SUMMARYThe supplying of oxygen to tissues, and the removal of gaseous wastes are quickly compromised once the chest has been surgically invaded. Of necessity the expansion of the lungs becomes one of a positive rather than a negative pressure process. Abnormal positioning of lobes of the lungs to facilitate exposure for surgery, reduced rate of respiration, atelectasis due to underinflation as well as diseased areas aggrevate the situation.Return of vascular flow to the heart is impaired by loss of negative pressure in the chest cavity. Blood flow through the pulmonary vasculature is impaired by anything that adds resistence. Life itself is very dependent on the delicate balance between hydrostatic and osmotic pressures within the pulmonary capillaries in order for there to be adequate oxygenization.Retention of CO2 or undersupply of oxygen to tissues contribute to an acidotic state. This acidosis can accelerate a viscious shock cycle if not controlled.Body temperature must not be allowed to drop excessively without careful monitoring of all vital parameters. Motility of cillia along the respiratory tree is slowed by drop in temperature. Phagacytosis within the alveoli undoubtedly
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