Causes of collapsed lung: A Synthesis of Findings from 26 Studies

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Original Abstract of the Article

Major Research Findings

Atelectasis during anesthesia can lead to impaired respiratory function. Positive end-expiratory pressure (PEEP) is a mechanical maneuver that can increase functional residual capacity (FRC) and prevent airway collapse, thereby reducing atelectasis. However, it is unknown if intraoperative PEEP affects the risk of postoperative mortality and pulmonary complications. 15 .

In patients with spontaneous pneumothorax (SP), adequate oxygenation can be maintained even when part of the lung is collapsed. The exact mechanism by which this occurs is unclear, but it may involve effective gas exchange within the affected lung, hyperventilation of the unaffected lung, or hypoxic vasoconstriction. 11 .

A case study of a young dog with pulmonary atelectasis secondary to bronchopneumonia showed that the condition resolved after 60 days of treatment with antibiotics, bronchodilators, mucolytics, and inhaled corticosteroids. 10

Causes of Atelectasis

Atelectasis is a common occurrence during general anesthesia, with up to 90% of patients experiencing it. 14 . It can persist for days after surgery and may contribute to pulmonary complications. 16 . The most common causes include:

Absorption Atelectasis

During anesthesia, the inhalation of high concentrations of oxygen can cause the absorption of nitrogen from the alveoli, leading to alveolar collapse and atelectasis. This is particularly common during the induction of anesthesia. 14 .

Compression Atelectasis

Muscle relaxation caused by anesthetics can lead to chest wall compression, putting pressure on the lungs and causing atelectasis. Surgeries involving increased abdominal or thoracic pressure, such as laparoscopic or thoracic surgeries, can also contribute to compression atelectasis. 14 .

Surfactant Dysfunction

Surfactant is a substance that reduces surface tension in the alveoli, preventing collapse. Anesthetics can impair surfactant function, increasing the risk of atelectasis. 14 .

Preventing Atelectasis

Preventing Absorption Atelectasis

During induction of anesthesia, using a gas mixture containing nitrogen and reducing the duration of high oxygen inhalation can help prevent absorption atelectasis. 14 .

Preventing Compression Atelectasis

During surgery, measures to avoid chest wall compression, such as proper positioning, supporting the torso, and avoiding abdominal pressure, can help prevent compression atelectasis. 14 . Monitoring the patient's respiratory status and using mechanical ventilation if needed can also help. 14 .

Preventing Surfactant Dysfunction

Adjusting the type and dose of anesthetics can help reduce surfactant dysfunction. Administering surfactant replacement therapy may also help restore surfactant function. 14 .

Comparing Research Findings

Similarities in Research

Several studies have shown that atelectasis during anesthesia can lead to respiratory complications. PEEP has been suggested as a potential preventative measure, but its impact on postoperative mortality and pulmonary complications remains unclear. 15 .

Differences in Research

There is variability in research findings regarding the causes, prevention, and effects of PEEP on atelectasis. This variability may be attributed to differences in research methods and study populations. 15 .

Practical Applications and Considerations

Atelectasis is a potential complication of anesthesia. However, with proper anesthesia management, the risk can be minimized. 14 . Prior to surgery, it is important to discuss your health history with your doctor and address any concerns. 14 .

Limitations of Current Research

More research is needed on atelectasis, particularly on the effectiveness of PEEP and the risk of postoperative mortality and pulmonary complications. 15 .

Future Research Directions

Future research should focus on determining the impact of PEEP on postoperative mortality and pulmonary complications, identifying the optimal settings for PEEP, and exploring other effective methods for preventing atelectasis. 15 .

Conclusion

Atelectasis is a potential complication of anesthesia that can lead to respiratory difficulties. Proper anesthesia management is crucial for minimizing the risk of atelectasis. 14 . While PEEP holds potential for preventing atelectasis, further research is required. 15 .

Literature analysis of 26 papers
Positive Content
12
Neutral Content
2
Negative Content
12
Article Type
3
4
3
10
25
1.

Association between coronary angiograms and cardiac events--a prospective 3-year follow-up. INTACT-Investigators. International Nifedipine Trial on Antiatherosclerotic Therapy.

Author: JostS, NikuttaP, DeckersJ W, WieseB

Cardiac events
Myocardial infarction

This study analyzes the correlation between the extent and severity of coronary artery disease, as documented by quantitative coronary angiography, and the incidence of cardiac events within three years. The results show a strong correlation between the incidence of cardiac events and the baseline number of all stenoses and high-grade stenoses, particularly in the left anterior descending artery. The study concludes that the total coronary stenosis burden is a better predictor of cardiac events than the number of high-grade stenoses alone.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

2.

The effect of coronary artery bypass grafting on specific causes of long-term mortality in the Bypass Angioplasty Revascularization Investigation.

Author: HolmesDavid R, KimLauren J, BrooksMaria Mori, KipKevin E, SchaffHartzell V, DetreKatherine M, FryeRobert L,

Coronary artery disease treatment
Coronary artery disease
Death

This study examined the effect of coronary revascularization with coronary artery bypass grafting on specific causes of death in patients with coronary artery disease. While the effect of coronary revascularization on long-term mortality has been previously described, limited data exist on its effect on specific causes of death. This study aims to provide further insights into disease mechanisms and inform the development of treatment strategies.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

3.

Management standards for stable coronary artery disease in India.

Author: MishraSundeep, RaySaumitra, DalalJamshed J, SawhneyJ P S, RamakrishnanS, NairTiny, IyengarS S, BahlV K

Coronary artery disease
Stable coronary artery disease

Stable coronary artery disease (SCAD) is a form of coronary artery disease characterized by episodes of chest pain (angina pectoris). SCAD is a major cause of cardiovascular morbidity and mortality globally, with an increasing burden in India.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

4.

Rationale and design of the British Heart Foundation (BHF) Coronary Microvascular Function and CT Coronary Angiogram (CorCTCA) study.

Author: SidikNovalia P, McEntegartMargaret, RoditiGiles, FordThomas J, McDermottMichael, MorrowAndrew, ByrneJohn, AdamsJacqueline, HargreavesAllister, OldroydKeith G, StoboDavid, WuOlivia, MessowClaudia-Martina, McConnachieAlex, BerryColin

Angina treatment
Diagnosis improvement

CorCTCA will prospectively characterize the prevalence of disease endotypes in INOCA and determine the clinical value of stratified medicine in this population. This prospective, multicenter, randomized, blinded, sham-controlled trial will assess the impact of stratified medicine on angina symptoms and quality of life in patients with INOCA.

Clinical Trial ProtocolA plan for conducting a clinical trial. It describes in detail the purpose, design, methodology, and statistical considerations of the trial, ensuring the transparency and consistency of the trial.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

5.

Association between coronary artery disease and incident cancer risk: a systematic review and meta-analysis of cohort studies.

Author: ChenHsin-Hao, LoYi-Chi, PanWei-Sheng, LiuShu-Jung, YehTzu-Lin, LiuLawrence Yu-Min

Cancer surveillance

Patients with coronary artery disease (CAD) had a significantly higher risk of developing cancer, particularly lung and colorectal cancers. This association was observed in both men and women, and in patients with and without myocardial infarction. Early cancer detection and surveillance programs are recommended for patients with CAD.

Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

Cardiac unilateral pulmonary edema: is it really a rare presentation?

Author: HassanWalid, ElShaerFayez, FawzyMohamed Eid, Al HelalySumaya, HegazyHesham, AkhrasNathem

Unilateral pulmonary edema

Unilateral pulmonary edema is an unusual clinical entity that can present diagnostic challenges. It is typically seen after re-expansion of a collapsed lung, but can also be an initial manifestation of heart failure.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

Airway closure, atelectasis and gas exchange during anaesthesia.

Author: HedenstiernaG

Oxygenation
Mechanical ventilation
Pulmonary gas exchange

This study explores the causes of pulmonary gas exchange impairment during general anesthesia with mechanical ventilation. It emphasizes the roles of atelectasis and airway closure, highlighting that these factors contribute significantly to decreased blood oxygenation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

9.

Role of Rho-kinase in reexpansion pulmonary edema in rabbits.

Author: SawafujiMakoto, IshizakaAkitoshi, KohnoMitsutomo, KohHidefumi, TasakaSadatomo, IshiiYoshiki, KobayashiKoichi

Reexpansion pulmonary edema

This study investigated the role of Rho-kinase (ROCK) in reexpansion pulmonary edema in a rabbit model. The results suggest that the Rho/ROCK pathway contributes to increased alveolar barrier permeability in reexpansion pulmonary edema.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

10.

Pulmonary atelectasis in a young dog with Cor pulmonale: clinical and radiographic follow-up.

Author: MendonçaDiana do Amaral, BallotSophie, SaikiDianna Caroline, SantosGabrielly Ferreira, FernandesLaércio Correia, AmorimCaroline de Oliveira, BendasAlexandre José Rodrigues, AlberigiBruno

Bronchopneumonia
Pulmonary atelectasis

Pulmonary atelectasis is a disease characterized by the collapse of the pulmonary alveoli. This study reports a case of a 4-month-old canine with pulmonary atelectasis secondary to bronchopneumonia and the successful treatment with antibiotics, bronchodilators, mucolytics, and inhaled corticosteroids.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

13.

Resorption of gas trapped in body cavities: comparison of alveolar and pleural space with inner ear and paranasal sinuses.

Author: IvezićZdravko, KurbelSven, Skrinjarić-CincarSanda, RadićRadivoje

Atelectasis
Otitis media
Pneumothorax
Sinusitis

This article describes a teaching method for understanding gas resorption in body cavities. Students are encouraged to calculate pressure gradients in various pathological conditions to understand the mechanisms behind paranasal sinusitis, otitis media, closed pneumothorax, and atelectasis.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

14.

Atelectasis formation during anesthesia: causes and measures to prevent it.

Author: HedenstiernaG, RothenH U

Lung risk

Pulmonary gas exchange is frequently impaired during general anesthesia due to atelectasis, which is present in 90% of patients. Strategies to prevent or treat atelectasis include positive end-expiratory pressure (PEEP), recruitment maneuvers, and avoiding high fractions of oxygen in inspired gas.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

15.

Positive end-expiratory pressure (PEEP) during anaesthesia for the prevention of mortality and postoperative pulmonary complications.

Author: ImbergerGeorgina, McIlroyDavid, PaceNathan Leon, WetterslevJørn, BrokJesper, MøllerAnn Merete

Respiratory function improvement
Postoperative mortality
Pulmonary complications

General anesthesia causes atelectasis, which can impair respiratory function. Positive end-expiratory pressure (PEEP) is used to prevent airway collapse and reduce atelectasis. This study aims to determine whether intraoperative PEEP alters the risk of postoperative mortality and pulmonary complications.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

16.

Mechanisms of atelectasis in the perioperative period.

Author: HedenstiernaGöran, EdmarkLennart

Atelectasis
Pulmonary complications

This article discusses the causes and consequences of atelectasis, a common complication of anesthesia. The use of high oxygen concentrations during anesthesia, along with anaesthetics that cause loss of muscle tone, can lead to absorption atelectasis. The article emphasizes the importance of using moderate inspired oxygen fractions after lung recruitment to minimize the risk of atelectasis.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

17.

An alternative method to achieve one-lung ventilation by surgical pneumothorax in difficult lung isolation patient: a case report.

Author: YehPin-Hung, HsuPo-Kai

Lung isolation
Difficult airway

This study presents a case of a patient with a difficult airway requiring one-lung ventilation for thoracic surgery. The authors describe an alternative technique using surgical pneumothorax under spontaneous breathing, which proved to be a safer, less time-consuming, and less skill-demanding approach compared to traditional methods.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

18.

Positive end-expiratory pressure (PEEP) during anaesthesia for prevention of mortality and postoperative pulmonary complications.

Author: BarbosaFabiano T, CastroAldemar A, de Sousa-RodriguesCélio F

Reduced atelectasis

This review examines the impact of intraoperative positive end-expiratory pressure (PEEP) on postoperative mortality and pulmonary complications. PEEP helps reduce atelectasis, a common complication of general anesthesia, but its effect on long-term outcomes remains uncertain.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

19.

Pneumonia presenting as acute abdomen in children: a report of three cases.

Author: VendargonS, WongP S, TanK K

Lung collapse
Pneumonia

Three children with lung collapse secondary to pneumonia presented with acute abdominal pain. Basal pneumonia was diagnosed post-operatively after surgical causes were excluded. Thoracotomy, evacuation of infected debris, and decortication of the collapsed lung were performed in all three cases.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

20.

Current concepts of protective ventilation during general anaesthesia.

Author: Serpa NetoAry, SchultzMarcus J, SlutskyArthur S

Lung-protective ventilation
Ventilation-induced lung injury

This article discusses the importance of lung-protective ventilation strategies during general anesthesia for surgery. Recent studies have shown that using low tidal volumes, positive end-expiratory pressure (PEEP) when indicated, and avoiding excessive oxygen concentrations can reduce the risk of ventilation-induced lung injury.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

21.

Inhalation of a nitric oxide synthase inhibitor to a hypoxic or collapsed lung lobe in anaesthetized pigs: effects on pulmonary blood flow distribution.

Author: FredénF, BerglundJ E, ReberA, HögmanM, HedenstiernaG

Lobar hypoxia treatment

Selective inhalation of nebulized L-NAME (nitric oxide synthase inhibitor) effectively reduced blood flow to a hypoxic or collapsed lung region in anesthetized pigs without causing systemic effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

22.

Computed tomography in adult respiratory distress syndrome: what has it taught us?

Author: PelosiP, CrottiS, BrazziL, GattinoniL

ARDS management

Computed tomography (CT) is a valuable tool for understanding the pathophysiology of the adult respiratory distress syndrome (ARDS) and for evaluating the effectiveness of different treatment strategies. CT can reveal the distribution of edema and atelectasis in the lungs, and how different maneuvers, such as changes in body position, positive end-expiratory pressure (PEEP), and mechanical ventilation, affect lung mechanics.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

23.

Driving Pressure During General Anesthesia for Open Abdominal Surgery (DESIGNATION): study protocol of a randomized clinical trial.

Author:

PPC prevention
Postoperative pulmonary complications

Intraoperative driving pressure (ΔP) is associated with postoperative pulmonary complications (PPC). This study tested the hypothesis that individualized high positive end-expiratory pressure (PEEP), compared to fixed low PEEP, protects against PPC in patients undergoing open abdominal surgery.

Clinical Trial ProtocolA plan for conducting a clinical trial. It describes in detail the purpose, design, methodology, and statistical considerations of the trial, ensuring the transparency and consistency of the trial.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

24.

Bilateral pulmonary edema after endoscopic sympathectomy in a patient with glucose-6-phosphate dehydrogenase deficiency.

Author: LanC J, LukH N, WuC T, ChangW K, TsouM Y, LuiP W, LeeT Y

Acute pulmonary edema
Endoscopic sympathectomy
Glucose-6-phosphate dehydrogenase deficiency
Palmar hyperhidrosis

A patient with palmar hyperhidrosis and glucose-6-phosphate dehydrogenase (G-6-PD) deficiency developed acute pulmonary edema after bilateral endoscopic sympathectomy under alternate one-lung anesthesia. This might be due to a combination of factors, including hypoxemia, G-6-PD deficiency, and sympathectomy, contributing to pulmonary edema upon lung reexpansion.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

25.

[Atelectasis in general anesthesia and alveolar recruitment strategies].

Author: MartínezG, CruzP

Alveolar recruitment strategies
Atelectasis

Atelectasis, or lung collapse, is a common complication during general anesthesia. This review examines the causes and strategies for preventing this complication.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : Spanish

26.

Ventilation/perfusion distributions revisited.

Author: BaumgardnerJames E, HedenstiernaGöran

VA/Q monitoring

Monitoring ventilation-perfusion (VA/Q) mismatch is crucial in anesthesia due to its role in hypoxemia. Newer methods simplify VA/Q measurement and link it to inflammation. VA/Q monitoring provides valuable insights into gas exchange in thoracic anesthesiology and intensive care medicine.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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