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September 14, 1940

POSTOPERATIVE ATELECTASISTHE ANESTHETIST'S PART IN THE DIAGNOSIS AND TREATMENT

JAMA. 1940;115(11):899-902. doi:10.1001/jama.1940.02810370007003
Abstract

The prevention and treatment of postoperative atelectasis are of great concern to all anesthetists, for proper management of the patient during and immediately following anesthesia in many instances probably will prevent the occurrence of such a catastrophe. Mismanagement in certain cases undoubtedly is responsible for the development of atelectasis following anesthesia.

Many theories have been advanced as to the etiologic factors involved in the production of atelectasis.1 It has been suggested that edema of the mucous membranes, similar to angioneurotic edema, might produce enough obstruction to cause pulmonary collapse. Bronchial spasm has been suggested as a possible cause of atelectasis, but this hypothesis seems unlikely because bronchial spasm usually produces the antithetic condition; that is, emphysema with bilateral distribution. The "vasomotor theory" suggests that dilatation and stasis in the blood vessels might produce obstruction in the bronchioles by an outpouring of secretion. It is my opinion that most instances

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