REFLEX PULMONARY ATELECTASIS

Abstract

Pulmonary atelectasis has important surgical, medical and roentgenologic implications. While there are many theories regarding the production of atelectasis, it is generally agreed that its essential cause is the obstruction of a bronchus with massive secretion.¹The weakened respiratory force and the accumulation of bronchial mucus, owing to insufficient movement of cilia together with a suppressed cough reflex, are sufficient causes to explain postoperative atelectasis in the opinion of most observers.² But ever since the first descriptions of this interesting postoperative or post-traumatic complication, the suggestion has been made that reflex nervous stimuli play a part in the initiation of bronchial obstruction. In fact, three different reflex mechanisms were proposed: that of the diaphragmatic splint,³vasodilation with bronchial edema⁴and bronchoconstriction.⁵All three theories were discussed and discounted by Coryllos and Birnbaum.² Recently, in studying the widespread autonomic reflexes which originate from the obstruction