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by Jones P

Definition

Atelectasis is a collapse in part of the lungs. Normally, air passes through the airways into small sacs of the lungs. Oxygen from the air passes through these sacs into the blood. Carbon dioxide also passes from the blood to the sacs to leave the body. With atelectasis, these sacs are collapsed. Oxygen and carbon dioxide cannot pass through the collapsed sacs.

A collapse over large parts of the lungs can lead to serious problems. In infants, atelectasis may be present at birth or caused by another health problem.

Healthy Lungs
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Causes

Atelectasis is not a disease. It is the result of a disease or problem in the body. It can be caused by:

  • Blockage in the airways from things like inhaled stool during birth, an inhaled object, or a mucus plug that keeps air from moving into the lung sacs
  • Lung infections that may cause fluid build-up that blocks air to the lung sacs
  • Lack of a fluid that lines the inside of the lungs and helps them work the right way (common in babies born very early)
  • Air that is not breathed deep enough into the lungs to open all sacs
  • Damage to nerve and muscles that control breathing—may prevent coughing, deep breathing, or yawning

Risk Factors

Things that raise the chance of this problem at birth are:

  • Inhaled meconium or amniotic fluid
  • A long or hard labor
  • Birth injury to the central nervous system

Children under three years old are more likely to get atelectasis than older children or adults. Things that may the risk are:

  • Premature birth
  • Lung problems or infection that make it hard to cough
  • Injury to the chest wall
  • Having anesthesia
  • Inhaling a foreign object, such as a peanut or marble
  • Respiratory distress syndrome
  • Being on ventilator—air does not move into lungs in a normal pattern

Symptoms

Atelectasis may not have symptoms that are easy to spot.

Larger areas of atelectasis may lead to:

  • Fast breathing
  • Shallow breaths
  • Agitation
  • Coughing
  • Fewer chest movement during breathing
  • Wheezing
  • Fever
  • Blue skin

Diagnosis

You will be asked about your child’s symptoms and health history. A physical exam will be done. It will focus on your child's breathing.

Images may be taken of your child's chest. This can be done with:

A bronchoscopy may be done to check for an obstruction. This is an exam of the lungs with a small tube.

Treatment

Treatment will be based on the cause. Oxygen or breathing support may be needed until the problem resolves. Treatment options are:

Removing the Blockage

Steps will be taken to remove any blockage that is causing the problem. This can be done using a tube that is passed down the throat and into the lungs. Small tools can be passed through the tube to remove the object or mucus plug.

Physical Therapy

Chest therapy can be used to help move mucus out of the lungs. One option uses a rhythmic tapping on the back and chest. Another option uses special positions to help move mucus out of the lungs.

Breathing Therapy

This type of therapy may include:

  • Breathing masks or treatments to help keep airways open
  • Suction to help remove fluids
  • Breathing support in babies who cannot breathe on their own

Medication

Medicines may be used to:

  • Open the airways
  • Treat the disease that caused the collapse
  • Treat an infection

Prevention

Not all atelectasis can be prevented. These steps may lower the risk:

  • Keep small objects out of reach.
  • Manage lung conditions.
  • Avoid premature birth by having regular prenatal care, eating a healthy diet, and getting enough activity.

RESOURCES

American Lung Association  http://www.lung.org 

Kids Health—Nemours Foundation  http://kidshealth.org 

CANADIAN RESOURCES

Health Canada  http://www.canada.ca 

The Lung Association  http://www.lung.ca 

References

Braverman M, Brown S. Congenital Atelectasis Discussion and Case Presentation. Radiology. December 2012, 265(3);1144.

Collapsed lung (atelectasis). Cedars-Sinai website. Available at: http://www.cedars-sinai.edu/Patients/Health-Conditions/Collapsed-Lung-Atelectasis.aspx. Accessed December 31, 2019.

Goligher E, Ferguson ND. Mechanical ventilation: epidemiological insights into current practices. Curr Opin Crit Care. 2009 Feb;15(1):44-51.

Mechanical ventilation. EBSCO DynaMed website. Available at:  https://www.dynamed.com/procedure/mechanical-ventilation  . Updated October 28, 2019. Accessed December 31, 2019.

What is atelectasis? National Heart Lung and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/atl. Accessed December 31, 2019.

Revision Information

  • Reviewer: EBSCO Medical Review Board Kari Kassir, MD
  • Review Date: 09/2019
  • Update Date: 12/31/2019