Document Detail


Vasopressin therapy for vasoplegic syndrome following cardiopulmonary bypass.
MedLine Citation:
PMID:  12643457     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hypotension refractory to maximal doses of alpha-adrenergic drugs after cardiac operations employing cardiopulmonary bypass (CPB) has been referred as "vasoplegic syndrome." Vasopressin has been used for its therapy with encouraging results. MATERIAL AND METHODS: 16 patients (mean age 71, range 47 to 84 years) were treated with intravenous vasopressin (0.1-1 IU/min) for hypotension refractory to maximal doses (>30 microg/kg/min) of norepinephrine after undergoing complex cardiac operations employing CPB. Preoperative ejection fraction was 40.5% (mean, range 20% to 60%), preoperative NYHA class was 3.5 (mean). Hemodynamic measurements were obtained one hour before and one hour after beginning vasopressin infusion; urine output was measured for the 4 hours before and the 4 hours after beginning the infusion. Duration of vasopressin treatment was 58.8 +/- 37.3 hours (mean +/- SD). RESULTS: Systolic blood pressure increased from 89.6 +/- 7.9 to 119.6 +/- 10.5 mmHg (mean +/- SD) (p < 0.001); systemic vascular resistance increased from 688.0 +/- 261.7 to 1043.3 +/- 337.1 dyne/s/cm2 (mean +/- SD) (p < 0.001); cardiac index decreased from 2.69 +/- 0.8 to 2.2 +/- 0.5 L/min/m2 (mean +/- SD) (p < 0.008); urine output increased from 36.8 +/- 30.4 to 72.8 +/- 38.2 mL/h (mean +/- SD) (p < 0.001). Seven patients (44%) survived the hospital stay. CONCLUSIONS: High-dose vasopressin is effective in the treatment of the vasoplegic syndrome after cardiac operations employing cardiopulmonary bypass.
Authors:
Paolo Masetti; Suzan F Murphy; Nicholas T Kouchoukos
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  17     ISSN:  0886-0440     ISO Abbreviation:  J Card Surg     Publication Date:    2002 Nov-Dec
Date Detail:
Created Date:  2003-03-19     Completed Date:  2003-05-30     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  485-9     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular and Thoracic Surgery and the Heart Center, Missouri Baptist Medical Center, St. Louis, Missouri, USA.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic alpha-Agonists / therapeutic use
Adrenergic alpha-Antagonists / therapeutic use
Aged
Aged, 80 and over
Blood Pressure / drug effects
Cardiac Output / drug effects
Cardiopulmonary Bypass*
Female
Hospital Mortality
Humans
Hypotension / etiology
Infusions, Intravenous
Male
Middle Aged
Paralysis / mortality,  physiopathology,  therapy*
Postoperative Complications / etiology,  mortality,  physiopathology
Reoperation
Syndrome
Systole / drug effects
Treatment Outcome
Vascular Resistance / drug effects
Vasoconstrictor Agents / therapeutic use*
Vasopressins / therapeutic use*
Chemical
Reg. No./Substance:
0/Adrenergic alpha-Agonists; 0/Adrenergic alpha-Antagonists; 0/Vasoconstrictor Agents; 11000-17-2/Vasopressins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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