Atelectasis of the lung is a disease associated with loss of airiness of the lung tissue. This condition is formed in connection with the influence of internal factors.
Today we will tell you what it is. The causes of lung atelectasis are also considered in this article.
Pathology can capture the respiratory organ completely or be limited only to its part. In this case, alveolar ventilation is disturbed, the respiratory surface narrows, signs of oxygen starvation are formed. In a collapsed area of the lung, conditions are created for the formation of inflammatory processes, bronchiectasis and fibrosis.
Complications that may arise may require surgical intervention, which will require the removal of atelectasis sites. Decay of the lung can also be caused by external causes. For example, this may be due to mechanical compression. In such a situation, the disease is called lung collapse. Next, we will examine the causes of this pathology, find out how its diagnosis is carried out, and also find out what treatment should be.
Pathology Description
Atelectasis of the lung is a pathological condition in which the whole lung or only a certain part of it falls. "Falls off" - this means that there is a rapprochement with simultaneous compression of the walls of the lung, as a result of such a process the air leaves this area, turning off gas exchange. The basis of this disease is primarily a violation of bronchial obstruction due to obstruction of the lumen of the bronchus or compression of the lung. For example, a blockage may be a sputum plug or some foreign body.
The magnitude of atelectasis of the lung directly depends on the size of the bronchus involved. In the event of a blockage of the main bronchus in a person, the entire lung can subside. And with violations of bronchial patency of smaller calibers, atelectasis of a single lung segment develops.
Pathology classification
There are several varieties of lung atelectasis. By origin, it is divided into primary and secondary types. The first is diagnosed at birth, when the lung in the child during the first inhalation can not completely straighten. The secondary form appears as a result of a complication after an inflammatory disease. The following types of atelectasis are distinguished by the appearance mechanism:
- Obstructive type. This type of atelectasis is formed in the case of a decrease in the lumen of the bronchus due to an obstruction in the form of a foreign body, tumor or clot of mucus. The main symptoms will be shortness of breath along with a dry cough and shortness of breath. There is a complete and partial collapse. Patients require urgent actions aimed at restoring air patency in the bronchi. With every minute, the likelihood that the body will be able to crack down fully decreases significantly. After three days, restoration of ventilation is not possible. The occurrence of pneumonia is a common occurrence with atelectasis of this type.
- The development of compression type. This type of atelectasis of the left lung or right differs in a favorable prognosis. Even despite a long period of compression of the lung tissue, it is possible to completely restore ventilation. This type of disease is formed as a result of the appearance of inflammatory fluid in the pleural cavity, which leads to lung compression. Symptoms are increasing gradually. Usually, the signs of the disease appear in the form of mixed dyspnea, while exhalation and inhalation are difficult.
- Functional type. This type of disease is formed, as a rule, in the lower lobes. This type is associated with impaired respiratory mechanisms. Most affected are patients who are on prolonged bed rest. Pathology can occur against the background of the desire to limit respiratory movements due to soreness associated with fracture of the ribs, and in addition, pleurisy. Atelectasis of the lung, which is caused by a stroke, is called contractile.
- The development of the contract type. This type of pathology is formed as a result of proliferation of connective tissue. Overgrowth leads to compression of the pleura and adjacent areas.
Separately, it is worth mentioning atelectasis of the middle lobe of the lung. In humans, the median lobar bronchus, being the longest, is most prone to blockage. The disease may differ in cough with the presence of sputum, it is also accompanied by fever and wheezing. The disease is especially acute in the presence of damage to the upper lobe of the lung on the right.
When the collapsed tissue is replaced by connective tissue, this is called fibroatelectasis. In a number of medical directories, a contractile type of this disease is distinguished, in which the size of the alveoli decreases, and surface tension is formed directly against the background of bronchospasm or as a result of an injury. Depending on the obstruction of the bronchi, which is found on x-rays, the following types of atelectasis are distinguished:
- A disk-shaped form in which several parts are compressed at once.
- Subsegmental form of atelectasis. This type can lead to complete obstruction in the lungs.
- Linear shape.
Before figuring out how to treat lung atelectasis, we find out what its causes are.
Causes of pathology
Congenital atelectasis is associated with the penetration of amniotic fluid, meconium and mucus into the respiratory organs. The development of the disease contributes to intracranial trauma, which was received by the infant during childbirth. Among the most common causes of acquired atelectasis are the following factors:
- The process of prolonged compression of the respiratory organ from the outside.
- The development of allergic reactions.
- The occurrence of obstruction of the gaps of one bronchus or several.
- The presence of neoplasms of various nature, which leads to compression of the lung tissue.
- The presence of obstruction of the bronchus with a foreign object.
- The accumulation of mucus in significant quantities can lead to atelectasis.
- Among the causes of fibroatelectasis is pleuropneumonia along with tuberculosis.
In addition to this atelectasis of the lobe of the lung, various factors often provoke, among which:
- Respiratory diseases in the form of pneumothorax, pleurisy in the exudative form, hemothorax, chylothorax, pyothorax.
- A long time ongoing bed rest.
- Fractures of the ribs.
- Uncontrolled use of drugs.
- The appearance of excess weight.
- Bad habits, especially smoking.
In addition, it should be noted that the risk of contracting atelectasis of the right lung or left in patients over the age of sixty is significantly increased. In addition, babies who are not yet three years old are affected by this ailment.
The causes of disk-shaped atelectasis in the lungs may be different.
This is an abnormal condition when the lung tissue loses its elasticity and it falls, and the respiratory surface becomes much smaller. As a result, there is a violation of gas metabolism, oxygen deficiency in the tissues for normal functioning develops. Do not confuse atelectasis with zones of reduced ventilation of the lung of a person in a calm state, when the body does not require increased oxygen supply.
Symptoms of the disease
The severity of symptoms directly depends on what area of the lungs the pathological process has spread. In the case of damage to one segment, as a rule, pulmonary pathology is almost asymptomatic. Only x-rays will help to detect it at this stage. The most noticeable manifestation of this disease with the development of atelectasis of the upper lobe of the lung on the right. In the case of damage to the middle lobe during the examination, doctors detect a diaphragm rise. The main symptoms of the disease are the following symptoms:
- The appearance of shortness of breath, which is observed during physical activity, and in addition, at rest.
- The presence of pain on the part where the pathological process proceeds.
- The occurrence of increased heart rate.
- Lowering the level of blood tone.
- The occurrence of dry cough.
- The appearance of cyanosis.
It should be noted that the listed symptoms are equally characteristic of all patients, regardless of age.
What is the diagnosis of lung atelectasis? Let's consider it further.
Pathology diagnostics
Primary diagnosis involves first of all collecting a medical history along with a physical examination, assessing the condition of the skin, measuring the pulse and pressure of the patient. The main technique for diagnosing atelectasis syndrome is x-ray. X-rays show signs of pulmonary tissue subsidence, which include:
- The presence of a uniform blackout in the affected area. Its dimensions with the shape may vary and depend on the type of pathology. The presence of an extensive eclipse detected by x-ray indicates lobar atelectasis of the lung.
- The presence of organ displacement. Due to the pressure that appears to be the affected side, the organs located between the lungs are displaced towards the healthy site.
Diagnosis of lung atelectasis is quite simple. An x-ray makes it possible to detect exactly where the organs are moved during breathing, as well as during coughing. This factor also determines the type of disease. Sometimes X-rays are supplemented by computed tomography or bronchoscopy. The level of lung damage along with the degree of deformation of the bronchi and the state of the vessels is determined by bronchography, and in addition, angiopulmonography.
Treatment of lung atelectasis should be comprehensive and timely.
Treatment methods
In case of detection of atelectasis in newborns, the respiratory canals are cleaned, and the contents are aspirated using a catheter. Sometimes patients require mechanical ventilation. The treatment regimen of atelectasis of the secondary form is made up for each patient individually, taking into account etiological factors. Conservative techniques include the following techniques:
- Conducting medical bronchoscopy to eliminate bronchial obstruction, when the cause of the ailment is the presence of a lump of mucus or a foreign object.
- The implementation of washing with the use of antibacterial agents.
- Carrying out bronchoalveolar lavage. This procedure involves the rehabilitation of the bronchi using the endoscopic method. It is carried out in case of accumulation of a large amount of pus or blood.
- Carrying out tracheal aspiration.
- Performing postural drainage. In situations in which atelectasis is localized in the upper regions, during the procedure, the patient should occupy an elevated position, and if in the lower, then he is laid on his side.
Regardless of the nature of the disease, the patient is prescribed anti-inflammatory drugs along with respiratory gymnastics, percussion massage, a light complex of therapeutic exercises and physiotherapeutic procedures.
It is important to emphasize that you can not self-medicate and try to eliminate the ailment through traditional medicine. Late requests for medical care significantly complicate and extend the treatment of lung atelectasis. In the event that conservative techniques do not give positive results, resort to surgical intervention, in which the affected part of the lung is removed.
Complications and consequences of pathology
Against the background of this lung disease (atelectasis), the following complications and consequences are likely:
- The development of acute respiratory failure, in which there is a violation of the respiratory process with a sharp lack of oxygen in the body.
- The appearance of infection with the occurrence of pneumonia or lung abscess. With an abscess, a cavity is formed in the focus of inflammation, filled with purulent masses.
- In the presence of a large size of atelectasis, the whole lung is compressed. In addition, against the background of the progressive development of pathology, a fatal outcome is likely.
Prophylaxis
It will be possible to prevent the development of atelectasis of any type if the rules necessary for this are observed:
- Try to adhere only to a healthy lifestyle.
- As part of the recovery period after suffering bronchopulmonary pathologies, all the advice and recommendations of a doctor are required to be observed.
- Constantly monitor your body weight.
- Do not take any medications without medical prescription.
- Examined regularly for preventive purposes.
The success of therapy directly depends on the causes of atelectasis, and in addition, on timely measures. The presence of a mild form of the disease can be cured quickly enough.
Also, in the prevention of atelectasis, it is very important to prevent aspiration of the gastric contents and foreign bodies. In addition, timely elimination of the causes of external compression of the lung tissue along with maintaining the patency of the respiratory canals is required. In the postoperative period, patients are shown adequate pain relief, exercise therapy, active coughing up bronchial secretions. If necessary, sanitize the tracheobronchial tree. Consider also the timing of recovery and treatment of lung atelectasis.
Forecast and timing
The success of lung expansion first of all depends, as already noted, on the causes of atelectasis, and in addition, on the timing of treatment initiation. If the cause is completely eliminated in the first three days, the prognosis regarding the complete morphological restoration of the lung region is favorable. In the case of later periods of expansion, the development of a secondary change in a collapsed area cannot be completely ruled out. Massive, and at the same time rapidly developing atelectases, can lead patients to death.
Conclusion
Thus, lung atelectasis acts as a pathological condition in which a person has a partial or absolute decline in lung tissue, leading to a significant decrease in air volume within the body. Because of this, the complete ventilation of the alveoli is disrupted. In cases in which the collapse of the lung tissue occurs due to external interventions, the term “collapse” is used. Against the background of this condition, a very favorable environment is formed for the development of pathogenic microflora, the risk of infectious inflammation, fibrosis and bronchiectasis increases. With the development of this pathology, it is necessary to seek medical help as soon as possible in order to achieve successful treatment and avoid serious consequences and complications.