Abstract
Vasoplegic syndrome is a common occurrence following cardiothoracic surgery and is characterized as a high-output shock state with poor systemic vascular resistance. The pathophysiology is complex and includes dysregulation of vasodilatory and vasoconstrictive properties of smooth vascular muscle cells. Specific bypass machine and patient factors play key roles in occurrence. Research into treatment of this syndrome is limited and extrapolated primarily from that pertaining to septic shock, but is evolving with the expanded use of catecholamine-sparing agents. Recent reports demonstrate potential benefit in novel treatment options, but large clinical trials are needed to confirm.
Keywords:
Angiotensin II; Cardiopulmonary bypass; De-catecholaminization; Hydroxocobalamin; Shock; Vasoplegic syndrome.
MeSH terms
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Adrenal Cortex Hormones / therapeutic use
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Angiotensin II / therapeutic use
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Ascorbic Acid / therapeutic use
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Cardiac Surgical Procedures / adverse effects*
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Cardiac Surgical Procedures / methods
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Dopamine / therapeutic use
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Enzyme Inhibitors / therapeutic use
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Epinephrine / therapeutic use
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Humans
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Methylene Blue / therapeutic use
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Norepinephrine / therapeutic use
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Phenylephrine / therapeutic use
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Sympathomimetics / therapeutic use
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Vascular Resistance / drug effects
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Vascular Resistance / physiology
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Vasoconstrictor Agents / therapeutic use
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Vasoplegia / drug therapy*
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Vasoplegia / etiology
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Vasoplegia / physiopathology*
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Vasopressins / therapeutic use
Substances
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Adrenal Cortex Hormones
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Enzyme Inhibitors
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Sympathomimetics
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Vasoconstrictor Agents
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Vasopressins
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Angiotensin II
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Phenylephrine
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Ascorbic Acid
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Methylene Blue
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Dopamine
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Norepinephrine
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Epinephrine