[Postoperative respiratory care and prevention of postoperative pulmonary complications by use of percutaneous intratracheal catheter].

A method of percutaneous intratracheal catheter (PITC) was studied for postoperative respiratory care and prevention of postoperative pulmonary complications. The oxygen was insufflated through the catheter persistently at 2-4 liters per minute. Successful results were obtained in 20 patients who were in poor pulmonary risk such as older age, major operation and pre-existing pulmonary insufficiency, revealing more effectiveness in oxygenation rather than other devices of oxygen supply. An experimental study was performed to evaluate its efficacy using dogs with respiratory impairment, which were designed by removal of 6 ribs of 5 cm in each from the left thoracic wall and bilateral division of phrenic nerves. The animals were maintained under the condition of spontaneous respiration with air-insufflation through the PITC. The following results were obtained. End-expiratory pressure (0.22 cm H2(0)/1 min) increased. Functional reserve capacity increased. Alveolar ventilation increased. Dead space to tidal volume ratio decreased. PaO2 and PaCO2 improved to the normal range. The immediate postoperative use of this method has been found most satisfactory in respiratory care and elimination of postoperative pulmonary complications.