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Na, K and Cl levels and pH were determined in 26 samples of nasal secretum and plasma obtained from orally intubated intensive care unit patients. In nasal secretum K and Cl were higher and Na lower than in plasma: pH was higher in secretum than in plasma, probably because of the fall of CO2, which freely diffuses to the air. The epithelial activities of lowering pH, secreting K, and reabsorbing Na appeared closely linked together. The chloride difference (DCl) probably balanced the decrease of other anions, such as bicarbonate. Finally, some influences of plasmatic values on ion active transport rates may be hypothesized on the ground of the correlations of chloride and potassium values in nasal secretion and plasma.

The anticatabolic properties of branched chain amino acids enriched protein solutions in 22 patients with multiple trauma have been evaluated. Nitrogen balance, nitrogen output, the daily change of blood urea nitrogen, plasma albumin and total protein levels were recorded daily. Each 2 days free amino acids and 3-methyl histidine urinary concentrations were measured. The results obtained in the study suggest that in trauma patients high ratios of essential amino acids/total nitrogen are needed and that amino acid solutions enriched in branched chain amino acids are most effective in preventing muscle catabolism and promoting protein synthesis.

Our clinical experience on the use of decompression chamber and intensive care in the treatment of decompression sickness in 64 patients is reported. The results obtained in this study allow the formulation of some considerations regarding the evaluation of type of patients; the effect of delay upon prognosis; the use of particular schedules of treatment; the management of residual damage.

Plasma, urinary and discriminate osmolality was measured in 44 patients suffering from shock due to various conditions. The variations of osmolality provide data to follow the clinical evolution of patients, especially those who developed an acute renal failure. Furthermore, discriminate osmolality measurements could indicate the presence of unknown metabolites in the blood of critically ill patients.

The nutritional value of regimes enriched with branched chain amino acids has been evaluated in 22 adult patients suffering from acute post-traumatic renal failure. The study was carried out for 12 days. The following data were recorded and compared daily: nitrogen balance, daily blood urea nitrogen (BUN), BUN/creatinine ratio, and plasma albumin levels. Also after 6 days of dialysis and nutritional support, the plasma medium molecular weight compounds (uremic toxins) were studied. It was concluded that: (a) the combined use of parenteral and oral nutrition appears most adequate in this type of patient; (b) the nitrogen intake should provide an essential amino acid/total nitrogen ratio of greater than or equal to 4 and a branched chain essential amino acid ratio of greater than or equal to 0.5; and (c) caution is still necessary in interpreting analyses of middle molecular weight compounds in this type of patient.

At the beginning of their discovery informatic technique procedures and methodologies generated a great wave of hopes for progress in theoretical and practical fields of human activity, but when passing to concrete application, an ebb phase followed. Recent theoretical and technical progress, however, has generated an enormous new up-surge of interest for applications of informatic processing in all fields of science. Medicine in the last three decades has gone through the same phases observed in other disciplines. In the ICU the potentiality of exploitation of the informatic techniques appeared enormous, however, initially from a practical point of view it found only limited, sectorial experimentation and implementation, but afterwards a limited and slow process of parcellar infiltration, the high tide of informatic, has broken the dam and deeply advanced in its territory, obliging the staff to a great effort of cultural and technical updating to cope with it. After recalling some of the history of Computer Science or Informatic, even if history was only yesterday, we will present some examples of the hand made experience of an ICU, (namely ours) with limited economical resources, and whose interest in this field arises from actual needs, personal interest and enthusiasm of a staff who works, on its free time, after fulfilling its stressing routine.

The concentration of free amino acids has been determined in plasma and erythrocytes of 10 patients with acute renal failure treated by peritoneal dialysis and haemodialysis, and of 10 healthy subjects as controls. The variations observed have been compared in an attempt to evaluate the effects of two different methods of dialysis on the amino acid pools. The effects of peritoneal dialysis on changes in the plasma valine, glycine, glutamic acid and taurine have been interpreted.

A method is presented for evaluating the efficiency of therapeutic correction of derangement of acid-base balance. This method is based on the introduction of empirical factors to make quantitative the effectiveness of the correction obtained. The expression of the acid-base status with single points located in a multi-parameter system has made possible the definition of an absolute correction and a directional index, as correlating factors between the clinical state of the patient before and after treatment. The effectiveness of treatment is assessed by mathematical and clinical criteria.

A study on 46 patients suffering from acute post-traumatic oliguric renal failure was carried out in order to provide adequate nutritional support. It was found that a high nitrogen intake was achieved by combined infusion of essential (EAA) and non-essential (NEAA) free amino acids; the essential amino acid/total ( E T ) nitrogen ratio had to be higher than four for the improvement of nitrogen balance and protein metabolism.

The clinical course and treatment of 21 critically ill patients suffering from gas gangrene are reported. Analysis of the results has underlined the importance of intensive care and hyperbaric management to prevent the evolution of disease and to improve patients' clinical conditions for surgical procedures.

Summary Plasma amino acid patterns were studied in three groups: one of 10 healthy subjects used as control, one of five patients in acute renal failure treated by haemodialysis plus a standard high-calorie non-protein diet, and one of five patients with the same clinical condition and treated in the same way except that the total parenteral nutrition consisted of a mixture of carbohydrate and essential l -amino acids. Our results indicate that haemodialysis seems to be responsible for some part of the depletion of amino acids and that their administration reduces this effect both for the essential and for the non-essential amino acids.

The aim of this study was to evaluate the plasma free amino acid patterns in patients suffering from traumatic shock. Changes found in the behaviour of single free amino acids appear to indicate that the nutritional infusate solutions should not contain glutamic acid, high concentrations of arginine or a ratio of essential free amino acids to total nitrogen of more than 3.2.