The Eurasian Journal of Medicine

Vasoplegia: Mechanism and Management Following Cardiopulmonary Bypass


Department of Cardiology and Vascular Medicine, Universitas Airlangga Faculty of Medicine, Dr. Soetomo General Hospital, Surabaya, Indonesia

Eurasian J Med 2022; 54: 92-99
DOI: 10.5152/eurasianjmed.2022.20394
Read: 2178 Downloads: 714 Published: 28 February 2022

Vasoplegia is defined by hypotension and low systemic vascular resistance despite the normal or elevated cardiac index, a complication frequently following cardiac surgery, carrying high morbidity and mortality rate. Vasoplegia is related with a profound systemic inflammatory response and is mainly mediated by cellular hyperpolarization, a relative vasopressin deficiency, and high levels of inducible nitric oxide, following cardiopulmonary bypass. Cardiopulmonary bypass is a distinct precipitant of vasoplegia, generally due to its association with nitric oxide production and severe vasopressin depletion. Postoperative vasoplegia is usually managed with vasopressors, of which catecholamines are the traditional agents of choice. Recent studies promote the use of non-catecholamine vasopressor (vasopressin) in restoring systemic vascular resistance. Alternative agents are also able to restore vascular tone and improve vasoplegia, including methylene blue, angiotensin II, hydroxocobalamin, and ascorbic acid; however, their effect on patient outcomes is still unclear

Cite this article as: Muhammad R, Dharmadjati BB, Mulia EPB, Rachmi DA. Vasoplegia: Mechanism and management following cardiopulmonary bypass. Eurasian J Med 2022;54(1):92-99.

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