Atelectasis is a collapse of lung tissue affecting part or all of one lung. It is a condition where the alveoli are deflated, as distinct from pulmonary consolidation. Infant respiratory distress syndrome is another distinct type of atelectasis.
Causes of Atelectasis
The most common cause is post-surgical atelectasis, characterized by splinting, restricted breathing after abdominal surgery. Smokers and the elderly are at an increased risk. Outside of this context, atelectasis implies some blockage of a bronchiole or bronchus, which can be within the airway (foreign body, mucus plug), from the wall (tumor, usually squamous cell carcinoma) or compressing from the outside (tumor, lymph node, tubercle). Another cause is poor surfactant spreading during inspiration, causing an increase in surface tension which tends to collapse smaller alveoli. Atelectasis may also occur during suction, as along with sputum, air is withdrawn from the lungs. There are several types of atelectasis according to their underlying mechanisms or the distribution of alveolar collapse; resorption, compression, microatelectasis and contraction atelectasis.
Classification of Atelectasis
Atelectasis may be an acute or chronic condition. In acute atelectasis, the lung has recently collapsed and is primarily notable only for airlessness. In chronic atelectasis, the affected area is often characterized by a complex mixture of airlessness, infection, widening of the bronchi (bronchiectasis), destruction, and scarring (fibrosis).
Acute atelectasis is a common postoperative complication, especially after chest or abdominal surgery. Acute atelectasis may also occur with an injury, usually to the chest (such as that caused by a car accident, a fall, or a stabbing). Atelectasis following surgery or injury, sometimes described as massive, involves most alveoli in one or more regions of the lungs. In these circumstances, the degree of collapse among alveoli tends to be quite consistent and complete. Large doses of opioids or sedatives, tight bandages, chest or abdominal pain, abdominal swelling (distention), and immobility of the body increase the risk of acute atelectasis following surgery or injury, or even spontaneously.
In acute atelectasis that occurs because of a deficiency in the amount or effectiveness of surfactant, many but not all alveoli collapse, and the degree of collapse is not uniform. Atelectasis in these circumstances may be limited to only a portion of one lung, or it may be present throughout both lungs. When premature babies are born with surfactant deficiency, they always develop acute atelectasis that progresses to neonatal respiratory distress syndrome. Adults can also develop acute atelectasis from excessive oxygen therapy and from mechanical ventilation.
Chronic atelectasis may take one of two forms—middle lobe syndrome or rounded atelectasis. In middle lobe syndrome, the middle lobe of the right lung contracts, usually because of pressure on the bronchus from enlarged lymph glands and occasionally a tumor. The blocked, contracted lung may develop pneumonia that fails to resolve completely and leads to chronic inflammation, scarring, and bronchiectasis.
In rounded atelectasis (folded lung syndrome), an outer portion of the lung slowly collapses as a result of scarring and shrinkage of the membrane layers covering the lungs (pleura). This produces a rounded appearance on x-ray that doctors may mistake for a tumor. Rounded atelectasis is usually a complication of asbestos-induced disease of the pleura, but it may also result from other types of chronic scarring and thickening of the pleura.
Another cause of Atelectasis is a Pulmonary embolism (PE).
Symptoms of Atelectasis
- cough, but not prominent
- chest pain (rare)
- breathing difficulty
- low oxygen saturation
- fever — debatable; no evidence to support this, although it is widely accepted
- pleural effusion (transudate type)
- cyanosis (late sign)
- increased heart rate
Diagnosis for Atelectasis
- chest X-ray
Post-surgical atelectasis will be bibasal in pattern.
- computed tomography
Treatment of Atelectasis
Treatment is directed at correcting the underlying cause. Post-surgical atelectasis is treated by physiotherapy, focusing on deep breathing and encouraging coughing. An incentive spirometer is often used as part of the breathing exercises. Ambulation is also highly encouraged to improve lung inflation. People with chest deformities or neurologic conditions that cause shallow breathing for long periods may benefit from mechanical devices that assist their breathing. One method is continuous positive airway pressure, which delivers pressurized air or oxygen through a nose or face mask to help ensure that the alveoli do not collapse, even at the end of a breath. This is helpful, as partially-inflated alveoli can be expanded more easily than collapsed alveoli. Sometimes additional respiratory support is needed with a mechanical ventilator.
The primary treatment for acute massive atelectasis is correction of the underlying cause. A blockage that cannot be removed by coughing or by suctioning the airways often can be removed by bronchoscopy. Antibiotics are given for an infection. Chronic atelectasis often is treated with antibiotics because infection is almost inevitable. In certain cases, the affected part of the lung may be surgically removed when recurring or chronic infections become disabling or bleeding is significant. If a tumor is blocking the airway, relieving the obstruction by surgery, radiation therapy, chemotherapy, or laser therapy may prevent atelectasis from progressing and recurrent obstructive pneumonia from developing.
Homeopathy Treatment for Atelectasis
Keywords: homeopathy, homeopathic, treatment, cure, remedy, remedies, medicine
Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines are selected after a full individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution, family history, presenting symptoms, underlying pathology, possible causative factors etc. A miasmatic tendency (predisposition/susceptibility) is also often taken into account for the treatment of chronic conditions. A homeopathy doctor tries to treat more than just the presenting symptoms. The focus is usually on what caused the disease condition? Why ‘this patient’ is sick ‘this way’. The disease diagnosis is important but in homeopathy, the cause of disease is not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness are also looked for. No a days, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathy remedy tries to correct this disease predisposition. The focus is not on curing the disease but to cure the person who is sick, to restore the health. If a disease pathology is not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can be greatly improved with homeopathic medicines.
The homeopathic remedies (medicines) given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathy treatment of this condition. The symptoms listed against each homeopathic remedy may not be directly related to this disease because in homeopathy general symptoms and constitutional indications are also taken into account for selecting a remedy. To study any of the following remedies in more detail, please visit the Materia Medica section at Hpathy.
None of these medicines should be taken without professional advice and guidance.
Homeopathy Remedies for Atelectasis :
- ^ Medical Terminology Systems: A Body Systems Approach, 2005
Incentive Spirometer is also used to prevent or help treat atelectasis after surgery.
- Gylys, Barbara A. and Mary Ellen Wedding, Medical Terminology Systems, F.A. Davis Company, 2005. Paul H. Park