Use of Ultrasound to Determine Changes in Diaphragm Mechanics During A Spontaneous Breathing Trial.

Objective: Assess change in ultrasound measures of diaphragm mechanics over the course of a 30-minute spontaneous breathing trial (SBT).

Design: Prospective observational study.

Setting: Single intensive care unit (Logan Hospital, Queensland, Australia), patients recruited from August 2016 to April 2018.

A fatal case of primary dengue infection with myocarditis and cerebral oedema.

With dengue fever emerging as a global health problem and more Australians travelling to endemic areas, imported dengue infection is on the rise and clinicians need to remain vigilant. Primary cardiac and neurologic involvement in dengue infection has been rarely described in the medical literature and the pathophysiology is poorly understood. A rare and fatal case of primary dengue infection in a 34-yearold woman who returned from Papua New Guinea is reported; the unusual features of this case include severe primary dengue infection, myocarditis, and acute cerebral oedema resulting in death.

Recurrent undifferentiated shock: Idiopathic Systemic Capillary Leak Syndrome.

Idiopathic Systemic Capillary Leak Syndrome is a potentially fatal disorder that is under diagnosed. It commonly presents as recurrent undifferentiated shock with hypotension, hypoalbuminemia and hemoconcentration. There are three distinct phases that define the syndrome; Prodromal, Extravasation and Recovery.