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However thishas been especially noted with midazolam, withdata reporting an incidence as high as 35 % withthis drug (Fonsmark et al. Based on these ?ndingswe can conclude that in patients with overt car-diac failure or borderline left ventricular func-tion, the increased afterload associated with thenegative intrathoracic pressure generated duringspontaneous respiration may result in worseningheart failure

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