Pulmonary atelectasis in childhood: Difficulties from diagnosis to treatment Çocuklarda Akciǧer Atelektazileri: Tanidan Tedaviye Zorluklar


Şişmanlar Eyüboğlu T., Aslan A. T., Derinkuyu B. E., Boyunaga Ö. L.

Turkiye Klinikleri Pediatri, vol.25, no.4, pp.201-206, 2016 (Scopus) identifier

  • Publication Type: Article / Article
  • Volume: 25 Issue: 4
  • Publication Date: 2016
  • Doi Number: 10.5336/pediatr.2016-54147
  • Journal Name: Turkiye Klinikleri Pediatri
  • Journal Indexes: Scopus
  • Page Numbers: pp.201-206
  • Keywords: Child, Pulmonary atelectasis
  • Gazi University Affiliated: Yes

Abstract

Copyright © 2016 by Türki ye Klinikleri.Objective: Atelectasis is a non-ventilated lung parenchyma that can ocur by several causes in children. Diagnosis and treatment are very important because it can cause lung damage. In this study, we aimed to evaluate the etiology, diagnostic methods, treatments and outcomes of patients with atelectasis in childhood. Material and Methods: The data of children with atelectasis in a tertiary pediatric pulmonology center between 2007 and 2015 were evaluated retrospectively. Results: In this time period 194 patients were diagnosed with atelectasis and mean age of diagnosis was 5.8±4.0 years. The most common complaint was coughing. The mean duration of complaints was 19.1±46.4 weeks. Ninety-five (49%) patients had pneumonia and 23 (12%) patients had acute asthma exacerbation during diagnosis. The underlying diseases were asthma, primary ciliary dys kinesia, neuromuscular disease such as hypotonia or myopathy, congenital heart disease, bronc hopulmonary dysplasia, tracheal/bronchomalacia, cystic fibrosis, restored trachea-esophagial fistula and other rare causes. Diagnosis was made via bilateral chest X-ray in 76% of the patients and computed tomography in 23%. The most common atelectasis was observed in right middle lobe. If present, the underlying condition was treated, all patients were treated by chest physiotherapy and mucolytic treatment (N-acetylcysteine) and10 % of the patients had bronchoscopy and 7% of them had dornase alpha treatment in addition to these treatments. Twenty-two patients had reccurent atelectasis, and in 37 patients atelectasis did not recover. Conclusion: Early diagnosis and treatment are essential in atelectasis, and it is important for clinicians to keep in mind that atelectasis may have different radiological findings. Recognizing radiological findings is important both for treatment and unnecessary further studies involving high-dose radiation. Patients with impaired mucociliary function may have recurrent or non-recovering atelectasis. An algorithm could be helpful for clinicians to demonstrate atelectasis approach.