Treatment of atelectasis: where is the evidence?
Lobar atelectasis is a common problem caused by a variety of mechanisms including resorption atelectasis due to airway obstruction, passive atelectasis from hypoventilation, compressive atelectsis from abdominal distension and adhesive atelectasis due to increased surface tension. However, evidence-based studies on the management of lobar atelectasis are lacking. Examination of air-bronchograms on a chest radiograph may be helpful to determine whether proximal or distal airway obstruction is involved. Chest physiotherapy, nebulised DNase and possibly fibreoptic bronchoscopy might be helpful in patients with mucous plugging of the airways. In passive and adhesive atelectasis, positive end-expiratory pressure might be a useful adjunct to treatment.
Schindler
Margrid B
MB
Paediatric Intensive Care Unit, Bristol Royal Hospital for Children, Bristol, UK. Margrid.Schindler@ubht.swest.nhs.uk
D001993:Bronchodilator Agents / Q000627:therapeutic use; D001999:Bronchoscopy; D002648:Child; D003850:Deoxyribonuclease I / Q000627:therapeutic use; D019317:Evidence-Based Medicine / Q000379:methods*; D006801:Humans; D026741:Physical Therapy Modalities; D011175:Positive-Pressure Respiration; D001261:Pulmonary Atelectasis / Q000628:therapy*; D011663:Pulmonary Surfactants / Q000627:therapeutic use; D013396:Suction; D016896:Treatment Outcome
D001993:Bronchodilator Agents; D011663:Pulmonary Surfactants; C085693:DNASE1 protein, human; D003850:Deoxyribonuclease I