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The use of intravenous hydroxocobalamin as a rescue in methylene blue-resistant vasoplegic syndrome in cardiac surgery


1 Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Florida, FL, USA
2 Division of Cardiothoracic Anesthesiology, Mayo Clinic Florida, FL, USA

Correspondence Address:
Archer Kilbourne Martin
4500 San Pablo Road, Jacksonville, FL 32224
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_88_17

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Year : 2017  |  Volume : 20  |  Issue : 4  |  Page : 462-464

 

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Vasoplegic syndrome is a well-recognized complication during cardiopulmonary bypass (CPB) and is associated with increased morbidity and mortality, especially when refractory to conventional vasoconstrictor therapy. This is the first reported case of vasoplegia on CPB unresponsive to methylene blue whereas responsive to hydroxocobalamin, which indicates that the effect of hydroxocobalamin outside of the nitric oxide system is significant or that the two drugs have a synergistic effect in one or multiple mechanisms.






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1 Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Florida, FL, USA
2 Division of Cardiothoracic Anesthesiology, Mayo Clinic Florida, FL, USA

Correspondence Address:
Archer Kilbourne Martin
4500 San Pablo Road, Jacksonville, FL 32224
USA
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_88_17

Rights and Permissions

Vasoplegic syndrome is a well-recognized complication during cardiopulmonary bypass (CPB) and is associated with increased morbidity and mortality, especially when refractory to conventional vasoconstrictor therapy. This is the first reported case of vasoplegia on CPB unresponsive to methylene blue whereas responsive to hydroxocobalamin, which indicates that the effect of hydroxocobalamin outside of the nitric oxide system is significant or that the two drugs have a synergistic effect in one or multiple mechanisms.






[FULL TEXT] [PDF]*


        
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