The concentration of neuron-specific enolase (NSE) was measured in plasma of 18 patients after cardiac arrest and resuscitation (14 nonsurvivors and 4 survivors). In all patients, the NSE concentration was significantly higher in comparison to reference values. The highest concentration was measured in nonsurvivors. Time-course investigation in the first 24 h after cardiac arrest was performed in five patients. Two nonsurvivors and one survivor of the five patients showed a significant rise, and a NSE peak concentration of 42.7 micrograms/L, 13.6 micrograms/L, and 10.5 micrograms/L, respectively, was found 10-19 h after cardiac arrest.
The effect of positive end-expiratory pressure on a value resulting in maximum static effective compliance was studied in 13 artificially ventilated patients suffering from adult respiratory distress syndrome. Applying positive end-expiratory pressure in this manner resulted in improvement of oxygen delivery and left ventricular stroke work. In the patients with high venous admixture under zero end-expiratory pressure cardiac output increased but in those with moderate pre-existing venous admixture cardiac output decreased. We conclude that the response to positive end-expiratory pressure depends on the importance of the venous admixture. Artificial ventilation with positive end-expiratory pressure on a level resulting in maximum static effective compliance is indicated in cases with high venous admixture.
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