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The role of the nursing administrator in community and regional health planning and institutional program planning is illustrated. A planning systems perspective is proposed and strategies for involvement at each level are outlined. Nursing administrators who are not already involved in these phases of health care planning may be stimulated to expand their scope of participation.

The left main pulmonary artery was ligated in 7 fully grown dogs. This resulted in an enlarged pulmonary collateral (systemic) flow to the left lung. By collecting gas from each lung separately, gas exchange in the pulmonary collateral circulation was studied and compared to that in the normal contralateral side. Studies were done repeatedly during a period of 3 years. Compared to that in the preoperative period, the ligated (left) side showed a decrease in ventilation (42.5 to 34.5 per cent of total), a marked increase in wasted ventilation (0.30 to 0.55), and a marked decrease in O2 uptake (45 to 11.2 per cent of total) and CO2 production (27.5 to 15.3 per cent of the total). There were no changes in arterial blood gases or pH. A significant, sustained, systemic hypertension was noted in all dogs in which the left main pulmonary artery was ligated (190/120). The mean blood flow through the pulmonary collateral circulation of the left lung with the dogs breathing room air was estimated to be 94 ml per min. When the dogs were made hypoxemic by breathing 12 per cent O2 through the normal right lung, there was a marked increase in pulmonary collateral (systemic) flow to the contralateral side (194 ml per min). This resulted in an increase in O2 consumption (29.4 per cent of total) and CO2 production (23.1 per cent of total) of the left lung. When the dogs were given 12 per cent O2 to breathe through the ligated left lung, there was no change in arterial PO2. There was a significant increase in blood flow through the pulmonary collateral circulation to 136 ml per min. Because of the gradient of O2 between the blood flowing into the left lung and that present in the alveoli, there was a net production of O2 from the left lung of 4.5 ml per min. When the pulmonary systemic circulation participates in gas exchange, it appears to increase during hypoxemia as well as during alveolar hypoxia.