Chest Physiotherapy as an Alternative to Bronchoscopy in Mucus Plug–Induced Atelectasis: A Case Report

JEREMIA ALVIAN WIRANATA; NI WAYAN PUSPITA SARI

doi:10.36948/ijfmr.2026.v08i02.74114

Chest Physiotherapy as an Alternative to Bronchoscopy in Mucus Plug–Induced Atelectasis: A Case Report

Author(s)	JEREMIA ALVIAN WIRANATA, NI WAYAN PUSPITA SARI
Country	Indonesia
Abstract	Pneumonia in patients with neurological disorders is associated with impaired airway protection, ineffective cough, and increased risk of secretion retention, which may lead to complications such as mucus plug–induced atelectasis. This case report describes a 60-year-old female with a history of ischemic stroke, vascular dementia, and prolonged immobilization who presented with dyspnea, fever, and difficulty expectorating sputum. Initial evaluation supported a diagnosis of pneumonia, which subsequently progressed to respiratory failure, sepsis, and acute respiratory distress syndrome (ARDS). During hospitalization, the patient developed acute deterioration with radiographic findings suggestive of left-sided atelectasis caused by mucus plugging. Due to limited availability of bronchoscopy, chest physiotherapy was implemented as the primary intervention for airway clearance. Management included a combination of suctioning, postural drainage, percussion, vibration, and positioning strategies, along with mechanical ventilation and supportive care. Gradual clinical improvement was observed, as evidenced by enhanced oxygenation, reduction in sputum retention, and radiological re-expansion of the affected lung. The patient was successfully weaned from mechanical ventilation, underwent tracheostomy due to persistent airway clearance impairment, and showed continued recovery. This case highlights the important role of chest physiotherapy as a non-invasive and effective modality in managing mucus plug–induced atelectasis, particularly in patients with neurological impairment and in settings where bronchoscopy is not readily available. Early recognition of secretion retention and aggressive airway clearance strategies are essential to improve respiratory outcomes and prevent further complications in this high-risk population.
Keywords	Pneumonia, Atelectasis, Chest physiotherapy, Stroke, Respiratory failure
Field	Medical / Pharmacy
Published In	Volume 8, Issue 2, March-April 2026
Published On	2026-04-10
DOI	https://doi.org/10.36948/ijfmr.2026.v08i02.74114

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Chest Physiotherapy as an Alternative to Bronchoscopy in Mucus Plug–Induced Atelectasis: A Case Report

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