[Respiratory work and pattern with different proportional assist ventilation levels].

Objective: To study the minimum assistance level during proportional assist ventilation (PAV) to decrease the work of breathing to physiological limits (0.6 j/l) and the relationship between breathing pattern changes and respiratory effort at different PAV levels.

Design: Prospective cohort study.

The neurologic effects of thiopental therapy after cardiac arrest.

We studied the effect of thiopental loading during resuscitation of 53 patients following cardiopulmonary arrest and compared the outcome with that found in 54 patients treated conventionally in the 30 previous months. Thiopental therapy (10 mg/kg i.v.

Myocardial depression in septic shock caused by meningococcal infection.

Comparative hemodynamic measurements recorded in 19 cases of septic shock associated with Neisseria meningitidis bacteremia and in 20 shock cases associated with bacteremia due to other Gram-negative bacilli showed a significantly higher incidence of early myocardial depression in the cases with meningococcal infection. Echocardiographic, ECG, and serum enzyme (CK-MB isoenzyme) studies closely correlated with impaired myocardial contractility and development of cardiogenic shock in patients with meningococcal bacteremia. Autopsy of the heart from three patients who succumbed to shock confirmed the presence of myocarditis with intracellular Gram-negative diplococci.

ST changes during sodium nitroprusside therapy in acute myocardial infarction.

Nineteen patients with acute anterior myocardial infarction who were hypertensive (systolic BP greater than or equal to 170 mm Hg and/or diastolic BP greater than or equal to 100 mm Hg) at the time of admission were treated with continuous infusion of sodium nitroprusside (NP). The administration of NP resulted in a significant elevation of ST segments probably related to decreased diastolic BP and increased HR; direct NP effects on coronary circulation cannot be excluded. These changes may indicate a negative effect on the ischemic portion(s) of the myocardium.