Cardiothoracic & vascular anesthesia
Use of Hydroxycobolamin in the Prevention of Vasoplegic Syndrome in Adult Patients Undergoing Cardiopulmonary Bypass: A Controlled Prospective Trial
Authors' conclusion
This study showed that prophylactic hydroxocobalamin can be used effectively to decrease the incidence of vasoplegic syndrome, and total vasopressor dose, as well as improve tissue perfusion in high-risk patients in cardiac surgeries.
Study context
- Population
- Adults 18–60 years at high risk of vasoplegia (≥2 preoperative risk factors) undergoing coronary artery bypass grafting (CABG) and/or valve surgery on cardiopulmonary bypass (CPB)
- Participants
- 30 vs 30
- Comparison
- Hydroxocobalamin 5 g IV vs normal saline at end of CPB
- Group In = 30
- Group IIn = 30reference
- Primary endpoint
- Change in MAP between baseline and all time points (30 and 60 minutes after CPB initiation and 30 and 60 minutes after CPB separation)
Methodological detailsplacebo-controlled, prospective, single-centre, Ain Shams University Hospitals, August 2019 to October 2023
- Placebo-controlled
- Prospective
- Single-centre
- Ain Shams University Hospitals, August 2019 to October 2023
Primary result
As reported in the abstract
- MAP significantly higher in group I vs group II
Further findings
Systemic venous resistance · 30 and 60 minutes after CPB separation
- Significantly higher in group I vs group II
Cardiac index
- Significantly lower in group I vs group II
Norepinephrine requirements and average total dose norepinephrine equivalent · 30 and 60 minutes after CPB separation
- Significantly lower in group I
Serum lactate
- Significantly lower in group I
Vasoplegic shock syndrome and norepinephrine-resistant refractory vasoplegia
- Less frequent in group I; difference statistically significant
Ventilator days, ICU LOS, hospital LOS
- Less frequent in group I; differences not statistically significant
Safety
AKI, shock liver and mortality · 1 week
- Less frequent in group I; differences not statistically significant
Original publication
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