17699 Atelectasis

Overview

Atelectasis happens when a part or all of your lung does not fully expand or collapses. This means the air sacs in that part of the lung cannot fill with air, so less oxygen gets into your blood. It is not the same as a collapsed lung caused by an injury, but it can still make breathing harder.

Yes, atelectasis is one of the most common breathing complications after surgery. It also happens often in people who spend a long time in bed or who have certain lung conditions.

Anyone can develop atelectasis, but it is more common in older adults, people who have just had surgery, and people with lung disease or limited mobility due to illness or injury.

Symptoms

Common symptoms

• Shortness of breath
• A dry or phlegmy cough
• Rapid, shallow breathing
• Mild chest discomfort or tightness
• Feeling tired or weak

Symptoms in children

• Rapid breathing or breathing harder than usual
• Flaring of the nostrils with each breath
• Grunting sounds when breathing out
• Restlessness or irritability
• Pale or bluish skin around the lips or fingertips

Symptoms in older adults

• Confusion or unusual sleepiness
• A sudden drop in energy
• Rapid breathing even at rest
• A cough that gets worse
• Sometimes no obvious symptoms at all

Causes

Main causes

• A blocked airway, often from a mucus plug or something inhaled by accident
• Pressure on the lung from fluid, air, or a growth such as a tumor
• Shallow breathing for long periods, often after surgery or during illness
• Lack of movement, such as being confined to bed
• Premature birth, when the lungs are not fully developed

Risk factors

• Recent abdominal or chest surgery
• General anesthesia
• Smoking or long-term tobacco use
• Chronic lung conditions such as COPD or asthma
• Being temporarily confined to bed or limited in movement
• Obesity
• Premature birth or a newborn with lung problems

When to see a doctor

See a doctor urgently if:

• You have sudden or severe difficulty breathing at rest
• You have chest pain with breathing or coughing
• You have a high fever along with breathing symptoms
• You are coughing up blood or a large amount of mucus

Book a routine appointment if:

• You have a cough that lasts more than a week
• You feel short of breath more than usual during daily activities
• You are recovering from surgery and your breathing has not improved within a few days

Diagnosis

A doctor will ask about your symptoms, listen to your lungs with a stethoscope, and may check the oxygen level in your blood. If atelectasis is suspected, they will likely order at least one imaging test to look at your lungs clearly.

Tests that may be done

• Pulse oximetry – a small clip on your finger to check oxygen levels
• Chest X-ray – the most common imaging test for atelectasis
• CT scan – a more detailed scan of the lungs
• Blood tests – to look for signs of infection or low oxygen
• Bronchoscopy – a thin, flexible tube used to look inside the airways and remove blockages, if needed

What to expect at your appointment

The tests are usually quick and painless. A chest X-ray takes just a few minutes. If you need a bronchoscopy, you may be given medicine to help you relax or numb your throat. Most people are awake and can go home the same day, but this depends on your situation.

Treatment

Treatment focuses on clearing the blocked or collapsed part of the lung so it can expand again, and on addressing the cause. In most cases, this means doing regular deep breathing exercises, moving your body, and helping mucus clear from your airways.

Self-care at home

• Take slow, deep breaths several times an hour while awake
• Use an incentive spirometer if your care team gives you one
• Cough gently but firmly to clear mucus
• Change positions often, and sit up or walk when possible
• Stay well hydrated to keep mucus thin and easier to clear

Medical treatments

Medical treatments may include breathing treatments that widen the airways and help clear mucus, oxygen therapy if your oxygen level is low, and in some cases a bronchoscopy to remove a blockage. Medicines for underlying conditions, such as infections or lung disease, may also be part of your care. Always follow your doctor's advice about any treatment plan.

When is surgery considered?

Surgery is rarely needed for atelectasis. It may be considered if a growth, foreign object, or severe blockage keeps a part of the lung collapsed and other treatments do not work.

Living with this condition

If you have had atelectasis, try to stay active but take it at your own pace. Practice the deep breathing exercises your care team showed you. If you smoke, quitting is one of the most helpful things you can do for your lungs.

Lifestyle tips

• Set a reminder to take slow, deep breaths every hour if you sit or lie for long periods
• Take short walks or move around gently throughout the day
• Avoid smoking and secondhand smoke
• Stay up to date with your general health checkups

Diet and exercise

Regular, gentle exercise like walking or light stretching can help your lungs stay clear. A balanced diet with plenty of fluids supports your immune system and keeps mucus from becoming thick and sticky.

Mental health and emotional wellbeing

It is normal to feel a little anxious or frustrated when you are having trouble breathing. Most cases of atelectasis improve with basic steps, and knowing what to expect can help. Talk to your doctor if worry or low mood continues.

Prevention

Atelectasis can often be prevented, especially after surgery. Getting up and moving as soon as your doctor says it is safe, taking deep breaths, and clearing your airway are effective ways to reduce your risk.

Vaccines

Staying up to date with recommended vaccines, such as the flu and pneumonia vaccines, can help prevent lung infections that might lead to atelectasis.

Screening programmes

There is no routine screening test for atelectasis in healthy people. However, if you are at higher risk, your healthcare team may check your breathing and oxygen levels more closely after surgery or during a hospital stay.

Complications

If left untreated

• Pneumonia, because mucus and bacteria can build up in the collapsed area
• Low oxygen levels in the blood, which can affect the heart and other organs
• Respiratory failure in severe cases, needing breathing support
• Long-term scarring or permanent damage to the lung tissue (less common)

Long-term outlook

The outlook for atelectasis is generally very good. Most people improve completely with simple steps like deep breathing, coughing, and moving around, and any symptoms usually resolve in a few days. Even when a larger area is affected, prompt treatment helps the lung re-expand and most people recover fully.

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