REDUCTION OF PULMONARY RESERVE

Abstract
THE CARDIORESPIRATORY readjustments after reductions of the lung area and after production of shunts in the lesser circulation have long been a problem of interest to one of us (W. E. A.).1 Reduction of lung parenchyma beyond 50% is difficult to accomplish by actual surgical removal of lung tissue. This is probably because of the ensuing sudden increase of tension in the pulmonary artery, due to the decrease in the vascular bed of the lung, and to circulatory disturbances due to shifting of the heart and great vessels. Attempts have been made in this laboratory to eliminate effects due to mediastinal shift by methods directed at reducing the pleural dead space after removal of lung area. The studies of R. A. Rasmussen and W. E. Adams11and of F. J. Phillips and W. E. Adams10on the gradual surgical ablation of lung tissue plus bronchial stenosis had

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