Vitamin B12 (hydroxocobalamin) administration in the management of persistent vasoplegic shock
Vasoplegia, characterized by low systemic vascular resistance despite normal to high cardiac output, can result from various conditions, including cardiac surgery, and progress to vasoplegic shock if untreated. This case study involves a male in his 70s with multiple risk factors, including a left v...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-01-01
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| Series: | Saudi Journal of Anaesthesia |
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| Online Access: | https://journals.lww.com/10.4103/sja.sja_463_24 |
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| author | Jibran Ikram Cassandra L. Williams Aariya Srinivasan Jose L. Diz Ferre Sabry Ayad |
| author_facet | Jibran Ikram Cassandra L. Williams Aariya Srinivasan Jose L. Diz Ferre Sabry Ayad |
| author_sort | Jibran Ikram |
| collection | DOAJ |
| description | Vasoplegia, characterized by low systemic vascular resistance despite normal to high cardiac output, can result from various conditions, including cardiac surgery, and progress to vasoplegic shock if untreated. This case study involves a male in his 70s with multiple risk factors, including a left ventricular ejection fraction of 35%, who developed vasoplegia after taking lisinopril on the day of his elective coronary artery bypass graft (CABG) surgery. Despite initial management with vasopressors, the patient’s condition necessitated postponing the CABG. The patient was stabilized in the ICU with a combination of vasopressin, epinephrine, norepinephrine, and hydrocortisone, and his vasoplegia was successfully treated with hydroxocobalamin, leading to significant clinical improvement. The patient later underwent a successful CABG without preoperative ACE inhibitor use. This case underscores the potential of hydroxocobalamin as an effective treatment for vasoplegia, particularly following ACE inhibitor use in cardiac surgery patients. |
| format | Article |
| id | doaj-art-8e6ec3729b414e6fae37c2e1d73a761c |
| institution | Kabale University |
| issn | 1658-354X 0975-3125 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Saudi Journal of Anaesthesia |
| spelling | doaj-art-8e6ec3729b414e6fae37c2e1d73a761c2025-02-06T07:24:16ZengWolters Kluwer Medknow PublicationsSaudi Journal of Anaesthesia1658-354X0975-31252025-01-0119111511710.4103/sja.sja_463_24Vitamin B12 (hydroxocobalamin) administration in the management of persistent vasoplegic shockJibran IkramCassandra L. WilliamsAariya SrinivasanJose L. Diz FerreSabry AyadVasoplegia, characterized by low systemic vascular resistance despite normal to high cardiac output, can result from various conditions, including cardiac surgery, and progress to vasoplegic shock if untreated. This case study involves a male in his 70s with multiple risk factors, including a left ventricular ejection fraction of 35%, who developed vasoplegia after taking lisinopril on the day of his elective coronary artery bypass graft (CABG) surgery. Despite initial management with vasopressors, the patient’s condition necessitated postponing the CABG. The patient was stabilized in the ICU with a combination of vasopressin, epinephrine, norepinephrine, and hydrocortisone, and his vasoplegia was successfully treated with hydroxocobalamin, leading to significant clinical improvement. The patient later underwent a successful CABG without preoperative ACE inhibitor use. This case underscores the potential of hydroxocobalamin as an effective treatment for vasoplegia, particularly following ACE inhibitor use in cardiac surgery patients.https://journals.lww.com/10.4103/sja.sja_463_24coronary artery bypass grafthydroxocobalaminvasoplegic shock |
| spellingShingle | Jibran Ikram Cassandra L. Williams Aariya Srinivasan Jose L. Diz Ferre Sabry Ayad Vitamin B12 (hydroxocobalamin) administration in the management of persistent vasoplegic shock Saudi Journal of Anaesthesia coronary artery bypass graft hydroxocobalamin vasoplegic shock |
| title | Vitamin B12 (hydroxocobalamin) administration in the management of persistent vasoplegic shock |
| title_full | Vitamin B12 (hydroxocobalamin) administration in the management of persistent vasoplegic shock |
| title_fullStr | Vitamin B12 (hydroxocobalamin) administration in the management of persistent vasoplegic shock |
| title_full_unstemmed | Vitamin B12 (hydroxocobalamin) administration in the management of persistent vasoplegic shock |
| title_short | Vitamin B12 (hydroxocobalamin) administration in the management of persistent vasoplegic shock |
| title_sort | vitamin b12 hydroxocobalamin administration in the management of persistent vasoplegic shock |
| topic | coronary artery bypass graft hydroxocobalamin vasoplegic shock |
| url | https://journals.lww.com/10.4103/sja.sja_463_24 |
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