From the Guidelines
For patients with discoid atelectasis at the left lung base, I recommend performing a thoracic bedside ultrasound to identify pleural effusions and parenchymal or interstitial lung pathology, as it can improve the reliability of physical examination findings and complement the physical examination in critical care settings 1.
Diagnosis and Management
When evaluating discoid atelectasis, it is essential to consider the patient's overall clinical presentation, including symptoms such as shortness of breath, chest pain, or cough. In critically ill patients with fever and an abnormal chest radiograph, thoracic bedside ultrasound can be a useful tool to further assess the lungs and guide management decisions 1.
Advantages of Thoracic Bedside Ultrasound
The use of thoracic bedside ultrasound has several advantages, including its lack of radiation, safety, low cost, and accessibility 1. It can detect parenchymal or interstitial lung pathology with reasonable sensitivity and specificity, and can also reliably identify pleural effusions and aid in sampling or drainage if needed 1.
Limitations and Considerations
However, it is essential to note that the competence and experience of the sonographer may influence the results of the ultrasound, and the presence of atelectasis may lower the specificity of the test 1. Additionally, in immunocompromised individuals, computed tomography (CT) imaging may be preferable to rule out pulmonary parenchymal disease 1.
Recommendations for Patients
To manage discoid atelectasis, patients can benefit from deep breathing exercises, regular physical activity, and frequent position changes to help re-expand collapsed alveoli and improve oxygen exchange 1. Staying well-hydrated and avoiding smoking can also help prevent further lung tissue collapse. If symptoms worsen or persist, patients should seek medical attention promptly.
From the Research
Atelectasis Description
- Atelectasis is a state of collapsed and non-aerated region of the lung parenchyma, which is otherwise normal 2.
- It is usually associated with several pulmonary and chest disorders and represents a manifestation of the underlying disease, not a disease per se 2.
Causes of Atelectasis
- Atelectasis may occur in three ways:
- airway obstruction
- compression of parenchyma by extrathoracic, intrathoracic, chest wall processes
- increased surface tension in alveoli and bronchioli 2.
Diagnosis of Atelectasis
- Chest radiographs using both the anterior-posterior and lateral projections are mandatory to document the presence of atelectasis 2.
- Differentiation from lobar consolidation may be a clinical dilemma 2.
Treatment of Atelectasis
- The treatment of atelectasis varies depending on duration and severity of the causal disease from chest physiotherapy to postural drainage, bronchodilator and anti-inflammatory therapy 2.
- Persistent mucous plugs should be removed by bronchoscopy 2.
Discoid Atelectasis
- There is no specific information available on discoid atelectasis left lung base in the provided studies.
- However, a study on the severity of atelectasis during bronchoscopy describes a new grading system (Atelectasis Severity Scoring System - "ASSESS") and at-risk-lung zones 3.
- Another study found that deep-breathing exercises reduce atelectasis and improve pulmonary function after coronary artery bypass surgery 4.
- A study on the effect of cyproterone acetate on growth and endocrine function in precocious puberty is not relevant to the topic of atelectasis 5.