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DISCUSSION 
CHAIRMAN Michael P. Kaye: Thank you 
very much for your most interesting paper. 
This paper is now open for discussion. 
Karl T. Weber, Jr., Birmingham : I'd like to 
ask you about the incidence of pulmonary hem- 
orrhage with inspiratory pressures of 40 cm 
of water and why you feel that POa's of 228 
are necessary as opposed to those of about 85 
with 90 per cent saturation or better? 
Dr. Molokhia : The PO2 you see as 85 was 
associated with less than 100 per cent oxygen, 
which, of course, cannot be maintained for a 
long time. We didn't have the chance to study 
any pulmonary hemorrhage with high ventric- 
ular pressures because all these calves were 
long-term survivors and were not subjected to 
any biopsies following the operation. 
Hugh Calderwood, University of Florida: 
Have you tried positive and expiratory pres- 
sure in your ventilation experiments? 
Dr. Molokhia: Yes. 
Dr. Calderwood: And how did that turn 
out? 
Dr. Molokhia: We couldn't sustain P02's 
for a long time. 
Dr. Calderwood: What pressures were you 
using? 
Dr. Molokhia : Up to 5 and 10 cm of water. 
Dr. Calderwood : I suggest you might try a 
little bit higher in the calf. 
Dr. Molokhia: Well, we are actually satis- 
fied with the higher ventricular pressures. We 
haven't had any problem so far. 
Dr. Calderwood: Have you determined a 
toxic dose for the lidocaine? 
Dr. Molokhia: No, we have not, but we 
have had no trouble with lidocaine so far. 
Chairman : Thank you very much. In a con- 
versation I had last evening, there was some 
discussion of the use of insulin for its anti- 
arrhythmic properties. Have you had any ex- 
perience with this? 
Dr. Molokhia : No, we haven't used insulin, 
but since we instituted our antiarrhythmic 
regimen, we haven't had any arrhythmias. 
Therefore, we haven't tried any other tech- 
niques. 
John C. Norman, Boston City Hospital: I 
want to thank Dr. Molokhia for presenting our 
paper. In response to Dr. Weber's question, I'd 
like to point out that most of the previous work 
indicates that if you use high inspiratory pres- 
sures in the young calf, you will get pulmonary 
hemorrhage. This varies with calf type. In the 
larger calves that we are using, with initial use 
of low inspiratory ■ pressures and measurement 
of F102 and pulmonary functions, we end up 
with some hemorrhage. However, the calves of 
the size range we use are quite able to tolerate 
a high inspiratory pressure. 
I might point out that our problem was a 
continued series of deaths from coronary em- 
bolism, hypotension, metabolic acidosis, respira- 
tory acidosis, blood loss, and pulmonary failure. 
Our mandate at that time was to work out a 
