Medicine:Vasoplegic syndrome
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Vasoplegic syndrome or Vasoplegia syndrome (VPS) is a postperfusion syndrome characterized by low systemic vascular resistance and a high cardiac output.
Causes
VPS occurs more frequently after on pump CABG surgery versus off pump CABG surgery.[1] Hypothermia during surgery may also increase ones risk of developing VPS post operatively.[2]
Diagnosis
Definition
Vasoplegic syndrome is defined as low systemic vascular resistance (SVR index <1,600 dyn∙sec/cm5/m2) and high cardiac output (cardiac index >2.5 L/min/m2) within the first 4 postoperative hours.[3]
Treatment
There is some evidence to support the use of methylene blue in the treatment of this condition.[4][5]
Epidemiology
One case series reports a rate of 1 in 120 cases.[6]
References
- ↑ "Is incidence of postoperative vasoplegic syndrome different between off-pump and on-pump coronary artery bypass grafting surgery?". Eur J Cardiothorac Surg 34 (4): 820–5. October 2008. doi:10.1016/j.ejcts.2008.07.012. PMID 18715792.
- ↑ "[Study of mechanism of vasoplegic syndrome for open heart surgery]" (in zh). Zhonghua Yi Xue Za Zhi 82 (2): 127–30. January 2002. PMID 11953144.
- ↑ Iribarren, J.; Jimenez, J.; Brouard, M.; Lorenzo, J.; Perez, R.; Lorente, L.; Nuñez, C.; Lorenzo, L. et al. (2007-03-22). "Critical Care | Full text | Vasoplegic syndrome after cardiopulmonary bypass surgery – associated factors and clinical outcomes: a nested case-control study". Critical Care 11 (2): P254. doi:10.1186/cc5414.
- ↑ "BestBets: Is Methylene Blue of benefit in treating adult patients who develop vasoplegic syndrome during Cardiac Surgery". http://www.bestbets.org/bets/bet.php?id=911.
- ↑ "Methylene blue and vasoplegia: who, when, and how?". Mini Rev Med Chem 8 (5): 472–90. May 2008. doi:10.2174/138955708784223477. PMID 18473936. http://www.bentham-direct.org/pages/content.php?MRMC/2008/00000008/00000005/0006N.SGM.
- ↑ "[Vasoplegic syndrome: a new dilemma]". Rev Assoc Med Bras 40 (4): 304. 1994. PMID 7633508.
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