SummaryUntil recently, the most appropriate technique of intubating a patient with a cervical spine injury has been the subject of debate. Tracheal intubation by means of the intubating laryngeal mask (Fastrache), a modified conventional laryngeal mask airway, seems to require less neck manipulation. The aim of this study was to compare the excursion of the upper cervical spine during tracheal intubation using direct laryngoscopy with that during intubation via the laryngeal mask (Fastrache), by examination of lateral cervical spine radiographs in healthy young patients. The intubating laryngeal mask (Fastrache) caused less extension (at C 122 and C 223 ) than intubation by direct laryngoscopy. Direct laryngoscopy is still the fastest method to secure an airway provided no intubating difficulties are present. However, in trauma patients requiring rapid sequence induction and in whom cervical spine movement is limited or undesirable, the intubating laryngeal mask (Fastrache) is a safe and fast method by which to secure the airway.

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In a clinical setting, patients who have their mono- and adjunctive therapy treatment substituted for latanoprost may on average experience reduced IOP, decreased side effects and increased quality of life measures.

Background: Biomarkers for the prognosis in severe illness are commonly used. Mean platelet volume (MPV) is an easily accessible haematological parameter which may reflect platelet activation as well as endothelial damage. There are only a few reports concerning the use of this parameter as a biomarker in severe illness.Purpose of the study was the evaluation of MPV as a prognostic biomarker in patients with sepsis.Methods: Patients with suspected sepsis attending the Infectious Diseases wards, medical ICU or interdisciplinary anesthesiology ICU were prospectively enrolled in the analysis. Measures included demographics, medical history as well as clinical and laboratory biomarker determinations on admission and/or first symprtomatic day and day of positive blood culture. Patients were followed having outcomes and biomarkers assessed in the course.Results: 183 patients (66 female) with confirmed sepsis were available for the analysis. Median age was 71 years (range 21-97 years), median BMI was 26.3 kg/m 2 . All had at least one premorbid medical conditions, more than two third had >3 significant pre-existing diseases. Bacteria most commonly detected were S. aureus (54/183) and E. coli (39/183) reflecting the origin of sepsis which mostly were device-related and endocarditis (in 37/183), urogenital (in 35/183) or skin, soft-tissues and bone/joints (27/183), respectively. Unfavourable outcomes (death) at day 30 had 27/183 (14.8%). Patients who died had a higher MPV at admission compared to the survivors (9.6 vs. 9.19 fl, p = 0.031) which increased to an MPV of 11.2 vs. 9.7 fl (p = 0.008) at the time of positive blood culture drawn. Only mean arterial pressure (MAP) at the detection of bacteremia (p = 0.02) and thrombocyte count at bacteremia (p = 0.033) had significant associations with death. Neither temperature, leukocytes, lactate, PCT or CrP had significant associations (all p > 0.1). Receiver operator curve showed AUC for MPV at admission of 0.71 and MPV at bacteremia of 0.68. MAP and thrombocytes at bacteremia had much lower AUC (0.39 and 0.36, respectively).Conclusion: These preliminary data confirm the potential usefulness of MPV as an easily accessible prognostic marker in sepsis. Further studies are required to confirm our results.

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