This confirms previous data from animal AZD-2281 as well as human studies demonstrating a deleterious effect of hyperglycaemia on gastric emptying [11]. Also, previous studies have suggested that small intestinal [12] and gallbladder motility [13] may be inhibited by a hyperglycaemic state. Glucose control may thus be important for optimal tolerance and absorption of nutrients in ICU patients.Future work should thus aim to confirm whether absorptive capacity of the gut is indeed impaired during critical illness and to determine the causes and mechanisms of this. With this aim in view, further development and validation of tools enabling reliable assessment of nutrient absorption in the ICU setting would be eminently desirable.Abbreviations3-O MG: 3-O methylglucose.

Competing interestsThe author declares that they have no competing interests.NotesSee related research by Chapman et al., http://ccforum.com/content/13/4/R140
The UK Health Protection Agency advises health care workers caring for patients with probable or confirmed flu-like illnesses, with serious respiratory illnesses or where aerosol generating procedures are being undertaken to use a filtering face piece-3 (FFP3) respirator [1].Whereas masks protect the environment from wearers, respirators by design protect wearers from the environment. Some surgical masks are splash resistant but offer no protection against viruses. Nevertheless, the Department of Health recommends that carers wear splash proof surgical masks when within one metre of symptomatic patients [2]; their rationale is not clear.

All FFP3 respirators meet European standard EN149:2001 and fitted properly will reduce exposure to airborne particles by a factor of 20 [3]. Aerosol generating procedures include tracheal intubation, manual ventilation, suctioning, cardiopulmonary resuscitation, bronchoscopy, and possibly non-invasive ventilation and nebulisation [2].NHS Trusts have started the time- and resource-consuming task of fit-testing their staff for respirators; well fitting respirators are essential to benefit from them but experience has shown that not all staff will fit the first one and the process may take up to 30 minutes [4]. In a UK emergency department, 23% of those fit-tested failed to fit any respirators [5].A survey of 68 anaesthetic and intensive care medicine trainees in the UK Kent, Surrey and Sussex Deanery in July 2009 identified that 80% had not been fit-tested for FFP3 respirators GSK-3 and more than 50% of respondents had not heard of respirator fit-testing. Of those already tested, 35% were fitted more than 4 months ago, before news of the swine influenza outbreak.