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Anesthesiology September 2013, Vol. 119, A13–A18. https://doi.org/10.1097/ALN.0b013e3182a79d1e

Editorial Board

Anesthesiology September 2013, Vol. 119, A17–A18. https://doi.org/10.1097/ALN.0b013e3182a79d08

This Month in Anesthesiology

Anesthesiology September 2013, Vol. 119, A3. https://doi.org/10.1097/ALN.0b013e3182a79caa

Anesthesiology CME Program

Anesthesiology September 2013, Vol. 119, A21. https://doi.org/10.1097/ALN.0b013e3182a79cf3

Editorial

Anesthesiology September 2013, Vol. 119, 495–497. https://doi.org/10.1097/ALN.0b013e3182a10cce
Anesthesiology September 2013, Vol. 119, 498–500. https://doi.org/10.1097/ALN.0b013e31829ce927
Anesthesiology September 2013, Vol. 119, 501–503. https://doi.org/10.1097/ALN.0b013e31829e4819
Anesthesiology September 2013, Vol. 119, 504–506. https://doi.org/10.1097/ALN.0b013e31829ce70b

Perioperative Medicine

Anesthesiology September 2013, Vol. 119, 507–515. https://doi.org/10.1097/ALN.0b013e3182a10e26

Intraoperative hypotension may be an important factor in the development of postoperative complications. Data from 27,381 patients undergoing 33,330 noncardiac surgeries were studied to determine the durations of various mean arterial pressures (MAP) that were associated with acute kidney injury and myocardial injury. Acute kidney injury occurred after 7.4% of surgeries while myocardial injury occurred after 2.3% of surgeries and 1.5% of patients died within 30 days of surgery. Any time spent with a MAP of less than 55 mmHg during noncardiac surgery was independently associated with an increased risk of acute kidney injury and myocardial injury. As the time with a MAP of less than 55 mmHg increased so too did the risk for acute kidney injury and myocardial injury. Thirty-day mortality was associated with more than 20 min of MAP less than 55 mmHg. Optimizing intraoperative hemodynamics may improve patient outcomes.

Anesthesiology September 2013, Vol. 119, 516–524. https://doi.org/10.1097/ALN.0b013e31829ce8fd

The authors developed an intraoperative predictive model for unplanned postoperative intensive care unit admission (area under the curve of the receiver operating characteristic curve 0.905, 95% CI, 0.900–0.909) and internally validated this model. This model may improve the process of allocating intensive care unit beds postoperatively.

Anesthesiology September 2013, Vol. 119, 525–540. https://doi.org/10.1097/ALN.0b013e31829ce6e6

Using patient data from the Massachusetts General Hospital, the Risk Stratification Indices had excellent discrimination and poor calibration but the 30-day mortality Risk Quantification Index performed well.

Anesthesiology September 2013, Vol. 119, 541–551. https://doi.org/10.1097/ALN.0b013e31829416dd

In women at cesarean delivery, oxytocin, 5 U and carbetocin 100 μg, produced a similar 25% reduction in mean arterial pressure lasting less than 2 min. Cardiac stroke volume was not increased in women receiving placebo, despite good uterine tone, questioning the autotransfusion hypothesis.

Anesthesiology September 2013, Vol. 119, 552–561. https://doi.org/10.1097/ALN.0b013e318297d347

In myometrial strips obtained at elective cesarean delivery from women not receiving oxytocin, in vitro pretreatment to oxytocin at concentrations more than 10−10 M reduced the subsequent contractile response to oxytocin. These data suggest that oxytocin-induced desensitization might explain the greater oxytocin dose required and greater bleeding in women at cesarean delivery who have undergone oxytocin-augmented labor.

Anesthesiology September 2013, Vol. 119, 562–568. https://doi.org/10.1097/ALN.0b013e318295a27b

Phasic, but not tonic, inspiratory activity of the genioglossus and palatoglossus muscles increases progressively with decreasing depth of sevoflurane anesthesia in spontaneously breathing children.

Anesthesiology September 2013, Vol. 119, 569–575. https://doi.org/10.1097/ALN.0b013e31829416ba

In a randomized, cross-over, multiple blinded study of healthy adult volunteers using 30 ml/kg over 1 h of either 0.9% saline or Plasmalyte, the authors found that measures of cognition did not differ, despite expected differences in plasma chemistry.

Anesthesiology September 2013, Vol. 119, 576–581. https://doi.org/10.1097/ALN.0b013e318299f72b

The investigators propose a new scoring system that includes performance tolerance such that more than 80% of subjects are considered recovered in the cognitive domain at 3 days. There were no important differences between methods of delivery; telephone administration of PQRS is thus, valid.

Anesthesiology September 2013, Vol. 119, 582–592. https://doi.org/10.1097/ALN.0b013e3182976036

Both sevoflurane and propofol based anesthesia increased electrocorticographic spike frequency and amplitude in a dose-dependent manner at comparable bispectral index ranges. Rather than interfering with detection, deeper levels of general anesthesia might actually facilitate intraoperative elctrocorticographic detection of epileptiform foci.

Anesthesiology September 2013, Vol. 119, 593–605. https://doi.org/10.1097/ALN.0b013e31829e47fd

Exposure of human renal cancer cells to isoflurane (0.5–2%, 2 h) resulted in up-regulation of levels of hypoxia-inducible factor-1α and -2α along with enhanced cell migration and cytoskeleton rearrangements. Isoflurane promotes cancer cell growth and migration in vitro and hence enhances malignant potential.

Anesthesiology September 2013, Vol. 119, 606–620. https://doi.org/10.1097/ALN.0b013e318292ee52

Supplemental Digital Content is available in the text.

Sevoflurane protected ventricular myocytes against H2O2-induced cellular Ca2+ overload and hypercontracture by correcting electrophysiological abnormalities associated with cellular Ca2+ handling.

Anesthesiology September 2013, Vol. 119, 621–630. https://doi.org/10.1097/ALN.0b013e318298e5f1

In mice, miR-21 contributes to the renoprotective effect (attenuation of tubular damage, apoptosis, and lipid peroxidation) of Xenon in vivo by inhibiting apoptosis and the Akt signaling pathway.

Critical Care Medicine

Anesthesiology September 2013, Vol. 119, 631–641. https://doi.org/10.1097/ALN.0b013e3182952608

Full closed-loop controlled ventilation, in comparison with pressure support ventilation, improved oxygenation, ventilatory variability and time spent in an adequate ventilation zone in critically ill patients.

Anesthesiology September 2013, Vol. 119, 642–651. https://doi.org/10.1097/ALN.0b013e318297d487

Supplemental Digital Content is available in the text.

A unilateral loss of aeration can lead to ventilator-induced lung injury in the contralateral uninjured lung.

Anesthesiology September 2013, Vol. 119, 652–662. https://doi.org/10.1097/ALN.0b013e31829b3692

Twelve hours of mechanical ventilation, both negative pressure and positive pressure, resulted in similar levels of ventilator-induced diaphragmatic dysfunction, and the levels of lung injury did not affect the magnitude of diaphragmatic dysfunction.

Pain Medicine

Anesthesiology September 2013, Vol. 119, 663–674. https://doi.org/10.1097/ALN.0b013e31829ce4cb

Supplemental Digital Content is available in the text.

During the first half hour after bolus injection of 3.5 μg/kg fentanyl, the probability of respiratory depression exceeds that of analgesia. The shape of the utility function depends on the response thresholds chosen and the rate of drug administration.

Anesthesiology September 2013, Vol. 119, 675–686. https://doi.org/10.1097/ALN.0b013e3182a10fbf

Supplemental Digital Content is available in the text.

In a prospective, blinded, placebo-controlled trial conducted on a heterogeneous group of chronic pain patients, no analgesic effects were identified during 22 days of intrathecal gabapentin infusion.

Anesthesiology September 2013, Vol. 119, 687–697. https://doi.org/10.1097/ALN.0b013e318299980c

Nuclear factor κB, a nuclear transcription factor that is increased under hyperglycemic conditions, contributes to pain-related hypersensitivity in ischemic pain.

Education: Images in Anesthesiology

Anesthesiology September 2013, Vol. 119, 698. https://doi.org/10.1097/ALN.0b013e31827ddeb6
Anesthesiology September 2013, Vol. 119, 699. https://doi.org/10.1097/ALN.0b013e31827bcdba

Education: Anesthesia Literature Review

Anesthesiology September 2013, Vol. 119, 700–702. https://doi.org/10.1097/ALN.0b013e3182a1102a

Education: Review Article

Anesthesiology September 2013, Vol. 119, 703–718. https://doi.org/10.1097/ALN.0b013e31829374c2

Education: Mind to Mind

Anesthesiology September 2013, Vol. 119, 719–720. https://doi.org/10.1097/ALN.0b013e31828607b3
Anesthesiology September 2013, Vol. 119, 721–723. https://doi.org/10.1097/ALN.0b013e318296b21f

Correspondence

Anesthesiology September 2013, Vol. 119, 724–725. https://doi.org/10.1097/ALN.0b013e31829dd337
Anesthesiology September 2013, Vol. 119, 725–726. https://doi.org/10.1097/ALN.0b013e31829dd42f
Anesthesiology September 2013, Vol. 119, 726. https://doi.org/10.1097/ALN.0b013e31829e090c
Anesthesiology September 2013, Vol. 119, 726–727. https://doi.org/10.1097/ALN.0b013e31829e094e
Anesthesiology September 2013, Vol. 119, 727–728. https://doi.org/10.1097/ALN.0b013e31829e4b54
Anesthesiology September 2013, Vol. 119, 728–729. https://doi.org/10.1097/ALN.0b013e31829e6d29
Anesthesiology September 2013, Vol. 119, 729. https://doi.org/10.1097/ALN.0b013e31829ff1f3
Anesthesiology September 2013, Vol. 119, 729–730. https://doi.org/10.1097/ALN.0b013e31829fff78
Anesthesiology September 2013, Vol. 119, 730. https://doi.org/10.1097/ALN.0b013e31829f00c0
Anesthesiology September 2013, Vol. 119, 730–731. https://doi.org/10.1097/ALN.0b013e31829f2bad
Anesthesiology September 2013, Vol. 119, 731–732. https://doi.org/10.1097/ALN.0b013e31829e4b42
Anesthesiology September 2013, Vol. 119, 732–733. https://doi.org/10.1097/ALN.0b013e31829e4c94
Anesthesiology September 2013, Vol. 119, 733. https://doi.org/10.1097/ALN.0b013e31829e6e32
Anesthesiology September 2013, Vol. 119, 733–735. https://doi.org/10.1097/ALN.0b013e31829ff2f4
Anesthesiology September 2013, Vol. 119, 735–736. https://doi.org/10.1097/ALN.0b013e31829ff30f
Anesthesiology September 2013, Vol. 119, 736–737. https://doi.org/10.1097/ALN.0b013e31829fffdb
Anesthesiology September 2013, Vol. 119, 737–738. https://doi.org/10.1097/ALN.0b013e3182a05cf0
Anesthesiology September 2013, Vol. 119, 738–739. https://doi.org/10.1097/ALN.0b013e3182a068d1
Anesthesiology September 2013, Vol. 119, 739–740. https://doi.org/10.1097/ALN.0b013e3182a05a7f
Anesthesiology September 2013, Vol. 119, 740–741. https://doi.org/10.1097/ALN.0b013e3182a06872

Reviews of Educational Material

Anesthesiology September 2013, Vol. 119, 742. https://doi.org/10.1097/ALN.0b013e318295a293
Anesthesiology September 2013, Vol. 119, 742–743. https://doi.org/10.1097/ALN.0b013e31829ff20c

Anesthesiology Reflections from the Wood Library-Museum

Anesthesiology September 2013, Vol. 119, 500. https://doi.org/10.1097/ALN.0b013e3182a79d2c
Anesthesiology September 2013, Vol. 119, 620. https://doi.org/10.1097/ALN.0b013e3182a79d40
Anesthesiology September 2013, Vol. 119, 697. https://doi.org/10.1097/ALN.0b013e3182a79d51
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