Plasmodium falciparum malaria remains a major cause of morbidity and mortality, particularly in endemic regions. We report the case of a 21-year-old male with recent travel to an endemic area (Guapi, Colombia), who presented with febrile symptoms, severe respiratory distress, and oxygen saturation below 75%, necessitating orotracheal intubation. During the procedure, he developed pulseless electrical activity cardiac arrest, achieving return of spontaneous circulation after advanced resuscitation. Diagnosis was confirmed by thick blood smear, demonstrating P. falciparum infection. The patient progressed to multiorgan failure, including acute respiratory distress syndrome with capillary leak pulmonary edema, refractory distributive shock, acute kidney injury with severe hyperkalemia, and consumptive thrombocytopenia. Management included invasive mechanical ventilation, vasopressor support, sedation-analgesia, neuromuscular blockade, methylene blue, unsuccessful hemodialysis due to hemorrhagic complications, and platelet transfusions. Despite these interventions, the patient experienced a second cardiac arrest and died. This case highlights the severity and rapid progression of severe malaria with multisystem involvement, underscoring the critical importance of early diagnosis and intensive multidisciplinary management. It also emphasizes the need for preventive strategies for travelers to endemic areas and the development of clinical protocols to improve outcomes in complicated malaria.

Background/Objectives: We will describe the early mobilization protocols applied to critically ill pediatric patients in PICUs, analyzing the strategies employed, the tools used, and the barriers perceived by the healthcare team during their implementation. Methods: The scoping review followed the guidelines established by PRISMA-ScR. A search was conducted across five electronic databases: PubMed, Scopus, Web of Science, Dimensions AI, and ScienceDirect. Articles published in English that focused on pediatric patients aged 0 to 18 years were included. Results: A total of 3508 records were initially identified, of which 3422 articles were evaluated after duplicate removal. Subsequently, 12 studies that met the inclusion criteria were included. The methodological quality of the studies was mostly adequate, with 71.43% achieving scores between eight and nine on the Newcastle–Ottawa scale and 50% of the randomized clinical trials obtaining the maximum score of 7/7 on the Jadad scale. The interventions analyzed, including active bed mobility, bed cycling, and virtual reality, showed positive results in terms of feasibility and safety. The most frequently reported barriers to mobilization were hemodynamic instability, excessive sedation, pain, and lack of personnel and equipment. Conclusions: Early mobilization in pediatric PICUs is linked to improvements in mobility, reduced hospital stays, and shorter mechanical ventilation duration. However, its implementation is limited by barriers such as hemodynamic instability, excessive sedation, and lack of personnel and equipment. Further research is needed to establish uniform protocols, reduce these barriers, and optimize their effectiveness.

This paper aims to investigate and analyze the correlation between diaphragmatic parameters through ultrasonography and sports performance in various sports disciplines. This systematic review followed the PRISMA methodology. The search strategy was applied in the Medline database through Ovid, EMBASE, LILACS, the Cochrane Central Register of Controlled Trials, and Open Gray. Clinical trials, cohort, case–control, and cross-sectional studies were included, and animal experiments were excluded. A total of 388 studies were identified. After removing duplicates and screening titles and abstracts, sixteen studies were selected for full review, and six were included in the qualitative analysis. The results demonstrated a positive correlation between diaphragm excursion and thickness during inspiration with the anaerobic power, highlighting their importance in high-intensity performance. Additionally, one study reported a positive correlation between diaphragm thickness and aerobic power, suggesting the need for further research. The impact of inspiratory muscle training in Paralympic athletes was also evaluated, providing valuable insights into diaphragmatic adaptation in disabled populations. Ultrasonography is a feasible tool for evaluating the structure and function of the diaphragm, the main element of the respiratory process during sports practice. Its use could contribute to the evaluation and planning of sports training and be a possible indicator of performance improvement.

Artificial intelligence (AI) has proven to be a highly useful tool in the clinical setting, especially in the Intensive Care Unit (ICU). The use of various AI-mediated instruments to guide medical treatments and even support surgical procedures has been previously described, but there is still no aggregated evidence on its usefulness in assisting the physical rehabilitation process of critically ill patients, understanding that this is extremely important to prevent the development of muscle weakness in the ICU. This review, therefore, aimed to describe the usefulness of AI in supporting the physical rehabilitation of patients admitted to the ICU. This scoping review was conducted following the Joanna Briggs Institute (JBI) methodology, originally developed by Arksey and O'Malley. A structured search strategy based on a Population, Concept, and Context (PCC) framework was used to search PubMed, Web of Science, Scopus, and the Virtual Health Library (VHL) databases. The initial search yielded 116 articles. After removing duplicates and applying exclusion criteria during title and abstract screening, eight studies were included in the final analysis. Identified tools included noninvasive mobility sensors, robotic assistance systems, machine learning algorithms, and software to support musculoskeletal ultrasound assessment. Artificial intelligence is emerging as a key tool for ICU rehabilitation, offering objective data, enhancing patient monitoring, and streamlining assessment processes. Payán-Salcedo HA, Castro Aguilera AM, Salinas Batioja MF, Castillo Diaz LM. Application of Artificial Intelligence in Physical Rehabilitation of Patients Admitted to the Intensive Care Unit: A Scoping Review. Indian J Crit Care Med 2025;29(10):851–860.

Introduction: Pulmonary rehabilitation is crucial to restore functional independence and improve quality of life of patients after discharge from COVID-19. In extra-hospital settings, it is consolidated as necessary in the intervention process in post-COVID-19 pulmonary fibrosis. Objective: The objective of the review is to describe the approach to post-COVID-19 pulmonary fibrosis through out-of-hospital pulmonary rehabilitation. Materials and methods: A bibliographic review was carried out in the academic databases PubMed, Scopus and ScienceDirect; standardized language in English was used with DeCS/MeSH terms: “Pulmonary rehabilitation”, “COVID-19”, “Pulmonary Fibrosis” and “ Ambulatory Care” published from 2020 to 2023; and the rigorous standards established by the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) to assess the quality of the evidence, was followed. Results: The initial search returned a total of 661 studies published from January 2020 to April 2024. After applying the inclusion and exclusion criteria to the documents, 11 articles were finally included that responded to the research objective. Conclusion: COVID-19 lung infection can leave serious sequelae, such as pulmonary fibrosis, which affects respiratory function and quality of life. Out-of-hospital pulmonary rehabilitation has been effective in improving lung function, reducing recurrent hospitalizations and improving quality of life in patients, beyond relieving respiratory symptoms. Introducción: La rehabilitación pulmonar es crucial para restaurar la independencia funcional y mejorar la calidad de vida de los pacientes tras el alta por COVID-19. En entornos extrahospitalarios, se consolida necesaria en el proceso de intervención en fibrosis pulmonar post-COVID-19. Objetivo: El objetivo de la revisión es describir el enfoque de la fibrosis pulmonar post-COVID-19 a través de la rehabilitación pulmonar extrahospitalaria. Materiales y métodos: Se realizó una revisión bibliográfica en las bases de datos académicas PubMed, Scopus y ScienceDirect; se usó lenguaje normalizado en inglés con términos DeCS/MeSH: “Pulmonary rehabilitation”, “COVID-19”, “Pulmonary Fibrosis” y “Ambulatory Care” publicados desde el 2020 al 2023; y se siguieron los rigurosos estándares establecidos por el Grading of Recommendations, Assessment, Development and Evaluations (GRADE) para valorar la calidad de la evidencia. Resultados: La búsqueda inicial arrojó un total de 661 estudios publicados desde enero de 2020 a abril de 2024. Después de aplicar los criterios de inclusión y exclusión a los documentos, finalmente se incluyeron 11 artículos que daban respuesta al objetivo de la investigación. Conclusión: La infección pulmonar por COVID-19 puede dejar secuelas graves, como la fibrosis pulmonar, que afecta la función respiratoria y la calidad de vida. La rehabilitación pulmonar fuera del hospital ha resultado efectiva para mejorar la función pulmonar, reducir hospitalizaciones recurrentes y mejorar la calidad de vida en pacientes, más allá de aliviar los síntomas respiratorios.

Introduction: The high-flow nasal cannula is a system that uses a humidified and heated air-oxygen mixture with a flow rate of up to 70 liters per minute. It is mostly used in acute respiratory failure of hypoxemic origin, where it has been shown to provide greater comfort and resolving power of hypoxemia, compared to conventional oxygen therapy. Although its indications and follow-up strategy are known, in clinical practice the weaning/weaning process is not clear. Objective: To identify in the bibliography the existing literature on weaning/ weaning strategies of high-flow nasal cannula in adults. Methods: A bibliographic review was carried out in the databases of the regional portal of the BVS, PubMed, Web Of Science, Scopus and Google scholar, without time limit and structuring a PIO equation with keywords and Boléan connectors. Articles published in English and Spanish, full text, were assumed. Results: The literature still reports discrepancy in the process of weaning and disassembling the high-flow nasal cannula, but most of the studies found in this review propose to decrease the Fio2 first gradually (5-10%) to values of 30-50% and then the flow. To dismantle it, one could consider having a Fio2 between 30-50%, flow between 20-30 liters per minute, Sao2 >92%, with adequate respiratory mechanics and state of consciousness. Conclusion: There is still no unanimity on the weaning/weaning process in the high-flow nasal cannula in the adult patient. Introducción: La cánula nasal de alto flujo es un sistema que utiliza una mezcla de aire-oxígeno humidificado y calentado con un caudal de hasta 70 litros por minuto. Es utilizada mayoritariamente en la insuficiencia respiratoria aguda de origen hipoxémico, donde ha demostrado brindar mayor comodidad y poder resolutivo de la hipoxemia, en comparación con la oxigenoterapia convencional. Aunque se conocen sus indicaciones y estrategia de seguimiento, en la práctica clínica no es claro su proceso de destete/desmonte. Objetivo: Identificar en la bibliografía la literatura existente acerca de estrategias de destete/desmonte de la cánula nasal de alto flujo en adultos. Métodos: Se realizó una revisión bibliográfica en las bases de datos del portal regional de la BVS, PubMed, Web Of Science, Scopus y Google scholar, sin límite de tiempo y estructurando una ecuación PIO con palabras clave y operadores booleanos. Se asumieron artículos publicados en inglés y español, texto completo. Resultados: En la bibliografía, aún se reporta discrepancia en el proceso de destete y desmonte de la cánula nasal de alto flujo, pero en la mayoría de los estudios encontrados en esta revisión se propone disminuir la Fio2 primero de forma gradual (5-10%) hasta valores de 30-50% y, posteriormente, el flujo. Para desmontarla, se podría considerar tener una Fio2 entre 30-50%, flujo entre 20-30 litros por minuto, Sao2 >92%, con adecuada mecánica respiratoria y estado de conciencia. Conclusión: Aún no existe unanimidad en el proceso de destete/desmonte en la cánula nasal de alto flujo en el paciente adulto.