What is Atelectasis? Atelectasis Causes and Treatment

by Abbas Jahangir · June 15, 2024

The lungs, the respiratory organs of the body, contain air sacs called alveoli. The air taken with breathing fills these sacs and is expelled again after delivering the oxygen it contains to the blood vessels. Atelectasis is a respiratory disease that occurs when the air sacs cannot inflate and relax properly due to blockage of a part or various parts of the lungs. The medical name of this condition, popularly called lung shrinkage, is linear atelectasis or linear atelectasis. Many factors, from smoking to tumors in the bronchi and disorders related to mucus secretion, may be effective in the development of atelectasis. If severe or seen in children and individuals with respiratory diseases, atelectasis can be life-threatening by causing serious respiratory distress.

What is Atelectasis?

The inability of air to reach a certain part of the lung due to any physical obstruction in any part of the lungs, consisting of the windpipe (trachea), bronchi, bronchioles and alveoli, constitutes the answer to the question of what atelectasis means. In other words, the lungs cannot be used at full capacity due to air not reaching the alveoli due to the obstruction, so the part of the lung in question cannot inflate with air and then relax. In addition to physical obstructions, situations such as air compression between the lung and the chest wall or pressure on the chest for any reason may also cause atelectasis. Serious problems may arise in atelectasis patients, especially during physical activities, as it creates problems with breathing.

What are the symptoms of atelectasis?

Atelectasis may not cause any symptoms in the early stages. If the area affected by the obstruction is small, this condition is usually not noticeable as there will be no significant decrease in respiratory capacity. However, as the severity of the disease increases, the likelihood of some symptoms appearing in patients increases. Some complaints among the symptoms of atelectasis can be listed as follows:

Shortness of breath
rapid breathing
Difficulty breathing deeply and intermittent breathing
Wheezing
chronic cough
pain in chest
Fast heartbeats (tachycardia)
Bruising or bluish discoloration of the skin and lips

Various diagnostic tests should be performed to investigate lung functions in patients who apply to health institutions with such complaints. Diagnostic methods such as chest x-ray, computed tomography, arterial blood gas measurement and bronchoscopy help detect a possible blockage in the lungs. Since these symptoms are among the symptoms of different diseases, different screening tests may be requested by the physician to support the diagnosis. As a result of evaluation of all findings, a treatment plan is initiated for patients diagnosed with atelectasis, taking into account the severity of the disease.

What are the causes of atelectasis?

There may be more than one answer to the question of what causes atelectasis. Any condition that causes collapse or congestion in the lung can lead to atelectasis. Causes of lung constriction or lung atelectasis include:

Obstruction in the lungs due to mucus, a foreign object entering the lungs through breathing, or a tumor in the airways
Tumors that put pressure on the lungs and airways from outside
Fluid or air trapped between the lung and chest wall (pleural effusion or pneumothorax)
Pneumonia
Surfactant deficiency in newborn babies
Scarred tissues in the lung (pulmonary fibrosis)
Surgical operations performed
Long-term lung infections such as tuberculosis
Medications that affect breathing
Having received oxygen support for a long time
Prolonged bed rest
Various diseases affecting muscles and nerves, such as spinal cord injury and muscular dystrophy
Using cigarettes and other tobacco products
Obesity and old age

What are the Types of Atelectasis?

There are two basic types of atelectasis. The first of these is obstructive atelectasis caused by obstructive factors, and the other is non-obstructive atelectasis caused by non-obstructive factors. The basic types of atelectasis are as follows:

Congenital atelectasis: It is caused by congenital anomalies in the bronchi and bronchioles.
Obstructive atelectasis: It is caused by physical obstructions such as mucus and inflammation-related deposits, postoperative stenosis, bronchial tumors and foreign body entry into the lungs.
Passive atelectasis: It is caused by air or fluid accumulations in the pleural space.
Acceleration atelectasis: Atelectasis occurs as a result of exceeding the sound barrier in airplanes.
Adhesive atelectasis: It is caused by diseases that cause breathing difficulties, pressurized oxygen treatments, being connected to a respirator, and pulmonary embolism.
Contraction atelectasis: It is called scar or cictrization atelectasis and is caused by the accumulation of fibrous tissue in the lung.
Acute atelectasis: These are atelectasis that occur temporarily due to reasons such as lung surgeries or lung injuries.
Chronic atelectasis: Middle lobe syndrome caused by tumor pressure in the middle lobe and atelectasis caused by chronic pleural inflammation.
Atelectasis in newborns: It is a type of atelectasis seen in newborn babies, especially in premature births, and the common cause is surfactant deficiency.
Subsegmental atelectasis: It is also called plate-like atelectasis and develops partially due to the decrease in air flow into and out of the alveoli.
Dependent atelectasis: Partial or complete obstruction of the respiratory tract due to the effect of physical obstructors.

Although these are the common types of atelectasis, there may be more than one reason for atelectasis in some patients. The effects of a particular respiratory disease may fall into more than one group when factors such as injury and tumor come together. In such cases, the treatment approach should be determined by taking into account the problems in the lung.

How is Atelectasis Treated?

The most important answer to the question of how to treat atelectasis is to ensure air flow in the lungs and eliminate the collapse. For this reason, if there is a physical obstruction, in other words, if there is obstructive atelectasis, necessary interventions should be made to eliminate the obstruction. If the cause of the obstruction is mucus accumulation, drug treatments can be applied to dilute these secretions and they can be removed through coughing. Patients may be referred to respiratory physiotherapists to remove mucus plugs from the respiratory tract. Studies in the field of respiratory physiotherapy are very effective in increasing lung capacity and relieving air flow to the deep parts of the lung. One of the common causes of linear atelectasis is infections. Therefore, if such an infection is detected in a patient with atelectasis, the infection should first be relieved with the help of appropriate antibiotic treatments. Once the infection is treated, airflow may ease and atelectasis may disappear. However, in some cases, permanent effects may occur and additional treatments may be needed.

Acute atelectasis, which occurs as a complication after surgery, can be treated with oxygen supplements. If there is a foreign object in the respiratory tract, this object can be removed by performing bronchoscopy. In cases such as tumor or fibrous tissue accumulation, treatment usually requires surgical operations. In chronic atelectasis that develops after long-term infections, surgical removal of the lung area that forms the focus of the infection is an effective treatment method for both treatment and prevention of recurrence of the infection. As can be seen from these approaches, the causes of atelectasis play a key role in determining the treatment process. Once patients are diagnosed with atelectasis, it is very important to fully identify the causes that play a role in the development of this condition in terms of treatment success.

If you have atelectasis, you can be protected from the complications that the disease may cause by having regular check-ups. If you are experiencing symptoms of atelectasis and have not yet received a diagnosis, you can consult a pulmonologist to undergo an examination and have the necessary scans.