Experience in Reconstructive Surgery with Patients Having Respiratory Paralysis

¹ Respiratory Center for Poliomyelitis, Rancho Los Amigos Hospital, Hondo, California; Department of Orthopaedics, College of Medical Evangelists, Los Angeles

On the basis of this series it is felt that patients with severe respiratory paralysis can be given the benefits of reconstructive surgery without greater risk than is now thought suitable. It is our opinion that the techniques used in this surgery may be used in the treatment of other diseases, such as paralysis resulting from cervical-spine injury. Probably most important in our work has been the use of these techniques in procedures which result in considerable chest splinting and depressed respiration. We are impressed with the easier course of the patient following such procedures as thoracic-spine fusion when a respirator is used postoperatively, even if this equipment is not absolutely essential for the maintenance of life. Much to our surprise, the patients with the lower vital capacities have, as a whole, tolerated the procedures better than the patients with the higher vital capacities for whom respiratory equipment was not felt to be necessary. It is our opinion that the advisability of using mechanical respiratory aids in operations upon patients with decreased breathing function will come to be generally recognized, just as we now recognize the need to provide blood replacement during surgery rather than waiting until shock has occurred. The respirator which originally saved the patient's life now permits this patient to be operated upon.

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