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Pulmonary Atelectasis Workup

  • Author: Michael R Bye, MD; Chief Editor: Michael R Bye, MD  more...
 
Updated: Sep 21, 2015
 

Laboratory Studies

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  • Laboratory studies in pulmonary atelectasis should include measurement of oxygenation, either by oximetry or ABG.
  • Pulmonary function studies may detect unrecognized airflow obstruction, restrictive disease, or decreased respiratory muscle pressures.
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Imaging Studies

See the list below:

  • CT scanning
    • Chest CT scanning may help evaluate for compression of the airway.
    • CT scanning may also detect any underlying pathology that predisposes to atelectasis. It may also reveal diffuse disease not suggested by plain radiography.
  • Chest radiography: Plain chest radiography is often the first study to reveal atelectasis.
  • A study that evaluated the usefulness of lung ultrasonography for the diagnosis of neonatal pulmonary atelectasis reported that lung ultrasonography is an accurate and reliable method for diagnosing neonatal pulmonary atelectasis. The authors also added that lung ultrasonography can find concealed lung atelectasis that could not be detected on a chest radiograph.[4]
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Procedures

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  • Flexible or rigid bronchoscopy may help distinguish intrinsic obstruction from extrinsic compression. These tests can also better define the nature of any intrinsic obstructing lesion.
  • Bronchoscopy offers the advantage of potential treatment. This can include removal of secretions with a rigid or flexible bronchoscope or removal of a foreign body, generally with a rigid bronchoscope.
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Contributor Information and Disclosures
Author

Michael R Bye, MD Professor of Clinical Pediatrics, State University of New York at Buffalo School of Medicine; Attending Physician, Pediatric Pulmonary Division, Women's and Children's Hospital of Buffalo

Michael R Bye, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American Thoracic Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Charles Callahan, DO Professor, Chief, Department of Pediatrics and Pediatric Pulmonology, Tripler Army Medical Center

Charles Callahan, DO is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American College of Osteopathic Pediatricians, American Thoracic Society, Association of Military Surgeons of the US, Christian Medical and Dental Associations

Disclosure: Nothing to disclose.

Chief Editor

Michael R Bye, MD Professor of Clinical Pediatrics, State University of New York at Buffalo School of Medicine; Attending Physician, Pediatric Pulmonary Division, Women's and Children's Hospital of Buffalo

Michael R Bye, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American Thoracic Society

Disclosure: Nothing to disclose.

Additional Contributors

Thomas Scanlin, MD Chief, Division of Pulmonary Medicine and Cystic Fibrosis Center, Department of Pediatrics, Rutgers Robert Wood Johnson Medical School

Thomas Scanlin, MD is a member of the following medical societies: American Association for the Advancement of Science, Society for Pediatric Research, American Society for Biochemistry and Molecular Biology, American Thoracic Society, Society for Pediatric Research

Disclosure: Nothing to disclose.

References
  1. Lutterbey G, Wattjes MP, Doerr D, Fischer NJ, Gieseke J Jr, Schild HH. Atelectasis in children undergoing either propofol infusion or positive pressure ventilation anesthesia for magnetic resonance imaging. Paediatr Anaesth. 2007 Feb. 17(2):121-5. [Medline].

  2. Engoren M. Lack of association between atelectasis and fever. Chest. 1995 Jan. 107(1):81-4. [Medline].

  3. Raman TS, Mathew S, Ravikumar, Garcha PS. Atelectasis in children. Indian Pediatr. 1998 May. 35(5):429-35. [Medline].

  4. Liu J, Chen SW, Liu F, Li QP, Kong XY, Feng ZC. The diagnosis of neonatal pulmonary atelectasis using lung ultrasonography. Chest. 2015 Apr. 147 (4):1013-9. [Medline].

  5. Bilan N, Galehgolab BA, Shoaran M. Medical treatment of lung collapse in children. Pak J Biol Sci. 2009 Mar 1. 12(5):467-9. [Medline].

  6. Prodhan P, Greenberg B, Bhutta AT, et al. Recombinant human deoxyribonuclease improves atelectasis in mechanically ventilated children with cardiac disease. Congenit Heart Dis. 2009 May-Jun. 4(3):166-73. [Medline]. [Full Text].

  7. Krause MF, von Bismarck P, Oppermann HC, Ankermann T. Bronchoscopic surfactant administration in pediatric patients with persistent lobar atelectasis. Respiration. 2008. 75(1):100-4. [Medline].

  8. [Guideline] National Heart, Lung and Blood Institute. Guidelines for the Diagnosis and Management of Asthma (EPR-3). [Full Text].

  9. Bagley CE, Gray PH, Tudehope DI, Flenady V, Shearman AD, Lamont A. Routine neonatal postextubation chest physiotherapy: a randomized controlled trial. Journal of Paedtrics & Child Health. November 2005. 41:592-7. [Medline].

  10. De Boeck K, Willems T, Van Gysel D. Outcome after right middle lobe syndrome. Chest. 1995 Jul. 108(1):150-2. [Medline].

  11. Finder J, Birnkrant DJ, Carl J et al. Respiratory care of the patient with Duchenne muscular dystrophy: An official ATS consensus statement. Am J Respir Crit Care Med. 2004. 170:456.

  12. Hendriks T, de Hoog M, Lequin MH, Devos AS, Merkus PJ. DNAse and atelectasis in non-cystic fibrosis pediatric patients. Critical Care. August 2005. 9:351-6. [Medline].

  13. Miske LJ, Hickey EM, Kolb SM, et al. Use of the mechanical in-exsufflator in pediatric patients with neuromuscular disease and impaired cough. Chest. 2004 Apr. 125(4):1406-12. [Medline].

  14. Schindler MB. Treatment of atelectasis: where is the evidence?. Crit Care. 2005 Aug. 9(4):341-2. [Medline].

  15. Slattery DM, Waltz DA, Denham B, et al. Bronchoscopically administered recombinant human DNase for lobar atelectasis in cystic fibrosis. Pediatr Pulmonol. 2001 May. 31(5):383-8. [Medline].

  16. Stiller K. Physiotherapy in intensive care: towards an evidence-based practice. Chest. 2000 Dec. 118(6):1801-13. [Medline].

  17. Woodring JH. Determining the cause of pulmonary atelectasis: a comparison of plain radiography and CT. AJR Am J Roentgenol. 1988 Apr. 150(4):757-63. [Medline].

  18. Wu KH, Lin CF, Huang CJ, Chen CC. Rigid ventilation bronchoscopy under general anesthesia for treatment of pediatric pulmonary atelectasis caused by pneumonia: A review of 33 cases. Int Surg. 2006 Sep-Oct. 91(5):291-4. [Medline].

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Atelectasis. Left lower lobe collapse. The opacity is in the posterior inferior location.
 
 
 
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