Post Op atelectasis Flashcards

1
Q

Describe atelectasis

A

An abnormal condition of the lungs characterized by partial or total collapse of previously expanded alveoli

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2
Q

What is the result of atelectasis?

A

Reduced gas exchange in the collapsed lung units and reduced compliance

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3
Q

What are some common minor post operative pulmonary complication?

A

Atelectasis
Bronchospasm
Pneumonia
Acute upper airway obstruction
Exacerbation OSA

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4
Q

What are common (but more severe) post operative pulmonary complications?

A

Pleural effusion
Chemical pneumonitis
Pulmonary embolism
Abdominal compartment syndrome
Tracheal laceration or rupture

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5
Q

What factors increase a patients chance for developing post operative atelectasis?

A

Obesity
Operative and post operative supine positioning
Advanced age
Use of inadequate tidal volumes during mechanical ventilation

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6
Q

What are the “levels” atelectasis and how common are they?

A

Micro atelectasis/subsegmental atelectasis = very common
Segmental atelectasis = fairly common
Lobar atelectasis = uncommon
Entire lung collapse = very rare

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7
Q

What portions of the lung most commonly experience post operative atelectasis?

A

20-25% of lung tissue in the basal lung area collapses after induction with general anesthesia

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8
Q

What are the two types of atelectasis

A

Obstructive
Non-obstructive

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9
Q

Describe compression atelectasis

A

A “space occupying lesion” develops in the pleural space and puts pressure on lung units resulting in collapse

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10
Q

Describe obstruction atelectasis

A

Airway is obstructed, if collateral flow doesnt exist or is inadequate, the obstructed unit will collapse

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11
Q

Give some examples of compression atelectasis

A

Pneumothorax
Hemothorax
Pleural effusion

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12
Q

Describe relation atelectasis

A

Contact between the parietal and visceral pleura is lost and the elastic recoil of the lung pulls it inward collapsing the lung units

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13
Q

When could a patient experience relaxation atelectasis?

A

Pleural effusion
Pneumothorax
Loss of surfactant

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14
Q

Describe cicatricial atelectasis

A

Cicatrix = scar
Parenchyma becomes scarred and collapse as a result

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15
Q

What processes could cause cicatricial atelectasis?

A

Diseases that form granulomas (sarcoid)
Necrotizing pneumonia
Radiation pneumonitis

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16
Q

How is post operative atelectasis diagnosed?

A

Clinical diagnosis drawn from signs and symptoms and reinforced with imaging

17
Q

Describe replacement atelectasis

A

Alveoli of lung units become filled with tumor tissue

18
Q

How might a patient with post op atelectasis present?

A

Elevated vital signs
Cyanotic
Diaphoretic

19
Q

What features of a chest assessment would indicate post op atelectasis?

A

Increased tactile or vocal fremitus
Dull percussion notes
Bronchial breath sounds
Diminished breath sounds
Crackles
Whisper pectoriloquy

20
Q

What features or a CXR would indicate post op atelectasis?

A

Increased density in areas of atelectasis
Air bronchograms
Elevation of diaphragm on affected side
Tracheal or mediastinal shift toward the affected side

21
Q

Increased density in areas of atelectasis
Air bronchograms
Elevation of diaphragm on affected side
Tracheal or mediastinal shift toward the affected side

A

Post op atelectasis

22
Q

A patient with post operative atelectasis has relatively few secretions but is having trouble taking deep breaths. What treatment options would be best for them?

A

CPAP

23
Q

A patient with post operative atelectasis has excessive secretions but is having trouble taking deep breaths. What treatment options would be best for them?

A

Airway clearance
ENT suctioning
Oral suctioning
OPEP
CPT
Bronch

24
Q

A patient who has post op atelectasis from pleural effusions. What would be the best way to treat the atelectasis?

A

By treating the pleural effusions with either diuretics or a thoracentesis

25
Q
A