Current therapy for sepsis and future immunotherapeutic approaches are reviewed.

Patients treated with Factor VIIa had significantly worse outcomes than cohorts who did not receive the drug.

Long-chain triglyceride emulsion was associated with fewer recurrences of asystole after resuscitation and lower myocardial bupivacaine concentrations. See the accompanying Editorial View on  page 1151 

Glucuronide metabolites of buprenorphine may contribute to its analgesic effects.

Bispectral index frequently correlates poorly with end tidal volatile anesthetic gas concentrations. See the accompanying Editorial View on  page 1149 

β-blockers are commonly used for prevention and treatment of perioperative myocardial infarction yet may have an unfavorable risk profile. This review presents evidence on the molecular, cellular, and physiologic consequences of genetic variation in the enzyme that metabolizes β-blockers, cytochrome p450 2D6. Genetic variation may alter adrenergic signaling and subsequently play a role in the variations in response to β-blocker therapy for patients with perioperative myocardial infarction.

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Simulation studies are becoming increasingly more popular for training and assessment of clinical skills. In this study, residents and fellows (N = 35) were evaluated using 10 simulation scenarios of perioperative pediatric anesthesia care. The content-based checklist scores were deemed reliable and valid. Overall performance correlated with experience. The lowest scores were achieved on the appendicitis with sepsis scenario (45.5%) and the highest scores were achieved on the bronchospasm scenario (66.0%). These scenarios may be helpful for competency assessments for pediatric anesthesiologists.

Interactions between opioids and serotonergic agents can result in a life-threatening serotonin syndrome. This paper describes two case studies of patients who developed drug-induced serotonin syndrome. Both patients were eventually properly diagnosed, medications discontinued, and symptoms resolved. These cases emphasize the need for increased knowledge of drug-drug interactions, and clinical diagnostic criteria for serotonin syndrome. Furthermore, these cases support the ability to prevent mortality from serotonin syndrome with early and accurate diagnosis and treatment.