• Ann Fr Anesth Reanim · May 2012

    Case Reports

    [Vasoplegic syndrome after cardiac surgery with cardiopulmonary bypass].

    • J-J Lehot.
    • Service d'Anesthésie Réanimation, Groupement Hospitalier Est, Hôpital Louis Pradel, 28, avenue du Doyen Lépine, 69677 Bron, France. jean- jacques.lehot@chu- lyon.fr
    • Ann Fr Anesth Reanim. 2012 May 1;31 Suppl 1:S18-21.

    AbstractA 71-year-old valvular patient with cardiac arrhythmia, low ejection fraction, administered angiotensin converting enzyme inhibitor underwent aortic and mitral valvular replacement. Starting during normothermic cardiopulmonary bypass (CPB), hypotension occurred, refractory to phenylephrine, noradrenaline, terlipressin, hydrocortisone and dexchlorpheniramine. After 3 hr of CPB biventricular hyperkinesia, severe hypotension and metabolic acidosis persisted despite volume loading, sodium bicarbonate, adrenaline infusion and intraaortic conterpulsation. Refractory asystole occurred 5 hr postoperatively. The responsability of sepsis and anaphylaxis were ruled out and post-CPB vasoplegic syndrome appeared to be involved. Moderate and severe vasoplegic syndromes are discussed with regards to risk factors, physiology and treatment, including prophylaxis with vasopressin and methylene blue.Copyright © 2012 Elsevier Masson SAS. All rights reserved.

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