Nelson Textbook of Pediatrics 22nd Edition | Collapse of lung tissue due to obstruction (resorption atelectasis) or compression (passive atelectasis). Causes: mucus plugging (asthma, CF, bronchiolitis), foreign body, postoperative (pain, splinting), pleural effusion, pneumothorax, neuromuscular disease (weak cough), anesthesia. Clinical: tachypnea, decreased breath sounds, crackles, hypoxemia, may be asymptomatic. Imaging: CXR (volume loss, mediastinal shift toward collapse, crowded vessels, fissure displacement). Treatment: treat underlying cause, chest physiotherapy, bronchodilators, CPAP, bronchoscopy for mucus plug/foreign body, recombinant DNase (off-label) for refractory atelectasis.
🌐 paeds.online — Pakistan's Pediatric Platform| Cause | Management |
|---|---|
| Mucus plug (asthma, CF) | Treat underlying disease (bronchodilators, steroids, airway clearance, dornase alfa). Bronchoscopy if refractory |
| Foreign body | Rigid bronchoscopy for removal |
| Postoperative | Incentive spirometry, early mobilization, chest physiotherapy, CPAP |
| Pleural effusion/pneumothorax | Drain effusion (chest tube), treat pneumothorax |
| Neuromuscular weakness | Mechanical insufflator-exsufflator (cough assist), noninvasive ventilation (BiPAP) |
| Refractory atelectasis | Bronchoscopy with saline lavage, recombinant DNase (off-label) |