[Propofol versus midazolam. Long-term sedation in the intensive care unit].

Sedative-analgesic treatment of patients on long-term artificial ventilation aims at protection from stress related to their disease or therapy. By stabilising both the patient's vital functions and psychological state this treatment may contribute to therapeutic success. The choice of drugs depends primarily on the nature and course of the underlying disease.

Haemodynamic and endocrine effects of deliberate hypotension with magnesium sulphate for cerebral-aneurysm surgery.

Deliberate hypotension is widely used during cerebral-artery aneurysm surgery to facilitate clipping and to prevent rupture. A large number of drugs are commonly employed to achieve hypotension, but all have their specific drawbacks. We investigated the effects of magnesium-sulphate-induced hypotension on haemodynamics, as well as on plasma catecholamine and renin concentrations in 11 patients undergoing cerebral-aneurysm surgery.

[The effect of selective decontamination on nosocomial infections, their causative agents and antibiotic resistance in long-term intubated intensive care patients].

During a 12-month period 45 long-term intubated patients were treated by topical application of non-absorbable antibiotics (tobramycin, polymyxin, amphotericin B) together with an initial short-term intravenous application of an antibiotic with only minimal activity against anaerobic intestinal flora. These patients were compared to 48 patients in the previous 12-month period who had only interventional antibiotic therapy in case of established infections. This selective decontamination of the digestive tract (SDD) reduced the colonisation of the respiratory tract, thus also decreasing incidence of nosocomial pneumonia.

Treatment of polycythemia vera by isovolemic large-volume erythrocytapheresis.

Excess red blood cells (RBC) in patients with polycythemia vera (PV) are usually removed by repeated phlebotomy. In order to improve the efficacy of this treatment, we used isovolemic large-volume erythrocytapheresis (EA) by a cell separator. A retrospective analysis of our experience with 69 PV patients (206 EA procedures) is reported.

Oxygen partial pressure distribution within skeletal muscle: indicator of whole body oxygen delivery in patients?

Simultaneously with determination of cardiac output, the distribution of oxygen partial pressure within biceps muscle was measured during and after open heart surgery in 29 patients. During extracorporeal circulation (ECC) mean muscular oxygen partial pressure (MPO2m) decreased from 25 mmHg to 14 mmHg with an increase of MPO2 values below 5 mmHg from 4% to 20%. Sustained decrease of MPO2m (greater than 1h) did not occur after ECC.