The perioperative management of the patient undergoing open thoracoabdominal aortic aneurysm repair is reviewed.

One in 760 hospitalizations for delivery is complicated by near-miss morbidity or mortality and these patients at risk can be identified.

Continuous central venous oximetry is a potential target parameter in high-risk pediatric patients. See the accompanying Editorial View on  page 926 

Reduced or absent offset analgesia indicates the inability to modulate pain perception in chronic neuropathic pain patients.

The biological effects of ultrasound, as reported in animal and human studies, are reviewed.

Oxidative stress from mechanical ventilation can lead to serious complications including death. This study assessed the protective effects of inhaled hydrogen sulfide (0, 1, 5, or 60 ppm) and intravascular sodium sulfide (Na2S) (single bolus infusion of 0.55 mg/kg) in anesthetized mice with high tidal volume (HVT) (40 mg/kg) ventilation for 4 h. Low-dose hydrogen sulfide did not alter lung injury induced by high tidal volume. The highest dose, 60 ppm hydrogen sulfide, accelerated ventilator-induced lung injury. In contrast, intravenous sodium sulfide reduced pulmonary neutrophil infiltration and edema. Oxidative stress-induced depletion of glutathione was also prevented by sodium sulfide. This study suggests beneficial effects of sodium sulfide in preventing lung injury during mechanical ventilation. See the accompanying Editorial View on  page 921 

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Despite its risks, blood transfusion is often required during cardiac surgeries. This prospective, single-center, single-blinded, randomized, parallel-arm controlled trial evaluated the effects of a single preoperative bolus of erythropoietin and an iron supplement 1 day before surgery. The incidence of transfusion was significantly lower in patients who received erythropoietin compared with saline controls (86%vs.  59%), as was the mean number of packed erythrocytes transfused. Patients who received erythropoietin had a significantly greater reticulocyte count 4 and 7 days postoperatively compared with controls. This study suggests that preoperative administration of erythropoietin and iron may be beneficial to conserve blood in anemic patients undergoing cardiac surgeries. See the accompanying Editorial View on  page 912 

Intraoperative neuromuscular blockade can result in residual blockade in the postanesthesia care unit (PACU) which may repair clinical recovery. In this study, patients (N = 155) were randomized to receive either intraoperative acceleromyography or conventional qualitative train-of-four rations monitoring (control group) in the PACU after intraoperative neuromuscular blockade. Patients who received acceleromyography monitoring had a significantly lower incidence of residual blockade, fewer symptoms of muscle weakness, and reduced overall weakness compared with the control group. This randomized study suggests that acceleromyography monitoring may improve PACU care and recovery. See the accompanying Editorial View on  page 918