AtelectasisIntroduction:
A partial lung collapse is called "atelectasis". Most
often it is only one of the segments of the lower
lung lobes that is adjacent to the diaphragm. The reason for this
is that a mucous plug can form easier in the lower bonchial tubes. This is particularly
the case in older patients. They are too weak to cough it up, or in otherwise
sick patients. Atelectasis is often associated with chronic lung diseases such
as COPD, asthma, ARDS, bronchiectasis or lung cancer. One special subcategory
is a "rounded atelectasis", due to the appearance of a round lesion
on X-rays, which is usually located close to the diaphragm and is associated with
asbestosis. Signs
and symptoms: The symptoms depend on the underlying cause and
how rapidly the bronchial tube was obstructed by a mucous plug. In asthma it may
be more in the smaller airways and would be more diffuse in nature. In a patient
with a cancer in the bonchial tube the mucous plug that forms around the tumor
could lead to a massive atelectasis very rapidly and affect a whole lung lobe,
which in turn may get infected with pneumonia. The above asthma patient may only
feel some chest wall pain and cough somewhat more. The patient with the lobar
atelectasis and lung cancer would have shortness of breath that comes on suddenly
coupled with a fever and excruciating chest pain to the point where the patient
will splint the affected chest and not breathe on that side. Diagnostic
tests: The doctor will do a thorough examination where the anatomical
landmarks are carefully inspected. Often the trachea and heart have shifted somewhat
to the affected side, which can be observed or percussed. Breath sounds and chest
wall movements on the affected side are diminished. Chest X-rays show typical
changes. a CT scan can help to show the physician many of the underlyying causes.
Arterial blood
gases can show how much the atelectasis has reduced the oxygen tension
in the blood. The reduction will be larger, if a larger area of the lung is affected.
Fiber
optics bronchoscopy is perhaps the most direct approach to identify
and remove a mucous plug or foreign body that may accidentally have been inhaled
and to remove it at the same time. Treatment: As
atelectasis causes can be quite varied, therapy for atelectasis depends on what
findings are obtained in a particular patient. Generally speaking, the cause of
obstruction of the airways has to be removed. For instance, after surgery where
the secretions in the bronchial tube are drier and more tenacious, a mucous plug
can form easier. To prevent atelectasis from happening, the physician will usually
order chest physiotherapy as a preventative. An aerosol machine may be used to
moisturize the air that is inhaled. All of this helps to liquefy the secretions
and make it easier to cough them up. In more debilitated nursing home patients
or in patients in the ICU nasotracheal suctioning with sterile flexible catheters
may have to be done occasionally. The sooner a patient can be mobilized after
surgery, the better it is, as the lung perfusion/ lung ventilation distribution
are more normalized in the upright position.This means that the oxygen level in
the blood stream is better and the surfactant recovers to normal levels allowing
the body to breathe normally again when the mucous plug has been removed. In
lung cancer the therapy
is directed at the findings of the staging process as explained in more detail
under this link. In severe reoccuring basal atelectases, particularly when
bronchiectases are present at the same time, a chest surgeon may have to remove
the lung segment that contains the bronchiectasis and chronic atelectasis (wedge
resection of the lung or segmentectomy). Pain relief: There
is an FDA approved non-drug method available, IceWave
patches from Lifewave, which will control pain. This is mentioned in the
book "Breakthrough" by Suzanne Somers (Ref. 10) where newer insights
of antiaging medicine are also reviewed. Although the patches are placed over
acupuncture points, there are no needles involved. Nanotechnology, a newer technology,
was used in the manufacturing of these patches and infrared (heat) waves from
body heat are utilized to stimulate an acupuncture point, which modifies pain
perception and reduces pain to half or less. Medically this would be considered
an excellent pain reliever. For more info on the patches see the IceWave patches
from Lifewave link above (click "products"). In the US a 5 pack of the
IceWave spray is available that can be directly sprayed onto the skin in the area
where the pain is located. |
