Multi-Modal Prehabilitation in Thoracic Surgery: From Basic Concepts to Practical Modalities.

Over the last two decades, the invasiveness of thoracic surgery has decreased along with technological advances and better diagnostic tools, whereas the patient's comorbidities and frailty patterns have increased, as well as the number of early cancer stages that could benefit from curative resection. Poor aerobic fitness, nutritional defects, sarcopenia and "toxic" behaviors such as sedentary behavior, smoking and alcohol consumption are modifiable risk factors for major postoperative complications. The process of enhancing patients' physiological reserve in anticipation for surgery is referred to as prehabilitation.

How to Manage Thrombocytopenia with ECLS: A Proposal of Clinical Reasoning Tools.

Extracorporeal life support (ECLS) is increasingly used as a rescue therapy in patients with refractory cardiac/respiratory failure for temporary support or bridge to decision-making in both adult and pediatric patients. Complications such as bleeding and thrombosis remain major causes of morbidity and mortality in patients treated with ECLS. Hemostatic complications related to ECLS are multifactorial in patients with multiple organ dysfunctions and are incompletely characterized.

Intensive Care Admissions for Severe Chikungunya Virus Infection, French Polynesia.

During the 2014-2015 chikungunya outbreak in French Polynesia, 64 patients with confirmed chikungunya virus infection were admitted into intensive care. Sixty-three were nonpregnant adults; 11 had an atypical form, 21 had severe sepsis or septic shock, and 18 died. These findings indicate that critical illness frequently complicates the course of chikungunya virus infection.

Improving ultrasonic measurement of diaphragmatic excursion after cardiac surgery using the anatomical M-mode: a randomized crossover study.

Purpose: Motion-mode (MM) echography allows precise measurement of diaphragmatic excursion when the ultrasound beam is parallel to the diaphragmatic displacement. However, proper alignment is difficult to obtain in patients after cardiac surgery; thus, measurements might be inaccurate. A new imaging modality named the anatomical motion-mode (AMM) allows free placement of the cursor through the numerical image reconstruction and perfect alignment with the diaphragmatic motion.