Atelectasis primary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sudarshana Datta, MD [2]

Overview

Judicious use of anaesthetic agents known to cause narcosis, use of epidural analgesia in patients with underlying pulmonary disease, incentive spirometry, early ambulation, humidifiers, breathing exercises, coughing exercises and supplemental oxygen are effective measures of primary prevention in patients undergoing operative procedures, in order to prevent post operative atelectasis.

Primary Prevention

• Effective measures for the primary prevention of post operative atelectasis include:
  • Judicious use of anaesthetic agents known to cause narcosis
  • Sparing use of narcotics to avoid depression of the cough reflex
  • Use of epidural analgesia in patients with underlying pulmonary disease
  • Incentive spirometry
  • Early ambulation
  • Humidifiers
  • Positive end-expiratory pressure (PEEP)
  • Continuous positive airway pressure (CPAP)
  • Breathing exercises
  • Coughing exercises
  • Supplemental oxygen: arterial oxygen saturation of greater than 90%
  • Nebulized bronchodilators
  • Chest physiotherapy: help clear secretions and improve cough in patients
    • Types of chest physiotherapy include:
      • Postural drainage
      • Chest wall percussion
      • Forced expiration technique (Huffing)