Pulmonary complications in the postoperative patient may be divided into two groups: those resulting from emboli and those produced by bronchial obstruction. This paper is concerned with the control of obstructive pulmonary lesions by tracheotomy in patients whose recovery is threatened by a respiratory complication that fails to respond to the ordinary measures for its prevention and control. Obstructive pulmonary complications produce two physiological disturbances: (1) the systemic, which is concerned with the problem of asphyxia,1 and (2) the local, which is concerned with atelectasis or its sequelae—pneumonitis, drowned lung and lung abscess. The asphyxial state can be caused by sudden obstruction, because of occlusion of the upper airway or aspiration of massive quantities of vomitus. It can also occur in atelectasis as a result of reduction in the ventilatory surface of the lung. In the latter case the onset is insidious and the degree of anoxic injury difficult
Atkins JP. TRACHEOTOMY FOR PREVENTION OF PULMONARY COMPLICATIONS IN POSTOPERATIVE AND SEVERELY DEBILITATED PATIENTS. JAMA. 1951;146(3):241–243. doi:10.1001/jama.1951.03670030019007
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