Recruitment manoeuvres involve transient elevations in airway pressure applied during mechanical ventilation to open (‘recruit’) collapsed lung units and increase the number of alveoli participating in tidal ventilation. Recruitment manoeuvres are often used to treat patients in intensive care who have acute respiratory distress syndrome (ARDS), but the effect of this treatment on clinical outcomes has not been well established. This review aims to determine the effects of recruitment manoeuvres on mortality, oxygenation and adverse events (e.g. rate of barotrauma) in adults with ARDS. Associated Cochrane Clinical Answer: What are the effects of recruitment maneuvers for adults with acute respiratory distress syndrome receiving mechanical ventilation?

Cough augmentation techniques, such as lung volume recruitment or manually and mechanically assisted cough, are used to prevent and manage respiratory complications associated with chronic conditions, particularly neuromuscular disease, and may improve short‐ and long‐term outcomes for people with acute respiratory failure. This review aims to determine extubation success using cough augmentation techniques compared to no cough augmentation for critically‐ill adults and children with acute respiratory failure admitted to a high‐intensity care setting capable of managing mechanically‐ventilated people (such as an intensive care unit, specialized weaning centre, respiratory intermediate care unit, or high‐dependency unit).

Physical disability in neuromuscular diseases can be due to progressive loss of strength in limb muscles, and for some people, there may also be respiratory muscle weakness. Respiratory muscle training (RMT) might be expected to improve respiratory muscle weakness, but its effects are still uncertain. This review assesses the effects of RMT for neuromuscular disease in adults and children, in comparison to sham training, no training, standard treatment, breathing exercises, or other intensities or types of RMT.

Critical illness polyneuropathy or myopathy (CIP/CIM) is a frequent complication in the intensive care unit (ICU) and can be associated with prolonged mechanical ventilation, longer ICU stay and increased mortality. This review aims to systematically review the evidence from RCTs concerning the ability of any intervention to reduce the incidence of CIP or CIM in critically ill individuals. Associated Cochrane Clinical Answer: What are the effects of interventions used to prevent critical illness polyneuropathy or myopathy in patients in intensive care units?

Patients with advanced progressive disease often experience muscle weakness, which can impact adversely on their ability to be independent and their quality of life. In those patients who are unable or unwilling to undertake whole‐body exercise, neuromuscular electrical stimulation (NMES) may be an alternative treatment to enhance lower limb muscle strength. Programmes of NMES appear to be acceptable to patients and have led to improvements in muscle function, exercise capacity, and quality of life. This review evaluates the effectiveness of NMES on quadriceps muscle strength in adults with advanced disease, as well as examining the safety and acceptability of NMES, and its effect on peripheral muscle function (strength or endurance), muscle mass, exercise capacity, breathlessness, and health‐related quality of life. Associated Cochrane Clinical Answer: Does neuromuscular electrical stimulation improve outcomes in adults with advanced disease who have muscle weakness?

During intensive care unit (ICU) admission, patients can experience extreme physical and psychological stressors, including the abnormal ICU environment. These experiences impact on a patient’s recovery from critical illness and their longer term mental and physical health. One strategy that has been developed and implemented by clinical staff to treat the psychological distress prevalent in ICU survivors is the use of patient diaries, which provide a background to the cause of the patient’s ICU admission and an ongoing narrative outlining day‐to‐day activities. This review assesses the effect of a diary versus no diary on patients, and their caregivers or families, during the patient’s recovery from admission to an ICU.

PCT is a non‐trauma, manualized psychotherapy for adults with PTSD. PCT was originally designed as a treatment comparator in trials evaluating the effectiveness of trauma‐focused cognitive‐behavioral therapy (TF‐CBT). Recent trials have indicated that PCT may be an effective treatment option for PTSD and that patients may drop out of PCT at lower rates relative to TF‐CBT. This review assesses the effects of PCT for adults with PTSD. Associated Cochrane Clinical Answer: What are the effects of present‐centered therapy for adults with post‐traumatic stress disorder (PTSD)?

Therapist‐delivered trauma‐focused psychological therapies are the accepted first‐line treatments for the disorder. However, many barriers limit treatment uptake, such as the limited number of qualified therapists to deliver the interventions, cost, and compliance issues, such as time off work, childcare, and transportation, associated with the need to attend weekly appointments. Delivering cognitive behavioural therapy (CBT) on the Internet is an effective and acceptable alternative to therapist‐delivered treatments for anxiety and depression. However, fewer Internet‐based therapies have been developed and evaluated for PTSD, and uncertainty surrounds the efficacy of Internet‐based cognitive and behavioural therapy (I‐C/BT) for PTSD. This review assesses the effects of I‐C/BT for PTSD in adults. Associated Cochrane Clinical Answer: How do internet‐based cognitive and behavioral therapies compare with usual care for adults with post‐traumatic stress disorder (PTSD)?

Cognitive behavioural therapy (CBT) is an evidence‐based treatment for anxiety disorders. Because many people have difficulty accessing treatment, due to a variety of obstacles, researchers have explored the possibility of using the Internet to deliver CBT. It is important to ensure the decision to promote such treatment is grounded in high quality evidence, and this review assesses the effects of therapist‐supported Internet CBT (ICBT) on remission of anxiety disorder diagnosis and reduction of anxiety symptoms in adults as compared to waiting list control, unguided CBT, or face‐to‐face CBT. Associated Cochrane Clinical Answer: What are the benefits of cognitive behavioral therapy (with a therapist's support) when delivered over the Internet?

People living in humanitarian settings (such as in the aftermath of a crisis triggered by natural hazards) in LMICs are exposed to stressors that make them vulnerable to developing mental disorders. Mental disorders with a higher prevalence in these settings include PTSD and major depressive, anxiety, and related disorders. This review aims to compare the effectiveness and acceptability of psychological therapies versus control conditions (wait list, treatment as usual, attention placebo, psychological placebo, or no treatment) aimed at treating people with mental disorders living in LMICs affected by humanitarian crises. Associated Cochrane Clinical Answers: What are the benefits and harms of psychological therapies for children in low‐ and middle‐income countries affected by humanitarian crises? and What are the benefits and harms of psychological therapies for adults in low‐ and middle‐income countries affected by humanitarian crises?