Atelectasis

( Incomplete Greek ateles =; ektasis = stretch) The term atelectasis is meant a collapsed lung section, which is filled with little or no air. The alveolar walls are at each other.

Molding

Congenital atelectasis

Congenital atelectasis is also referred to as primary or fetal atelectasis atelectasis. The lung shares are not or only partially ventilated after birth. The reasons are central respiratory disorders (eg, damage to the respiratory center ), Fruchtwasseraspirationen, lung malformation and immature lungs ( surfactant deficiency ) in question.

A special form of primary atelectasis is found as a typical finding in a stillbirth: Since the lung is deployed physiologically Although in fetal life, but no air contains ( but amniotic fluid ), this finding may also be utilized forensic medicine to detect an existing respiratory activity after birth or exclude.

Acquired atelectasis

An acquired atelectasis is also referred to as secondary atelectasis. All acquired atelectasis have a minimum residual air in the atelectatic lung sections and are in principle reversible.

Diagnostics

In the percussion you hear an attenuation of the lung sound. The breathing sound is attenuated on auscultation of the lungs. The chest radiograph can be seen as direct characters a decrease in transparency and displacement of the cloth column and as indirect signs of an elevated diaphragm, a mediastinal shift, a compensatory emphysema, a Hilusverlagerung and a narrowing of the ribs. The differential diagnosis should be suspected pneumonia, atelectasis show, in contrast to the latter no bronchogram. Alternatively, or in addition to x-ray image can make a computer tomography uptake. In the ultrasound you can see atelectasis in the area of pleural effusion as a non-ventilated, volume decreased lung sections.

Follow

Most atelectasis dissolve again by itself or to be removed by medical and nursing measures. As a complication, it can cause inflammation and edema, fibrosis come to later. Depending on the size of atelectasis the surface of gas exchange is reduced, which can lead to central cyanosis. In the atelectatic lung section, the pulmonary blood flow is throttled by vasoconstriction ( Euler - Liljestrand mechanism). This increases the resistance in the pulmonary circulation and thus the right heart strain. There may be a cor pulmonale. In the non-ventilated parts of the lung pneumonia can occur.

Therapy

Physical measures ( change of position, cold water applications, knocking massage, breathing exercises) are very effective. The effect of a mucolysis ( = mucus liquefaction) is controversial. When rib fractures or pleurisy pain treatment is necessary. As medicines you can use theophylline, beta-sympathomimetics and antibiotics in bacterial infection. Bronchoscopy using the suction of the pus, tenacious secretions, or the removal of the foreign matter is carried out. Similarly, the application of PEEP bzw.CPAP has proven to be an additional therapeutic strategy.