Vasoplegic syndrome after off-pump coronary artery bypass surgery

Vasoplegic syndrome after off-pump coronary artery bypass surgery

Author Gomes, Walter José Autor UNIFESP Google Scholar
Erlichman, Manes R. Autor UNIFESP Google Scholar
Batista, Mario L. Google Scholar
Knobel, Marcos Google Scholar
Almeida, Dirceu R. Google Scholar
Carvalho, Antonio C. Google Scholar
Catani, Roberto Google Scholar
Buffolo, Enio Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Objective: the vasoplegic syndrome (VS) has been implicated in life-threatening complications after open heart surgery, where the whole-body inflammatory reaction is attributed to the cardiopulmonary bypass (CPB). Off-pump coronary artery bypass grafting (OPCAB) has been recently achieving growing enthusiasm mainly due avoiding the side effects of CPB. However herein the occurrence of VS in OPCAB is reported. Methods: the vasoplegic syndrome usual findings occurring in the early postoperative period include severe hypotension, tachycardia, normal or elevated cardiac output and low systemic vascular resistance. Four patients underwent to OPCAB presented all the signs of VS intraoperatively or within the first 6 postoperative h. Results: the patients needed aggressive vasoactive drug support for hemodynamic stabilization and all of them developed complications. These patients also had tendency to require administration of blood and blood derivatives due to diffuse and oozing type bleeding. Mean intensive care unit stay of surviving patients was 70 h and mean period of postoperative hospitalization was 9 days. Tumor necrosis factor-ot blood levels in one patient were elevated postoperatively though no signs of infection were observed. One patient died. Conclusions: Although vasoplegic syndrome can complicate OPCAB surgery, the rationale for avoiding CPB remains valid considering the benefits provided by OPCAB. (C) 2002 Elsevier Science B.V. All fights reserved.
Keywords heart surgery
coronary artery bypass surgery
systemic inflammatory response syndrome
Language English
Date 2003-02-01
Published in European Journal of Cardio-thoracic Surgery. Amsterdam: Elsevier B.V., v. 23, n. 2, p. 165-169, 2003.
ISSN 1010-7940 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 165-169
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000180995200007

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