Early tracheotomy in secretional anoxia.

Abstract

TRACHEOTOMY has been done since the Middle Ages, usually as a last resort and only for obstruction of the upper respiratory tract. Lee, Tucker, and Clerf 1 (1928) showed that postoperative pneumonias were the result of respiratory obstruction, with consequent atelectasis. Early promotion of coughing and early bronchoscopic suction relieved the obstruction. Durand 2 (1929) demonstrated the effectiveness of postural drainage in relieving pulmonary obstruction in poliomyelitis. The idea of a lower respiratory obstruction, which is the basis of secretional anoxia, was conceived at this time. Wilson 3 (1931) mentioned tracheotomy as a means of relieving lower respiratory obstruction. Figi 4 (1934) demonstrated that bronchopneumonia is a common complication of pulmonary obstruction and that death in most cases of lower respiratory obstruction was due to delay in performing a tracheotomy. Davison 5 (1936) mentioned tracheotomy for the relief of pulmonary obstruction in poliomyelitis. The actual reporting of results, however, was