Summary One hundred and twenty‐six children, 3 to 63 weeks of age, have been exposed to a mixed noise (100‐7000 Hz) in intensities between 50 and 80 dB under steady conditions of room acoustic during different periods of time between 10.30 p.m. and 01.00 a.m. A noise level of 75 dB led to obvious sleep disturbance or waking‐up in ⅔ of the children after 3 minutes and in all after 12 minutes. The waking threshold according to these investigations is higher than in adults. A 24‐hour recording of the noise level in different types of infants' and children's care units demonstrated that the acoustic stress– especially by “interior working‐noise”–in care units of light construction reaches or exceeds the obligate waking‐noise threshold of infants during most of the day and night hours. This is regarded as a deficiency of hospital hygiene.

We report on a 21-year old patient who nearly drowned in cold water under inexplicable circumstances. About 1/2 hour later he was found with cardiac arrest. Immediate cardiopulmonary resuscitation remained unsuccessfully but was continued. After transportation to the nearest hospital a core temperature of 26.1 degrees C was recorded. A team of our hospital arrived 2 1/2 hours after start of cardiopulmonary resuscitation. After introducing a femo-femoral bypass the patient was rapidly rewarmed and oxygenated using a portable extracorporeal circulation and membrane oxygenation. Defibrillation succeeded at a core temperature of 34.4 degrees C. A severe ARDS developed the same day which was successfully treated by membrane oxygenation. 41 days later the patient left the hospital fully recovered.

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From September 1987 to September 1994 61 patients between 29 and 78 years of age received mechanical circulatory support by means of the Biomedicus centrifugal pump. The patients were divided into three groups by indication: Group I included 15 patients with early postcardiotomy cardiogenic shock and 24 patients with late postcardiotomy cardiogenic shock. Group II 11 patients with therapy-resistant cardiogenic shock following acute myocardial infarction, and Group III 11 patients with cardiogenic shock of other etiologies. Duration of support was 1 to 347 hours. Survival rates were 46.7% and 33.3% in patients with early and late postcardiotomy cardiogenic shock, respectively (Group I), 27.2% in Group II, and 18.1% in Group III. Most frequent complications were bleeding (40%, 58%) and acute renal failure (26.7%, 29.2%) in Group I and multiple organ failure in Groups II and III (64% and 45.5%). Major causes of death were bleeding and multiple organ failure in Group I (37.5%) and multiple organ failure in Groups II and III (87.5% and 50%). Groups II and III (87.5% and 50%).

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