatment. If breathing becomes increasingly difficult, seek emergency care.
Atelectasis can be the result of blocked airways (obstructive atelectasis) or pressure outside the lungs (nonobstructive atelectasis). Just like soap bubbles, the surface of the liquid keeps the bubbles intact, the surface of each of the tiny air sacs (alveoli) in the lungs that keep them from collapsing. Anything that reduces the surface area, such as pressure on the lungs, causes atelectasis.
Obstruction in the airways (bronchial tubes) can cause obstructive atelectasis. Possible causes of a blockage include:
Mucus: The accumulation of mucus in the airways, which often occurs during and after surgery, is the most common cause of atelectasis. Drugs used during surgery cause less of the lungs to expand than normal, and secretions would collect in the airways. Aspiration of lung fluid during surgery will help reduce secretions but may continue to release afterward. This is why it is important to practice breathing and coughing during recovery. Expanding the lungs with inhaling air makes it easier to cough up. Mucus is also common in people with cystic fibrosis and during severe asthma attacks.
Respiratory tract foreign body: Children can inhale foreign bodies, most commonly peanuts, into their lungs.
Narrowing of the respiratory tract: Tuberculosis and other diseases involving the large respiratory tract can cause atelectasis.
Tumor in the respiratory tract: A cancerous or benign tumor can narrow the respiratory tract.
Blood clot: Occurs if there is bleeding into the lungs that cannot be coughed up.
Pressure outside the lungs can cause nonobstructive atelectasis. Causes may include:
Chest trauma: Trauma from a fall or car accident can damage and collapse a lung.
Pleural effusion: This is a buildup of fluid between the pleura, lungs, and inside the chest wall.
Pneumonia: Pneumonia can temporarily cause atelectasis as well as obstructive atelectasis. Atelectasis for a few weeks or more can lead to bronchiectasis, a condition in which damage to the respiratory tract, lead to weakened and dilated bronchi.
Pneumothorax: Air leaks between the lungs and chest wall, indirectly causing some or all of the lungs to atelectasis.
Scarring of lung tissue: Scarring can be caused by injury, lung disease, or surgery. In rare cases, atelectasis causes scarring of lung tissue.
Tumor: Some large tumors can put pressure on the lungs, blocking the respiratory tract.
Factors that increase the risk of atelectasis include:
Born prematurely, the lungs are not fully developed.
Any spontaneous condition that causes coughing, yawning, and sighing.
Lung disease, such as asthma, bronchiectasis, cystic fibrosis.
Sleeping without often changing positions.
Chest or abdominal surgery.
Shallow breathing - For example due to abdominal pain or broken ribs.
Respiratory muscle weakness due to muscular dystrophy, spinal cord injury, or neuromuscular disease.
Obesity, which can elevate the diaphragm and interfere with the ability to inhale adequately.
The following complications can lead to atelectasis:
Low blood oxygen (hypoxia): Atelectasis interferes with the lungs' ability to get adequate alveolar oxygen.
Scar: Some damage or scarring may remain after the lungs re-expand, eventually causing bronchiectasis.
Pneumonia: There is a risk of developing atelectasis in pneumonia.
Respiratory failure: A small area of a collapsed lung, especially in adults, is usually treatable. However, a large area, especially in an infant or someone with lung disease, can cause life-threatening respiratory failure.
Tests and diagnostics
Chest X-ray can often diagnose atelectasis. With symptoms of a respiratory infection, especially pneumonia, a child's chest x-ray may indicate a foreign body, the most common cause of obstructive atelectasis in children.
To determine the underlying cause, your doctor may indicate other tests, including:
Computed tomography (CT scan). CT is an X-ray technique that produces detailed images. A CT scan can help determine whether a tumor may have caused atelectasis or something that may not show up on a regular X-ray.
Oxygen: This simple test uses a small device placed on the fingers to measure the oxygen saturation in the blood.
Bronchoscopy: A lighted tube that goes down the throat allows the doctor to see and possibly remove at least part of the objects in the respiratory tract, such as a mucus plug, tumor, or foreign body.
Treatments and drugs
Treatment of atelectasis depends on the cause. Atelectasis in a small area of the lung may not require treatment. If there is an underlying condition, such as a tumor, treatment may involve removing or shrinking the tumor with chemotherapy, surgery, or radiation.
In some cases, medication may be used which include:
- Acetylcysteine (Acetadote, Mucomyst), which loosens mucus and makes it easier to eliminate when coughing.
- Bronchodilator inhalers (Foradil, Maxair, Proventil, Serevent, Ventolin, Xopenex), open the bronchial tubes, making breathing easier.
- DNase (Dornase Alfa), is used to clear mucus in children with cystic fibrosis and is approved for the treatment of atelectasis in people without cystic fibrosis.
Certain therapies called chest physiotherapy are used to treat atelectasis which includes:
- Clap your hands on your chest over the flattened area to loosen the mucus.
- Perform deep breathing exercises (spirometry recommended).
- Position the body so that the head is lower than the chest (known as the drainage position), allowing the mucus to drain better.
- Oxygen supplement, which can help ease shortness of breath.
Surgery or procedures
Your doctor may recommend the removal of the respiratory tract foreign bodies, which can be done with mucus aspiration or bronchoscopy. Bronchoscopy uses a tube that is threaded down the throat to the respiratory tract. Often, procedures are performed that can remove part of the tumor to open up the respiratory tract and temporarily relieve the blockage.
Eliminate the nuts: Do not give nuts to children until they are about 3 years old when their molars chew nuts more thoroughly.
Stop smoking: Smoking increases mucus production and damages small hair-like structures in the bronchial tubes (hairs). Its wave motion helps to remove mucus from the respiratory tract.
Deep breathing exercises: After surgery, follow your doctor's instructions to cough frequently and do deep breathing exercises.
If you must stay in bed, change positions often; reposition yourself; get up and walk as soon as you can.