Naloxone therapy of human septic shock.

A 0.01 and 0.1-mg/kg dose of iv naloxone was administered to seven patients in septic shock, in order to evaluate naloxone's hemodynamic effect and possible relation to changes in plasma beta-endorphin and catecholamine levels. Naloxone failed to modify cardiac index, blood pressure, heart rate, and systemic vascular resistance. Plasma beta-endorphin, norepinephrine, and epinephrine were elevated but did not change after naloxone administration. These results suggest that beta-endorphin release is a consequence but not a cause of shock, and that the beneficial hemodynamic effects of naloxone in animal studies could be related to species differences or nociceptive stimulations.

Cardiac arrest related to anaesthesia: a prospective survey in France (1978-1982).

This report analyses the rate, predisposing factors, causes and outcome of 119 cardiac arrests related (totally or partially) to anaesthesia which were collected in France by a national prospective survey performed between 1978 and 1982. The overall rate of cardiac arrests occurring during anaesthesia and recovery was 1 per 1665 anaesthetics, resulting in death, before the 24th postoperative hour, in 56% of cases, i.e. 1 per 2900 anaesthetics. Approximately a quarter of cardiac arrests occurred during induction, another quarter during maintenance and a half during recovery from anaesthesia. The first were mainly related to anaesthesia and had the lowest mortality rate. The last were mainly related to unrecognized postoperative respiratory depression and resulted in the highest mortality. Cardiac arrests were less frequent in private hospitals than in teaching hospitals but the mortality rate was higher.

[Pericardial effusions (85 cases): radiological aspects (author's transl)]. / Epanchements péricardiques (85 cas). Aspects radiologiques actuels.

A radiological study of 85 patients with acute pericarditis and effusion included a group of 35 cases observed before the introduction of ultrasonography and a second group of 50 patients in whom the presence of pericarditis had been confirmed by this investigation. The most important conclusions established were the following: --Absence of radiological signs in 55% of cases (group 1 : 46%, group 2 : 60%); normal heart size in 54% (group 1) and 78% (group 2), and increased size in 34% (group 1) and 20% (group 2). --Hilar manifestations (overlapping and obscuring of the left hilar region) in 26% of cases with a clear predominence of the left forms (14 out of 22). The cardiomegaly was not significant in 28% (group 1) and 14% (group 2). --The high frequency of pericarditis with a normal heart size has to be emphasized. The diagnostic value of hilar manifestations is also mentioned; the sign of left hilar overlapping is described in greater detail. --An overall comparison between the two groups shows, more particularly, the equal importance of left hilar manifestations for the radiological diagnosis of pericarditis. In a general way, it would appear that these hilar signs are the only elements which enable objective diagnosis of pericardial effusions on standard films.