What is Atelectasis? Is it something to be afraid of?

Sometimes you may feel a little short of breath, just a cough. It's common to feel this way, especially after major surgery. One of the main reasons for this is that part of your lung has collapsed. In medical terms, we call this atelectasis (pronounced: at-lek-ta-sis). While the name may sound a bit scary, it's usually not serious. So today, let's take a look at exactly what it is, why it happens, and what you can do about it.

Simply put, what is Atelectasis?

Imagine that your lungs are made up of millions of tiny air sacs. These tiny air sacs are called alveoli . When we breathe, these tiny air sacs fill with air. The oxygen in the air is then absorbed into our blood. The blood then carries that oxygen throughout the body.

Now, if for some reason these air sacs called alveoli do not get enough air, or if they are squeezed by external pressure, they collapse like a balloon that has deflated. That is what we call `Atelectasis`. This can happen in a small part of the lung, or the entire lung can collapse. If a large part of the lung collapses in this way, our blood cannot get the required amount of oxygen, which can lead to various health problems.

Are Atelectasis and Pneumothorax two different things?

Yes. Many people confuse these two conditions.

• Atelectasis is the collapse of the air sacs (alveoli) within the lungs.
• Pneumothorax is the leakage of air from outside the lung, that is, into the empty space between the lung and the chest wall, and that air pushes the lung out.

Simply put, in one case the lung collapses from within, in the other case it collapses due to pressure from outside.

Who is most at risk for this condition?

You may be at higher risk of developing atelectasis if:

• If you have had chest or abdominal surgery: The anesthesia drugs used to keep you asleep during surgery can cause your breathing to become shallow and you may not be able to cough up enough mucus. This can cause your air sacs to become blocked.
• If you have a condition that blocks the small airways in your lungs: Conditions like asthma may prevent your lungs from expanding properly.
• If you have a chest injury or broken rib: You may have difficulty breathing deeply due to the severe pain.
• If you are a smoker.

What are the main types of atelectasis?

This condition can be divided into several main types depending on how it occurs. Let's see what they are.

In addition, there is a special type that is seen in premature babies and patients with acute respiratory distress syndrome (ARDS), which is caused by a lack of a protein called surfactant in the lungs.

What are the symptoms of this condition?

In most cases, if only a small part of the lung is affected , there will be no symptoms. However, if a large area of ​​the lung is affected, the level of oxygen in the blood can become low (hypoxemia). This can cause symptoms such as:

• Difficulty breathing/shortness of breath (dyspnea)
• Cough
• Chest pain
• Increased breathing rate (tachypnea)
• Bluish discoloration of the skin and lips

Main causes of atelectasis

As we discussed earlier, the most common cause of this is surgery. Because we are not breathing deeply due to anesthesia and are not coughing properly to clear mucus, the airways to the air sacs can become blocked and choke.

In addition, there are other reasons:

• Mucus plug: This condition is common after surgery, in severe asthma patients, and in young children.
• Inhaled object: Accidental inhalation of objects, such as toys and food, especially in young children, can cause airway obstruction.
• Pleural effusion: This can be caused by other medical conditions, such as heart disease.
• Air accumulation around the lungs (Pneumothorax).
• Non-cancerous (benign) tumors.
• Cancerous tumors.
• Scarring of the lungs.
• Other medical conditions: Chronic obstructive pulmonary disease (COPD), infections such as pneumonia.

How does a doctor diagnose this?

The first test to diagnose this is a chest X-ray. This can clearly see the affected part of the lung. If necessary, a CT scan can be done to see in more detail.

Sometimes, if there is a suspicion of a blockage in the airway, the doctor will insert a small tube with a camera down the throat to examine the inside of the lungs. This is called a bronchoscopy . During this test, they may also remove something that is blocking the airway, such as a piece of mucus.

How is it treated?

Most cases of atelectasis resolve spontaneously under medical supervision, without any special treatment.

However, depending on the cause and extent of the swelling, other treatments may be necessary.

• Deep breathing exercises: Especially exercises done using a device called ``incentive spirometry''.
• Clearing obstructions: Removing mucus or other objects through a bronchoscopy.
• Physical therapy: Exercises that help the lungs expand.
• Inhaled medications: Medicines that open the airways (bronchodilators).
• Treating the underlying condition: If this is due to cancer or another chronic disease, treat that disease.

Can atelectasis be serious?

Although this condition is usually not serious, in some cases complications can occur:

• Low oxygen levels in the blood (Hypoxemia): When the air sacs become inflamed, oxygen cannot pass into the blood.
• Pneumonia: Mucus can become trapped in the airways, causing infection.
• Respiratory failure: This can be a life-threatening condition if an entire lung collapses. However, this is very rare.

In most cases, once the cause of atelectasis is treated, the lung will return to normal. Most people recover quickly and there are no long-term effects.

Atelectasis, lung collapse, difficulty breathing, surgery, alveoli, pneumothorax, bronchoscopy