RAUL LAGUARDA, M.D.
To the editor: The article by Hudgel, Cooper, and Souhrada in the September issue (Ann Intern Med 85:328-332, 1976) clearly established that the patient's increase in elastic recoil occurred with a simultaneous increase in P(A-a)O2 gradient and acute decrease in PaO2 from 74 to 68 mm Hg. The authors postulate that histamine or kinins "were not playing an active role . . . as evidenced by the normal 5HIAA and 1, 4 methylimidazole acetic acid values."
We believe that the recoil response could have indeed occurred secondary to hypoxia, inducing local release of mediators (histamine) as shown experimentally to be
LAGUARDA R. Hypoxia, Histamine, and Pulmonary Elastic Recoil. Ann Intern Med. ;86:359. doi: 10.7326/0003-4819-86-3-359_1
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Published: Ann Intern Med. 1977;86(3):359.
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