J.Jpn. Surg. Soc.. 55(9): 1034-1056, 1954

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Original article

A STUDY ON POSITIVE-NEGATIVE ARTIFICIAL RESPIRATION UNDER THE CONDITION OF ENDOTRACHEAL ANESTHESIA

The positive-negative respiration method under the condition of endotracheal anesthsia of closed circulation type was applied to 105 cases, while as control experiments 33 cases were subjected to intermittent positive respiration methed. The results obtained by the comparative study of these cases are summarized below:
1) The contents of O₂ in blood showed generally a moderate increase over that at the time of operation. In some cases the variation was very slight.
2) Carbon dioxide contents of blood did not show a tendency towards accumulation in the body. It either decreased moderately or showed mostly no change.
3) Scarcely any change was observed in the acid-base equilibrium (pH) in blood.
4) There was no increase in the PCO₂ contents in blood indicating that the alveolar gas exchange was adequate.
5) In pulmonary tissues no damage, bleeding, edema or other abnormal sympotoms were observed.
6) Carbon dioxide contents in expiratory air showed a normal figure of 4 ~ 4.5%, indicating that pulmonary ventilation was adequate.
7) Oxygen consumption showed only a moderate increase, and no fluctuation was observed during the whole process.
8) No decrease was observed in pulmonary blood flow and cardiac output.
9) Pulserate did not undergo much change and no irregularities or pause of pulsation were observed.
10) Much changes in the respiratory frequency was not found and rhythm of pulse was regular.
11) Onset of unconsciousness or convulsion was prevented completely.
12) Occurrence of pulmonary edema was reduced.
13) This method of respiration gives the patients less painful than any other method. The patients were free from respiration of ala of the nose or movement of muscle of anterior neck region and presented no symptons of dyspnea.
14) It did not cause troubles in circulatory system, and prevented moreover the pause of heart beat and helped the patients to recover quickly from anesthesia.
15) The prognosis was favorable and there was no case of death due to the impediments incurred directly by this method.
16) Blood pressure did not show much changes and fluctuated little durng the whole course of the treatment.
17) Reactions of the eyelids, cornea, reaction to light and muscular strain showed no marked change.
From the findings above stated, we strongly recommend the use of the positive-negative artificial respiration method for open chest operations.
(author's abstract)

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