PEDIATRICS Vol. 63 No. 5 May 1979, pp. 823
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Drs. Galant, Croncy and Shaw Reply

Stanley P. Galant M.D.1, Charles E. Groncy M.D.1, and Kathryn C. Shaw R.N.1

1 Department of Pediatrics, University of California, Irvine, GA 92717

We agree with Dr. Morin's contention that the marked increase in negative intrapleural pressure seen in the severely obstructed asthmatic patient during inspiration, which results in a significant increase in pooling of blood in the pulmonary veins, is an important cause of the pulsus paradoxus (PP) phenomenon.1 However, other mechanisms can also be contributing to the decreased left ventricular stroke volume. Rebuck and Pengelly2 conclude that the pulmonary hyperinflation and high intrapulmonary pressures could decrease right atrial filling by compressing intrathoracic, extracardiac vessels and limiting atrial distensibility.




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[Abstract] [PDF]