Further Studies in Obstructive Pulmonary Atelectasis.

Abstract

In some recent investigative work, two factors were found essential in the experimental production of massive atelectasis of the lung in dogs, viz., A straining type of respiration, and secondly, some form of obstruction to the bronchus of the lung lobe; either total or valvular. In this work an artificial means of obstruction was used, this obstruction being located in the primary bronchus of the lung lobe. Either total or valvular obstruction, in the presence of a staining type of respiration, was followed by a massive atelectatic condition of the obstructed lung. If a quiet, normal type of respiration was exhibited, no resultant atelectasis was observed. An example was given of complete obstruction of a secondary bronchus, of 6 weeks'duration, with quiet respiration in which no atelectasis occurred. In carrying out some experiments with thermal and silver nitrate cautery,, it was found that cauterization of a bronchus was followed by complete stenosis in from one to 2 weeks. If this stenosis was located in the primary bronchus of the lung lobe, that lobe was found to be completely atelectatic with the secondary bronchi and bronchioles filled with a mucogelatinous material. However, if the stenosis was located in one of the several divisions of the primary bronchus to the lobe, no resultant atelectasis occurred; only a filling of the secondary and tertiary bronchi and bronchioles distal to the stenosis with the mucogelatinous material. Group A. 4 dogs. Silver nitrate or thermal cauterization of a secondary bronchus of a lung lobe. Sacrificed at the end of 2 to 6 weeks. Results: Total stenosis of secondary bronchus with no atelectasis distal to the stenosis.