Abstract
A Study were made of diagnosis and treatment of respiratory failure in pulmonary tuberculosis.
1) Out of 000 patients with pulmonary tuberculosis, pulmonary insufficiency were seen in 192 cases (about one third) and respiratory failure in 118 cases (about one fifth).
Out of 100 patients with hypercapnia, 40 had undergone thoracoplasty, while the remainder 60 had not operated on. The most of cases of the former group presented minimal or curable tuberculosis and the latter had far advanced tuberculosis.
2) Remarkable reduction in vital capacity was seen in the thoracoplasty group. Severe obstruction was seen in the far advanced group. In patients with hypercapnia, especially in the thoracoplasty group, O2 cost of breathing was considerably higher, while efficiency of the respiratory muscles and compliance of lungs and thorax were considerably lower than the normal subjects. Therefore, it was suggested that increase of work of breathing might be an important factor for hypercapnia in patients with pulmonary tuberculosis.
The large number of patients with moderate hypercapnia had alkalotic Trather than acidotic values of plasma pH.
3) Low flow oxygen administration (0.2 to 0.3 liter /min) had beneficial effect in patients with hypercapnia to prevent CO2 narcosis.
A Study was designed to determine the effect of isoproterenol administered by I. P. P. B. in subjects with obstruction.
Another study was designed to determine the effect of 35mgm of Opistan on blood gases in subjects with severe dispnea.
Sodium bicarbonate was administered intravenously (1.5 to 2mEq per kg) to patients with hypercapnia.
The dose of penetration into cells or uptake by tissues of injected bicarbonate was calculated.
The dose entered cells or tissue was various in patients with hypercapnia who had normal extraceilular pH.
