Atelectasis Causes and Mechanisms

Classification and Causes

Compression of airways by external masses can cause atelectasis, as reported by the British Journal of Anaesthesia 1
Pleural effusion can cause compressive atelectasis, according to the American Journal of Respiratory and Critical Care Medicine 2
Rounded atelectasis (folded lung) can occur following pleuritis of any cause, particularly asbestos exposure, as noted by the American Journal of Respiratory and Critical Care Medicine 3, 4

Neonatal respiratory distress syndrome can cause adhesive atelectasis, as reported by the American Journal of Respiratory and Critical Care Medicine 5
Bronchopulmonary dysplasia can cause regions of atelectasis to alternate with emphysema, according to the American Journal of Respiratory and Critical Care Medicine 5, 6
COPD and other pulmonary conditions can increase the risk of atelectasis, as noted by the European Heart Journal 7
Malignant pleural effusions can cause compressive atelectasis, as reported by the American Journal of Respiratory and Critical Care Medicine 8

The British Journal of Anaesthesia recommends considering head-up or ramped positioning during anesthesia induction, particularly in obese patients, to prevent platelike atelectasis 9
Pulmonary embolism can present with platelike atelectasis as a non-specific radiographic finding, according to the European Heart Journal 10

Alveolar recruitment maneuvers may temporarily reverse atelectasis, though benefits in the post-operative period are not well established, as reported in Anaesthesia 11, 12

Foreign body aspiration can cause persistent cough and is a common cause of obstructive atelectasis, along with broncholithiasis (calcified lymph nodes eroding into airways) 13

Rounded atelectasis, also known as folded lung, shrinking pleuritis, or Blesovsky's syndrome, develops from infolding of thickened visceral pleura with collapse of intervening lung and is most commonly associated with asbestos exposure 14
Rounded atelectasis presents radiographically as a mass that may be mistaken for tumor and has a classic "comet sign" that is pathognomonic, more visible on HRCT than plain films 14