Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Treatment of Chylothorax

Treatment of Chylothorax Abstract To the Editor.—The article by Kurtz and Hsu in the Archives (115:73-74, 1980) regarding resolution of chylothorax after positive end-expiratory pressure (PEEP) ventilation is enlightening and a logical approach to the clinical problem. Several years ago, Bittar and I1 undertook to determine the mechanism by which patients receiving PEEP ventilation acquired a positive water balance.2 We envisioned PEEP as retarding lymphatic return to the central venous pool, thereby allowing fluid to accumulate in the more peripheral interstitium. To test this hypothesis, we anesthetized dogs and cannulated the thoracic duct above the diaphragm in a manner that allowed us to measure the volume of lymph flowing per unit of time. We measured lymph flow during mechanical ventilation before, during, and after PEEP and found that there was a highly significant relationship between application of PEEP and reduction of lymph flow. Furthermore, when PEEP was removed lymphatic flow References 1. Pilon R, Bittar D: The effects of positive end-expiratory pressure on thoracic-duct lymph flow during controlled ventilation in dogs . Anesthesiology 39:607-642, 1973.Crossref 2. Sladen A, Taver MB, Pontoppidan H: Pulmonary complications and water retention in prolonged mechanical ventilation . N Engl J Med 279:448-452, 1968.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Treatment of Chylothorax

PILON, ROBERT N.
Archives of Surgery , Volume 115 (9) – Sep 1, 1980
Download PDF
1 page

Treatment of Chylothorax

Abstract

Abstract To the Editor.—The article by Kurtz and Hsu in the Archives (115:73-74, 1980) regarding resolution of chylothorax after positive end-expiratory pressure (PEEP) ventilation is enlightening and a logical approach to the clinical problem. Several years ago, Bittar and I1 undertook to determine the mechanism by which patients receiving PEEP ventilation acquired a positive water balance.2 We envisioned PEEP as retarding lymphatic return to the central venous pool, thereby allowing...
Loading next page...
 
/lp/american-medical-association/treatment-of-chylothorax-P2VSJnPgne

References (3)

Publisher
American Medical Association
Copyright
Copyright © 1980 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1980.01380090101028
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor.—The article by Kurtz and Hsu in the Archives (115:73-74, 1980) regarding resolution of chylothorax after positive end-expiratory pressure (PEEP) ventilation is enlightening and a logical approach to the clinical problem. Several years ago, Bittar and I1 undertook to determine the mechanism by which patients receiving PEEP ventilation acquired a positive water balance.2 We envisioned PEEP as retarding lymphatic return to the central venous pool, thereby allowing fluid to accumulate in the more peripheral interstitium. To test this hypothesis, we anesthetized dogs and cannulated the thoracic duct above the diaphragm in a manner that allowed us to measure the volume of lymph flowing per unit of time. We measured lymph flow during mechanical ventilation before, during, and after PEEP and found that there was a highly significant relationship between application of PEEP and reduction of lymph flow. Furthermore, when PEEP was removed lymphatic flow References 1. Pilon R, Bittar D: The effects of positive end-expiratory pressure on thoracic-duct lymph flow during controlled ventilation in dogs . Anesthesiology 39:607-642, 1973.Crossref 2. Sladen A, Taver MB, Pontoppidan H: Pulmonary complications and water retention in prolonged mechanical ventilation . N Engl J Med 279:448-452, 1968.Crossref

Journal

Archives of Surgery – American Medical Association

Published: Sep 1, 1980

There are no references for this article.