The effectiveness of iloprost, a prostacyclin derivative, was assessed in a placebo-controlled multicentre trial on 101 patients with chronic arterial disease, stage IV. All patients were on a basic local treatment, 53 randomly being assigned to the iloprost group, 48 to the placebo one. Both groups received identical saline infusions, one with the other without iloprost. Infusions were given on 28 consecutive days, iloprost being added at a dose of up to 2 ng/kg.min over six hours. At the end of the treatment period, 32 of 52 patients (61.5%) of the iloprost group and eight of the 47 in the placebo group (17%) had partial or complete healing of ulcers (P less than 0.05), the treatment effect persisting in both groups for a mean duration of at least one year. Iloprost was well tolerated, once individual dosages had been appropriately adjusted. Facial flushes, headache and nausea were the most common side effects. Heart rate and blood-pressure variations did not differ between the two groups.

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Summary. Eighteen calves (weight: 100 + 30 kg) with a total artificial heart are ventilated by a Bennett MA-IB respirator. The atelectasis of the lung seems to be the most important complication in the respiratory system. The static thoraxlung-"compliance" decreases relatively more d~ring HLYf-perfusion than during TAH-perfusion. The tidal volume of 11 _+ 3 × 10 ~ ml, combined with a frequency of 10/rain leads to a breathing pressure of 20 to 30 cm H20. Humidified, warm gases, PEEP-(6 to 8 cm H2) and SIGH-ventilation are applied. The oxygen concentration of the inspired gas is kept as low as possible. Generally this ventilation technique provides a normal arterial oxygen saturation. Four animals substituted by 02-insufflation breathed spontaneously, maximal t00 h. Several changes of blood pressure in the artificial heart, the pulmonary artery and the aorta depend on the phase of ventilation, which may be influenced by a change of artificial heart's position and of the lung-vessels' capacity.Key words: Total Artificial Heart Replacement --Ventilation --Blood Gases --Blood Pressure.Zusammen/assung. 18 K~lber (KSrpergewicht = 100 _+ 20 kg) mit einem kfinstlichen Totalherzen werden mit einem Bennett MA-tB Respirator beatmet. Unter den prim/iren pulmonalen Komplikationen wird der Lungenatelektase eine vorrangige Bedeutung beigemessen. Die statische Thorax-Lungen-,,Compliance" nimmt deutlich unter der Perfusion mit der Herz-Lungenmaschine und weniger deutlich unter der des kiinstlichen Totalherzens ab. Bei einem Atemzugvolumen yon II + 3 × 10 ~ ml und einer Atemfrequenz yon 10/rain kommen Beatmungsdrucke yon 20 bis 30 cm H20 zustande. Dabei werden m6glichst niedrige Sauerstoffkonzentrationen in der Inspirationsluft angestrebt. Es wird mit feuchtwarmer Luft positiv-endexspiratorischen Drucken yon 6--8 cm H20 und SIGH beatmet. Diese Beatmungstechnik gew£hrleistet auch in kritischen Versuchsphasen eine normale arterielle Sauerstoffs/ittigung. Bei vier Versuchstieren war eine Spontanatmung unter Sauerstoffinsufflation fiber eine Nasensonde bis maximal 100 Std m6glich. In Abh/ingigkeit yon der in-und exspiratorischen Beatmungsphase werden Druckschwankungen im kiinstlichen Totalherzen sowie in der Arteria pulmonalis und in der Aorta infolge yon Anderungen erstens der Lage des kfinstlichen Totalherzens und zweitens der Lungengef~Bkapazit/it analysiert.