Is atelectasis a dangerous disease?

The lungs are a very important organ of the respiratory system, with the function of gas exchange. Any lung disease can affect respiratory function, even respiratory failure and death. Lung diseases can cause many complications. One of the very serious complications is atelectasis. So how dangerous is this complication? Can it be treated? Let's find the answer through the following article.

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• 1. Overview of atelectasis
• 2. Types of atelectasis
• 3. What can cause a collapsed lung?
• 4. Risk factors for a collapsed lung
• 5. Symptoms of a collapsed lung
• 6. Complications
• 7. How is a collapsed lung diagnosed?
• 8. Treatment
• 9. Prognosis
• 10. Conclusion

1. Overview of atelectasis

Atelectasis is an abnormality in the lungs that occurs when the airways or the small sacs at their ends don't expand the way they should when a person breathes. As we inhale and exhale, our lungs will rise and fall like balloons.

Atelectasis is an abnormal condition in the lungs

However, if a person's airways are blocked or something is putting pressure on the lungs, the lungs will not inflate as they should. Doctors call the condition atelectasis . This condition can be life-threatening in children or people with other lung problems.

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Atelectasis is a complete or partial collapse of the entire lung or an area (lobe) of the lung. It occurs when the small air sacs (alveoli) in the lungs collapse, or may fill with alveolar fluid.

2. Types of atelectasis

There are two main types of atelectasis : obstructive and nonobstructive atelectasis. Obstructive atelectasis occurs when something blocks the flow of the airways. For example, foreign body, mucus plug, tumor, etc.

Types of nonobstructive deflation include:

Stretching or compressing

The lining of the chest wall and the surface of the lungs are often in close contact, allowing your lungs to expand. But if fluid or air builds up and separates them, your lungs can pull in and the alveoli can lose air. Depending on where this happens in your lungs, it's either a collapse or a compression.

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Sticky

The fluid that surrounds the alveoli in your lungs has a substance called pulmonary surfactant. It supports your lungs in a number of ways, including keeping the alveoli stable and functional.

Lack of surfactant can cause the alveoli to collapse

If there is a problem with this material (for example, if your body is not making enough), the alveoli can collapse. When that happens, it's called sticky atelectasis. It can be caused by serious lung problems such as respiratory distress syndrome or a bleeding lung.

Lung scars

This type of atelectasis is when the tissue that makes up your lungs has scars that prevent them from holding in as much air as they should. This scarring can occur from some serious lung conditions such as sarcoidosis.

Sarcoidosis

Collapsed due to replacement

This is when your alveoli are filled with a tumor. That deflates an area of ​​your lung.

Collapse due to acceleration

When jet pilots ascend very quickly (between 5 and 9 G-forces), the acceleration can close the airways in their lungs, leading to this type of atelectasis . It can make you short of breath, chest pain, and cough.

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3. What can cause a collapsed lung?

Lungs can collapse for a variety of reasons. Any condition that makes it difficult to breathe deeply or cough can lead to a collapsed lung . Possible causes include:

• Surgery is the most common cause of a person's atelectasis . A collapsed lung can happen during or after any surgical procedure. These procedures often involve the use of anesthesia and a ventilator. Then there are painkillers and sedatives.
• Increased thoracic pressure: Pressure from outside the lungs can make it difficult to breathe normally. It can be caused by deformed bones, tight splints or body casts.
• Pleural effusion or pneumothorax.
• Lung scarring is also known as pulmonary fibrosis. It is usually caused by a long-term lung infection, such as tuberculosis. Long-term exposure to irritants, including cigarette smoke, can also cause this condition. This scarring is permanent and makes it difficult for the alveoli to inflate.
• Congested airways can also cause the lungs to collapse. If air cannot pass through the blockage, the affected part of the lung may collapse. Inhaled mucus or foreign body can cause airway obstruction.

Congested airways can also cause the lungs to collapse

4. Risk factors for a collapsed lung

Some people's lungs may be more at risk of collapsing than others. These risk factors include:

• Smoke or regularly breathe secondhand smoke.
• A long-term, chronic lung disease such as chronic obstructive pulmonary disease (COPD)
• Conditions that damage a person's nerves and muscles. Such as spinal cord injury or muscular dystrophy.
• Illness or injury makes it difficult for the patient to breathe or swallow.
• Medicines that affect your breathing (respiratory depression).
• Fat.
• Use oxygen for a long time.
• Long-term bed rest.
• Elderly.

Collapsed lungs due to lying down for a long time

5. Symptoms of a collapsed lung

Symptoms of atelectasis range from vague to very severe. It depends on how much the lungs are affected and how fast the lungs are growing. If only a few alveoli are affected or it happens slowly, the person may not have any symptoms.

When atelectasis involves multiple alveoli or occurs rapidly, the patient will not have enough oxygen to the blood. Low blood oxygen levels can lead to the following symptoms:

• Shortness of breath.
• Chest pain, especially when taking a deep breath or coughing.
• Breathe fast
• Increase heart rate
• Blue-purple skin, lips, fingernails or toenails.
• Occasionally, pneumonia can develop in the affected part of the lung. When this occurs, the person may have symptoms typical of pneumonia. For example, cough with phlegm, fever and chest pain.

Atelectasis is asymptomatic unless hypoxic or pneumonia

6. Complications

A small area of atelectasis , especially in adults, is usually treatable. The following complications can result from a collapsed lung:

• Low blood oxygen (hypoxia). A collapsed lung makes it harder for a person's lungs to get oxygen to the air sacs (alveoli).
• Pneumonia. The patient's risk of pneumonia continues until the atelectasis stops . Mucus in the collapsed lungs can lead to an infection.
• Respiratory failure. Loss of a lobe or all of a lung, especially in infants or people with lung disease, can be life-threatening.

Respiratory failure can be life-threatening

7. How is a collapsed lung diagnosed?

To diagnose a collapsed lung, a doctor begins by taking a patient's medical history. They look for any previous lung conditions the patient has had. Or any recent surgery.

Next, doctors will try to get a closer look at how your lungs are working. To do this, the therapist may:

• Check the patient's blood oxygen levels with an oximeter, a small device that fits at the tip of a finger.
• Draw blood from an artery, usually in the wrist, and check oxygen, carbon dioxide, and blood chemistry with a blood gas test.
• Chest X-ray.
• A CT scan to check for an infection or blockage, such as a tumor in a person's lungs or airways.
• Perform bronchoscopy. This involves inserting a camera, located at the end of a thin, flexible tube, through the nose or mouth and into the patient's lungs.

X-ray image of collapsed lung

8. Treatment

Treatment for atelectasis depends on the underlying cause and severity of your symptoms.

8.1. Non-surgical treatment

Most cases of collapsed lung do not require surgery. Depending on the underlying cause, your doctor may recommend one or a combination of the following treatments:

8.1.1. thoracic physiotherapy

This involves moving your body into different positions. Also use tapping, vibrating, or wearing a vibrating shirt motion to help loosen and drain the slime. It is often used for collapsed lungs due to obstruction or after surgery. This treatment is also commonly used in people with pulmonary fibrosis.

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8.1.2. Bronchoscopy

The doctor may insert a small tube through the nose or mouth into the patient's lungs to remove the foreign body or clear the mucus plug. This can also be used to remove a foreign body from the airway.

Bronchoscopy

8.1.3 Breathing exercises

Exercises or devices, such as a spirometer, force you to take deep breaths and help open up the alveoli. This is especially helpful for a collapsed lung after surgery.

8.1.4. Drainage

If your collapsed lung is caused by a pneumothorax or pleural effusion, your doctor may need to drain air or fluid from your lungs. To remove the fluid, they will likely insert a needle through the back, between the ribs of the person, into the effusion.

Drainage of pleural effusion

To remove air, your doctor may need to insert a plastic tube, called a chest tube, to remove excess air or fluid. A chest tube may be required for several days in more severe cases.

8.2. Surgical treatment

In rare cases, you may have to remove a small area or lobe of your lung. This is usually only done after trying all other options or in cases involving permanently scarred lungs.

9. Prognosis

The prognosis of a collapsed lung depends on several factors, including the cause of the atelectasis . After treatment, a collapsed lung usually begins to function normally again. But the condition can cause permanent damage in some cases.

10. Conclusion

Atelectasis is not a disease that is a result of many abnormalities in the lungs. This situation can have complex consequences. To limit the risk of a collapsed lung, you should quit smoking. At the same time, go to the doctor for timely treatment of lung diseases.

Dr. Nguyen Lam Giang

See also: How is pulmonary fibrosis treated?