Monitoring of extubated patients: are routine arterial blood gas measurements useful and how long should patients be monitored in the intensive care unit?
The authors aimed to investigate whether serial arterial blood gas measurements done in the post-extubation period would help to identify patients requiring restitution of ventilatory support and to determine the optimal duration of close monitoring post-extubation. One hundred and fifteen adult patients were retrospectively analysed. Arterial blood gases were measured at one and three hours post-extubation and patients were followed [...]
The Incidence of Dysphagia Following Endotracheal Intubation
A systematic review was conducted to determine: the incidence of dysphagia following endotracheal intubation, the association between dysphagia and intubation time, and patient characteristics associated with dysphagia. Fourteen articles met the  inclusion criteria for the review. The studies were heterogeneous in design, swallowing assessment, and study outcome. Dysphagia frequency ranged from 3% to 62% and intubation duration from 124.8 to 346.6 [...]
Efficacy and Costs of Nutritional Rehabilitation in Muscle-Wasted Patients With Chronic Obstructive Pulmonary Disease in a Community-Based Setting: A Prespecified Subgroup Analysis of the INTERCOM Trial
In a 2-year RCT, 199 COPD patientswith moderate airflow obstruction  (FEV1%pred. 60%) and impaired exercise capacity were randomized to the interdisciplinary community-based COPD management program (INTERCOM) or usual care (UC). A prescheduled subgroup analysis was performed on 39 of the 199 patients who were muscle wasted and received UC or nutritional therapy in combination with [...]
Lung Opening and Closing during Ventilation of Acute Respiratory Distress Syndrome
This study was desgined to determine how lung recruitability influences alveolar strain and intratidal opening and closing after the application of high PEEP. Data from 68 patients with acute lung injury or acute respiratory distress syndrome (ARDS) who underwent whole-lung computed tomography at 5, 15, and 45 cm H2O airway pressure was analysed. In patients with a higher [...]
Home based versus centre based cardiac rehabilitation: Cochrane systematic review and meta-analysis.
This Cochrane review was completed to compare the effect of home based and supervised centre based cardiac rehabilitation on mortality and morbidity, health related quality of life, and modifiable cardiac risk factors in patients with coronary heart disease. The review included publications from 2001 – January 2008. Twelve studies (1938 participants) were included. Most studies recruited [...]
Consequences of bed rest
This article gives an overview of the consequences of bed rest and possible treatment options for reducing these consequences. Brower, RG. CRITICAL CARE MEDICINE 2009; 37 (10): S422 – S428
Physical inactivity and muscle weakness in the critically ill
This article puts forward some of the causes for muscle weakness in intensive care. The aquired muscle weakness reflects loss of mechanical loading due to physical inactivity, bed rest, or immobilization. They go on to describe the complex adaptive response that is stimualted with mechanical unloading and results in muscle atrophy and loss of specific force. Countermeasures that [...]
Intensive care unit-acquired weakness: Risk factors and prevention
 In this article the authors discuss the risk factors for and the prevention of intensive care unit-acquired weakness.  Five main risk factors for  intensive care unit-acquired weakness have been identified. These include multiple organ failure, muscle inactivity, hyperglycemia, and use of corticosteroids and neuromuscular blockers. The authors point out that although strong evidence regarding the efficacy of preventive measures is [...]
Measurement of muscle strength in the intensive care unit
This paper explores the measures available to assess and predict intensive care unit-acquired muscle weakness. The discussion centres around the selection of the appropriate muscle to test in order to make adequate predictions of a patient’s outcome. The authors propose that the upper airway dilators are much more susceptible to a decrease in muscle strength than [...]
Noninvasive Ventilation Reduces Intubation in Chest Trauma-Related Hypoxemia – A randomized Clinical Trial
This single-center randomized clinical trial set out to determine if non invasive mechanical ventilation (NIMV) reduced the incidence of intubation in severe chest trauma-related hypoxemia.  Patients with Pao2/Fio2<200 for >8h while receiving oxygen by high-flow mask within the first 48 h after thoracic trauma were included in the study. After 25 patients were enrolled in each group, the trial [...]
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