Laboratory Studies

Laboratory studies in pulmonary atelectasis should include measurement of oxygenation, either by oximetry or ABG.

Microbiological tests to detect underlying infection.

Pulmonary function studies may detect unrecognized airflow obstruction, restrictive disease, or decreased respiratory muscle pressures.

Imaging Studies

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 but may fail to detect small areas of 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. The advantages of lung ultrasound include avoiding transport, easy to control body position, no radiation exposure, and it is available at bedside.^[8]

Treatment & Management

Priftis KN, Rubin B. Atelectasis, Middle Lobe Syndrome and Plastic Bronchitis. Progress in Respiratory Research. April 2010. 38:149-155.
Duggan M, Kavanagh BP. Pulmonary atelectasis: a pathogenic perioperative entity. Anesthesiology. 2005 Apr. 102 (4):838-54. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
Rivera R, Tibballs J. Complications of endotracheal intubation and mechanical ventilation in infants and children. Crit Care Med. 1992 Feb. 20 (2):193-9. [QxMD MEDLINE Link].
Thomas K, Habibi P, Britto J, Owens CM. Distribution and pathophysiology of acute lobar collapse in the pediatric intensive care unit. Crit Care Med. 1999 Aug. 27 (8):1594-7. [QxMD MEDLINE Link].
Engoren M. Lack of association between atelectasis and fever. Chest. 1995 Jan. 107(1):81-4. [QxMD MEDLINE Link].
Raman TS, Mathew S, Ravikumar, Garcha PS. Atelectasis in children. Indian Pediatr. 1998 May. 35(5):429-35. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
Schindler MB. Treatment of atelectasis: where is the evidence?. Crit Care. 2005 Aug. 9(4):341-2. [QxMD MEDLINE Link].
Galvis AG, Reyes G, Nelson WB. Bedside management of lung collapse in children on mechanical ventilation: saline lavage--simulated cough technique proves simple, effective. Pediatr Pulmonol. 1994 May. 17 (5):326-30. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link]. [Full Text].
Bar-Zohar D, Sivan Y. The yield of flexible fiberoptic bronchoscopy in pediatric intensive care patients. Chest. 2004 Oct. 126 (4):1353-9. [QxMD MEDLINE Link].
Zhang DJ, Zhao DY, Liang H, Tian M, Han Q. [Application of flexible bronchoscopy in diagnosis and treatment of 104 children with pulmonary atelectasis]. Zhonghua Er Ke Za Zhi. 2010 Oct. 48 (10):767-70. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
Sood S, Ganatra HA, Perez Marques F, Langner TR. Complications during mechanical ventilation-A pediatric intensive care perspective. Front Med (Lausanne). 2023. 10:1016316. [QxMD MEDLINE Link]. [Full Text].
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. [QxMD MEDLINE Link].
Roncin C, Scemama U, Zieleskiewicz L, Loundou A, Lesavre N, Vialet R. Atelectasis prevention during anaesthesia using high-flow nasal cannula therapy: A paediatric randomised trial using MRI images. Anaesth Crit Care Pain Med. 2020 Dec. 39 (6):819-24. [QxMD MEDLINE Link].
[Guideline] National Heart, Lung and Blood Institute. Guidelines for the Diagnosis and Management of Asthma (EPR-3). [Full Text].
Bilan N, Galehgolab BA, Shoaran M. Medical treatment of lung collapse in children. Pak J Biol Sci. 2009 Mar 1. 12(5):467-9. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
De Boeck K, Willems T, Van Gysel D. Outcome after right middle lobe syndrome. Chest. 1995 Jul. 108(1):150-2. [QxMD MEDLINE Link].
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.
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. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
Stiller K. Physiotherapy in intensive care: towards an evidence-based practice. Chest. 2000 Dec. 118(6):1801-13. [QxMD MEDLINE Link].

Media Gallery

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

of 1

Author

Nazir A Lone, MD, MBBS, MPH, FACP, FCCP Physician in Pulmonary and Critical Care Medicine, Peconic Bay Medical Center, Northwell Health

Nazir A Lone, MD, MBBS, MPH, FACP, FCCP is a member of the following medical societies: American Association for Bronchology and Interventional Pulmonology, American College of Chest Physicians, American College of Physicians, International Association for the Study of Lung Cancer, Medical Society of the State of New York, Society of Critical Care Medicine

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, The Society of Federal Health Professionals (AMSUS), Christian Medical and Dental Associations

Disclosure: Nothing to disclose.

Chief Editor

Girish D Sharma, MD, FCCP, FAAP Professor of Pediatrics, Rush Medical College; Director, Section of Pediatric Pulmonology and Rush Cystic Fibrosis Center, Rush Children's Hospital, Rush University Medical Center

Girish D Sharma, MD, FCCP, FAAP is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American Thoracic Society, Royal College of Physicians of Ireland

Disclosure: Nothing to disclose.

Additional Contributors

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.

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.

Pulmonary Atelectasis Workup

Laboratory Studies

Imaging Studies

References

Tables

Contributor Information and Disclosures

What would you like to print?