A comprehensive survey of recent advances is given in this Update. The wide spectrum of experimental and clinical investigations include the pathophysiologic, diagnostic and therapeutic aspects.

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Cardiopulmonary Resuscitation.- Abdominal Interposed Between Thoracic Compressions During Cardiopulmonary Resuscitation.- The Resuscitation of Submersion Victims: WET-CPR?.- Vasopressor Therapy in Cardiopulmonary Resuscitation.- Myocardial Infarction.- Bolus Administration of Thrombolytic Agents.- Cardioversion and Defibrillation: The Esophageal Approach.- Origins, Evolution, and Prognosis of Acute Myocardial Ischemic Syndromes: Focus on Non-Q-Wave Myocardial Infarction.- Cardiovascular Support.- Effects of Therapy on Regional Blood Flow in Heart Failure.- Effects of Dopamine Receptor Agonists on Cardiovascular and Renal Function.- Inappropriateness of "Inotropic" Support with Epinephrine.- Dobutamine Withdrawal.- Oxygen Derived Parameters in Acute Heart Failure.- Should Lactic Acidosis Be Corrected?.- Circulatory Shock.- Oxygen Transport Pattern in Hemorrhagic and Septic Patients.- Classification of Shock in the Intensive Care Unit Using Transesophageal Two-Dimensional Echocardiography.- Cardiac Alterations in Septic Shock: Pathophysiology, Diagnosis, Prognostic, and Therapeutic Implications.- Improvement of Tissue Oxygenation with Enoximone in Septic Shock.- Blood Flow and Adrenergic Drugs in Septic Shock.- Gastro-intestinal Mucosal Injury in Shock.- Optical Spectroscopy for the Measurement of Tissue Hypoxia.- Sepsis and ARDS.- Oxygen Delivery and Consumption in Adult Respiratory Distress Syndrome and Sepsis.- The Respiratory Distress Syndrome in Adults with Gram-negative Sepsis.- Bronchoalveolar Lavage (BAL) in Adult Respiratory Distress Syndrome (ARDS).- Mediators of ARDS: A "Magic" Funnel.- Is There an Analogy Between Sepsis and Strenuous Physical Exercise in the Process of Neutrophil Activation in Man: A Working Hypothesis?.- Interactions Between Cytokines and Vascular Wall: Effect on the Contractile Function.- Modulation of the Cytokine Response in Sepsis.- The Orchestra of Mediators in the Pathogenesis of Septic Shock: A Review.- Ways to Interfere with Lethal Cytokinemia.- Cytokines: Role in Human Metabolism.- Clinical Role of Tumor Necrosis Factor in Septic Shock.- Tumor Necrosis Factor and the Disbalance Between Coagulant and Anticoagulant Mechanisms in Septicemia.- Heart-Lung Interactions.- Hemodynamic Variable Analysis During Mechanical Ventilation: Defining the Steady State.- Pulsatile Flow Pulmonary Hemodynamics.- Acute Left Ventricular Dysfunction During Weaning from Mechanical Ventilation.- Vasodilating Therapy in ARDS.- Respiratory Failure.- Intensive Care Management of Life-Threatening Status Asthmaticus.- Assessment of Respiratory Mechanics in ICU Patients.- Diagnosis of Respiratory Muscle Dysfunction.- Respiratory Workload During Mechanical Ventilation.- Alternative Modalities for Ventilatory Support.- Severe Infections.- Diagnosis of Lung Infection in Intensive Care Unit Patients Using the Protected Specimen Brush Technique.- The Protected Minialveolar Lavage Technique for the Diagnosis of Nosocomial Pneumonia.- Selective Decontamination in ICU Patients: Benefits and Doubts.- Mechanisms of Resistance to ß-Lactam Antibiotics.- Ho Do We Select Bacterial Resistance in the ICU?.- Intravenous Fluids.- Clinical Use of Hydroxyethyl Starches.- Small Volume Hypertonic Resuscitation in Uncontrolled Hemorrhage.- Small Volume Hypertonic Resuscitation: The Conceptional Basis for Volume Therapy in Septic Shock.- Renal Failure.- Susceptibility of the Kidney to Hypoxia.- Continuous Renal Replacement Therapy.- Emergency.- Initial Management of Trauma Patients.- Emergency Treatment of Multiple Trauma in Children.- Use and Misuse of Flumazenil in Clinical Toxicology.- Neurologic Crisis.- Lung Dysfunction After Head Injury.- Cerebral Circulatory Monitoring.- Venous Oxygen Saturation in the Jugular Bulb.- Cerebral Blood Flow Velocity Using Doppler Techniques.- Treatment of Tetanus.- Plasma Exchange in the Guillain-Barré Syndrome.- Sedation and Paralysis.- Sedation in Intensive Care.- Using Neuromuscular Blocking Agents in ICU: A Need for More Control?.- Current Issues.- Evaluation of Iatrogenic Complications in Intensive Care Units.- Use of a Probability Model for Predicting ICU Outcome.- Enteral Nutrition and Infection: Benefits and Risks.- Approach to the Patient with Severe Liver Failure.