血胸 (肺虚脱) と大量出血の持続, 並びに解除の血液化学組成に及ぼす影響

Abstract

In order to investigate the influence of postoperative hemothorax in the field of thoracic surgery, the author performed experiments on 73 normal hybrid dogs in which liquid paraffin was poured into the left thoracic cavity, thus intrathoracic condition simulating hemothorax being produced, and hypotension averaging 50mmHg was maintained by means of massive hemorrhage.Influence of the stated condition with the pulmonary compression and hemorrhagic stress, influence of removing the condition, and effect of oxygen inhalation and blood transfusion were scrutinized from the standpoint of blood gas volume, amino N and fluctuation of the acid-base balance.1. Fluctuations in chemical composition of the blood were slight in degree when only liquid paraffin was present in the thoracic cavity, while, when hemorrhagic stress was added to the condition, fluctuations in the form of decrease of blood gas volume, decline of pH and increase of amino N were all more prominent than in simple bleeding. The group with massive paraffin injection showed particularly rapid changes and died in a short period of time.2. The acid-base balance tended to develop compensatory respiratory alkalosis by the intrathoracic injection of liquid paraffin and it shifted to the side of compensatory acidosis after hemorrhage occurred.3. Improvement in the composition of blood chemistry was induced by removal of intrathoracic liquid paraffin, oxygen inhalation and blood transfusion. Combined administration of removal and oxygen inhalation showed a prominent effect on the survival time, and combination of removal and blood transfusion showed more remarkable results in these respects.