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Physiology of Respiratory Resistance.John S. Gray (by invitation).
The sequence of physiopathologic changes in progressive obstruction of the upper respiratory passages is described as (a) impairment of ventilation capacity which causes dyspnea and (b) hypoventilation, i. e., a ventilation inadequate to the requirements for gas exchange, which causes asphyxial changes in the arterial blood, consisting predominantly of a rise in free carbon dioxide but also a fall in oxygen saturation and ph. Each of these blood changes eventually constitutes a serious threat, and restoration and maintenance of the airway is the only way to correct all three. As hypoventilation progresses, a crisis is reached in which respiration weakens because of the inhibitory effects on respiration of severe asphyxial changes. A vicious cycle is thus set up which terminates abruptly in apnea.
Favorable Results in Bulbar Poliomyelitis Treated as a Problem in Respiratory Obstruction.Thomas C. Galloway and Martin
Van Alyea OE, Lawson LJ. CHICAGO LARYNGOLOGICAL AND OTOLOGICAL SOCIETY. Arch Otolaryngol. 1950;51(5):773–778. doi:10.1001/archotol.1950.00700020798016
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