The Effects of Pulmonary Atelectasis and Reexpansion on Lung Cellular Immune Defenses

Hani Shennib, MD; David S. Mulder, MD; Ray Chu-Jeng Chiu, MD, PhD
Arch Surg. 1984;119(3):274-277. doi:10.1001/archsurg.1984.01390150016004.
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• Pulmonary atelectasis predisposes the lung to infection. This condition may be partly due to impaired cellular immune response of the collapsed lung segment. We postulated that atelectasis may affect alveolar macrophage (AM) antibacterial function. To test this hypothesis, atelectasis was induced in the right upper lobes of piglet lungs. Alveolar macrophages harvested by bronchoalveolar lavage of collapsed segments for up to 24 hours showed progressive depression of their phagocytic activity against Pseudomonas aeruginosa in vitro. However, their intracellular bactericidal activity did not change. Reexpansion of the atelectatic lobes with mechanical ventilation and 100% oxygen supplementation for four hours after six hours of atelectasis resulted in reversal of the impaired AM phagocytic activity. These observations presented insight into the mechanisms of susceptibility to lung infection in pulmonary atelectasis and the potential for its reversal.

(Arch Surg 1984;119:274-277)


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