Nebulizer therapy in post-operative atelectasis: A narrative review

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Atelectasis, the collapse of lung tissue, is a significant complication following surgical procedures, particularly in thoracic or abdominal surgeries. Nebulizer therapy has emerged as a potential adjunctive treatment for post-operative atelectasis, aiming to improve lung expansion, mucociliary clearance, and patient outcomes. This narrative review provides a comprehensive analysis of nebulizer therapy in post-operative atelectasis management, covering its mechanisms of action, clinical effectiveness, safety considerations, challenges, and future perspectives. The review highlights the pathophysiology of post-operative atelectasis, emphasizing anesthesia-induced hypoventilation, loss of functional residual capacity, impaired mucociliary clearance, and airway obstruction. It discusses the role of nebulizer therapy in delivering pharmacological agents, such as bronchodilators, mucolytics, and inhaled corticosteroids, directly to the airways to alleviate atelectasis-associated symptoms and promote lung re-expansion. Safety considerations, including the risk of bronchospasm, infection control, drug-related adverse effects, and environmental hazards, are addressed. Furthermore, patient management strategies, challenges, and limitations of nebulizer therapy, comparative analysis of nebulizer types, and special population considerations are explored. Future perspectives focus on personalized therapy, novel drug formulations, smart nebulizer devices, and targeted therapies to optimize atelectasis management. In conclusion, while nebulizer therapy demonstrates efficacy in treating atelectasis, ongoing advancements in technology and therapeutic strategies offer opportunities to overcome challenges and improve treatment outcomes, ultimately enhancing patient care and quality of life.