Physiologic Evaluation and Treatment of Kyphoscoliotic Patients
Authors: ISRAEL BRUDERMAN
Journal: Annals of Internal Medicine (1961)

Article1 July 1961Physiologic Evaluation and Treatment of Kyphoscoliotic PatientsISRAEL BRUDERMAN, M.D., MYRON STEIN, M.D.ISRAEL BRUDERMAN, M.D.Search for more papers by this author, MYRON STEIN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-55-1-94 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptNew techniques of investigation have clarified the nature of the abnormalities of pulmonary function in patients with severe kyphoscoliosis. Restricted lung volumes, alveolar hypoventilation, hypercapnia, arterial oxygen unsaturation, and normal distribution of inspired air have been observed in these patients. However, arterial oxygen unsaturation when it occurs is unusually large for the degree of alveolar hypoventilation. Previous investigations have eliminated a diffusion abnormality (1) or atelectasis as a basis for this defect. The present study is concerned with the problem of arterial oxygen unsaturation and with the therapy of the acutely ill kyphoscoliotic patient.PATIENTS AND METHODSPATIENTSThree male...References1. BERGOFSKYTURINOFISHMAN EHGMAP: Cardiorespiratory failure in kyphoscoliosis. Medicine 38: 263, 1959. CrossrefMedlineGoogle Scholar2. COMROEFOWLER JHWS: Lung function studies. VI. Detection of uneven alveolar ventilation during a single breath of oxygen: a new test of pulmonary disease. Amer. J. Med. 10: 408, 1951. CrossrefMedlineGoogle Scholar3. COURNANDBALDWINDARLINGRICHARDS AEDRCDW Studies on the intrapulmonary mixing of gases. IV. The significance of the pulmonary emptying rate and a simplified open circuit measurement of residual air. J. Clin. Invest. 20: 681, 1941. CrossrefMedlineGoogle Scholar4. LILLYANDERSONHOWEY JCTFJP: The nitrogen meter. National Research Council. CMR-CAM Rep. No. 299, 1943. Google Scholar5. VAN SLYKENEILL DDJM: The determination of gases in blood and other solutions by vacuum extraction and manometric measurement. J. Biol. Chem. 61: 523, 1924. CrossrefGoogle Scholar6. COMROEWALKER JHP: Normal human arterial oxygen saturation determined by equilibration with 100 per cent O2 in vivo and by oximeter. Amer. J. Physiol. 152: 365, 1948. CrossrefMedlineGoogle Scholar7. VAN SLYKESENDROY DDJ: Line charts for graphic calculations by Henderson-Hasselbach equation for calculation plasma CO2 content from whole blood content. J. Biol. Chem. 79: 781, 1928. CrossrefGoogle Scholar8. SCHOLANDER PF: Analyzer for accurate estimation of respiratory gases in one-half cubic centimeter samples. J. Biol. Chem. 167: 235, 1947. CrossrefMedlineGoogle Scholar9. COMROEFORSTERDUBOISBRISCOECARLSEN JHREABWAE: The Lung. The Year Book Publishers, Inc., Chicago, Ill., 1956, p. 178. Google Scholar10. RAVINSTEIN HAM: Bedside measurement of alveolar carbon dioxide tension. New Engl. J. Med. 259: 811, 1958. CrossrefMedlineGoogle Scholar11. STEINCOLP MCR: Simple method for the measurement of alveolar carbon dioxide. J.A.M.A. 173: 671, 1960. CrossrefMedlineGoogle Scholar12. BALDWINCOURNANDRICHARDS EDADW: Pulmonary insufficiency.I. Physiologic classification, clinical methods of analysis, standard values in normal subjects. Medicine 27: 243, 1948. CrossrefMedlineGoogle Scholar13. SCHNABELRATTOKIRBYJOHNSONCOMROE TGOCKJJH: Postural cyanosis and angina pectoris following pneumonectomy; relief by closure of an interatrial septal defect. J. Thor. Cardiov. Surg. 32: 246, 1956. Google Scholar14. CHAPMANDILLGRAYBIEL EMDBA: The decrease in functional capacity of the lungs and heart resulting from deformities of the chest: Pulmonocardiac failure. Medicine 18: 167, 1939. CrossrefGoogle Scholar15. HANLEYPLATTSCLIFTONMORRIS TMMMTL: Heart failure of the hunchback. Quart. J. Med. (new series) 27: 155, 1958. MedlineGoogle Scholar16. COMROEFORSTERDUBOISBRISCOECARLSEN JHREABWAE: The Lung. The Year Book Publishers, Inc., Chicago, Ill., 1956, p. 35. Google Scholar17. CAROBUTLERDUBOIS CGJAB: Some effects of restriction of chest cage expansion on pulmonary function in man: an experimental study. J. Clin. Invest. 39: 573, 1960. CrossrefMedlineGoogle Scholar18. FINLEYLENFANTHAABPIIPERRAHN TNCPJH: Venous admixture in the pulmonary circulation of anesthetized dogs. J. Appl. Physiol. 15: 418, 1960. CrossrefMedlineGoogle Scholar19. FISHMANBERGOFSKYTURINOJAMESONRICHARDS APEHGMAGDW: Circulation and respiration in kyphoscoliosis. Circulation 14: 935, 1956. Google Scholar20. LIEBOWHALESBLOOMER AAMRWE: Pulmonary Circulation. Grune & Stratton, New York, 1959, p. 88. Google Scholar21. PRINZMETALORNITZSIMKINBERGMAN MEMBHC: Arteriovenous anastomoses in liver, spleen and lungs. Amer. J. Physiol. 152: 48, 1948. CrossrefMedlineGoogle Scholar22. RAHNSTROUDTOBIN HRCCE: Visualization of arteriovenous shunts by cinefluorography in the lungs of normal dogs. Proc. Soc. Exp. Biol. Med. 80: 239, 1952. CrossrefMedlineGoogle Scholar23. TYLER JM: The influence of tracheostomy on ventilation in pulmonary emphysema. Clin. Res. Proc. 8: 381, 1960. Google Scholar24. MARESCAOKINO RLSY: Size of tracheotomy tubes: its effect on ventilation of respirator patients with poliomyelitis. Ann. Otol. 65: 674, 1956. Google Scholar25. GREENE NM: Fatal cardiovascular and respiratory failure associated with tracheotomy. New Engl. J. Med. 263: 846, 1959. CrossrefGoogle Scholar26. FERRISPOLLARD BGDS: Effect of tracheostomy tubes on the resistance to breathing and pulmonary resistance in patients with poliomyelitis. New Engl. J. Med. 263: 1048, 1960. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Boston, MassachusettsReceived for publication March 4, 1961.From the Department of Medicine, Harvard Medical School, and the Medical Research Department of the Yamins Research Laboratories and the Medical Service, Beth Israel Hospital, Boston, Mass.Supported in part by U. S. Public Health Service Grant No. H-3795 (C2).Requests for reprints should be addressed to Myron Stein, M.D., Beth Israel Hospital, 330 Brookline Ave., Boston 15, Mass. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByRestrictive Lung DisordersControl of Breathing in Diseases of the Respiratory Tract and LungsSleep in Restrictive Lung DisordersAssisted ventilation at home: Is it worth considering?Arrest of alveolar multiplication in kyphoscoliosisUnexpected longevity in patients with severe kyphoscoliosis.Cuirass respirator treatment of chronic respiratory failure in scoliotic patients.Regional pulmonary ventilation and perfusion distribution in patients with untreated idiopathic scoliosisReversible pulmonary hypertension in a child with respiratory obstruction and cor pulmonale 1 July 1961Volume 55, Issue 1Page: 94-102KeywordsHospital medicineHypercapniaLungsMedical servicesNormal distributionOxygenPatientsPulmonary functionResearch laboratoriesRespiration Issue Published: 1 July 1961 PDF DownloadLoading ...