Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Clinical Trial
The intercristal line determined by palpation is not a reliable anatomical landmark for neuraxial anesthesia.
The radiological intercristal line (Tuffier's line) usually intersects the spine at the L4-L5 interspace. The intercristal line determined by palpation may be used erroneously as a surrogate for the true radiological Tuffier's line. We studied term pregnant women to establish the level at which a transverse line connecting the superior aspects of the iliac crests, as determined by palpation, intersects the lumbar spine, as assessed by ultrasound. ⋯ In pregnant women at term, the intercristal line determined by palpation does not correspond to the Tuffier's line determined radiologically, and it may intersect the spine at up to three interspaces higher.
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In patients with ventilator-associated pneumonia (VAP), the isolation of Candida species (spp.) in respiratory secretions has been associated with worse outcomes. It is unclear whether Candida colonization is causally related or is a marker of disease severity. The objective of this study was to compare systemic inflammatory markers in patients with a clinical suspicion of VAP with Candida in respiratory tract (RT) cultures vs patients who have bacteria and those with no pathogens. ⋯ In patients with a clinical suspicion of VAP, the presence of Candida spp. only in the RT is associated with similar levels of inflammation and worse clinical outcomes compared with patients without Candida in RT secretions.