Pulmonary atelectasis - description, causes, symptoms (signs), diagnosis, treatment. Diagnosis and treatment of lung atelectasis (collapse) Video: pulmonary atelectasis in the program “Live Healthy!”

Atelectasis(collapse) lung- loss of airiness in an area of the lung, occurring acutely or over a long period of time. In the affected collapsed area, a complex combination of airlessness, infectious processes, bronchiectasis, destruction and fibrosis is observed.

Code according to the international classification of diseases ICD-10:

J98.1

Causes

Etiology and pathogenesis. Obstruction of the bronchial lumen by plugs of viscous bronchial secretion, tumor, mediastinal cysts, endobronchial granuloma or foreign body. Increased surface tension in the alveoli due to cardiogenic or non-cardiogenic pulmonary edema, surfactant deficiency, infection. Pathology of the bronchial tube walls: edema, swelling, bronchomalacia, deformation. Compression of the respiratory tract and/or the lung itself, caused by external factors (myocardial hypertrophy, vascular abnormalities, aneurysm, tumor, lymphadenopathy). Increased pressure in the pleural cavity (pneumothorax, effusion, empyema, hemothorax, chylothorax). Restriction of chest mobility (scoliosis, neuromuscular diseases, phrenic nerve palsy, anesthesia). Acute massive pulmonary collapse as a postoperative complication (unrecognized and unsanitized obstruction of the main bronchus).

Genetic aspects determined by the underlying disease (cystic fibrosis, bronchial asthma, congenital heart disease, etc.). Risk factors. Surgeries on the chest organs, COPD, tuberculosis, smokers, obese people and people with short and wide chests.

Pathomorphology. Capillary and tissue hypoxia causes fluid transudation. The alveoli are filled with bronchial secretions and cells, which prevents the atelectatic area from completely collapsing. The addition of infection causes fibrosis and bronchiectasis.

Symptoms (signs)

Clinical picture varies depending on the rate of development of bronchial occlusion, the volume of atelectasis and the presence of infection.

Diffuse microatelectasis, small atelectasis, slowly developing atelectasis and middle lobe syndrome (chronic atelectasis of the middle lobe of the right lung due to compression by lymph nodes) may be asymptomatic.

Extensive atelectasis due to acute occlusion is characterized by the following symptoms... Pain on the affected side, sudden shortness of breath and cyanosis. area.. Percussion: dullness of percussion sound over the area of atelectasis.. Auscultation... absence of respiratory sounds - with occlusion of the airways... bronchial breathing, if the airways are passable... moist rales with focal obstruction.. Decreased chest excursion. . Displacement of the apex beat.

Chronic atelectasis.. Shortness of breath.. Cough.. Percussion: dullness of percussion sound.. Auscultation: moist rales.. In case of infection: increased amount of sputum, rise in body temperature.. Recurrent bleeding from the affected area is possible.

Age characteristics. Early childhood: aspiration mechanism, pneumonia. Children: the most common causes are mediastinal cysts and vascular anomalies. Elderly: among the most common causes are lung tumors, cicatricial stenosis, and bronchiectasis.

Diagnostics

Special studies. X-ray of the chest in two projections.. triangular in shape, intense homogeneous shadow with clear boundaries, with the apex directed to the root of the lung, with a decrease in the volume of the affected area of the lung.. With atelectasis of the lobe or lung - persistent displacement of the mediastinum to the affected side, the dome of the diaphragm on the side lesions are raised, intercostal spaces are narrowed.. diffuse microatelectasis - an earlier manifestation of oxygen intoxication and acute respiratory distress syndrome: a “ground glass” picture.. rounded atelectasis - rounded shading with a base on the pleura, directed towards the root of the lung (“comet-shaped” tail of blood vessels and airways). It most often occurs in patients who have been in contact with asbestos and resembles a tumor. Right-sided middle lobe and lingular atelectasis merge with the borders of the heart on the same side (Armand-Delisle symptom). Bronchoscopy is indicated to assess airway patency. EchoCG to assess the condition of the heart in cardiomegaly. CT or MRI of the chest.

Treatment

Treatment

The regimen depends on the patient's condition. Physical activity should be encouraged.

Acute atelectasis (including acute postoperative massive collapse).. The main cause of atelectasis should be eliminated, bronchoscopy should be performed, especially in cases of obstruction of the bronchial lumen with viscous sputum or vomit.. In case of foreign body aspiration - endoscopic removal... Adequate oxygenation, humidification of the respiratory mixture .. In severe cases, mechanical ventilation with positive expiratory pressure or the creation of constant positive pressure in the airways in persons with neuromuscular weakness.. Postural drainage (the head of the bed is lowered so that the trachea is below the affected area), breathing exercises, early postoperative mobilization of the patient.. Physiotherapeutic procedures, massage.. Broad-spectrum antibiotics are prescribed from the first day.

Chronic atelectasis.. Postural drainage, breathing exercises (spirosimulator).. Ventilation of the lungs with positive expiratory pressure or the creation of constant positive pressure in the airways in persons with neuromuscular weakness.. Broad-spectrum antibiotics for purulent sputum.. Surgical resection atelectatic segment or lobe with recurrent infection and/or bleeding from the affected area. If the obstruction is caused by a tumor, then the choice of treatment method is determined by the nature and extent of the tumor, and the general condition of the patient.

Bronchodilators (salbutamol, fenoterol) are of auxiliary value.

Complication- lung abscess (rare).

Prevention. To give up smoking. Prevention of aspiration of foreign bodies and liquids, incl. vomit. In the postoperative period, the use of long-acting painkillers should be limited. Early postoperative mobilization of the patient. Breathing exercises.

ICD-10. J98.1 Pulmonary collapse

– airlessness of the lung tissue, caused by the collapse of the alveoli in a limited area (in a segment, lobe) or in the entire lung. In this case, the affected lung tissue is excluded from gas exchange, which may be accompanied by signs of respiratory failure: shortness of breath, chest pain, cyanotic discoloration of the skin. The presence of atelectasis is determined by auscultation, radiography and CT scan of the lung. To straighten the lung, therapeutic bronchoscopy, exercise therapy, chest massage, and anti-inflammatory therapy may be prescribed. In some cases, surgical removal of the atelectatic area is required.

General information

Lung atelectasis (Greek “ateles” - incomplete + “ektasis” - stretching) is incomplete expansion or total collapse of lung tissue, leading to a decrease in the respiratory surface and impaired alveolar ventilation. If the collapse of the alveoli is caused by compression of the lung tissue from the outside, then in this case the term “lung collapse” is usually used. In the collapsed area of lung tissue, favorable conditions are created for the development of infectious inflammation, bronchiectasis, fibrosis, which dictates the need to use active tactics in relation to this pathology. In pulmonology, pulmonary atelectasis can be complicated by a variety of diseases and lung injuries; Among them, postoperative atelectasis accounts for 10-15%.

Causes

Atelectasis of the lung develops as a result of restriction or impossibility of air flow into the alveoli, which can be due to a number of reasons. Congenital atelectasis in newborns most often occurs due to aspiration of meconium, amniotic fluid, mucus, etc. Primary atelectasis of the lung is characteristic of premature infants who have reduced education or lack of surfactant, an anti-atelectasis factor synthesized by pneumocytes. Less commonly, the causes of congenital atelectasis are lung malformations and intracranial birth injuries, which cause depression of the respiratory center.

In the etiology of acquired lung atelectasis, the greatest importance belongs to the following factors: blockage of the bronchial lumen, compression of the lung from the outside, reflex mechanisms and allergic reactions. Obstructive atelectasis can occur as a result of a foreign body entering the bronchus, the accumulation of a large amount of viscous secretion in its lumen, or endobronchial tumor growth. In this case, the size of the atelectatic area is directly proportional to the caliber of the obstructed bronchus.

The immediate causes of compression atelectasis of the lung can be any space-occupying formation of the chest cavity that puts pressure on the lung tissue: aortic aneurysm, tumors of the mediastinum and pleura, enlarged lymph nodes in sarcoidosis, lymphogranulomatosis and tuberculosis, etc. However, the most common causes of lung collapse are massive exudative pleurisy, pneumothorax, hemothorax, hemopneumothorax, pyothorax, chylothorax. Postoperative atelectasis often develops after surgical interventions on the lungs and bronchi. As a rule, they are caused by an increase in bronchial secretion and a decrease in the drainage function of the bronchi (poor coughing up of sputum) against the background of a surgical injury.

Distension atelectasis of the lungs is caused by impaired stretching of the lung tissue of the lower pulmonary segments due to limited respiratory mobility of the diaphragm or depression of the respiratory center. Areas of hypopneumatosis can develop in bedridden patients, in diseases accompanied by reflex limitation of inhalation (ascites, peritonitis, pleurisy, etc.), poisoning with barbiturates and other drugs, and paralysis of the diaphragm. In some cases, pulmonary atelectasis can occur as a result of bronchospasm and swelling of the bronchial mucosa in diseases of an allergic nature (asthmoid bronchitis, bronchial asthma, etc.).

Pathogenesis

In the first hours, vasodilation and venous congestion are noted in the atelectatic area of the lung, leading to transudation of edematous fluid into the alveoli. There is a decrease in the activity of enzymes in the epithelium of the alveoli and bronchi and the redox reactions occurring with their participation. The collapse of the lung and the increase in negative pressure in the pleural cavity cause a displacement of the mediastinal organs to the affected side. With severe disturbances of blood and lymph circulation, pulmonary edema may develop. After 2-3 days, signs of inflammation develop in the focus of atelectasis, progressing to atelectatic pneumonia. If it is impossible to straighten the lung for a long time, sclerotic changes begin at the site of atelectasis, resulting in pneumosclerosis, bronchial retention cysts, deforming bronchitis and bronchiectasis.

Classification

By origin, pulmonary atelectasis can be primary (congenital) and secondary (acquired). Primary atelectasis is understood as a condition when a newborn child, for some reason, does not expand the lung. In the case of acquired atelectasis, there is a collapse of the lung tissue that was previously involved in the act of breathing. These conditions must be distinguished from intrauterine atelectasis (an airless state of the lungs observed in the fetus) and physiological atelectasis (hypoventilation that occurs in some healthy people and represents a functional reserve of lung tissue). Both of these conditions are not true pulmonary atelectasis.

Depending on the volume of lung tissue “switched off” from breathing, atelectasis is divided into acinar, lobular, segmental, lobar and total. They can be one- or two-sided - the latter are extremely dangerous and can lead to the death of the patient. Taking into account etiopathogenetic factors, pulmonary atelectasis is divided into:

obstructive(obstructive, resorption) – associated with mechanical disruption of the patency of the tracheobronchial tree
compression(lung collapse) – caused by compression of the lung tissue from the outside by the accumulation of air, exudate, blood, pus in the pleural cavity
contractionary– caused by compression of the alveoli in the subpleural parts of the lungs by fibrous tissue
acinar– associated with surfactant deficiency; found in newborns and adults with respiratory distress syndrome.

In addition, one can find a division of pulmonary atelectasis into reflex and postoperative, developing acutely and gradually, uncomplicated and complicated, transient and persistent. In the development of pulmonary atelectasis, three periods are conventionally distinguished: 1- collapse of the alveoli and bronchioles; 2 – phenomena of plethora, extravasation and local edema of the lung tissue; 3 – replacement of functional connective tissue, formation of pneumosclerosis.

Symptoms of pulmonary atelectasis

The severity of the clinical picture of pulmonary atelectasis depends on the rate of collapse and the volume of non-functioning lung tissue. Single segmental atelectasis, microatelectasis, and middle lobe syndrome are often asymptomatic. The most pronounced symptoms are characterized by acutely developed atelectasis of a lobe or the entire lung. In this case, sudden pain occurs in the corresponding half of the chest, paroxysmal shortness of breath, dry cough, cyanosis, arterial hypotension, and tachycardia. A sharp increase in respiratory failure can cause death.

Examination of the patient reveals a decrease in the respiratory excursion of the chest and a lag of the affected half during breathing. A shortened or dull percussion sound is determined above the focus of atelectasis, breathing is not audible or is sharply weakened. With gradual exclusion of lung tissue from ventilation, symptoms are less pronounced. However, subsequently atelectatic pneumonia may develop in the area of hypopneumatosis. An increase in body temperature, the appearance of a cough with sputum, and an increase in symptoms of intoxication indicate the addition of inflammatory changes. In this case, pulmonary atelectasis may be complicated by the development of abscess pneumonia or even a lung abscess.

Diagnostics

The basis for the instrumental diagnosis of pulmonary atelectasis is X-ray examinations, primarily X-rays of the lungs in direct and lateral projections. The X-ray picture of atelectasis is characterized by homogeneous shading of the corresponding pulmonary field, a shift of the mediastinum towards atelectasis (in case of lung collapse - to the healthy side), a high position of the dome of the diaphragm on the affected side, increased airiness of the opposite lung. During fluoroscopy of the lungs, during inhalation, the mediastinal organs shift towards the collapsed lung, and during exhalation and coughing - towards the healthy lung. In doubtful cases, X-ray data are clarified using CT scan of the lungs.

To determine the causes of obstructive pulmonary atelectasis, bronchoscopy is informative. With long-standing atelectasis, bronchography and angiopulmonography are performed to assess the extent of the lesion. X-ray contrast examination of the bronchial tree reveals a decrease in the area of the atelectatic lung and deformation of the bronchi. According to the APG data, one can judge the condition of the pulmonary parenchyma and the depth of its damage. A study of the blood gas composition reveals a significant decrease in the partial pressure of oxygen. As part of the differential diagnosis, agenesis and hypoplasia of the lung, interlobar pleurisy, relaxation of the diaphragm, diaphragmatic hernia, lung cyst, mediastinal tumors, lobar pneumonia, cirrhosis of the lung, hemothorax, etc. are excluded.

Treatment of pulmonary atelectasis

Detection of pulmonary atelectasis requires active, proactive tactics from the doctor (neonatologist, pulmonologist, thoracic surgeon, traumatologist). In newborns with primary atelectasis of the lung, in the first minutes of life, the contents of the respiratory tract are suctioned with a rubber catheter, and, if necessary, tracheal intubation and straightening of the lung are performed.

In case of obstructive atelectasis caused by a bronchial foreign body, therapeutic and diagnostic bronchoscopy is necessary to remove it. Endoscopic sanitation of the bronchial tree (bronchoalveolar lavage) is necessary if the collapse of the lung is caused by the accumulation of secretions that are difficult to cough up. In order to eliminate postoperative lung atelectasis, tracheal aspiration, percussion chest massage, breathing exercises, postural drainage, and inhalations with bronchodilators and enzyme preparations are indicated. For pulmonary atelectasis of any etiology, it is necessary to prescribe preventive anti-inflammatory therapy.

In case of lung collapse caused by the presence of air, exudate, blood and other pathological contents in the pleural cavity, urgent thoracentesis or drainage of the pleural cavity is indicated. In the case of prolonged existence of atelectasis, the impossibility of straightening the lung using conservative methods, or the formation of bronchiectasis, the question of resection of the affected area of the lung is raised.

Prognosis and prevention

The success of lung expansion directly depends on the cause of atelectasis and the timing of treatment. If the cause is completely eliminated in the first 2-3 days, the prognosis for complete morphological restoration of the lung area is favorable. At later stages of lung expansion, the development of secondary changes in the collapsed area cannot be ruled out. Massive or rapidly developing atelectasis can lead to death. To prevent pulmonary atelectasis, it is important to prevent aspiration of foreign bodies and gastric contents, timely elimination of the causes of external compression of the lung tissue, and maintain airway patency. In the postoperative period, early activation of patients, adequate pain relief, exercise therapy, active coughing up of bronchial secretions, and, if necessary, sanitation of the tracheobronchial tree are indicated.

Lung atelectasis is a pathological process associated with a decrease in the airiness of the organ due to the collapse of a certain area. As a result, the organ is not able to perform such an initial function as gas exchange.

Features of the development of the disease

Atelectasis of the lung in newborns is considered primary, that is, the lung or part of it initially does not participate in gas exchange and breathing. Usually appears in premature babies, infants who have suffered severe hypoxia during birth or in the womb due to aspiration of the respiratory tract with meconium or amniotic fluid.

Sometimes congenital pneumonia develops due to transplantent infection from mother to child. Sometimes a collapsed lung appears in absolutely healthy children, in which case this process is called physiological and the organ straightens within two to three days.

Pathology in older children has almost the same etiology as in adults, but with one caveat - in most cases, the causes of pulmonary atelectasis are infectious lesions and allergic reactions. This is due to an incompletely formed immune system, which is susceptible to external attacks.

In addition, the duration of breastfeeding affects the duration of breastfeeding, since with mother's milk the child receives the necessary number of antibodies that protect his body.

The causes of atelectasis are divided into several groups:

The risk group includes people who are overweight, suffer from cystic fibrosis and bronchial asthma, and do not follow a healthy lifestyle.

Development mechanism and classification

What is atelectasis and how does the disease develop? In the collapsed area of the lungs, the lumen of the blood vessels increases, and venous congestion is noted. Fluid enters the alveoli in large quantities and edema develops.

The work of enzymes in the epithelium covering the wall of the respiratory tract is reduced, and the process of redox reactions is disrupted. Negative pressure increases, which shifts the mediastinal organs towards the affected area.

After a few days, an infection may develop - atelectatic pneumonia, the tissue is overgrown with connective tissue cells, collagen, and pneumosclerosis is formed.

Atelectasis of the lung is classified depending on the etiopathogenesis into:

By origin, atelectasis can be:

Primary.
Acquired.

By prevalence there are:

Focal.
Subtotal.
Total atelectasis.

Depending on the level of bronchial obstruction, atelectasis of the entire lung, lobar, subsegmental, discoid and lobular atelectasis are distinguished. Atelectasis can also be unilateral or bilateral.

According to the International Classification of Diseases, Tenth Revision (ICD-10), it refers to other respiratory disorders (J98).

Symptoms and diagnosis

The severity of the symptoms depends on the time during which the disease developed and the area of the collapsed area, as well as on the cause of the pathology. Common features are:

If a person has chronic atelectasis syndrome, cor pulmonale is formed, chest pain is possible due to the discrepancy between the required energy and the actual reserves of nutrients and oxygen. Swelling of the lower extremities appears, as blood stagnates in the circulation.

Hypoxia is formed, to which nervous tissue is most sensitive. The patient complains of constant headaches, malaise, chronic fatigue, weakness, and nausea. In newborn children, there is a violation of the shape of the chest, further lag in mental and physical development due to disturbances in metabolic processes.

When diagnosing, the doctor takes into account the symptoms and medical history of the patient; examining the patient, he notes a decrease in the size or deformation of the chest, a decrease in the intercostal spaces. When palpating the chest above the area of atelectasis, vocal tremors decrease.

On percussion, the lower edge of the lung moves upward, a clear pulmonary sound is replaced by a pronounced dullness. During auscultation, breathing is weakened and cannot be heard at all over the affected area. Sometimes moist rales are heard.

An objective research method is a plain chest x-ray. The X-ray shows:

darkening of areas of the lungs;
displacement of mediastinal organs;
the presence of a foreign object or tumor;
scoliosis;
changes in the diaphragm dome;
level of damage, that is, atelectasis of the upper, middle or lower lobe.

For better image quality and layer-by-layer study, magnetic resonance and computed tomography are used. Most patients undergo bronchoscopy – endoscopy of the bronchial wall. Additionally, tissue biopsy and mucus collection for microscopy are performed.

Spirography is necessary to clarify volumes and capacities, assess ventilation and respiratory failure. In case of cardiac dysfunction, ultrasound examination and electrocardiography are prescribed.

Treatment and prognosis

Treatment of pulmonary atelectasis is aimed at restoring airway patency and eliminating the clinical picture. It is initially necessary to undergo treatment in a hospital setting, comprehensively, taking into account the individual characteristics of the body.

With obstructive atelectasis, bronchial patency is restored, that is, the foreign body and accumulated mucus are removed, the cavity is washed with antibacterial agents and enzyme-containing substances.

Lung collapse, compression form implies a different approach to the patient. It is necessary to pump out fluid or air from the pleural space, remove a benign or malignant formation, or an enlarged lymph node.

In severe cases of respiratory failure or congenital collapse of an organ in an infant, artificial ventilation is required.

Based on biochemical blood tests, therapy is prescribed aimed at restoring water and electrolyte balance. In the absence of contraindications, solutions of glucose, sodium salts, calcium, magnesium, potassium and other minerals are administered intravenously.

To compensate for the lack of oxygen, physiotherapy is prescribed to improve blood circulation, tissue trophism, and prevent further replacement of lung tissue with connective tissue fibers.

Electrophoresis with medications, ultra-high-frequency irradiation, and diadynamic currents have a good effect on the lung area. The patient needs massage and breathing exercises to strengthen the muscles involved in the act of breathing.

The doctor is obliged to tell the patient about atelectasis, explain what it is, what consequences may occur if the recommendations are violated. It is the dialogue with the patient, the formation of ideas about the pathology that allows you to avoid further complications.

Pulmonary atelectasis is a rather dangerous disease in which there is airlessness in the lung tissue. This means that there is insufficient expansion or diffuse collapse of the tissues of this organ. There are a large number of predisposing factors that lead to the development of such a disease, ranging from congenital anomalies to many years of addiction to smoking cigarettes.

The clinical picture is dominated by specific symptoms, which are expressed in the sternum, shortness of breath and cyanosis of the skin.

It is possible to make a correct diagnosis based on a physical examination and instrumental examinations of the patient. Treatment of pulmonary atelectasis is often conservative, but in advanced forms surgery may be necessary.

The International Classification of Diseases identifies its own significance for such pathology. The ICD-10 code is J98.1.

Etiology

Since the disease can be congenital or acquired, the causes will be slightly different.

Lung atelectasis in a newborn can be caused by:

getting meconium, amniotic fluid or mucus into the baby’s lungs;
decreased formation or complete absence of surfactant-antiatelectic factor, which is synthesized by pneumocytes;
defects in the formation or functioning of the left or right lung;
intracranial injuries received during childbirth - against this background, inhibition of the functioning of the respiratory center is noted.

Other sources of disease development in adults and children may include:

obstruction of the bronchial lumen;
prolonged external compression of the lung;
pathological reactions of an allergic nature;
reflex mechanisms;
entry of a foreign object into the bronchi;
accumulation of significant volumes of viscous liquid;
any voluminous benign or malignant neoplasms in the chest area that lead to compression of the lung tissue.

The most common causes of pulmonary atelectasis are represented by the following ailments:

hemopneumothorax;
pyothorax;
chylothorax.

In addition, such a disease is often a consequence of surgical treatment performed on the bronchi or lungs. In this case, an increase in bronchial secretion and a decrease in the drainage capacity of these organs develops.

Often the pathology occurs in bedridden patients who have suffered severe illnesses, which are characterized by reflex limitation of inhalation. These include:

and drug poisoning;
diaphragmatic paralysis;
diseases of an allergic nature that cause swelling of the mucous layer of the bronchus.

In addition, it is worth highlighting the main risk groups that are most susceptible to lung damage from collapse:

age category under three years and over sixty years of age;
long-term bed rest;
rib fractures;
premature babies;
uncontrolled use of certain medications, in particular sleeping pills or sedatives;
chest deformities;
the person has any neurogenic condition that can lead to respiratory muscle weakness;
high body mass index;
long-term abuse of such a bad habit as smoking cigarettes.

Classification

In pulmonology, there are a large number of varieties of this disease. The first of them implies the division of the disease depending on its origin:

primary– diagnosed in infants immediately after birth, when, due to the influence of one factor or another, he was unable to take his first breath, and the lung did not fully expand;
secondary– is acquired. In such cases, a collapse of the lung occurs, which has already taken part in the breathing process.

It is worth noting that the above forms should not be confused with collapse, which developed in utero and is observed in a child in the womb, as well as physiological atelectasis, which is inherent in every person. The intrauterine and physiological form do not belong to the category of true atelectasis.

According to the prevalence of the pathological process, the disease is divided into:

acinous;
lobular;
segmental;
share;
diffuse.

According to the etiopathogenetic principle, the following types of disease are distinguished:

obstructive– formed due to bronchial obstruction caused by mechanical disorders;
compression atelectasis of the lung– is caused by external compression of the lung tissue, for example, by air, pus or blood, which accumulates in the pleural cavity;
contractionary– caused by compression of the alveoli;
acinar– diagnosed in both children and adults in cases of progression.

The development of the disease goes through several stages:

light– expressed in the collapse of the alveoli and bronchioles;
medium-heavy– characterized by the appearance of plethora and swelling of the lung tissue;
heavy– healthy tissue is replaced by connective tissue. At the same time, development occurs.

Depending on the image obtained after the X-ray, the pathology has several types:

discoid atelectasis– develops against the background of compression of several lobes of the lung;
subsegmental atelectasis– characterized by complete obstruction of the left or right lung;
linear atelectasis.

In addition, the following classifications of this disease are distinguished:

according to the degree of compression of the lung tissue - acute and gradual;
according to the presence of consequences - uncomplicated and complicated;
by the nature of the flow - transient and persistent;
according to the mechanism of appearance - reflex and postoperative;
according to the affected area - unilateral and bilateral.

Symptoms

The degree of intensity of the symptoms of the clinical picture will directly depend on the volumes of the lung involved in the pathological process. For example, microatelectasis or damage to only one segment of the lung can be completely asymptomatic. In such cases, the pathology will be a diagnostic finding, which is often discovered during a radiograph for prophylactic purposes.

The disease manifests itself most acutely when an entire lobe of this organ is affected, in particular, atelectasis of the upper lobe of the right lung. Thus, the basis of the clinical picture will be the following signs:

shortness of breath - it appears suddenly both during physical activity and at rest, even in a horizontal position;
pain of varying degrees of intensity in the chest area from the affected lung;
severe dry cough;
violation of heart rate, namely its increase;
decreased blood tone;
cyanosis of the skin.

Similar symptoms are typical for both adults and children.

Diagnostics

Making a correct diagnosis, as well as finding out the localization and extent of the pathological process, is possible only with the help of instrumental examinations of the patient. However, before carrying out such procedures, it is necessary for the pulmonologist to independently carry out several manipulations.

Thus, the primary diagnosis will include:

studying the medical history and collecting the patient’s life history - to identify the most likely etiological factor;
a thorough physical examination, including auscultation of the patient. In addition, it is necessary for the doctor to assess the condition of the skin, measure pulse and blood pressure;
detailed survey of the patient - to obtain detailed information regarding the first time of onset and the degree of intensity of symptoms. This will allow the doctor to assess the severity of the disease and its form, for example, atelectasis of the lower lobe of the right lung.

Laboratory research is limited to carrying out only blood biochemistry, which is necessary to study its gas composition. Such an analysis will show a decrease in the partial pressure of oxygen.

To definitively confirm the diagnosis, the following is carried out:

bronchoscopy - will help to accurately identify the cause of this disease;
X-ray – performed while inhaling. In this case, there will be a displacement of the organs of the mediastinal region towards the affected lung, and on exhalation - towards the area of the healthy half;
bronchography and angiopulmonography - to assess the level of damage to the pulmonary-bronchial tree;
CT scan of the lungs is performed in case of questionable radiographic findings and to clarify the localization of the pathology, in particular, to identify atelectasis of the upper lobe of the left lung or any other focus.

Treatment

After studying the results of all diagnostic measures, the clinician draws up an individual treatment strategy for each patient, taking into account the etiological factor.

However, in almost all cases, conservative techniques are sufficient. Thus, treatment of pulmonary atelectasis may include:

suction of exudate from the respiratory tract using a rubber catheter - this measure is indicated for patients with primary atelectasis. In some cases, newborns may need to be intubated or inflated with air;
therapeutic bronchoscopy – if the etiological factor was the presence of a foreign object;
lavage of the bronchi with antibacterial substances;
sanitation of the bronchial tree endoscopically - if the collapse of the lung is caused by the accumulation of blood, pus or mucus. This procedure is called bronchoalveolar lavage;
tracheal aspiration - in cases where pulmonary atelectasis was caused by a previous surgical intervention.

For a disease of any nature, patients are advised to:

taking anti-inflammatory drugs;
performing breathing exercises;
completing a percussion massage course;
postural drainage;
exercise therapy class;
UHF and drug electrophoresis;
inhalations with bronchodilators or enzyme substances.

It is worth noting that patients are prohibited from independently treating the disease with folk remedies, since this can only aggravate the problem and lead to the development of complications.

If conservative methods of therapy are ineffective in straightening the lung, they resort to surgical intervention - resection of the affected area of the lung, for example, with atelectasis of the middle lobe of the right lung or other localization of the pathology.

Possible complications

Pulmonary atelectasis is a rather dangerous disease that can lead to the following complications:

acute form;
the addition of a secondary infectious process, which is fraught;
compression of the entire lung, which entails the death of the patient;
formation .

Prevention

Preventive measures to prevent the development of such a disease include the following rules:

maintaining a healthy and active lifestyle;
competent management of the recovery period after serious illnesses and operations on the bronchi or lungs;
taking medications strictly as prescribed by the attending physician;
control of body weight so that it does not exceed the norm;
preventing foreign objects from entering the bronchi;
Regularly undergoing a complete preventive examination at a medical institution.

The prognosis of pulmonary atelectasis directly depends on the cause that caused it and timely treatment. A severe course or fulminant form of the disease very often leads to complications, often leading to death.