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| Atelectasis, Definition, Symptoms, Causes, Diagnosis, Treatment, Prevention, Complications |
Atelectasis is a condition when the small air sacs in the lungs (alveoli) collapse and are not filled with air. Atelectasis is one of the causes of lung collapse and cannot expand.
The alveoli are where the exchange of oxygen and carbon dioxide takes place in the lungs. For this exchange to take place properly, the alveoli must be filled with air. However, in atelectasis, the alveoli are not filled with air. As a result, there is no exchange of oxygen and carbon dioxide.
Atelectasis needs to be treated quickly, because it can cause a lack of oxygen supply to the body's organs. If left untreated, atelectasis can develop into a life-threatening disease.
Causes of Atelectasis
Atelectasis is often caused by an obstruction, either a tumor, foreign body, or mucus, in the respiratory tract. The blockage (obstruction) can occur in the respiratory tract, namely the trachea, bronchi, and bronchioles.
In addition to the blockage of the respiratory tract, atelectasis can also be caused by the following conditions:
- Injury to the chest that causes severe pain when breathing
- Scar tissue in the lungs, either due to injury, complications of lung disease, or side effects of lung surgery
- Lung infections, such as tuberculosis or pneumonia
- Pleural effusion, which is a buildup of fluid in the pleural lining
- A chest tumor that presses on the lungs and blocks the airways
- Pneumothorax, which is the collection of air in the pleural cavity
Atelectasis can also occur due to a lack of surfactant in the alveolar walls. Surfactant is a substance that serves to keep the alveolus stable and expand. Lack of surfactant will cause the alveoli to collapse and cannot expand again. This condition is common in babies born prematurely.
In addition to some of the causes above, there are several factors that can increase a person's risk of experiencing atelectasis, including:
- Old age
- Recently had surgery on the chest or abdomen
- Just had surgery using general anesthesia
- Taking certain medications that affect the respiratory system
- Have a smoking habit
- Suffering from sleep disorders such as sleep apnea
- Have a respiratory disease, such as chronic obstructive pulmonary disease, asthma, bronchiectasis, or cystic fibrosis
- Have an injury that causes pain and difficulty taking deep breaths, including broken ribs
- Suffering from obesity
- Is pregnant
Symptoms of Atelectasis
At first, atelectasis does not cause any symptoms. Atelectasis will only cause symptoms if the damaged part of the lung is large enough and the body begins to experience a lack of oxygen. Symptoms of atelectasis that will arise are:
- Cough and wheezing
- Difficulty breathing
- Breath fast and shallow
- Right or left chest pain, depending on the part of the lung affected
- Blueness of the skin, lips, and fingertips (cyanosis)
- Increased heart rate (tachycardia)
Atelectasis that continues over time will cause a decrease in oxygen levels in the body (hypoxia) and a drastic drop in blood pressure. If the damaged part of the lung is getting wider, atelectasis can also trigger shock.
When to go to the doctor
Go to the emergency room immediately if you experience the above symptoms. Early treatment will prevent complications and more severe lung damage.
If you suffer from conditions that increase your risk of developing atelectasis, such as recent surgery under general anesthesia, and have asthma, cystic fibrosis, or a broken rib, see your doctor for a check-up and follow-up according to the schedule given by your doctor.
Atelectasis Diagnosis
The doctor will ask about the symptoms that are felt and the patient's medical history, including a history of chest surgery. After that, the doctor will perform a thorax or chest examination using a stethoscope.
To confirm the diagnosis, the doctor will perform the following investigations:
- Scanning with X-rays or chest CT scans, to determine the condition of the lungs
- Bronchoscopy, to see the condition of the lungs, take tissue samples, or treat blockages in the airways
- Tissue examination (biopsy), to detect abnormalities in lung tissue, including to detect tumors, cancer, or infections
- Examination with an oximeter, to measure oxygen levels in the blood
Atelectasis Treatment
Mild atelectasis resolves on its own without treatment. However, if atelectasis is caused by certain conditions, the doctor will take action to treat the cause.
Treatment methods to treat atelectasis include:
Chest physiotherapy
In atelectasis caused by complications after surgery, the doctor will recommend physiotherapy to the patient to help the lungs expand and deflate normally. The therapies provided include:
- Teach patients the correct cough technique, to help remove mucus from the respiratory tract
- Teach patients deep breathing techniques, with the aid of an incentive spirometry device
- Perform tapping or percussion therapy on the chest wall, either by hand or with an air-pulse vibrator
- Position the head lower than the body to help remove mucus
Operation
If the atelectasis is caused by a blockage of mucus in the airway, the doctor will suction the mucus using a special tube. This can be done with bronchoscopy.
Bronchoscopy can also be used to remove foreign bodies that are stuck in the airways.
If the atelectasis is caused by a tumor or cancer, the doctor will perform surgery to remove the tissue. This surgery can be combined with chemotherapy and radiotherapy.
Drugs
To help treat and cure atelectasis, your doctor may give you the following medications:
- Bronchodilators
- This drug serves to dilate the bronchi and encourage the release of mucus trapped in the respiratory tract. Examples of bronchodilator drugs that can be used are salmeterol or theophylline.
- Antibiotics
- Antibiotics can be given to treat atelectasis caused by a bacterial infection. Antibiotics that can be given generally have a broad spectrum, such as cefuroxime and cefaclor.
- Mucolytic
- Mucolytic drugs work to thin the mucus in the respiratory tract so that it is easier to expel. Examples of mucolytic drugs that can be given are N-acetylcysteine, guaifenesin, and dornase alpha.
Complications of Atelectasis
Untreated atelectasis can lead to complications such as:
- Hypoxemia, which is a condition of low oxygen levels in the blood
- Pneumonia or wet lungs, which is inflammation caused by an infection in the lungs
- Bronchiectasis, which is a lung disease caused by permanent damage, thickening, and widening of the bronchial tubes
- Respiratory failure, which is a condition when the respiratory system is unable to deliver oxygen and remove carbon dioxide
Prevention of Atelectasis
Atelectasis can be prevented by avoiding factors that can increase the risk. Efforts that can be made include:
- Quit smoking
- Pay attention to the safety of the children's play area, including keeping objects that are at risk of entering the child's respiratory tract
- Consult a doctor regularly if you suffer from diseases or conditions that can increase the risk of atelectasis
- Undergo physiotherapy after surgery on the chest or surgery under general anesthesia, according to doctor's advice
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