We studied the prognostic applicability of electroencephalograms (EEGs) of seventy-nine patients within 24 hours after successful cardiopulmonary resuscitation. The EEGswere classified into five grades according to a modified Hockaday's scale. The EEGs of grades I and II implied full recovery, while those of grade III gave a varied but generally unfavorable prognosis. Patients with grades IV and V EEGssurvived in a vegetative condition or died without awakening. Eighteen patients showed EEGwith periodic patterns, all of which led to a fatal or vegetative outcome. One case showed EEGs associated with periodic triphasic waves and repetitive sharp transients in the same record. Several cases showed EEGswith different periodic patterns in consecutive records.Weconclude that an EEGis a good indicator of patient prognosis after cardiopulmonary resuscitation. However, the clinical significance of morphological differences of various periodic patterns that can occur during an EEGremains to be established. (Internal Medicine 34: 71-76, 1995)

We evaluated the effect of nitric oxide (NO) on infants after congenital cardiac surgery. Inhaled NO was administered to 7 infants after congenital cardiac surgery. Inhaled NO concentration ranged from 2.5 to 10 parts per million (ppm). The respiratory index (RI = A-aDo,/Pao,) decreased from 7.4 f 2.5 to 4.7 ? 3.1 in the high RI group (RI 2 3, n = 4) 30 min after NO inhalation. After discontinuation of NO inhalation, RI increased to the preinhalation level. NO inhalation was restarted in 2 patients in the high RI group because of severe worsening of oxygenation. RI was not affected by starting or discontinuing of NO in the low RI group (R1 < 3, n = 3). Systemic blood pressure did not significantly change in the 2 groups. Pulmonary arterial pressure (PAP) was measured in 4 patients, and it decreased by 21, 10, and lo%, respectively, 30 min after NO inhalation in 3 patients, but did not change in the remaining patient. After discontinuation of NO inhalation, PAP increased in all patients, and in 2 cases, PAP was higher than baseline value. NO inhalation is effective in improving oxygenation in infants with a high RI after cardiac surgery. However, careful monitoring of the respiratory and hemodynamic states is required after discontinuing NO inhalation.

We report two aged patients with Guillain-Barre syndrome (GBS), in whom the rapid progression necessiated the use of a respirator. The first case, a 72-year-old woman, needed a respirator on the 5th day after onset of illness and the second case, a 74-year-old woman, needed a respirator on the 23rd day. We treated the first patient with plasmapheresis; the second patient underwent plasmapheresis as well as a large dose of intravenous methylprednisolone. Both patients showed remarkable recovery and did not need the respirator from the early stages.

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