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Category: BRONCHOSCOPY IN DISEASES OF THE TRACHEA AND BRONCHI
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
Autodrownage is the name given by the author to the
drowning of the patient in his own secretions. Tracheobronchial
secretions in excess of the amount required to moisten the inspired
air, become, in certain cases, a mechanical menace to life, unless
removed. The cough reflex, forced expiration, and ciliary action,
normally remove the excess. When these mechanisms are impaired, as in
profound asthenia, laryngeal paralysis, laryngeal or tracheal
stenosis, etc.; and especially when in addition to a mild degree of
glottic stenosis or impaired laryngeal mobility, the secretions become
excessive, the accumulation may literally drown the patient in his own
secretions. This is illustrated frequently in influenza and arachidic
bronchitis. Infants cannot expectorate, and their cough reflex is
exceedingly ineffective in raising secretion to the pharynx;
furthermore they are easily exhausted by bechic efforts; so that age
may be cited as one of the most frequent etiologic factors in the
condition of autodrownage. Bronchoscopic sponge-pumping (q.v.) and
bronchoscopic aspiration are quite efficient and can save any patient
not afflicted with conditions that are fatal by other pathologic
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