Letters Section Editor: Robert M. Golub, MD, Senior Editor.
To the Editor: In their trial of preoperative intensive IMT, Dr Hulzebos and colleagues1 describe the preoperative and postoperative study methods, but the actual conduct of the operative course is only briefly mentioned. A study attempting to determine the efficacy of IMT should control for the many operative variables known to have an effect on the incidence of the measured complications, particularly because there is no specific mention of the blinding status of the surgeon, anesthesiologist, or intensivist.
Culp WC, Beyer EA. Preoperative Inspiratory Muscle Training and Postoperative Complications. JAMA. 2007;297(7):697–699. doi:10.1001/jama.297.7.697-b