Alteration in pulmonary physiology occurred in 20 patients who had nasal packing, bed rest and sedation for control of epistaxis. While the packs were in place there was a uniform decrease in the arterial P02 and an increase in the arterial PC02 which was statistically significant. These changes were most marked in six patients who had pre-existing chronic obstructive pulmonary disease. Removal of the packing or ligation of the internal maxillary artery quickly reversed the hypoxic state.It is postulated that the cardiovascular stress resulting from purposely inducing a hypoxic state with nasal packing, bed rest, and sedation may be the underlying etiology for sudden death. The alternative of using internal maxillary artery ligation not only avoids this hypoxic state but can also shorten the hospital stay and eliminate the discomfort and local complications known to occur with nasal packing.
ASJC Scopus subject areas