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June 20, 1959


Author Affiliations

51 N. 39th St. Philadelphia 4.

JAMA. 1959;170(8):995. doi:10.1001/jama.1959.03010080103025

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To the Editor:—  I was disturbed by some statements made by Henderson and associates in The Journal, May 2, pages 28-32, relating to the need for physiological monitors during open-heart surgery. When one undertakes surgical bypass of the heart and lungs for open-heart operations, thus eliminating the vitally normal functions of the heart and lungs, good sense dictates that we know how effectively we have substituted the man-made for the God-made machinery. Without such knowledge anything we do to maintain a status quo as close to normal as possible becomes purely empirical. In such situations mistakes can be made over and over again without our knowing why.For example, there is the simple matter of how well the blood is being oxygenated. How does one know this unless it is being measured? Studies indicate that even with experienced observers cyanosis cannot be reliably detected until the oxygen saturation has fallen

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