Risk factors for post-cardiopulmonary bypass vasoplegia in patients with preserved left ventricular function

Mekontso-Dessap, Armand; Houël, Rémi; Soustelle, Céline; Kirsch, Matthias; Thébert, Dominique; Loisance, D

doi:10.1016/s0003-4975(01)02486-9

Cited by 147 publications

(113 citation statements)

References 17 publications

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“…Observing the other 55 studies we can find: 1) one study (1.67%) based on evidences through metanalysis of literature [13]; 2) seven review articles (11.67%) [4,14,23]. The other bibliographical citations in number of 44 (73.33%) are distributed as case reports (great majority) [24][25][26][27][28][29][30][31][32][33][34][35][36], letters [37][38][39][40][41][42][43][44], technical aspects of the MB use [45][46][47][48][49][50] and other studies involving risk [51,52], the VS incidence in the "off pump" CABG and the possibility of MB use in anaphylaxis and anaphylactic shock [53], also a proposal of the author of this text ( Figure 4) [54][55][56][57][58]. The presented numbers, surely, are not totally compatible with the total of publications, but it is possible to assume that this imprecision does not affect the general vision of the problem.…”

Section: Resultsmentioning

confidence: 99%

Methylene blue for vasoplegic syndrome treatment in heart surgery: fifteen years of questions, answers, doubts and certainties

Évora¹,

Ribeiro

Vicente³

et al. 2009

Rev Bras Cir Cardiovasc

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Azul de metileno no tratamento da síndrome vasoplégica em cirurgia cardíaca. Quinze anos de perguntas, respostas, dúvidas e certezasMethylene blue for vasoplegic syndrome treatment in heart surgery. Fifteen years of questions, answers, doubts and certainties AbstractObjective: There is strong evidence that methylene blue (MB), an inhibitor of guanylate cyclase, is an excellent therapeutic option for vasoplegic syndrome (VS) treatment in heart surgery. The aim of this article is to review the MB's therapeutic function in the vasoplegic syndrome treatment.Methods: Fifteen years of literature review.Results: 1) Heparin and ACE inhibitors are risk factors; 2) In the recommended doses it is safe (the lethal dose is 40 mg/ kg); 3) The use of MB does not cause endothelial dysfunction; 4) The MB effect appears in cases of nitric oxide (NO) upregulation; 5) MB is not a vasoconstrictor, by blocking of the GMPc system it releases the AMPc system, facilitating the norepinephrine vasoconstrictor effect; 6) The most used dosage is 2 mg/kg as IV bolus followed by the same continuous infusion because plasmatic concentrations strongly decays in the first 40 minutes; 7) There is a possible "window of opportunity" for the MB's effectiveness.Conclusions: Although there are no definitive multicentric studies, the MB used to treat heart surgery VS, at the present time, is the best, safest and cheapest option, being a Brazilian contribution for the heart surgery.

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Section: Resultsmentioning

confidence: 99%

Methylene blue for vasoplegic syndrome treatment in heart surgery: fifteen years of questions, answers, doubts and certainties

Évora¹,

Ribeiro

Vicente³

et al. 2009

Rev Bras Cir Cardiovasc

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“…51,52 Stopping these drugs the day before surgery may reduce the risk of serious intraoperative hypotension. 53 Similarly, if various anticoagulants that are used in the treatment of stroke, atrial fibrillation, and venous thrombosis are not identified in the preoperative period, they may pose a serious risk for procedures such as regional anesthesia. Overall, with the steadily increasing number of drug products (now more than 20,000) in Canada, the opportunities for harmful drug interactions are likely to increase.…”

Section: Improved Identification and Management Of Drug Interactionsmentioning

confidence: 99%

Review article: Improving drug safety for patients undergoing anesthesia and surgery

Orser

Hyland²,

David³

et al. 2012

Can J Anesth/J Can Anesth

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Purpose This article presents a summary of recent advances, including tools and interventions, that are designed to improve drug safety for patients in critical care settings, particularly those undergoing anesthesia and surgery. Principal findings Medication error remains a leading cause of adverse events among patients undergoing anesthesia. Misidentification of ampoules, vials, and syringes is a common source of error. Systems are now being engineered to reduce the likelihood of medication misidentification through approaches such as revision of standards for labelling of drug ampoules and vials and the development of bar code systems that allow ''double checking'' or drug verification in the operating room. Also, efforts are being made to improve medication reconciliation, a process for accurately communicating a patient's medication information during transitions from one healthcare setting to another. Finally, the opportunity exists for anesthesiologists to increase awareness about the rising problem of opioid addiction in patients for whom typical doses are initially prescribed for appropriate indications such as postoperative pain. Conclusions There is a need to improve drug delivery systems in complex critical care environments, particularly the operating room. Anesthesiologists must continue to play a leading role in promoting drug safety in these environments.

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“…We have tried to increase the power and efficacy of rFVIIa by molecular engineering acting on DNA, but no studies. 71,72,73,74,75 …”

Section: Postoperative Bleedingmentioning

confidence: 99%

Intensive Care Management of Patients in the First 24 Hours After Cardiac Surgery

Silva¹,

Sanchez²,

Sanchez³

et al. 2012

Special Topics in Cardiac Surgery

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Risk factors for post-cardiopulmonary bypass vasoplegia in patients with preserved left ventricular function

Cited by 147 publications

References 17 publications

Methylene blue for vasoplegic syndrome treatment in heart surgery: fifteen years of questions, answers, doubts and certainties

Methylene blue for vasoplegic syndrome treatment in heart surgery: fifteen years of questions, answers, doubts and certainties

Review article: Improving drug safety for patients undergoing anesthesia and surgery

Intensive Care Management of Patients in the First 24 Hours After Cardiac Surgery

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