Definition

Atelectasis is a collapse in part of the lungs. Normally, air passes through the airways into small sacs of the lungs. Oxygen from the air passes through these sacs into the blood. Carbon dioxide also passes from the blood to the sacs to leave the body. With atelectasis, these sacs are collapsed. Oxygen and carbon dioxide cannot pass through the collapsed sacs.

A collapse over large areas of the lungs can lead to serious problems. In infants, atelectasis may be:

• Congenital—present at birth
• Acquired—caused by an acquired condition

Causes

Atelectasis is not a disease. It is the result of a disease or abnormality in the body. It can be caused by:

• Blockage in the airways—as a result of inhaled stool during birth, an inhaled object, or a mucus plug that keeps air from moving into the lung sacs
• Lung infections—may cause fluid build-up that blocks air to the lung sacs
• Lack of surfactant (common in premature infants)—surfactant is a fluid that lines the inside of the lungs and helps them function properly
• Impaired breathing—air is not pulled deep enough into the lungs to open all sacs
• Damage to nerve and muscles that control breathing—may prevent coughing, deep breathing, or yawning

Risk Factors

Factors that increase the chance of congenital atelectasis include:

• Inhaled meconium or amniotic fluid
• Prolonged or difficult labor
• Birth injury to the central nervous system

Children under 3 years old are more likely to develop atelectasis than older children or adults. Factors that may increase your baby’s chance of atelectasis include:

• Premature birth
• Lung condition or infection—particularly if coughing is impaired
• Injury to chest wall
• Having anesthesia
• Inhaling a foreign object, such as a peanut or marble
• Respiratory distress syndrome
• Being on ventilator—air does not move into lungs in a normal pattern

Symptoms

Atelectasis may not have obvious symptoms.

Larger areas of atelectasis may lead to:

• Rapid breathing
• Taking shallow breaths
• Agitation
• Coughing
• Decreased chest movement during breathing
• Wheezing
• Fever
• Blueness of the skin

Diagnosis

You will be asked about your child’s symptoms and medical history. A physical exam will be done. The doctor will listen to breath sounds.

Images may be taken of your child’s bodily structures. This can be done with:

• Chest x-ray
• Chest CT scan

A bronchoscopy may be done if an obstruction is a possibility. This is an exam of the lungs with a small tube.

Treatment

Treatment will be based on the cause of the atelectasis. Some oxygen or breathing support may also be needed until the problem resolves. Treatment options include:

Prevention

Not all atelectasis can be prevented. To help reduce your baby’s chance of atelectasis, take these steps:

• Be careful with small objects around infants.
• Work with your doctor to treat or manage any lung conditions your baby has.
• Take steps to avoid premature birth such as:
  • Get regular prenatal care.
  • During pregnancy, eat a well-balanced diet with plenty of fruits and vegetables.
  • Get adequate activity.

Some medical conditions or treatments increase your baby’s risk of atelectasis. Steps will be taken to prevent atelectasis such as:

• Medication to improve surfactant in premature babies
• Treating and monitoring lung infections
• Careful management of necessary oxygen or breathing therapy in infants

Kids Health—Nemours Foundation http://kidshealth.org

The Lung Association of Canada http://www.lung.ca

Collapsed lung (atelectasis). Cedars-Sinai website. Available at:
http://www.cedars-sinai.edu/Patients/Health-Conditions/Collapsed-Lung-Atelectasis.aspx
Accessed September 16, 2015.

What is atelectasis? National Heart Lung and Blood Institute website. Available at:
http://www.nhlbi.nih.gov/health/health-topics/topics/atl
Updated January 13, 2012. Accessed September 16, 2015.