Original communication| Volume 17, ISSUE 4, P538-551, April 1945

Cardiovascular disturbances following pneumonectomy

An attempt to correlate blood pressure and intrapleural pressure changes
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      Rather severe fall of blood pressure immediately following pneumonectomy has been noted commonly. In 64 per cent of a series of thirty-six cases herein reported such a drop occurred. Abrupt changes of the intrapleural pressure on the side of the pneumothorax, which were produced by changes in the position of the body of the patient, were investigated as a possible cause.
      Determinations of intrapleural pressure were made on five patients immediately after closure of the thorax after pneumonectomy. These determinations were made with the patient in three positions. Simultaneous records of the blood pressure and pulse rate were kept. Records of a number of other patients were reviewed for data pertinent to this study.
      In cases in which the mediastinum was mobile, changes in the position of the patient produced changes in the intrapleural pressure, but no constant change in the blood pressure or pulse rate could be correlated with this change.
      As factors in this postoperative lowering of the blood pressure, hemorrhage, anoxia, and cardiovascular reflexes mediated through the vagus were briefly considered.
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