Atelectasis is what? Diagnosis, treatment and prognosis

Atelectasis - what is it? The answer to this medical question is known only to experienced specialists. But to find out, you do not need a doctor. Details about atelectasis you can find out from the materials of the article in question.

Definition of the term

Atelectasis is a pathological condition characterized by loss of airiness by all of the lungs or by a specific site. The term in question is of Greek origin. Translated into Russian, it means "failed" or "incomplete stretching of the tissue."

Causes of development of

Atelektase is a decrease in the segment of the lung. Several factors can lead to the development of such a pathological condition. Let's list the main of them right now:

• An increase in the surface tension observed on the walls of the alveoli. As a rule, such a pathology is caused by pulmonary edema of non-cardiogenic or cardiogenic origin, as well as a lack of surfactant or infectious processes.
• Ventilation of the respiratory tract or lung, which is caused by various external factors( for example, mediastinal tumor, anomaly in the development of large blood vessels, lymphadenopathy, myocardial hypertrophy, etc.).
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• Pathology of the mucosa( inner) walls of the bronchus( eg, bronchodilation, deformity, swelling, or swelling).
• Obstruction or so-called occlusion of the lumen of the bronchi by foreign bodies, mucus, caseous masses( for example, with tuberculosis), and also swelling of the mucous membrane.
• Violations of natural chest excursions that occur due to paralysis of the diaphragmatic nerve, general anesthesia, scoliosis or neuromuscular diseases.
• Increased internal pressure in the pleural cavity( including hemothorax, hydrothorax, empyema, pneumothorax).

Why else can atelectasis arise? The causes of this condition are often hidden in the acute massive collapse of the lung, which occurs as a postoperative complication due to prolonged immobility of the patient, an overdose of oxygen, hypothermia, the use of large doses of sedatives and opiates, and vasodilating drugs.

Risk Factors

Who most often has atelectasis? This disease is inherent in people with obesity, cystic fibrosis and bronchial asthma. He is also susceptible to heavy smokers.

Classification of

By origin, lung atelectasis may be congenital( ie primary) or acquired( ie, secondary).

Primary disease means a condition where a newborn baby does not have a lung spreading. With regard to acquired atelectasis, in this case there is a decrease in lung tissue, which previously participated in the process of breathing.

It should be said that such phenomena should be distinguished from intrauterine atelectasis, that is, the airless state of the lungs that is observed in the fetus, and the physiological( that is, hypoventilation that occurs in quite healthy people and is a kind of functional reserve of lung tissue).

Types of the disease

Depending on the volume of lung tissue that comes out of the respiration process, the disease under consideration is divided into:

• acinous;
• is segmented;
• lobular;
• total;
• share.

It can also be two-sided or one-sided. By the way, the first variety is extremely dangerous and can easily lead to the death of the patient.

Types of the disease

Depending on the etiopathogenetic factors, the pathology of the pulmonary system under consideration is divided into the following types:

• Compression atelectasis, or collapse, of the lung. This condition is caused by the compression of the pulmonary tissues from the outside, and by the accumulation in the pleural cavity of exudate, air, blood or pus.
• Obturation atelectasis. This phenomenon is associated with a mechanical violation of the patency of the trachea and bronchi.
• Discoid atelectasis of the lung. This pathology usually develops after a concussion of the chest or fracture of the ribs.
• Contractile - is caused by compression of the alveoli with a fibrous tissue( in the subpleural parts of the lungs).
• Acinar - is associated with a lack of surfactant( most often occurs in adults and newborns with respiratory distress syndrome).

It should also be noted that the disease under consideration can be reflex and postoperative, developing gradually and acutely, uncomplicated and complicated, transient and persistent.

Symptoms of

The severity of the lung atelectasis clinic depends on the volume of nonfunctioning and the rate of lung tissue loss. Micro-teleclases, single segmental atelectasis and mid-diarrheal syndrome very often occur asymptomatically.

As for the acute disease, it has a marked symptomatology. In this case, the patient feels sudden pain, paroxysmal dyspnea, cyanosis, dry cough, tachycardia and arterial hypotension. With a sudden increase in respiratory insufficiency, even a lethal outcome may occur.

When examining the patient, lagging of the affected lung lobe during breathing is revealed, as well as a reduction in the respiratory chest excursion. In addition, blunt percutaneous or shortened sound is defined above the focus of atelectasis. At the same time, breathing is greatly weakened( may not be audible).

Complications of atelectasis

With the gradual switching off of the lung segments from ventilation, the signs of the disease are less pronounced. But in the future, atelectatic pneumonia develops in the area of ​​hypopneumosis.

The appearance of a cough with sputum, an increase in body temperature, as well as an increase in symptoms of intoxication indicate the attachment of inflammation. In this case, the disease in question is complicated by the development of a lung abscess or abscessed pneumonia.

Diagnosis of

Diagnosis of lung atelectasis is carried out by means of radiological examination of the respiratory organ in lateral and direct projections. This reveals a homogeneous darkening of the pulmonary field, as well as a shift in the mediastinum towards the fraction that has fallen out of the respiration process. In addition, the x-ray shows a high position of the dome of the diaphragm and increased airiness of the lung.

In doubtful cases, this method of investigation is refined by CT.Also, bronchoscopy is used to find out the causes of obstructive atelectasis, and with prolonged atelectasis, angiopulmonography and bronchography are performed.

Treatment of

Detection of atelectasis of the lung requires from the doctor( pulmonologist, neonatologist, traumatologist or thoracic surgeon) active tactics. Newly born babies with primary atelectasis of the lung produce sucking of the contents of the respiratory organs by means of a rubber catheter. If required, intubation of the trachea and dilatation of the lung are performed.

With this type of disease, as obstructive atelectasis, which was caused by a foreign body, it is extracted by means of medical diagnostic bronchoscopy.

If the recession of the lung was caused by the accumulation of a difficult secret, an endoscopic sanation of the bronchial tree is performed.

To eliminate postoperative atelectasis, tracheal aspiration, respiratory gymnastics, percussion chest massage, postural drainage, as well as inhalations with enzyme and bronchodilators are performed.

One can not help saying that atelectasis of the lungs of any origin requires the mandatory implementation of preventive anti-inflammatory therapy.

Forecast of

Success in lung extension depends on the timing of onset of treatment and the cause of atelectasis. With the complete elimination of the latter in the first three days, the prognosis regarding the restoration of the respiratory tract site is favorable.

In case of running cases, it is impossible to exclude the development of secondary changes in the collapsed share. Rapidly developed and massive atelectasis can lead to death.