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
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LAGUARDA R. Hypoxia, Histamine, and Pulmonary Elastic Recoil. Ann Intern Med. 1977;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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