Cardiothoracic & vascular anesthesia
Hydroxocobalamin Versus Methylene Blue for the Treatment of Vasoplegic Shock Associated With Cardiopulmonary Bypass
Authors' conclusion
Hydroxocobalamin was associated with a greater reduction in vasopressor requirements than methylene blue in treating VS associated with cardiopulmonary bypass.
Study context
- Population
- Adult cardiothoracic surgery patients with vasoplegic shock associated with CPB
- Participants
- 120 patients
- Exposure
- Hydroxocobalamin vs methylene blue
- Hydroxocobalaminn = 77
- Methylene bluen = 43reference
- Outcome
- Change in vasopressor requirements (1, 3, 6, 12 and 24 hours after initiation)
- Follow-up
- First 24 hours
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Vasopressor requirements (norepinephrine equivalent) · hour 1
| Group | Value | Baseline |
|---|---|---|
| Hydroxocobalamin | mean 0.27 (95% CI 0.21–0.33) µg/kg/min | 0.34 µg/kg/min (95% CI 0.28-0.4) |
| Methylene blue | mean 0.44 (95% CI 0.38–0.51) µg/kg/min | 0.59 µg/kg/min (95% CI 0.52-0.66) |
Value
Hydroxocobalaminmean 0.27 (95% CI 0.21–0.33) µg/kg/min
Methylene bluemean 0.44 (95% CI 0.38–0.51) µg/kg/min
Baseline
Hydroxocobalamin0.34 µg/kg/min (95% CI 0.28-0.4)
Methylene blue0.59 µg/kg/min (95% CI 0.52-0.66)
- Hydroxocobalamin vs Methylene blue: P < 0.001 — hour 1
Observational data: associations, not effects.
Secondary outcomes
MAP · hour 1
P < 0.001
Baseline Hydroxocobalamin 65 mmHg (95% CI 63-67) · Methylene blue 57 mmHg (95% CI 54-59)
- Mean arterial pressure (MAP): baseline difference p < 0.001
MAP · hour 1
- MAP increased significantly from baseline at each time point within each group
- Significantly greater increase in MAP with hydroxocobalamin after adjustment for baseline characteristics
Original publication
Hydroxocobalamin Versus Methylene Blue for the Treatment of Vasoplegic Shock Associated With Cardiopulmonary Bypass. J Cardiothorac Vasc Anesth. Published 19 July 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →