Die Untere Leistungsgrenze Der Lunge: Eine Experimentelle Untersuchung Zur Klinischen Ermittlung Der Unteren Leistungsgrenze Der Menschlichen Lunge
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Die Priifung der Leistungsfahigkeit des Respirations- und Ventilations- apparates hat friiher in der Klinik kaum Interesse gefunden. Was von den Physiologen erarbeitet war, blieb ungenutzt. Selbst der erste VorstoB im inter- nistisch-klinischen Bereich ist von der Chirurgie wenig beachtet worden, obwohl die postoperativen Storungen der Lungenfunktion und ihre Auswirkungen den Chirurgen standig groBte Sorgen bereiteten. Einen neuen kraftigen AnstoB verdanken wir der modernen Lungenchirurgie, die uns zwingt, vor dem Eingriff zu priifen, ob die Funktion des Atmungs- apparates gewisse empirische LeistungsgroBen erreicht. Grundlage der Bewer- tung ist die Spirometrie. Was gemessen wird, sind VentilationsgroBen, was sie aussagen, reprasentiert einen aktuellen Wert, den wir prospektiv einzuschatzen gelernt haben. Die tagliche Erfahrung lehrt, daB dieses Verfahren in der Regel fUr die operative Planung und fUr die prognostische Beurteilung ausreicht. Es fehlen MaB und Zahl fUr die Entscheidung im schweren Krankheitsfall, also zuverlassige GroBen, die bei erkennbarem Risiko das FUr und Wider des Entschlusses entscheiden. Hier setzen W ASSNERS Untersuchungen an. Die zu- verlassige Ermittlung der voraussichtlichen postoperativen Lungenfunktion und der funktionellen Atemreserven ist das Ziel; als Methodik dient der CO-Riick- 2 atmungstest nach C. W. HERTZ, als MaB das CO-Ausscheidungsvermogen des 2 postoperativ nutzbaren Lungenparenchyms.
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