TRYPSIN IN POLIOMYELITIS PATIENTS WITH TRACHEOTOMY

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Abstract
During the acute phase of poliomyelitis the commonest cause of death is inadequate ventilation. The means for ensuring adequate ventilation must be highly individualized at frequent intervals. Abrupt periods of cyanosis erroneously ascribed to "central episodes" often yield to prompt reestablishment of pulmonary oxygenation and carbon dioxide removal. In properly selected instances, tracheotomy facilitates access to the tracheobronchial tree for aspiration, lavage, and oxygen therapy. In poliomyelitis patients on whom tracheotomy has been done viscid tracheobronchial secretions soon develop. To some degree this may be countered by adequate systemic hydration, attempted humidification of room air or oxygen, administration of appropriate antibiotics locally and systemically, and tracheal instillation of saline or other fluids prior to aspiration. Despite the use of such measures, tenacious viscid mucoid secretions often result in progressive impairment of ventilation. Aspiration of secretions through the tracheotomy opening must be done swiftly to avoid aggravating the existing hypoxia. The

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