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Abstract
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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References
- Cardiopulmonary Disturbances Associated With Mediastinal Displacement After Pneumonectomy.Surgery. 1944; 15: 432-439
- Blood Pressure With Special Reference to High Altitudes.Am. J. Physiol. 1908; 23: 90-104
- Studies on the Responses of the Circulation to Low Oxygen Tension; VI. The Cause of the Changes Observed in the Heart During Extreme Anoxemia.Am. J. Physiol. 1922; 60: 155-192
- Studies of the Arterial Oxygen Saturation in the Postoperative Period After Pulmonary Resection.Surgery. 1943; 13: 199-213
- The Vagus and Its Relation to the Surgery of the Lung.J. Thoracic Surg. 1936; 5: 386-392
- Preliminary Phrenic-Vagus Inhibition in Thoracic Surgery.J. Thoracic Surg. 1943; 12: 544-547
Article info
Publication history
Received:
December 13,
1944
Identification
Copyright
© 1945 Published by Elsevier Inc.
