Lean Mass Loss and Altered Muscular Aerobic Capacity after Bariatric Surgery.

Introduction: Patients undergoing weight loss surgery do not improve their aerobic capacity or peak oxygen uptake (VO2peak) after bariatric surgery and some still complain about asthenia and/or breathlessness. We investigated the hypothesis that a post-surgery muscular limitation could impact the ventilatory response to exercise by evaluating the post-surgery changes in muscle mass, strength, and muscular aerobic capacity, measured by the first ventilatory threshold (VT).

Methods: Thirteen patients with obesity were referred to our university exercise laboratory before and 6 months after bariatric surgery and were matched by sex, age, and height to healthy subjects with normal weight.

Near-Infrared Fluorescence Lymphatic Imaging to Reconsider Occlusion Pressure of Superficial Lymphatic Collectors in Upper Extremities of Healthy Volunteers.

Background: There are very little scientific data on occlusion pressure for superficial lymphatic collectors. Given its importance in determining the transport capacity of lymphatic vessels, it is crucial to know its value. The novel method of near-infrared fluorescence lymphatic imaging (NIRFLI) can be used to visualize lymphatic flow in real time.

Placement of the nebulizer before the humidifier during mechanical ventilation: Effect on aerosol delivery.

Background: Therapeutic aerosols are commonly used in mechanically ventilated patients. The position of the nebulizer in the ventilator circuit and the humidification of inhaled gases can influence the efficiency of aerosol delivery. We evaluated the effect of nebulizer position on the pulmonary bioavailability of nebulized ipratropium in ventilated patients without known preexisting respiratory disease.

Effects of acetazolamide on aerobic exercise capacity and pulmonary hemodynamics at high altitudes.

Aerobic exercise capacity is decreased at altitude because of combined decreases in arterial oxygenation and in cardiac output. Hypoxic pulmonary vasoconstriction could limit cardiac output in hypoxia. We tested the hypothesis that acetazolamide could improve exercise capacity at altitude by an increased arterial oxygenation and an inhibition of hypoxic pulmonary vasoconstriction.

Respiratory muscle strength may explain hypoxia-induced decrease in vital capacity.

Purpose: High altitude exposure has consistently been reported to decrease forced vital capacity (FVC), but the mechanisms accounting for this observation remain incompletely understood. We investigated the possible contribution of a hypoxia-related decrease in respiratory muscle strength.

Methods: Maximal inspiratory and expiratory pressures (MIP and MEP), sniff nasal inspiratory pressure (SNIP), FVC, peak expiratory flow rate (PEF), and forced expiratory volume in 1 s (FEV1) were measured in 15 healthy subjects before and after 1, 6, and 12 h of exposure to an equivalent altitude of 4267 m in a hypobaric chamber.

Estimation of total-body skeletal muscle mass in children and adolescents.

Purpose: The estimation of total-body skeletal muscle mass (SMM) has been predicted in healthy adults using anthropometric measurements and urine creatinine excretion. SMM measurement is compulsory to evaluate exercise performance and the influence of physical training on muscle mass. However, there is a lack of information on children and adolescents when quantifying appendicular skeletal muscle mass.

Effects of high altitude exposure on cerebral hemodynamics in normal subjects.

Background And Purpose: Acute mountain sickness (AMS) may be an early stage of high altitude cerebral edema. If so, AMS could result from an alteration of dynamic autoregulation of cerebral blood flow resulting in overperfusion of capillaries and vasogenic cerebral edema.

Methods: We measured middle cerebral artery blood flow velocity (Vmca) by transcranial Doppler and arterial blood pressure by finger plethysmography at 490 m and 20 hours after arrival at 4559 m in 35 volunteers who had been randomized to tadalafil, dexamethasone, or placebo in a study on the pharmacological prevention of high altitude pulmonary edema.

The cuff leak test to predict failure of tracheal extubation for laryngeal edema.

Objective: Laryngeal edema secondary to endotracheal intubation may require early re-intubation. Prior to extubation the absence of leak around an endotracheal tube may predict laryngeal edema after extubation. We evaluated the usefulness of a quantitative assessment of such a leak to identify the patients who will require early re-intubation for laryngeal edema.

Prone positioning in acute respiratory failure: survey of Belgian ICU nurses.

Objective: To determine the frequency of use and attitudes towards prone positioning in patients with acute respiratory failure.

Design And Setting: Verbal questionnaire survey in all 79 intensive care units in French-speaking Belgium.

Methods: Of the 79 ICUs 29 performed prone-positioning, and 25 agreed to participate in the questionnaire.