Anaes Cases · Vasopressors & inotropes
The post-CPB vasoplegic syndrome
The hot case — the refractory post-CPB vasoplegia. The vasopressin second-line; the methylene blue third-line; the corticosteroid; the Chatterjee algorithm; the TEE assessment.
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Prompt
After the CPB separation, the patient requires escalating noradrenaline (1.5 mcg/kg/min) with the MAP still 50. Manage.
Presentation
After the CABG on CPB, the patient separated from the bypass but requires escalating noradrenaline (now at 1.5 micrograms/kg/min) with the MAP at 50 mmHg. The cardiac output appears adequate on the TEE. The SVR is very low. Manage.[42309295]
References2ShowHide
- [3]Chatterjee S, et al. Management algorithm for vasoplegic shock after cardiac surgery. Ann Thorac Surg, 2026.PMID 42309294
- [42309295]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.