Tuesday, January 25, 2011

Pulmonary atelectasis

Pulmonary atelectasis

    
* Introduction
    
* Signs and symptoms
    
* Diagnosis
    
* Treatment
Atelectasis is defined as the absence of gas in the alveoli, alveolar collapse due to consolidation or liquid. It can affect a part or the whole lung. It is a condition in which alveoli are deflated, distinct from pulmonary consolidation. It is frequently found in chest X-rays and other radiological studies. It can be caused by some disease or a wound in the chest that releases air from the lungs. Although often described as the collapse of the lung tissue, atelectasis is not synonymous with pneumothorax, which is more specific. Acute atelectasis may occur as a postoperative complication or as a result of surfactant deficiency. In premature infants results in acute respiratory distress.
The most common cause is postsurgical, characterized by restricting breathing after abdominal surgery. Smokers and older people are prone to this risk. atelectasis involves blocking the bronchial tree by foreign bodies or mucus, tubers, tumors, lymph nodes. Another reason is the lack of surfactant during the breathing increases the surface tension of alveoli and their collapse. Atelectasis may occur during suctiunii, with the air is removed from lung sputum. There are several types of mechanisms atelectazii after the collapse of their core or distribution laveolar: resorption, compression, and atelectazii microatelectazii contraction. Another cause is pulmonary embolism.
Treatment is directed toward correcting the cause of the fund. Postsurgical Atelectaziile treated by physiotherapy, the deep breaths and cough encouraging. Outpatient departments are also encouraged to improve lung inflation. People with neurological conditions or deformities with shallow breathing for long periods of time benefit for mechanical assistance. One method is continuous positive air pressure breathing, which releases the pressurized air through a mask on your nose or mouth to ensure noncolabarea alveoli.
Treatment for acute massive atelectasis is correction of the underlying cause. Deadlock can not be removed by coughing or suctioning the airway may be removed by bronchoscopy. Antibiotics are indicated in case of infection. Chronic Atelectaziile are treated with antibiotics because infection is inevitable. In some cases surgically resected lung can be affected if they become chronic or recurrent infections.
Make a tumor blocking the release of airway obstruction by surgery, radiotherapy, chemotherapy or laser therapy can prevent progression and development atelectaziile of recurrent obstructive pneumonia.
Pathogenesis Obstructive atelectasis: Obstructive atelectasis is the most common and result from reabsorption of gas from the alveoli when communication between them and the trachea is stopped. Obstruction may occur at a large or small bronsii. Causes of obstructive atelectasis include foreign bodies, tumors and mucus plugs. The rate at which they develop and expand atelectaziile depends on several factors, including the extension of collateral ventilation is present and inspired gas composition. Obstruction of a lobar bronchus lobar atelectasis occurs, the obstruction of segmental bronchi segmental atelectasis cause. Due to possible collateral ventilation without a lobe or segment lung ventilation depends on the nature atlectaziilor collateral by Kohn's pores and channels of Lambert. Atelectasis nonobstructiva: Nonobstructiva atelectasis may be caused by loss of contact between the parietal and visceral pleurele, compression, loss of surfactant and reinlocuirea parenchymal tissue by scarring or infiltrative disease.
Atelectaziile liabilities arise when pneumothorax pleurisy or remove the contact pleurele visceral and parietal tooth. Generally uniform elasticity of a normal lung leads to preservation of its shape when the volume is low. Different lobes also function differently: the lower and middle lobes are higher than those colabeaza faster in the presence of pleurisy, and higher education is affected by pneumothorax.
Atelectaziile compression arising from any space occupying lesion in the lung and chest compression force of the air to spiral out of wafers. Atelectaziilor passive mechanism is similar.
Adhesive Atelectaziile result from surfactant deficiency. Surfactant reduces the surface tension of alveoli increase usage structures tend to collapse. Decreased production or inactivation of surfactant leads to alveolar instability and collapse. The phenomenon is observed in acute respiratory distress.
Atelectaziile by scarring occurs by decreasing the volume as sechela excessive tissue scarring and is usually caused by granulomatous disease or necrotizing pneumonia.
Right middle lobe syndrome: This syndrome is a disorder or recurring fixed atelectaziilor right middle lobe and / or lingula. Can occur by external compression or obstruction bronsiilor their domestic. It can thrive in a patent lobar bronsii identifiable without obstruction. Inflammatory processes and bronchial anatomy of defects, along with collateral ventilation have been designated as onobstructive causes of this syndrome.
It was reported as a manifestation of Sjogren's syndrome. Transbronchial biopsies in these patients shows lymphocytic bronchiolitis in atelectatici lobes. Atelectasis responds well to glucocorticoid treatment, suggesting the important role of these infiltrates in the right middle lobe syndrome development.
Atelectaziile round: Represents the circular demarcated atelectatic lung tissue with fibrous bands and adhesions in the visceral pleura. Incidence is high in asbestos workers because of the degree of pleural disease. Affected patients are typically asymptomatic, and the age of presentation is 60 years.
Causes and risk factors: Atelectaziilor main cause of acute or chronic airway obstruction is the following: Sputum-plugs, foreign bodies -Endobronchial tumors -Lymph nodes, which compresses bronsiile aneurysms.
Bronsiilor external compression by pleural effusion, pneumothorax can cause atelectasis.
Abnormalities of surfactant production contribute to alveolar instability and may lead atelectazii. These anomalies occur frequently in oxygen toxicity and ARDS.
Atelectaziile resorption are caused by the following: Bronhogenic-cell carcinoma, metastatic bronchial obstruction -Inflammatory etiology (tuberculosis, fungal infections) Foreign-body vacuum Bad-positioned endotracheal tube External compression of the airway, tumors, lymphadenopathy, aneurysm, cardiomegaly.
Passive atelectasis is caused by the following: -Pleural effusion, pneumothorax Emfizematoasa-bubble high.
Atelectaziile adhesive produced the following: -Hyaline membrane disease, acute respiratory distress syndrome Smoke-inhalation, cardiac bypass surgery -Uremia, prolonged shallow breathing.
Atelectaziile scarring produced by the following: -Idiopathic pulmonary fibrosis Tuberculosis, chronic fungal infections -Irradiation fibrosis.

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