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Resolution of Resorptive and Compressive Atelectasis without Invasive Manoeuvres: A Case Report

Authors :
Simone Ielo
Paolo Calò
Alessia Del Pizzo
Riccardo Cucurachi
Giovanni Piraino
Eirini Lemontzi
Source :
European Medical Journal Respiratory, Pp 108-114 (2023)
Publication Year :
2023
Publisher :
European Medical Journal, 2023.

Abstract

A care challenge that clinicians and other healthcare professionals face very frequently is the complications of bedridden syndrome. Respiratory involvement readily occurs in these patients for whom medical therapy alone is not sufficient. In this clinical case, the authors describe the results of chest physiotherapy in an elderly patient who had developed complete atelectasis of the left lung, attributable to two mechanisms: obstructive, due to mucus plugging, and compressive, due to pleural effusion. The patient was accessed in the authors’ Respiratory Rehabilitation Department, San Raffaele Pisana Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), Rome, Italy, with dyspnoea at rest and high O2 requirement (venturi mask fraction of inspired O2: 40%), demonstrated by severe respiratory failure on blood gas analysis (partial pressure of O2/fraction of inspired O2: 155). Physical examination revealed marked reduction of lung sounds, especially on the left side, with diffuse rhonchi. A chest CT scan was performed to demonstrate complete left lung collapse that would have required invasive therapeutic procedures, such as bronchoscopy. However, given the high risk of periprocedural complications and the patient’s refusal, a chest physiotherapy programme was started. The lung was able to re-expand 7 days later, as evidenced by X-ray and improved gas exchange. The manuscript describes the physiotherapeutic techniques used and collects the main scientific evidence on them. The main purpose is to highlight the role of respiratory physiotherapy as an effective, safe, co-adjuvant treatment, and sometimes alternative to invasive manoeuvres in the treatment of frail patients.

Details

Language :
English
ISSN :
20543166
Database :
Directory of Open Access Journals
Journal :
European Medical Journal Respiratory
Publication Type :
Academic Journal
Accession number :
edsdoj.68e7f126705141e3b1b90d83388ef25c
Document Type :
article
Full Text :
https://doi.org/10.33590/emjrespir/10309984