Atelectasis in pilots

Q: 32-year-old professional pilot is admitted to ICU after he required intubation in the field after he performed some quick maneuverings during a practice session. Bedside CXR showed various sites of collapse on bilateral lungs. What kind of atelectasis is suspected?  


Answer: Acceleration Atelectasis

There are at least eight types of non-obstructive atelectasis

• Relaxation
• Compressive
• Adhesive
• Cicatrization
• Replacement
• Acceleration
• Rounded 
• Plate-like

Definitions/details of above atelectasis can be found at reference below. 1

Acceleration atelectasis is unique in the sense that it occurs in professional pilots who get engaged to very high, vertical accelerative forces at or above 5G. Airways get distorted and closed at 5G due to gravitational forces. Also, the atelectasis gets exacerbated by a high fractional concentration of oxygen on board.

#pulmonary



References:

1. Woodring JH, Reed JC. Types and mechanisms of pulmonary atelectasis. J Thorac Imaging 1996; 11:92. 

2. Tacker WA Jr, Balldin UI, Burton RR, et al. Induction and prevention of acceleration atelectasis. Aviat Space Environ Med 1987; 58:69.