Welcome to my blog which is dedicated to sharing and analyzing cardiology trends and information ranging from the basics, all the way to new, cutting edge discoveries. In this site you will find lectures, journal reviews, guidelines, researches, news ,CMEs and articles. Students and professionals alike are invited. I hope you will enjoy reading and sharing your valuable perspectives too. "Dr.Nabil Paktin , MD.,F.A.C.C."
Thursday, February 27, 2014
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What is "Vasoplegia Syndrome" and how to manage it ???
The development of systemic inflammatory response during cardiopulmonary bypass may cause severe generalized vasodilation , known as "Vasoplegia syndrome", which can result in increased early mortality , especially in heart transplant reciopients.
This syndrome is associated with prolonged cardiopulmonary bypass time , orthotropic heart transplantation , and LV assist devices insertion and is characterized by sever persistent hypotension , metabolic acidosis , decreased SVR and low intracardiac filling pressures , with normal or elevated CO.
Perioperative Risk factors include preoperative ACE inhibitor , CCB or IV heparin use and Poor LV function .
development of Vasoplegia syndrome may be related to the release of Vasodilatory inflammatory mediators , extensive complement activation or vasoactive substance depletion , such as vasopressin .
Although catecholamine therapy is often ineffective , methylene blue (through a nitric oxide- inhibition mechanism ) and vasopressin have been shown to improve outcome .
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