Studies of venous pressure, vital capacity, circulation times and electrocardiograms in the course of pulmonary collapse therapy.

Thk study was stimulated through the observation, by one of us (L.H.H.) of the appearance of the picture of right-sided heart failure in two patients who had been receiving artificial pneumothorax. Our purpose was to see if we could detect, early in the course of collapse therapy, any evidences of right heart strain. In addition to clinical observations we employed certain laboratory procedures which will be discussed below. Other similar studies have been carried out in this regard but as yet there has been nothing to demonstrate definite evidence of cardiac strain induced by collapse therapy. Kroetz (quoted by Heise and Steidls) in 1922 was apparently the first to study the venous pressure of patients before and after pneumothorax. Orellety-Bosirel (quoted by Heise and Steidls) found that as a rule the establishment of pneumothorax produces no modifications of venous pressure. Gerdier (quoted by Heise and 8teid19) concluded that in pneumothorax venous pressure was a valuable indication of circulatory obstruction not always detected by clinical 0bse~at ion. He stated that venous pressure could predict that the collapse should be interrupted even when auscultatidn, x-ray studies and the respiratory rhythm failed to forecast dfssster. However, others',s have failed to note any significant changes of venous pressure during collapse therapy. Studies of the circulation time1 B.' have consistently shown a decrease with induction of collapse therapy but nothing to indicate right heart failure. Dock and Harrisonll found in rabbits an initially increased volume flow of blood through the lungs and a delayed decreased volume flow. Electrocardiographic studies3.B.10.14~16 have shown some changes which have been ascribed largely to rotation of the heart or the presence of air in the chest interfering with conduction of the heart current. In our present study we have 'From the Tuberculosis League Hospital, Pittsburgh, Pennsylvania. **Santa Barbara, California.