Respiratory Insufficiency and Chronic Cor Pulmonale

[摘要] This is a review of the current state of our knowledge of pulmonary function in relation to cardiac physiology and the effects of pathologic processes in the lungs on these systems. The pathologic physiology, diagnosis and treatment of respiratory insufficiency and chronic cor pulmonale are thoroughly considered. The article is based on observations of chronic pulmonary disease in adults. The findings and recommendations are directly applicable to conditions which occur in childhood, especially in the pulmonary complication of cystic fibrosis of the pancreas. Pediatricians occupied with the care of the latter condition will find this review particularly enlightening. Efforts to relieve cynosis and hypoxia due to disturbed pulmonary ventilation in children with fibrocystic disease of the pancreas by treatment with oxygen are not without hazard. The respiratory centers are usually unresponsive to carbon dioxide and correction of the hypoxemia may lead to hypoventilation and retention of carbon dioxide with ensuing acidosis and death. Oxygen should be administered in low concentrations, intermittently, and only when it seems absolutely necessary. Digitalis has been shown to be beneficial in the treatment of congestive failure when chronic cor pulmonale develops as a complication of respiratory insufficiency. Detailed discussion of other therapeutic measures is provided. The incidence of cor pulmonale in respiratory insufficiency in diseases of childhood will undoubtedly be found to be greater when the techniques of clinical and pathologic examination described in this review are applied.

[学科分类] 儿科学