From the FDA Drug Label
Atelectasis due to mucous obstruction
The cause of bilateral atelectasis is not directly stated in the drug label, but it is mentioned that acetylcysteine is indicated for atelectasis due to mucous obstruction. This suggests that mucous obstruction may be a cause of atelectasis, but it does not provide a direct answer to the question of what causes bilateral atelectasis. The FDA drug label does not answer the question.
From the Research
Introduction to Bilateral Atelectasis
Bilateral atelectasis refers to the collapse or closure of a lung resulting in reduced or absent gas exchange. It can occur in various clinical settings and has multiple causes.
Causes of Bilateral Atelectasis
The causes of bilateral atelectasis can be diverse, including:
- Airway obstruction due to mucus plugging, which can occur after mechanical ventilation and endotracheal intubation, leading to excessive mucus secretions and increased risk of respiratory failure post extubation 1
- Prolonged intubation and invasive mechanical ventilation, as seen in patients with veno-arterial extracorporeal membrane oxygenation (VA ECMO) support 2
- Aspiration pneumonia, which can lead to lung collapse and atelectasis, particularly in elderly patients in home medical care settings 3
- Central airway collapse, an underappreciated cause of respiratory morbidity, which can coexist with and mimic other respiratory conditions such as asthma, chronic obstructive pulmonary disease, and bronchiectasis 4
Treatment and Management
Treatment of bilateral atelectasis depends on the underlying cause and may include:
Chest Physiotherapy
- Chest wall percussion and vibrations
- Patient positioning to facilitate mucus drainage
- Coughing and breathing exercises 1
Bronchoscopy
- Bronchoscopic aspiration and lavage to remove retained secretions or mucus plugs
- Large-volume saline instillation in aliquots and repeated suctioning 1
Ventilator Support
- Use of ventilators to support patients with atelectasis, with the goal of improving lung function and preventing further complications 5
Antibiotics
- Treatment of underlying infections, such as aspiration pneumonia, with antibiotics 3
Differentials and Caveats
It is essential to consider other respiratory conditions, such as asthma, chronic obstructive pulmonary disease, and bronchiectasis, in the differential diagnosis of bilateral atelectasis. Central airway collapse should also be considered as a potential cause of respiratory symptoms. Awareness of these conditions and their symptoms is crucial for accurate diagnosis and effective treatment.