Atelectasis: Symptoms, Causes & Treatment

Atelectasis is the partial or complete collapse of the air sacs in the lungs. It can affect the entire lung or only one lobe, causing symptoms such as shortness of breath, cough, or chest pain.

This respiratory complication can occur in people who are already hospitalized, especially those with cystic fibrosis, a lung tumor, or fluid buildup in the lung after a strong blow to the chest. In some cases, it can also develop after surgery or when part of the airway becomes blocked.

If atelectasis is suspected, you should go to the hospital right away. Early diagnosis and treatment are essential, because a lung that stays collapsed can become life-threatening.

Main symptoms

The main symptoms of atelectasis are:

• Shortness of breath or trouble breathing

• Rapid, shallow breathing

• Persistent cough, either dry or with mucus

• Chest pain or discomfort

• Bluish or purplish skin, nails, or lips

Atelectasis does not always cause symptoms. However, as more alveoli are affected and the body receives less oxygen, symptoms may start to appear.

If you have symptoms of atelectasis, you should go to the hospital right away so the condition can be diagnosed and the most appropriate treatment can be started.

Confirming a diagnosis

Atelectasis is diagnosed clinically by a pulmonologist or primary care provider based on symptoms, medical history, risk factors, and a physical exam.

If needed, the doctor may order imaging tests, such as a chest X-ray or CT scan, to look at the lungs in more detail.

The provider may also order an arterial blood gas (ABG) test to measure oxygen levels in the blood or a bronchoscopy to identify blockages in the lungs.

Possible causes

The main causes of atelectasis are:

• A buildup of secretions in the airways

• Chronic obstructive pulmonary disease (COPD)

• Pleural effusion or pneumothorax

• Tuberculosis or pulmonary fibrosis

• A foreign body in the lung

• A hard blow to the chest

• Pneumonia

• Lung cancer or tumors inside the chest

Atelectasis can also develop up to 72 hours after surgery performed under general anesthesia, because anesthesia can cause some alveoli to collapse.

According to the National Heart, Lung, and Blood Institute, newborn respiratory distress syndrome is caused by a lack of surfactant, and surfactant replacement therapy may be used when a baby continues to have breathing difficulties.

In general, atelectasis happens when an airway is blocked, when there is scarring in the lung, or when there is too much pressure outside the alveoli.

Treatment options

Treatment for atelectasis should be guided by a pulmonologist or primary care provider and depends on the cause and severity of symptoms.

The main treatments for atelectasis are:

1. Bronchoscopy

Bronchoscopy may be performed to clear the lungs by removing mucus, objects, or other foreign material that is blocking the airways.

2. Medications

Medications such as bronchodilators or mucolytics may be recommended to relax the airways and thin the mucus, making it easier to clear and allowing air to move more easily into the lungs.

In cases of acute respiratory distress syndrome (ARDS), treatment may also include intratracheal surfactant.

3. Breathing exercises

If atelectasis symptoms are more severe, breathing exercises may be used to help reopen the alveoli.

These exercises may include coughing, taking several deep breaths, or gently tapping over the affected area to help loosen built-up secretions.

Exercises may also be done with an incentive spirometer, which is a device with three balls that move when the person inhales deeply and exhales through the tube.

4. Respiratory therapy

Respiratory therapy for atelectasis helps improve lung capacity.

The goal of this treatment is to support breathing rehabilitation through exercises prescribed by a physical therapist and techniques that improve lung efficiency and endurance.

5. Surgery

In more severe cases, surgery may be needed to clear the airways or even remove the affected part of the lung so it can function properly again.

Surgery may also be done in cases of pleural effusion or abscesses to drain fluid or pus from the lungs through thoracentesis.

Whenever there is an identifiable cause of atelectasis, such as a tumor or fluid in the lung, the underlying problem should also be treated to help prevent it from happening again.