Causes of Atelectasis - Research Paper Example

? Atelectasis Introduction Partial or full collapse of a lung is known as atelectasis. This impairs the patient's normal breathing ability. There could be several causes for atelectasis but important thing is that the patient must get enough oxygen through any possible device before the root cause is eliminated. Alveoli, the tiny air sacs in lungs, are quite flexible and absorb oxygen by inflating and then pass on the oxygen to the blood by deflating. In atelectasis, they fail to perform this important work causing oxygen starving to the blood of the person affected. If left untreated for a long time, this medical condition can cause several other complications culminating into the death. Causes of Atelectasis Pulmonary Surfactant is necessary for the reduction of the surface tension of the alveoli to prevent them collapsing. Sometimes infants are born with the congenital atelectasis for their lungs are not developed with the ability to inflate. This usually happens in premature birth of the baby where lungs are not yet developed enough to produce surfactant to keep lungs inflated. It takes away the deep breathing capability of the infant. The causes of atelectasis are many and varied. Swollen lymph nodes or tumors may be the reason for chocking the airway passage. Atelectasis may also cause due to the compression of airway passage. That is why asthma is one primary cause of lung atelectasis. Small chest wall is also a reason for the compressed airway passage and sometimes neuromuscular disease could also be a reason. (Alam, 2011) Among other causes, anesthesia is found to compress the lung tissues of patients who undergo surgery. The patient with enlarged heart due to heart problem will get their lower left lobe of the bronchus compressed resulting into atelectasis. Atelectasis could also be a result of neurological disorders. People having passed through accident trauma often get their lung punctured causing atelectasis. Smokers and people suffering from COPD (chronic obstructive pulmonary disease) are prone to develop atelectasis at some stage in their life. (Alam, 2011) Incentive Spirometry and Deep Inhalation for Healthy Lungs Incentive spirometer is a device which helps keep alveoli inflated. It also measures how well the functioning of the lungs is. Spirometer is a simple but an effective device that helps exercise the lungs of a person. During the use, Indicator can be placed at some desired level while breathing in as deeply as possible. The piston of the device rises toward the top. The person holds breath for 3-4 seconds and then allows the piston to fall to the original position. This exercise can be done as many times as possible. It is good for a person recovering from surgery to keep lungs inflated. In the absence of spirometer, deep inhaling and exhaling keeps lung fit and could be beneficial in prevention and reversing pulmonary complications. (Incentive Spirometry 1991) Intermittent Positive Pressure Breathing (IPPB) IPPB is a kind of mechanical ventilation device that is used to expand lungs using aerosol medication for short term or intermittently. It is not first choice of treatment in spontaneously breathing patients as other less expensive treatment methods can meet the needs of treatment. IPPB can be given in clinic, hospital and home settings. This is usually applied when other therapies such as incentive spriometry, deep breathing exercises, and positive airway pressure have failed to deliver the results. This is suitable when patient is unable to clear secretions adequately due to pathology limiting the ability to cough effectively. This is also suitable in an alternative to tracheal intubation. IPPB is also used for the patients to deliver aerosol medications who are found to be with ventilatory muscle weakness (R.C Journal 2003). For patients who suffer from acute breathlessness and excessive secretions, IPPB helps them for easy breath. IPPB has certain limitations in that it needs compressed air or oxygen and being a pressure cycled device the noncompliant lungs will receive less volume. IPPB has not been found to work in the patient with respiratory muscle weakness such as neuromuscular disorders or weakness due to spinal cord injury. IPPB has been found to increase tidal volume and it happens through passively ventilating the patient and thus improving arterial blood gases. To a relaxed patient the work of breathing is reduced. (Denehy 2001) The Positive Expiratory Pressure (PEP) PEP is another device that helps keep lung healthy if employed regularly. The device consists of mask which provides one-way breathing valve and tube adaptor to create resistance. The patient inhales through the inspiratory port. The PEP mask facilitates the airways open so as to allow mucus to be secreted. Mask has valves that allow airways to stay open longer so that air can push the secretions out. Mask is provided with different size valves so that it can fulfill the specific needs of each patient. (Physical Therapy 1998) The PEP device help to increase the inhaled lung volume; it increases patient's ability to rid lungs of mucus by providing vibrations as patient exhale; it helps avoid lung infection after any surgical procedure. Nurse or respiratory therapist will set the level of frequency dial depending upon the need of the patient. A deep breath is taken and hold for 2-3 seconds before putting mouthpiece in mouth and then exhaling through the PEP device gradually and smoothly. The PEP device can be used as per the need of the patient or performing 10-20 breaths per use. (Positive Expiratory Therapy 2007) Continuous Positive Airway Pressure (CPAP)/Expiratory Positive Airway Pressure (EPAP) In CPAP therapy, the patient is required to breathe against a spring loaded or water-column weighted threshold resistor. This consistently maintains preset airway pressures of 5-20 cm H2O during inspiration and expiration activities. CPAP operation of device is above atmospheric pressure and needs a continuous gas flow to the airway during inspiration. Air is pushed through the tubing/mask through the nose and then to the throat. The proper treatment pressure is needed for necessary comfort levels to the patient. A device consists of a flow generator, mask and humidifier to relieve nasal dryness or irritation. The drawback with CPAP device is that it requires a trained person for setup and maintenance. Due to requirement of external positive pressure gas source – a need of compressor makes the operation expensive and not suitable for home setting. (Positive Airway Pressure...1993) In EPAP therapy, the patient breathes out against a threshold resistor. No pressurized external gas source is needed to run EPAP device. EPAP device is provided with a one-way valve that allows air at ambient pressure. The gas enters airway on inspiration and exhales through the threshold resistor. (Positive Airway Pressure...1993) Conclusion Atelectasis is not a disease but rather a medical condition that can cause serious lung diseases if left untreated. If all the alveoli are affected then it can lead to a severe problem causing death of the patient. The available devices in the form of IPPB, Incentive spirometry, PEP or CPAP can provide needed relaxation to the patient and buy time to the physician. For a long term survival of the patient it is necessary to remove the root cause of atelectasis. References 1. Alam, Shah (2011), Lung Atelectasis: Causes, Symptoms and Treatment, online available October 16 2011, http://www.buzzle.com/articles/lung-atelectasis-causes-symptoms-and-treatment.html 2. Incentive Spirometry (1991), available online October 16 2011, http://www.rcjournal.com/cpgs/ispircpg.html 3. R.C Journal (2003), Issue of Respiratory Care, available online October 16, 2011, http://www.rcjournal.com/cpgs/05.03.0540.html 4. Denehy, L; Berney, S., (2001), The use of positive pressure devices by physiotherapists, online available October 16 2011, http://erj.ersjournals.com/content/17/4/821.full#sec-2 5. Physical Therapy (1998), available online October 16, 2011, http://cystic-l.org/handbook/html/physical_therapy.htm#Positive 6. Positive Expiratory Therapy (2007), available online October 16 2011, http://www.stjude.org/SJFile/sedation_pep_therapy.pdf 7. Positive Airway Pressure...(1993), available online October 16 2011, http://www.rcjournal.com/cpgs/papcpg.html Read More