Table of contentsP001 - Sepsis impairs the capillary response within hypoxic capillaries and decreases erythrocyte oxygen-dependent ATP effluxR. M. Bateman, M. D. Sharpe, J. E. Jagger, C. G. EllisP002 - Lower serum immunoglobulin G2 level does not predispose to severe flu.J. Solé-Violán, M. López-Rodríguez, E. Herrera-Ramos, J. Ruíz-Hernández, L. Borderías, J. Horcajada, N. González-Quevedo, O. Rajas, M. Briones, F. Rodríguez de Castro, C. Rodríguez GallegoP003 - Brain protective effects of intravenous immunoglobulin through inhibition of complement activation and apoptosis in a rat model of sepsisF. Esen, G. Orhun, P. Ergin Ozcan, E. Senturk, C. Ugur Yilmaz, N. Orhan, N. Arican, M. Kaya, M. Kucukerden, M. Giris, U. Akcan, S. Bilgic Gazioglu, E. TuzunP004 - Adenosine a1 receptor dysfunction is associated with leukopenia: A possible mechanism for sepsis-induced leukopeniaR. Riff, O. Naamani, A. DouvdevaniP005 - Analysis of neutrophil by hyper spectral imaging - A preliminary reportR. Takegawa, H. Yoshida, T. Hirose, N. Yamamoto, H. Hagiya, M. Ojima, Y. Akeda, O. Tasaki, K. Tomono, T. ShimazuP006 - Chemiluminescent intensity assessed by eaa predicts the incidence of postoperative infectious complications following gastrointestinal surgeryS. Ono, T. Kubo, S. Suda, T. Ueno, T. IkedaP007 - Serial change of c1 inhibitor in patients with sepsis – A prospective observational studyT. Hirose, H. Ogura, H. Takahashi, M. Ojima, J. Kang, Y. Nakamura, T. Kojima, T. ShimazuP008 - Comparison of bacteremia and sepsis on sepsis related biomarkersT. Ikeda, S. Suda, Y. Izutani, T. Ueno, S. OnoP009 - The changes of procalcitonin levels in critical patients with abdominal septic shock during blood purificationT. Taniguchi, M. OP010 - Validation of a new sensitive point of care device for rapid measurement of procalcitoninC. Dinter, J. Lotz, B. Eilers, C. Wissmann, R. LottP011 - Infection biomarkers in primary care patients with acute respiratory tract infections – Comparison of procalcitonin and C-reactive proteinM. M. Meili, P. S. SchuetzP012 - Do we need a lower procalcitonin cut off?H. Hawa, M. Sharshir, M. Aburageila, N. SalahuddinP013 - The predictive role of C-reactive protein and procalcitonin biomarkers in central nervous system infections with extensively drug resistant bacteriaV. Chantziara, S. Georgiou, A. Tsimogianni, P. Alexandropoulos, A. Vassi, F. Lagiou, M. Valta, G. Micha, E. Chinou, G. MichaloudisP014 - Changes in endotoxin activity assay and procalcitonin levels after direct hemoperfusion with polymyxin-b immobilized fiberA. Kodaira, T. Ikeda, S. Ono, T. Ueno, S. Suda, Y. Izutani, H. ImaizumiP015 - Diagnostic usefullness of combination biomarkers on ICU admissionM. V. De la Torre-Prados, A. Garcia-De la Torre, A. Enguix-Armada, A. Puerto-Morlan, V. Perez-Valero, A. Garcia-AlcantaraP016 - Platelet function analysis utilising the PFA-100 does not predict infection, bacteraemia, sepsis or outcome in critically ill patientsN. Bolton, J. Dudziak, S. Bonney, A. Tridente, P. NeeP017 - Extracellular histone H3 levels are in...

To the Editor,Emerging literature suggests the usefulness of preprocedural ultrasound (US) assessment of the lumbar spine 1 to facilitate epidural catheter insertion. There are also reports of single-operator real-time US-guided epidural catheter insertion in patients with normal anatomy. 2,3 Epidural catheter insertion in morbidly obese parturients can be technically challenging. 4 We describe the advantage of real-time US-guided epidural insertion in this patient population after failure of a pre-procedural US of the lumbar spine followed by an attempted standard loss-of-resistance epidural technique.Following Institutional Ethics Committee approval (CERCAR-HIAB-FARU-2009-005) and patient consent, morbidly obese (body mass index[40 kgÁm -2 ) parturients with failed epidural catheter insertion (more than three attempts by an experienced operator despite pre-procedural US assessment of the lumbar spine) participated in this study from May 31, 2010 to August1, 2013. With the parturient in the sitting position, one operator applied a SonoSite Edge TM 2-5 MHz curved array probe (Bothell, WA, USA) over the mid-lumbar spine to obtain a scan of the paramedian oblique sagittal plane. 1 During real-time US guidance, a second operator carefully advanced a 17G Tuohy needle (Vygon, France) into the interlaminar space until the needle tip reached the posterior part of the ligamentum flavum-dura mater complex. In cases where the tip was not visible, a slight jiggling of the needle to move the tissues helped localize its position. With the probe held firmly against the patient's back, the needlesyringe (5 mL saline) assembly was carefully advanced in a standard manner using the loss of resistance technique. Epidural anesthesia was obtained with sufentanyl 10 lg and 0.1%, ropivacaine 15 mL (patient's height \ 165 cm) or 20 mL. After 30 min, the level of sensory block (cold perception), motor block (Bromage scale), and patient satisfaction score (1 = best to 6 = worst) were assessed.Real-time US-guided epidural catheters were successfully inserted in all patients who took part in this project (Table). The epidural space was identified using one to three attempts. The tip of Tuohy needle was not visible in four cases, and we were able to identify the catheter in only 1/10 parturients. No inadvertent dural puncture occurred, and recovery from epidural analgesia was uneventful in all parturients.We report real-time US-guided epidural catheter insertion in morbidly obese patients. This technique may be useful in cases where patient anatomy presents difficult epidural catheter insertion. Further studies are warranted to assess safety and efficacy of such a strategy.

(Can J Anaesth. 2015;62(11):1226–1227) Preprocedural and real-time ultrasound assessment can aid practitioners in the placement of epidural catheters, which can be a technique that is particularly difficult to perform on morbidly obese patients. To investigate this, these authors conducted a study to assess real-time ultrasound guidance in patients who had failure of epidural insertion using pre-procedural ultrasound and the loss-of-resistance technique.

The French Army medical service carried out an epidemiological survey to estimate health indicators in children living in Meulaboh, Indonesia, in the weeks following the tsunami of December 26, 2004, within a sample from refugee camps, schools, and quarters of the town. Thirty-four percent of the children in camps, 21.9% in schools, and 49.5% from quarters presented psychological trauma. Malnutrition affected 20.5% in camps and 34.4% in the town between 6 and 59 months, 11.3% in camps, and 7.6% in schools between 6 and 15 years. The children had suffered various symptoms since the tsunami; access to care was possible for 53.9% in the camps, 23.8% from schools, and 39.3% from the town. Those results have been subsequently used by the local health authorities to improve child health care. The method used for this survey could be applied for future disaster scenarios.

For a decade, depth of anesthesia monitoring has become a reality in the operating room. It provides valuable help for managing anesthesia, especially for unstable patients. This might be particularly relevant during aeromedical evacuation. In this study, we aimed to assess the validity of the bispectral index (BIS) during long-range patient transportation aboard fixed-wing aircraft. BIS was recorded in 30 patients, 25 under anesthesia and 5 awake, during aeromedical evacuations performed by the French Air Force. BIS index was available and analyzable (signal quality index above 50%) more than 90% of time. Despite potential pitfalls related to mechanical or electrical interference, BIS monitor can be reliably used to monitor depth of anesthesia during individual strategic aeromedical evacuations.