Vasoplegia During Cardiac Surgery: Current Concepts and Management

被引:180
作者
Fischer, Gregory W. [1 ]
Levin, Mathew A. [1 ]
机构
[1] Mt Sinai Med Ctr, Dept Anesthesiol, One Gustave L Levy Pl,Box 1010, New York, NY 10029 USA
关键词
vasoplegia; cardiac surgery; cardiopulmonary bypass;
D O I
10.1053/j.semtcvs.2010.09.007
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Vasoplegic syndrome (VS) is a recognized and relatively common complication of cardiopulmonary bypass (CPB), appearing with an incidence ranging between 5% and 25%. It is characterized by significant hypotension, high or normal cardiac outputs and low systemic vascular resistance (SVR), and increased requirements for fluids and vasopressors during or after CPB. Patients developing VS are at increased risk for death and other major complications following cardiac surgery. This review will focus on the pathophysiology and contemporary strategies of treating VS encountered after CPB. © 2010 Elsevier Inc.
引用
收藏
页码:140 / 144
页数:5
相关论文
共 25 条
[1]   Management of vasodilatory shock after cardiac surgery: Identification of predisposing factors and use of a novel pressor agent [J].
Argenziano, M ;
Chen, JM ;
Choudhri, AF ;
Cullinane, S ;
Garfein, E ;
Weinberg, AD ;
Smith, CR ;
Rose, EA ;
Landry, DW ;
Oz, MC .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 1998, 116 (06) :973-980
[2]   INTERLEUKIN-1 ACTIVATES SOLUBLE GUANYLATE-CYCLASE IN HUMAN VASCULAR SMOOTH-MUSCLE CELLS THROUGH A NOVEL NITRIC OXIDE-INDEPENDENT PATHWAY [J].
BEASLEY, D ;
MCGUIGGIN, M .
JOURNAL OF EXPERIMENTAL MEDICINE, 1994, 179 (01) :71-80
[3]   Low systemic vascular resistance after cardiopulmonary bypass: Incidence, etiology, and clinical importance [J].
Carrel, T ;
Engelberger, L ;
Mohacsi, P ;
Neidhart, P ;
Schmidli, J .
JOURNAL OF CARDIAC SURGERY, 2000, 15 (05) :347-353
[4]   Systemic inflammatory response syndrome after cardiac operations [J].
Cremer, J ;
Martin, M ;
Redl, H ;
Bahrami, S ;
Abraham, C ;
Graeter, T ;
Haverich, A ;
Schlag, G ;
Borst, HG .
ANNALS OF THORACIC SURGERY, 1996, 61 (06) :1714-1720
[5]   Should methylene blue be the drug of choice to treat vasoplegias caused by cardiopulmonary bypass and anaphylactic shock? [J].
Evora, PRB .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2000, 119 (03) :632-633
[6]  
Gomes WJ, 1998, J CARDIOVASC SURG, V39, P619
[7]   Methylene blue during cardiopulmonary bypass to treat refractory hypotension in septic endocarditis [J].
Grayling, M ;
Deakin, CD .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2003, 125 (02) :426-427
[8]   High-dose vasopressin is not superior to norepinephrine in septic shock [J].
Klinzing, S ;
Simon, M ;
Reinhart, K ;
Bredle, DL ;
Meier-Hellmann, A .
CRITICAL CARE MEDICINE, 2003, 31 (11) :2646-2650
[9]   Reversal of severe vasoplegia with single-dose methylene blue after heart transplantation [J].
Kofidis, T ;
Strüber, M ;
Wilhelmi, M ;
Anssar, M ;
Simon, A ;
Harringer, W ;
Haverich, A .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2001, 122 (04) :823-824
[10]   Mechanisms of disease: The pathogenesis of vasodilatory shock [J].
Landry, DW ;
Oliver, JA .
NEW ENGLAND JOURNAL OF MEDICINE, 2001, 345 (08) :588-595