Lobectomy in a Chronic Respirator Patient

INTRODUCTION  Each epidemic of poliomyelitis leaves in its wake a number of severely disabled patients who require continued respiratory aid. It has been demonstrated in the Regional Respirator Centers established with the assistance of the National Foundation for Infantile Paralysis that most of these patients can be sufficiently improved to be placed in a home-care situation instead of continuing hospitalization with its attendant greater cost. The commonest complications encountered by these patients are minor respiratory infections and atelectasis due to the plugging of the smaller and larger bronchi with mucus which the patient, owing to his lack of an adequate cough, is unable to expel. When such an atelectasis occurs which cannot be relieved by bronchoscopic methods, exsufflation techniques, and use of detergent aerosols, chronic infection in the affected lung supervenes and the incidence of further upper respiratory complications increases in the patient. The following case is cited to demonstrate