Is incidence of postoperative vasoplegic syndrome different between off-pump and on-pump coronary artery bypass grafting surgery?

Abstract

The incidence of PVS after off-pump CABG surgery was significantly lower than after on-pump CABG surgery.

Reply to Sadaba

“…We very much appreciate the comments by Sadaba [1] and he is correct to highlight the importance of the rho-kinase pathway. From the data presented in our paper [2] and that from earlier studies on the actions of phenoxybenzamine [3,4] it is clear that should an irreversible inhibitor of rhokinase become available it would represent an ideal candidate for the topical treatment of arterial bypass grafts.…”

“…From the data presented in our paper [2] and that from earlier studies on the actions of phenoxybenzamine [3,4] it is clear that should an irreversible inhibitor of rhokinase become available it would represent an ideal candidate for the topical treatment of arterial bypass grafts. The paper from Sun et al reporting the incidence of vasoplegic syndrome (VS) after off-pump coronary artery bypass grafting (OPCAB) draws attention to a remarkable change in the postoperative complications related to this procedure [1].…”

Vasoplegic versus septic shock in cardiac surgery. Possibilities of differentiating between them and implementing appropriate therapy

“…Mortality for the severe forms of vasoplegic shock reaches 25% in spite of employing adequate treatment [1,15,17].…”

“…It is important to note the occurrence of vasoplegia in procedures that do not employ extracorporeal circulation (off-pump), in which the activation of pro-inflammatory cytokines and iNOs appears to be initiated by heparin-protamine administration with all the consequences of the development of SIRS and multi-organ failure due to hypotension refractory to catecholamines [1].…”

“…The mean arterial pressure (MAP) < 70 mm Hg, systemic vascular resistance index (SVRI) < 1400 dyn/s/cm 5 /m 2 , systemic vascular resistance (SVR) < 400 dyn/s/ cm 5 ; cardiac index (CI) > 2.5 l/min/m 2 , central venous pressure (CVP) > 10 mm Hg, and time coincidence: the presence of clinical symptoms 2-12 h after the end of cardiopulmonary bypass (CPB) [1][2][3][4].…”