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At least 217 records · Page 12Linked to original sources
PubMed1990

Acute lobar atelectasis. A comparison of two chest physiotherapy regimens.

Fourteen cases of acute lobar atelectasis were alternately allocated to one of two chest physiotherapy regimens for treatment. Treatment in group 1 comprised positioning, vibrations, hyperinflation, and suction, and in group 2, treatment consisted of hyperinflation and suction alone. Treatment in either group was given hourly for six hours. Patients in group 1 had a significantly higher mean percentage resolution of their atelectasis (mean value, 60.1 percent), as seen on chest roentgenogram, after one treatment intervention than patients in group 2 (mean value, 7.6 percent; p less than .006). After the intensive six-hour treatment period, the difference between the groups was marginally statistically significant, still favoring group 1 over group 2 (p less than .055). Follow-up roentgenograms at 24 and 48 hours revealed no significant difference between the treatment groups (p greater than .10 and greater than .20, respectively). These results suggest that, at least initially in the course of acute lobar atelectasis, positioning and vibrations add to the efficacy of a treatment of hyperinflation and suction alone.

Acute Disease↗
PubMed1980

Rounded atelectasis.

A little-known form of collapse, rounded atelectasis, is occasionally seen on chest radiographs. Previous reports are mostly in the German and French literature (Hanke collected more than 50 personal cases). Rounded atelectasis appears as a masslike lesion that often mimics a pulmonary neoplasm. Distinctive features that permit radiographic diagnosis include a rounded or oval shadow 2.5--5 cm in greatest diameter, pleural-based, usually lying along the posterior surface of a lower lobe. The blood vessels near the mass appear to be gathered together in a sheaf as they converge in a curved course toward the mass, much like the tail of a comet. The mass itself is always in contact with a chronically thickened pleura. Five cases of rounded atelectasis have been identified in recent years; three of these are reported here in some detail. Lack of familiarity with this clinically innocuous entity usually leads to a mistaken diagnosis of neoplasm and thoracotomy may be performed.

Aged↗
PubMed1980

Pulmonary atelectasis following upper urinary tract surgery on patients in the 25 degrees and 45 degrees 'jack-knife' position. A sequential analysis.

The development of pulmonary atelectasis following upper urinary tract surgery in patients positioned either in the 25 degrees or the 45 degrees 'jack-knife' position was evaluated in a randomized clinical trial with sequential analysis. Atelectasis was diagnosed from chest radiographs and/or from a decrease in arterial oxygen tension during the first three postoperative days. 32.1% of 78 patients developed atelectasis, but no statistically significant differences was found between the two positions.

Adolescent↗
PubMed2000

[Bronchial atresia with atelectasis of the left upper lobe].

A 69-year-old woman visited her physician on October 1 complain of dry cough. However, the chest radiograph revealed no abnormalities. She was later admitted to our hospital because a radiograph taken by another physician on November 26 revealed a massive lesion in the right upper mediastinum. Computed tomographic findings showed a massive lesion containing a branching structure with a few calcifications, suggesting a case of atelectasis of the left upper lobe with mucus plug. Bronchoscopic examination revealed complete obstruction of the orifice of the left upper lobe bronchus, and so a diagnosis of bronchial atresia was made. However, since the patient had a history of tuberculous peritonitis and the mass lesion was somewhat calcified, the possibility that this was an acquired case could not be ruled out. After treatment with oral antibiotics, the size of the atelectasis was decreased. Therefore, we considered that the expansion of the atelectasis could have been due to superimposed bacterial infection.

Aged↗
PubMed2001

DNase treatment for atelectasis in infants with severe respiratory syncytial virus bronchiolitis.

Respiratory insufficiency due to respiratory syncytial virus (RSV) bronchiolitis is partly due to the abundance of thickened mucus and the inability to clear it from the airways. Mucus in RSV bronchiolitis contains necrotic inflammatory and epithelial cells. The viscoelastic properties of purulent airway secretions are largely due to the presence of highly polymerized deoxyribonucleic acid (DNA). Recombinant human deoxyribonuclease (rhDNase) is known to liquefy such mucus in patients with cystic fibrosis, whereas case reports described a beneficial effect in other respiratory disorders. The authors hypothesized that rhDNase would diminish atelectasis and mucus plugging in infants with severe RSV bronchiolitis. Two infants with RSV bronchiolitis with massive unilateral atelectasis in whom mechanical ventilation was imminent due to exhaustion, and three mechanically ventilated infants (two neonates, one with bronchopulmonary dysplasia) with RSV bronchiolitis with pneumonia received treatment with 2.5 mg nebulized rhDNase twice daily. Following administration of nebulized recombinant human deoxyribonuclease, clinical and radiological parameters improved quickly. Mechanical ventilation could be avoided in two infants while in three infants on artificial ventilation, clinical recovery started following the first dose of the drug. A therapeutic trial of recombinant human deoxyribonuclease may be an option in the treatment for atelectasis in severe or complicated respiratory syncytial virus bronchiolitis in infancy.

Administration, Inhalation↗
PubMed1975

[Therapy of secondary atelectasis by pulmonary lavage in full-term and premature infants (author's transl)].

Obstructive atelectasis can be successfully treated by means of pulmonary lavage. Atelectasis of this type may result from the formation of mucous plugs in the bronchi during or after prolonged artificial ventilation, after thoracic surgery and after vigorous suction. The pathophysiological alterations taking place during routine suction of an intubated and ventilated infant are discussed. The technique of pulmonary lavage with lukewarm physiological saline through an endotracheal tube is demonstrated in 2 newborn infants, in whom atelectasis occurred as a complication of long-term ventilation.

Female↗
PubMed2003

Effects of expiratory rib cage compression and/or prone position on oxygenation and ventilation in mechanically ventilated rabbits with induced atelectasis.

INTRODUCTION: Expiratory rib cage compression is a chest physiotherapy technique known as "squeezing" technique in Japan. It has been claimed that rib cage compression effectively treats and/or prevents lung collapse, but no studies have been reported on rib cage compression focused on improving ventilation and/or oxygenation in subjects with collapsed lung. Therefore, we studied whether rib cage compression, with and without prone positioning, improves the ratio of P(aO)(2) to fraction of inspired oxygen (P(aO)(2)/F(IO)(2)), P(aCO)(2), or dynamic compliance of the respiratory system. METHODS: We used anesthetized adult rabbits with induced atelectasis. An endotracheal tube and an 18-gauge catheter were placed into the airway via a tracheostoma, and pressure-controlled mechanical ventilation was used. To create atelectasis, artificial mucus was infused into the airway via the catheter. The rabbits were randomly assigned to one of 4 groups ( = 10 in each group): (1) supine without rib cage compression, (2) supine with rib cage compression, (3) prone without rib cage compression, and (4) prone with rib cage compression. Each rib cage compression session lasted for 5 min and was repeated 5 times every 30 min. After these interventions for 180 min all animals were placed in the supine position for 120 min. RESULTS: The prone-position groups had significantly higher P(aO)(2)/F(IO)(2) than the supine-position groups at 60 min after the beginning of the intervention, and at 60, 90, and 120 min after the end of the intervention (p < 0.05). Rib cage compression did not significantly affect P(aO)(2)/F(IO)(2), P(aO)(2), or dynamic compliance. CONCLUSIONS: It is unlikely that rib cage compression re-expands collapsed lung. Prone positioning improved oxygenation in rabbits with induced atelectasis.

Animals↗
PubMed1992

[A case of round atelectasis associated with spontaneous pneumothorax].

A 59-year-old female was admitted for spontaneous pneumothorax. After evacuation, the chest X-ray film showed a round mass lesion at the left hilum. Following curettage and bronchoalveolar lavage of the left B3c, the mass became smaller, suggesting the diagnosis of round atelectasis. This is the first report of round atelectasis complicated by spontaneous pneumothorax. The mechanism of this case is suggested to resemble that of round atelectasis associated with pleural effusion.

Bronchoalveolar Lavage Fluid↗
PubMed1992

[Atelectasis after segmental resection of the lungs in patients with tuberculosis].

Study of 219 tuberculosis patients who underwent segmental resections showed that the rate of atelectasis development constituted 16.4%. In the right-sided operations atelectases developed 3 times more frequently than those in the left-sided ones (27.5 and 7.5%, respectively) and were mainly segmental (atelectasis of the anterior segment after excision of the ++apico-posterior segment), while in the left-sided intervention they were total in the majority of patients. The character of atelectasis in the right- and left-sided operations was determined by specific features of bronchial structure of the right and left lungs. As a result of therapeutic measures all total atelectases were relieved within 3-5 days, while segmental atelectases persisted for a long time; in 6 patients they still remained by the time of discharge.

Adolescent↗
PubMed2004

[Two cases of gravity dependent atelectasis after laparoscopic nephrectomy].

Two patients developed postoperative pulmonary atelectasis after receving laparoscopic nephrectomy in the lateral kidney position. In both patients, the trachea was intubated with a single lumen tube and the lateral kidney position was kept over 9 hours. Because the pulmonary atelectasis had developed on the lower side of the lungs, we considered it as the gravity dependent atelectasis (GDA). We have also described treatments and prophylaxis for GDA in this case report.

Aged↗
PubMed2006

Redistribution of blood flow and lung volume between lungs in lateral decubitus postures during unilateral atelectasis and PEEP.

The effect of left lung atelectasis on the regional distribution of blood flow (Q), ventilation (V(A)) and gas exchange on the right lung ventilated with 100% O2 was studied in anesthetized dogs in the lateral decubitus posture. Q and V(A) were measured in 1.7 ml lung volume pieces using injected and aerosolized fluorescent microspheres, respectively. Hypoxic pulmonary vasoconstriction (HPV) in the atelectatic lung shifted flow to the ventilated lung. The increased flow in the ventilated lung ensured adequate gas exchange, compensating for the hypoxemia due to shunt contributed by the atelectatic lung. Left lung atelectasis caused a compensatory increase in the ventilated lung FRC that was smaller in the right (RLD) than left (LLD) lateral posture, the effect of lung compression by the atelectatic lung and mediastinal contents in the RLD posture. The O2 deficit measured by (A-a)DO2 increased with left lung atelectasis and was exacerbated in the LLD posture by 10 cm H2O PEEP, a result of increased shunt caused by a shift in Q from the ventilated to the atelectatic lung. The PEEP-induced O2 deficit was eliminated with inversion to the RLD posture.

Adaptation, Physiological↗
PubMed1991

[Respiratory care with prone position for diffuse atelectasis in critically ill patients].

Diffuse atelectasis often occurs in the dorsal region of the lung of critically ill patients under long term mechanical ventilation. Conventional physical therapies (ex. PEEP, Sigh) have little effect on diffuse dorsal atelectasis. We provided respiratory care with prone position for 7 patients with severe respiratory distress (Two patients were treated twice). Improvement of their Respiratory Indexes (RI, mean 2.97) was obtained in the prone position for 6-163 (mean 35.8) hours. Ventilation efficiency also improved. Static lung compliance didn't change. It was assumed that the prone position was the factor responsible for the improvement of pulmonary V/Q ratio, the change of movement pattern of the diaphragm, and the ease of postural drainage of sputum. There were no complications. We conclude that prone position respiratory care has high utility for critically ill patients with diffuse dorsal atelectasis.

Adult↗
PubMed1990

[A case of round atelectasis].

A case of round atelectasis was reported. The roentgenographic features of round atelectasis are "comet tail sign" and localized pleural thickening. Round atelectasis appears as a mass like lesion that often mimics a pulmonary neoplasm. Recognition of this entity will help to prevent unnecessary procedures such as thoracotomy and pulmonary resection.

Bronchography↗
PubMed1988

[Superiority of fiberoptic inflation compared to fiberoptic bronchoscopy in the early treatment of atelectasis under mechanical ventilation].

The purpose of this study was to compare the effectiveness of a simple technique of active lung reexpansion through a fiberoptic bronchoscope, using a large volume syringe, with that of the conventional fiberoptic bronchoscope suction. Thirty consecutive patients with atelectasis were divided at random into two groups: with and without active inflation. The two groups were similar as regards age, sex-ratio, side and area involved in atelectasis. The group without inflation was less hypoxaemic than the other group (PaO2 202 and 140 mmHg respectively). Early and lasting improvement in chest X-ray and arterial blood gases occurred in both groups, but patients were significantly more improved during fiberoptic inflation. No pneumothorax or haemoptysis was observed during the procedure. These data prompt us to recommend active inflation instead of fiberoptic bronchoscopy suction alone for the emergency treatment of patients with severe hypoxaemic atelectasis.

Adolescent↗
PubMedDate not supplied

[Rounded atelectasis of the lung].

Rounded atelectasis is an uncommon but increasingly recognized form of pulmonary collapse that often mimics a pulmonary neoplasm. It is suggested that these lesions can occur many years after exposure to asbestos or exudative pleural effusions. The authors report 16 cases of rounded atelectasis seen during a period of over 10 years, 9 of which in the last 18 months. They describe the plain film, tomographic and CT appearances of the lesion. The radiographic features that allow a diagnosis are rounded or oval shadows lying along the posterior surface of the lower lobe, adjacent to thickened pleura. Lateral tomography and CT show the blood vessels and bronchi curving toward the mass and converging on one edge, like a comet tail. Differentiation of rounded atelectasis from neoplastic disease is essential in avoiding unnecessary thoracotomy.

Aged↗
PubMed1987

Recurrent pulmonary atelectasis as a manifestation of familial Mediterranean fever.

Recurrent attacks of pulmonary atelectasis were the leading sign of familial Mediterranean fever in a young man of Jewish-Georgian extraction. His mother suffered from the more common manifestations of the disease. Treatment with colchicine caused a complete disappearance of his attacks. However, when challenged by discontinuing colchicine therapy for eight days, another, documented attack of pulmonary atelectasis occurred. To our knowledge, this is the first case of familial Mediterranean fever presenting with recurrent pulmonary atelectasis.

Adult↗
PubMed1979

[Structure of the alveolar wall in obstructive pulmonary atelectasis in children].

The results of light and electron microscopy and morphometric studies of the alveolar wall in obstructive atelectasis in children with chronic nonspecific lung diseases (materials of 40 biopsies) are presented. Morphological changes in obstructive atelectases of various durations are described. Fresh atelectasis was shown to be characterized mostly by discirculatory and dystrophic changes. In atelectasis of a long duration, inflammatory reactions developed and, besides, regeneration-proliferation processes were activated which in children were manifested mainly by an increase in the number of large alveolar cells and, to a lesser extent, some increase in sclerotic changes. The release of osmiophilic lamellated corpuscules of large alveolar cells was disturbed, which was one of the factors conducive to the lack of a surfactant.

Adolescent↗
PubMed1979

[Morphology of pulmonary atelectasis in patients operated on and not operated on taking into account pulmonary surfactant state].

The results of clinico-anatomical analysis and of histological examinations of 210 cases of atelectasis with simultaneous study of lung surfactant (126 cases) are described. Electron microscopic examinations of lung tissues were conducted in 8 cases of early autopsy. The postoperative atelectases were compared with those in nonoperated patients. The postoperative atelectases were characterized by substantially larger lesions and prevalence of reflectory, aspiratory, and polyetiological types of lesions. A certain dynamics of changes in the lung surfactant activity was established: a substantial increase of the activity during in the acutest phase of atelectasis and its significant decline towards the end of the first week of the disease. The changes of the surfactant indices directly depend on the synthesizing activity of type II pneumocytes. The decrease of the surfactant occurs secondarily as atelectasis advances.

Adolescent↗