| Vasopressin therapy for vasoplegic syndrome following cardiopulmonary bypass. | |
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MedLine Citation:
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PMID: 12643457 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Paolo Masetti; Suzan F Murphy; Nicholas T Kouchoukos |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of cardiac surgery Volume: 17 ISSN: 0886-0440 ISO Abbreviation: J Card Surg Publication Date: 2002 Nov-Dec |
Date Detail:
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Created Date: 2003-03-19 Completed Date: 2003-05-30 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8908809 Medline TA: J Card Surg Country: United States |
Other Details:
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Languages: eng Pagination: 485-9 Citation Subset: IM |
Affiliation:
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Division of Cardiovascular and Thoracic Surgery and the Heart Center, Missouri Baptist Medical Center, St. Louis, Missouri, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic alpha-Agonists
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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:
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0/Adrenergic alpha-Agonists; 0/Adrenergic alpha-Antagonists; 0/Vasoconstrictor Agents; 11000-17-2/Vasopressins |
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