Effect of Intermittent or Continuous Feed on Muscle Wasting in Critical Illness: A Phase 2 Clinical Trial.

Background: Acute skeletal muscle wasting in critical illness is associated with excess morbidity and mortality. Continuous feeding may suppress muscle protein synthesis as a result of the muscle-full effect, unlike intermittent feeding, which may ameliorate it.

Research Question: Does intermittent enteral feed decrease muscle wasting compared with continuous feed in critically ill patients?

Study Design And Methods: In a phase 2 interventional single-blinded randomized controlled trial, 121 mechanically ventilated adult patients with multiorgan failure were recruited following prospective informed consultee assent.

The use of ultrasound as an adjunct to peripheral venous cannulation by junior doctors in clinical practice.

Purpose: There is little consensus on the role of training in bedside ultrasound skills for medical students or junior doctors early in their careers.

Methods: We trained 20 Foundation Year 1 doctors in the use of ultrasound as an adjunct to peripheral venous cannulation and following an assessment of competence gave them access to an ultrasound machine to assist with difficult cannulations in their clinical practice. Self-reported confidence and competence were assessed using pre- and post-training questionnaires, with competence objectively assessed immediately post-training and at one and three months follow up.