Failure of pulmonary lobe function (Atelectasis)

Atelectasis is a condition in which part or one of the lung lobes is not functioning, the air sacs (alveoli) in the lungs are collapsed so that it interferes with respiratory function. Alveolar tissue damage due to atelectasis depends on the cause.

Patients who have a history of respiratory disease, the appearance of atelectasis can exacerbate breathing difficulties and reduce oxygen levels in the blood.

2 types of atelectasis :

1. Obstructive atelectasis ➡ the most common type of atelectasis. Occurs because the channel between the trachea (throat) and the alveoli is blocked, so that carbon dioxide is reabsorbed by the blood in the alveoli. Obstructive atelectasis can result from tumors, foreign bodies or mucous obstruction of the mucosa. Obstructive atelectasis can occur in large (lobular) and small (segmental) bronchi.
2. Non-obstructive atelectasis ➡

• Relaxation atelectasis : occurs when the inner membrane of the lungs (visceral pleura) loses contact with the outer membrane of the lungs (parietal pleura), due to the presence of fluid (pleural effusion) or air (pneumothorax) in the pleural cavity.
• Compression atelectasis : occurs as a result of the appearance of a lesion in the chest cavity that compresses the lungs and pushes air out of the alveoli, reducing lung volume.
• Adhesive atelectasis : occurs due to lack of surfactant in the lungs. Surfactants function to reduce surface pressure on the alveoli. Lack of surfactant can lead to deflation of the alveoli.
• Cicatricial atelectasis : reduced alveolar volume due to damage or injury to the alveoli walls due to granulomatous disease or lung necrosis.
• Atelectasis replacement : occurs when the alveoli in all segments of the lung are filled or replaced by tumor cells, so that the volume of air in the lungs decreases.

Symptoms.

Symptoms are difficult to see because they do not appear quickly. Common symptoms of atelectasis :

• Difficulty breathing (dyspnea).
• Cough.
• Quick, short breaths.

If atelectasis occurs due to blockage in the bronchi, symptoms will develop :

• Pain in the area affected by atelectasis.
• Dyspnea that occurs suddenly.
• Cyanosis : bluish skin, lips and fingertips due to lack of oxygen.
• Increased heart rate (tachycardia).
• Low blood pressure (hypotension).
• Fever.
• Shock.

Atelectasis that develops slowly is generally asymptomatic or mild.

Cause.

• Use of anesthesia for surgery. Anesthesia can cause changes in breathing pattern, absorption of foreign gases and pressure on the lungs. This condition causes the alveoli to collapse.
• Blockage of mucus fluid due to clumping of mucus or mucus fluid, so that air flow from the trachea to the alveoli is disturbed.
• A foreign object that was accidentally inhaled, such as a bean or toy, gets into the lungs.
• Airway narrowing.
• Chronic infections such as yeast infection, tuberculosis (TB) can injure and narrow the bronchi.
• Tumors of the large bronchial tubes.
• Blood clots if there is bleeding in the lungs.

Causes of relaxation atelectasis :

• Pleural effusion : the appearance of fluid in the lungs.
• Pneumothorax.
• Bullous emphysema.

Causes of compression atelectasis :

• Lumps on the chest muscle wall, lung lining or in the lung parenchyma tissue.
• Fluid clots in the lining of the lungs.

Causes of adhesive atelectasis :

• Hyaline membrane disease.
• Acute respiratory stress syndrome (ARDS).
• Inhaling smoke or cigarettes.
• Operation bypass.
• Uremia: increased levels of urea in the blood due to kidney failure.
• Short breath.

Causes of cicatricial atelectasis :

• Idiopathic pulmonary fibrosis.
• Chronic tuberculosis.
• Yeast infection.
• Radiative fibrosis.

Diagnosis.

• Chest X-ray.
• CT scan.
• Oximetry to measure oxygen levels.
• Bronchoscopy to view the inside of the lungs and remove airway obstruction.
• Histology or tissue examination.

Treatment.

Mild atelectasis can resolve on its own without treatment. If atelectasis is caused by a certain disease or condition, then treatment will focus on the underlying problem.

Complications.

Atelectasis can cause complications :

• Hypoxemia : oxygen deficient blood.
• Pneumonia.
• Respiratory failure.
• Bronchiectasis : lung disease caused by damage, thickening and dilation of the bronchial tubes.