{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T01:48:35Z","timestamp":1767836915682,"version":"3.49.0"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[1994,4,1]],"date-time":"1994-04-01T00:00:00Z","timestamp":765158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[1994,4]]},"abstract":"<jats:p>Posterior epistaxis and its management are associated with increased morbidity and sudden death. A \u201cnasopulmonary reflex,\u201d changes in pulmonary function induced by packing, has been postulated to cause hypoxia and lead to the reported morbidities. However, no study has followed patients prospectively to associate complications with oxygen status. Continuous pulse oximetry monitoring of 19 patients hospitalized with posterior packing was undertaken to document the Incidence and extent of oxygen desaturation, and to correlate complications with O2 status and historical factors. A further aim was to clarify the clinical relevance of the nasopulmonary reflex. In 1200 hours of monitoring, desaturations to less than 90% were observed on only two occasions: one self\u2010limited episode in an actively bleeding patient and one major hypoxic event with respiratory arrest in an alcoholic patient under sedation for delerium tremens. Complications, while uncommon, were more appropriately ascribed to rebleedlng or underlying medical problems than to primary O2 status. The nasopulmonary reflex, as previously described in terms of a primary drop in O2, therefore seems clinically irrelevant. Early surgery for posterior epistaxis is not warranted on the basis of maintenance of adequate oxygenation alone.<\/jats:p>","DOI":"10.1177\/019459989411000403","type":"journal-article","created":{"date-parts":[[2015,11,25]],"date-time":"2015-11-25T06:52:37Z","timestamp":1448434357000},"page":"363-369","source":"Crossref","is-referenced-by-count":16,"title":["Epistaxis, medical history, and the nasopulmonary reflex: What is clinically relevant?"],"prefix":"10.1002","volume":"110","author":[{"given":"Bernadette C.","family":"Loftus","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Kaiser Foundation Hospital Santa Clara California"},{"name":"Division of Otolaryngology\u2014Head and Neck Surgery Stanford University Medical Center Santa Clara California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Blitzer","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology Santa Clara California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Cozine","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology College of Physicians and Surgeons Columbia University New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[1994,4]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1962.00740040266016"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM196210112671507"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-197108000-00009"},{"key":"e_1_2_1_5_1","first-page":"334","article-title":"Thanatology: a study of 100 deaths","volume":"76","author":"Lucente FE","year":"1972","journal-title":"Trans Am Acad Ophthalmol 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