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The ability of H2S to regulate vascular tone, inflammation, oxidative stress, and apoptosis might be particularly useful in the therapeutic management of critical illness. However, neither the inhalation of gaseous H2S, nor the administration of inorganic H2S-releasing salts or slow-releasing H2S-donors are feasible for clinical use. Na2S2O3 is a clinically approved compound with a good safety profile and is able to release H2S, in particular under hypoxic conditions. Pre-clinical studies show promise for Na2S2O3 in the acute management of critical illness. A current clinical trial is investigating the therapeutic potential for Na2S2O3 in myocardial infarct. Pre-eclampsia and COVID-19 pneumonia might be relevant targets for future clinical trials.<\/jats:p>","DOI":"10.3390\/biom12040543","type":"journal-article","created":{"date-parts":[[2022,4,4]],"date-time":"2022-04-04T09:49:41Z","timestamp":1649065781000},"page":"543","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["H2S in Critical Illness\u2014A New Horizon for Sodium Thiosulfate?"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5519-9171","authenticated-orcid":false,"given":"Tamara","family":"Merz","sequence":"first","affiliation":[{"name":"Institute for Anesthesiological Pathophysiology and Process Engineering, Ulm University Medical Center, 89081 Ulm, Germany"},{"name":"Clinic for Anesthesiology and Intensive Care, Ulm University Medical Center, 89081 Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7879-7695","authenticated-orcid":false,"given":"Oscar","family":"McCook","sequence":"additional","affiliation":[{"name":"Institute for Anesthesiological Pathophysiology and Process Engineering, Ulm University Medical Center, 89081 Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7172-5218","authenticated-orcid":false,"given":"Cosima","family":"Brucker","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Nuremberg General Hospital, Paracelsus Medical University, 90419 Nuremberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane","family":"Waller","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Medicine and Psychotherapy, Nuremberg General Hospital, Paracelsus Medical University, 90419 Nuremberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2663-9147","authenticated-orcid":false,"given":"Enrico","family":"Calzia","sequence":"additional","affiliation":[{"name":"Institute for Anesthesiological Pathophysiology and Process Engineering, Ulm University Medical Center, 89081 Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Radermacher","sequence":"additional","affiliation":[{"name":"Institute for Anesthesiological Pathophysiology and Process Engineering, Ulm University Medical Center, 89081 Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Datzmann","sequence":"additional","affiliation":[{"name":"Clinic for Anesthesiology and Intensive Care, Ulm University Medical Center, 89081 Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1097\/ALN.0b013e31823306cf","article-title":"Protective and Detrimental Effects of Sodium Sulfide and Hydrogen Sulfide in Murine Ventilator-Induced Lung Injury","volume":"115","author":"Francis","year":"2011","journal-title":"Anesthesiology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1097\/SHK.0b013e3181674185","article-title":"Hemodynamic and Metabolic Effects of Hydrogen Sulfide during Porcine Ischemia\/Reperfusion Injury","volume":"30","author":"Simon","year":"2008","journal-title":"Shock"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1097\/SHK.0b013e3181d0ee3d","article-title":"Hydrogen Sulfide Does Not Increase Resuscitability in a Porcine Model of Prolonged Cardiac Arrest","volume":"34","author":"Derwall","year":"2010","journal-title":"Shock"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1186\/cc13782","article-title":"Is Pharmacological, H2S-Induced \u201csuspended Animation\u201d Feasible in the ICU?","volume":"18","author":"Asfar","year":"2014","journal-title":"Crit. 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