PEDIATRICS Vol. 36 No. 2 August 1965, pp. 173-182
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BILATERAL VAGOTOMY AND PULMONARY HYALINE MEMBRANE FORMATION

Paul S. Milley M.D., C.M.1 and Louis J. Casarett Ph.D.2

1 Department of Radiation Biology, University of Rochester School of Medicine and Dentistry, Rochester, New York
2 Department of Anatomy, University of Rochester School of Medicine and Dentistry, Rochester, New York

Bilateral midcervical vagotomy in adult and newborn rabbits results in the formation of pulmonary hyaline membranes similar to those observed in newborn infants dying of the respiratory distress syndrome. There are, however, important differences in the histopathology of the two conditions. Twenty adult rabbits survived unilateral right-sided cervical vagotomy for 30 days, but the majority died with hyaline membranes soon after the remaining left vagus was cut. Survival times were generally longer in animals in which the right recurrent laryngeal nerve was intact. Bilateral recurrent laryngeal nerve section resulted in death and pulmonary edema, but no hyaline membrane formation. Ten rabbits survived section of distal vagal fibers. Subsequent recurrent nerve section in 5 of these resulted in hyaline membrane formation not seen in sacrificed controls. Vagotomy-induced hyaline membrane formation appears to depend on loss of both recurrent laryngeal and distal vagal fibers, the former being more important. While there may be no relationship between experimental vagotomy and the respiratory distress syndrome, these experiments raise the possibility of an upper airway disorder in the clinical disease.

Submitted on December 29, 1964
Accepted on February 15, 1965