From the Research
Patchy bibasilar subsegmental atelectasis typically requires no specific treatment if it's mild and the patient has no symptoms, but for symptomatic cases, I recommend deep breathing exercises, incentive spirometry, adequate hydration, and early mobilization. This condition refers to partial collapse of small sections of lung tissue in the lower portions of both lungs. The treatment focuses on re-expanding the collapsed lung segments by improving ventilation, as the collapsed areas prevent normal gas exchange, which is why deep breathing is beneficial 1. Some key measures include:
- Deep breathing exercises (10 deep breaths every hour while awake)
- Incentive spirometry (10 breaths every hour while awake) as it has been shown to be effective in improving lung expansion and reducing the work of breathing in patients with chronic obstructive airway diseases 2
- Adequate hydration (at least 2 liters of water daily unless contraindicated)
- Early mobilization (walking as tolerated) If the patient has thick secretions, using a humidifier and considering mucolytics like guaifenesin (400mg every 4 hours as needed) may help. Most cases resolve with these conservative measures, but persistent atelectasis may require further evaluation to rule out underlying causes such as mucus plugging, tumors, or other obstructive processes. It's also worth noting that incentive spirometry has been compared to routine chest physiotherapy for the prevention of pulmonary complications after abdominal surgery, and both methods have been found to be of equivalent clinical efficacy 3. However, the most relevant and recent evidence should always guide the treatment approach, prioritizing the patient's morbidity, mortality, and quality of life as the primary outcomes.