Electrophrenic Respiration in Acute Bulbar Poliomyelitis

Acute bulbar poliomyelitis is not infrequently complicated by involvement of the center which drives and coordinates respiration. Such a defect is occasionally severe enough to interfere with adequate ventilation, even though the peripheral neuromyal respiratory mechanism may be spared by the disease. The difficulties resulting from involvement of the respiratory center are generally thought to be of two types, (a) grossly irregular respiratory rhythm and depth and (b) lack of coordination of the muscles of respiration. These difficulties, when severe enough, reduce the respiratory exchange to a critical level and result in sufficient hypoxia to intensify the pathologic conditions already present. Attempts to manage this type of patient in the tank type respirator of Drinker and Shaw1are generally thought to be ineffective when involvement of the respiratory center is severe. This is largely because of the inability to substitute the respirator's rhythm for the patient's grossly irregular "respiratory