Atelectasis of the lower lobe accounts for 60-70% of post-CPB atelectasis. Which of the following will promote airway collapse?

Atelectasis refers to the partial or complete collapse of the lung, and in the context of post-cardiopulmonary bypass (CPB), it is particularly significant in the lower lobes. The correct answer indicates that all the options contribute to the promotion of airway collapse.

Choosing the response that includes all factors is logical because each scenario individually can lead to conditions that predispose the airway to collapse and influence lung function after surgery.

The first scenario, involving fluid infiltration due to left internal mammary artery (LIMA) harvesting, highlights how surgical manipulation can lead to pleural effusion. This accumulation can exert pressure on the lung, particularly in the lower lobe, facilitating collapse.

In the second scenario, preferential suctioning of the right lung, particularly through blind suctioning, can inadvertently lead to hypoventilation or inadequate clearance of secretions in the left lung. This impairs lung function on the left side and promotes atelectasis.

The third scenario suggests that the heart resting on the immobile left lower lobe during CPB can create mechanical compression, leading to atelectasis in that region. If the lower lobe is unable to inflate properly because of this external pressure, it becomes susceptible to collapse.

In summary