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Sedation of the critically ill patient without an artificial airway is a difficult and challenging clinical problem. Careful attention to preparations, selection of appropriate techniques, and monitoring of patient responses during sedation will reduce problems in this patient population. Preparation to provide airway support is essential in the sedation of these patients, and the appropriate training of the clinician is important.

This article discusses the therapeutic and toxic effects of sedative drugs and neuromuscular blocking agents in the critically ill patient. Common misconceptions of drug properties are highlighted and dispelled. A rational plan for the use of each type of drag is described. The appropriate use of sedative drugs may cause withdrawal syndromes; treatment options are outlined.

Pulmonary artery catheters are frequently used and may be the cause of pulmonary artery rupture. The “feel” of balloon inflation, a clinical sign of a “wedged” catheter, was noted to vary among different manufacturers' catheters. The inflation pressures of five catheters from four manufacturers were examined in the laboratory. Peak pressures ranged from 475 ± 10 mm Hg to 1,037 ± 36.8 mm Hg. Plateau pressures ranged from 220 ± 4 mm Hg to 495 ± 2.9 mm Hg. Catheters with high inflation pressures may make detection of a wedged catheter by feel impossible and, thus, may increase the risk of a pulmonary artery rupture.

INTRODUCTION EXPERIMENTS herewith reported were made in connection with the investigational activities of the Food and Drug Administration to support enforcement of the Federal Food, Drug, and Cosmetic Act against misbranded drugs for livestock and poultry. When the occasion demands, remedies are tested on a “class basis” to evaluate their particular merit in a given field of disease. This can be done when many remedies in a particular category, which contain a common basic ingredient, are recommended for a specific disease or condition. In this instance, attention was drawn to almost universally made recommendations for copper sulfate as a remedy for crop mycosis in poultry caused by the fungus Candida albicans. Interest was concentrated in the validity of such recommendations when the literature revealed a paucity of factual evidence to support copper sulfate as a competent treatment of moniliasis (crop mycosis). This article presents critical information collected from the experimental …

THE use of synthetic estrogens for the hormonal fattening of poultry, and studies designed to demonstrate whether or not estrogenic residues remain in the edible tissues of the treated poultry have recently been reviewed by Lorenz (1954) and by Merker et al. (1955). Commercial use of the estrogens has been limited to the implantation or injection of stilbestrol and to the oral feeding of dienestrol diacetate. The usual practice is to treat the birds at 7 to 9 weeks of age and to slaughter the birds 4 to 6 week later. With the development of a sensitive assay method (Umberger, Gass and Curtis, 1958) based on the work of Stob, Andrews and Zarrow (1954), an examination has been made of the edible tissues from chickens treated with various commercial preparations of stilbestrol. The results of these assays are the subject of this report. A subsequent report will detail the studies …