Anestezjologia i Intensywna Terapia <br>Vasoplegic syndrome – current status

Ewa Kucewicz-Czech; Jacek Puzio; Michał Zembala; Bronisław Czech; Jacek Wojarski; Marcin Maruszewski; Piotr Knapik

eISSN: 1897-4252
ISSN: 1731-5530

Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery

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1/2007
vol. 4

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abstract:

Anestezjologia i Intensywna Terapia
Vasoplegic syndrome – current status

Ewa Kucewicz-Czech

,

Jacek Puzio

,

Michał Zembala

,

Bronisław Czech

,

Jacek Wojarski

,

Marcin Maruszewski

,

Piotr Knapik

Kardiochirurgia i Torakochirurgia Polska 2007; 4 (1): 45–48

Online publish date: 2007/04/05

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Low systemic vascular resistance is a recognized complication of cardiopulmonary bypass and it is related to activation of an inflammatory response. A release of proinflammatory cytokines can cause a systemic inflammatory response contributing to generalized profound vasodilatation. Vasoplegia syndrome was defined using the following criteria: hypotension, low filling pressures, normal or elevated cardiac index, low peripheral resistance and metabolic acidosis. Low ventricular ejection fraction, preoperative ACE inhibitors and heparin use are the independent risk factors for the development of postoperative vasoplegia syndrome. Treatment of this syndrome requires the use of vasopressive agents but in some cases prolonged vasoplegia is resistant to norepinephrine. In these situations a single dose of methylene blue can restore systemic vascular resistance. When a dose no greater than 2 mg/kg is administered side effects do not occur. Methylene blue is a nitric oxide inhibitory drug which probably plays an important role in occurrence of vasoplegic syndrome.

keywords:

Anestezjologia i Intensywna Terapia Vasoplegic syndrome – current status

Ewa Kucewicz-Czech , Jacek Puzio , Michał Zembala , Bronisław Czech , Jacek Wojarski , Marcin Maruszewski , Piotr Knapik

vasoplegic syndrome, cardiopulmonary bypass, methylene blue

Anestezjologia i Intensywna Terapia
Vasoplegic syndrome – current status

Ewa Kucewicz-Czech

,

Jacek Puzio

,

Michał Zembala

,

Bronisław Czech

,

Jacek Wojarski

,

Marcin Maruszewski

,

Piotr Knapik