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The effect of ventricular asystole on respiration
SELECTED
239
ABSTRACTS
Six cases of pulmonary is very prominent and may appear aneurysmal. In one of these there was endarteritis presented, four provea by autopsy. Cor pulmonale must be distinguished from congenital heart, mitral tumors of the mediastinum.
sclerosis are obliterans. heart, and L. N. K.
The Urban, H.: 1597, 1935.
Carotid
Sinus
Reflex
in
Man.
Deutsche
Med.
Wchnschr.
61:
Stimulation of the sinus nerve surgically exposed in man had no effect on epilepsy but caused a marked fall in the blood pressure. After a delay of a few seconds, changes in the pulse were inconstant, but usually a tachycardia developed which outExtirpation of the sinus nerves caused a rise in the lasted stimulation for a minute. Similar blood pressure elevation blood pressure lasting at most an hour or two. was caused by pressure on the common carotid and also followed novocainization of the sinus nerves. A respiratory standstill of a few minutes’ duration occurred an hour after the operation, and this was stopped by carbon dioxide inhalation. These , observations confirm studies on animals. L. N. K. Ulrlch, B.: CircuIatory
The Action of Carbaminocholinchloride and Gastrointestinal Systems. Klin.
(Doryl, Wchnsehr.
Merck) Upon 15: 1445, 1936.
the
Dory1 was given to twenty-seven patients with anacidity or low gastric acidity and to eleven patients with hypertension by subcutaneous injections of from 0.25 to 0.50 mg. in an attempt to evaluate the proportionate muscarine-like and nicotine-like action of the drug. In patients with ans&lity it had little if any effect, but, if the acidity was low, its effect was quicker and at least as great as histamine. Of the patients with hypertension four had arteriosclerosis, and in these patients little change in blood pressure was noted. In the others a fall in pressure was observed in all cases (the only example given shows a drop from 155/115 to 135/90 mm. Hg). Although the P-R interval of the electrocardiogram was generally slightly increased, and in a few cases ventricular extrasystoles occurred, the author believes that the effect on blood pressure was entirely peripheral because the pulse pressure remained constant. This seems a doubtful conclusion since, when pressure falls, a greater systolic output is required to maintain the same blood pressure. The author concludes that the chief action of dory1 is muscarine-like, i.e., stimulation of the parasympathetics.
Tho%&, Bull.
Henry Johns
M., Jr.: The Effect Hopkins Hosp. 59: 213,
of Ventricular 1936.
Asystole
on
Respiration.
Records are presented showing the respiratory irregularities which occur in a patient with ventricular asystole. These records reveal close similarity to those which have been produced in laboratory animals by lowering and raising arterial pressure in the carotid sinus or by sudden obstruction and release of cerebral blood flow. One or both of these mechanisms seems to be responsible for the changes in respiration produced by asystole. Alterations in the oxygen or carbon dioxide tension of the arterial blood or in its hydrogen ion concentration do not afford an explanation of the changes in respiration caused by asystole. Carotid sinus respiratory reflexes produced by changes in arterial pressure have not previously been pointed out in human beings. This recently discovered mechanism. must be considered as an active factor in governing the respiration of man. AUTHOR.
239
ABSTRACTS
Six cases of pulmonary is very prominent and may appear aneurysmal. In one of these there was endarteritis presented, four provea by autopsy. Cor pulmonale must be distinguished from congenital heart, mitral tumors of the mediastinum.
sclerosis are obliterans. heart, and L. N. K.
The Urban, H.: 1597, 1935.
Carotid
Sinus
Reflex
in
Man.
Deutsche
Med.
Wchnschr.
61:
Stimulation of the sinus nerve surgically exposed in man had no effect on epilepsy but caused a marked fall in the blood pressure. After a delay of a few seconds, changes in the pulse were inconstant, but usually a tachycardia developed which outExtirpation of the sinus nerves caused a rise in the lasted stimulation for a minute. Similar blood pressure elevation blood pressure lasting at most an hour or two. was caused by pressure on the common carotid and also followed novocainization of the sinus nerves. A respiratory standstill of a few minutes’ duration occurred an hour after the operation, and this was stopped by carbon dioxide inhalation. These , observations confirm studies on animals. L. N. K. Ulrlch, B.: CircuIatory
The Action of Carbaminocholinchloride and Gastrointestinal Systems. Klin.
(Doryl, Wchnsehr.
Merck) Upon 15: 1445, 1936.
the
Dory1 was given to twenty-seven patients with anacidity or low gastric acidity and to eleven patients with hypertension by subcutaneous injections of from 0.25 to 0.50 mg. in an attempt to evaluate the proportionate muscarine-like and nicotine-like action of the drug. In patients with ans&lity it had little if any effect, but, if the acidity was low, its effect was quicker and at least as great as histamine. Of the patients with hypertension four had arteriosclerosis, and in these patients little change in blood pressure was noted. In the others a fall in pressure was observed in all cases (the only example given shows a drop from 155/115 to 135/90 mm. Hg). Although the P-R interval of the electrocardiogram was generally slightly increased, and in a few cases ventricular extrasystoles occurred, the author believes that the effect on blood pressure was entirely peripheral because the pulse pressure remained constant. This seems a doubtful conclusion since, when pressure falls, a greater systolic output is required to maintain the same blood pressure. The author concludes that the chief action of dory1 is muscarine-like, i.e., stimulation of the parasympathetics.
Tho%&, Bull.
Henry Johns
M., Jr.: The Effect Hopkins Hosp. 59: 213,
of Ventricular 1936.
Asystole
on
Respiration.
Records are presented showing the respiratory irregularities which occur in a patient with ventricular asystole. These records reveal close similarity to those which have been produced in laboratory animals by lowering and raising arterial pressure in the carotid sinus or by sudden obstruction and release of cerebral blood flow. One or both of these mechanisms seems to be responsible for the changes in respiration produced by asystole. Alterations in the oxygen or carbon dioxide tension of the arterial blood or in its hydrogen ion concentration do not afford an explanation of the changes in respiration caused by asystole. Carotid sinus respiratory reflexes produced by changes in arterial pressure have not previously been pointed out in human beings. This recently discovered mechanism. must be considered as an active factor in governing the respiration of man. AUTHOR.