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Atelectasis is a condition that occurs when your entire lung or a part of your lung gets deflated. This results in the reduction or absence of proper gas exchange in the body. There are various factors that could cause the lung to collapse, some of which include a tumor in the airway, obstruction in the respiratory passage, cigarette smoking, excessive exposure to smoke, shallow breathing, asthma, injuries and infections. Little children have also been known to experience this problem when they inhale foreign objects like small toys, stationary and so on. Almost everyone who has been through a surgery in which anesthesia was used has experienced some form of atelectasis. This is commonly known as postoperative atelectasis and it constitutes around 90% of all surgical pulmonary complications. The lung tissue collapses due to the depressing effects of the anesthetic medication. Post-operative atelectasis usually occurs within 48 hours after the surgery is completed.

Causes of Postoperative Atelectasis

When you are under the influence of anesthesia, your diaphragm relaxes and has the tendency to get displaced. An upward displacement may cause the lungs to get deflated and collapse. The depressant properties present in anesthetic drugs may also make the lung tissue cave in.

While anyone can experience postoperative atelectasis after going through a surgery, there are certain factors that increase its risks, such as -

• Obesity
• Smoking cigarettes
• Muscular weakness
• Abdominal distension
• Prior history of respiratory infections or illnesses like asthma
• Being elderly or bedridden

Pregnant women who are undergoing a surgery for any reason are also at a higher risk of experiencing post-operative atelectasis.

Symptoms

Many people suffering from postoperative atelectasis experience no symptoms at all, the problem is detected when they undergo a chest x-ray. However, some of the signs and symptoms that may be present include -

• Shallow breathing or other breathing difficulties
• Fever
• Increase in heart rate
• Pain in the chest
• Coughing, but not a prominent cough

However, these symptoms are not specific to a deflated lung and may be present even in patients who are not suffering from atelectasis. Doctors may need to conduct a few tests, like an x-ray, a CT scan or an ultrasound, for a more accurate diagnosis.

Treatment Options

The treatment for post-operative atelectasis usually involves physiotherapy. Your doctor will advise you to practice deep breathing. A medical device known as an incentive spirometer may also be included in your deep breathing exercises to improve the functioning of your lungs. At the same time, you may also be asked to cough at regular intervals.

Another way to treat postoperative atelectasis is providing continuous airway pressure. In this technique, pressurized air or oxygen is delivered through your nose, using a face mask, to ensure that the alveoli don’t collapse completely, even after you breathe out. Partially deflated alveoli expand more easily as compared to collapsed ones.

Tips for Preventing Postoperative Atelectasis

• There is no definite way to prevent atelectasis after a surgery, but there are a few ways in which its risks can be reduced.
• Patients who stop smoking around 6 to 8 weeks before their surgery are less likely to develop post-operative atelectasis.
• Elderly people, especially those who are bedridden, can also avoid this problem, by moving around as much as possible. This could mean changing positions or just sitting up in bed every few hours.
• When lying down, try to make sure that your head is below your chest. This is known as postural drainage and it allows the mucus to drain from the bottom of your lungs.
• Practicing the recommended deep breathing exercises suggested by the doctor soon after a surgery may also improve the functioning of the lungs and prevent postoperative atelectasis.

References

http://www.ncbi.nlm.nih.gov/pubmed/12580216

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