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Atelectasis Vs. Scarring
Atelectasis and scarring are two conditions of the lungs that make it difficult to breath 12. Atelectasis, a complete or partial collapse of a lung, can be reversed; scars in the lung cannot 12. Atelectasis can lead to lung scarring and, in some cases, scar tissues can escalate into interstitial lung disease 123.
Causes
Scarring of the lungs can occur for a variety a reasons, and unlike atelectasis, it is not necessarily the result of a blockage 12. An injury to your lungs can trigger an abnormal healing response, resulting in the production of excess scar tissue. This excess scar tissue interferes with lung function. Lung injuries leading to scar tissue development can also include long-term exposure to toxins, bacterial or fungal growth, as well as viral and parasitic infections . Radiation and chemotherapy drugs, as well as some drugs used to treat heart arrhythmias, psychiatric drugs and some antibiotics can also damage lungs, leading to scar tissue formation. Some conditions do not attack the lungs directly, but nevertheless due to their effects on tissues throughout the body, lead to scar formation. These include:
- lupus
- scleroderma
- rheumatoid arthritis
- dermatomyositis
- polymyositis
- Sjogren's syndrome
- sarcoidosis
- Scarring of the lungs can occur for a variety a reasons, and unlike atelectasis, it is not necessarily the result of a blockage 1.
- Radiation and chemotherapy drugs, as well as some drugs used to treat heart arrhythmias, psychiatric drugs and some antibiotics can also damage lungs, leading to scar tissue formation.
Symptoms
What Is Perihilar Scarring of the Lungs?
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Symptoms of lung scarring are similar and include:
- a feeling of breathlessness
- especially during or after physical activity
- a dry cough
- fever
- chills
- wheezing
- chest pain
- night sweats
- weight loss
- decreased energy level
- fingers that curve over the tops of your fingertips
These symptoms become progressively worse. When the condition is severe, you may also develop low blood oxygen levels, high blood pressure, right-sided heart failure and respiratory failure.
Treatment
The specific treatment for atelectasis depends upon the cause, although the ultimate goal remains the same: removal of whatever is causing the constricted air tube so that the collapsed lung can re-expand 12. If fluid is compressing the lung, the treatment would be to remove the fluid. If mucus is blocking the tube, loosening the mucus with percussion or clapping on the chest is usually attempted. Obstructions can sometimes be removed by bronchoscopy. Tumors can be removed by surgery, radiation, laser or chemotherapy. Aerosolized respiratory treatments, inhaled medications, can also be used to open the airway.
Unfortunately, the formation of scars on the lungs are not reversible. However, a small scar, or a small number of scars, are often well-tolerated as long as the underlying condition causing the scars is treated or does not progress.
- The specific treatment for atelectasis depends upon the cause, although the ultimate goal remains the same: removal of whatever is causing the constricted air tube so that the collapsed lung can re-expand 1.
- If mucus is blocking the tube, loosening the mucus with percussion or clapping on the chest is usually attempted.
Prognosis
What Causes Scarring of the Lungs?
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Atelectasis in a small area of the lung, as well as small lung scars, are usually not life-threatening 12. Lungs are resilient; a collapsed lung usually reinflates once the obstruction is removed. However, some scarring or damage may remain. If small enough, it will not cause further problems.
- Atelectasis in a small area of the lung, as well as small lung scars, are usually not life-threatening 1.
- If small enough, it will not cause further problems.
Prevention
Atelectasis can be prevented by encouraging movement and deep breathing, particularly for patients who are bedridden for long periods of time or who have been under anesthesia, as well as keeping choking hazards away from small children 12. Smoking increases your risk for atelectasis, particularly before surgery 12. Decreasing your risks of developing atelectasis as well as any other lung injury also decreases your risk for lung scarring 12.
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References
- Medline Plus: Atelectasis
- Mayo Clinic: Atelectasis
- Mayo Clinic: Interstitial Lung Disease
- University of Cincinnati: Lung Scarring
- What is Atelectasis. Heart, Lung and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/atl
- Miskovic A, Lumb AB. Postoperative pulmonary complications. Br J Anaesth. 2017;118(3):317-334. doi:10.1093/bja/aex002
- Pelosi P, Rocco PRM, Gama de abreu M. Close down the lungs and keep them resting to minimize ventilator-induced lung injury. Crit Care. 2018;22(1):72. doi:10.1186/s13054-018-1991-3
- Ray K, Bodenham A, Paramasivam E. Pulmonary atelectasis in anaesthesia and critical care. Continuing Education in Anaesthesia Critical Care & Pain. 2014;14(5):236-245. doi:10.1093/bjaceaccp/mkt064
- Zammit C, Liddicoat H, Moonsie I, Makker H. Obesity and respiratory diseases. Int J Gen Med. 2010;3:335-43. doi:10.2147/IJGM.S11926
- Collapsed Lung | Atelectasis | Pneumothorax. MedlinePlus. Aug 30, 2019.
- Urell C, Emtner M, Hedenström H, Tenling A, Breidenskog M, Westerdahl E. Deep breathing exercises with positive expiratory pressure at a higher rate improve oxygenation in the early period after cardiac surgery--a randomised controlled trial. Eur J Cardiothorac Surg. 2011;40(1):162-7. doi:10.1016/j.ejcts.2010.10.018
- What is Atelectasis. Heart, Lung and Blood Institute.
Writer Bio
Robin Wasserman has been writing and prosecuting biochemical patents since 1998. She has served as a biochemical patent agent and a research scientist for a gene-therapy company. Wasserman earned her Doctor of Philosophy in biochemistry and molecular biology, graduating from Harvard University in 1995.