The Role of Bronchoscopy and Chest Physiotherapy in Postoperative Patients With Acute Lung Atelectasis Due to Airway Mucus Plugging: A Case Series and Review of Entity

• Published in: Curēus (Palo Alto, CA) Vol. 16; no. 4; p. e59324
• Main Authors: Athish, K K, T J, Guruprasad, Padmanabha, Spurthy, K R, Harshitha
• Format: Journal Article
• Language: English
• Published: United States Cureus Inc 29.04.2024; Cureus
• Subjects: Abdomen; Bronchoscopy; Cesarean section; Emergency medical care; Extubation; Females; Intensive care; Internal Medicine; Intubation; Laparotomy; Oxygen saturation; Patients; Peritonitis; Physical Medicine & Rehabilitation; Physical therapy; Pleural effusion; Pneumothorax; Pulmonology; Respiratory failure; Surgery; Thorax; Tuberculosis; Ultrasonic imaging; Ventilators; chest physiotherapy; complication of mechanical ventilation; acute lung collapse; lung atelectasis; pulmonary rehabilitation and medicine; flexible bronchoscopy; postoperative pulmonary complications; post abdominal surgery; postoperative lung collapse
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.59324

Mechanical ventilation and endotracheal intubation can cause airway damage and inflammation resulting in excessive mucus secretions, thereby increasing the risk of respiratory failure post extubation. An abundance of secretions may result in bronchial obstruction and lung collapse distant from the site of obstruction. If lung collapse is diagnosed, extra support, including oxygen and, rarely, reintubation, can be necessary. The combination of chest wall percussion and vibrations, patient positioning to facilitate mucus drainage, coughing, and breathing exercises was the chest physiotherapy method employed for airway clearance in this study. Since the late 20th century, pulmonary rehabilitation strategies have been a standard aspect of care to prevent lung collapse in postoperative cases. Bronchoscopic aspiration and lavage are the common techniques used to remove retained secretions or mucus plugs. Large-volume saline instillation in aliquots and repeated suctioning are required during the procedure. Thus, the current case series emphasizes the role of bronchoscopy and pulmonary rehabilitation in the management of acute lung atelectasis during the postoperative period.