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Inicio Revista Española de Anestesiología y Reanimación (English Edition) Vasoplegic syndrome in cardiac surgery: Definitions, pathophysiology, diagnostic...
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Vol. 66. Issue 5.
Pages 277-287 (May 2019)
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Vol. 66. Issue 5.
Pages 277-287 (May 2019)
Review
DOI: 10.1016/j.redare.2018.12.010
Vasoplegic syndrome in cardiac surgery: Definitions, pathophysiology, diagnostic approach and management
Síndrome vasopléjico en cirugía cardíaca: definición, fisiopatología, enfoque diagnóstico y manejo
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D.M. Orozco Vinascoa,
Corresponding author
damorov@yahoo.com

Corresponding author.
, C.A. Triana Schoonewolffb, A.C. Orozco Vinascoc
a Departamento de Anestesia Cardiovascular, Clínica Colsubsidio Calle 100, Instituto del Corazón de Bucaramanga sede Bogotá, Bogotá, Colombia
b Departamento de Anestesia Cardiovascular, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
c Departamento de Anestesia, Hospital Universitario Severo Ochoa, Leganés Madrid, Spain
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Table 1. Diagnostic criteria of vasoplegic syndrome.
Table 2. Differential diagnoses.
Table 3. Vasopressors in vasoplegic syndrome.
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Abstract

Vasoplegic syndrome is a state of vasopressor resistant systemic vasodilation in the presence of a normal cardiac output. Its definition, pathophysiology, risk factors, diagnosis and therapeutic approach will be reviewed in this paper. It occurs frequently during cardiac surgery and is associated with high morbidity and mortality. A search in the LILACS, MEDLINE, and GOOGLE SCHOLAR databases was conducted to find the most relevant papers during the last 18 years.

Prompt identification and diagnosis of patients at risk must be undertaken in order to implement an optimal therapeutic approach. This latter includes early treatment with vasopressors with different mechanisms of action.

Keywords:
Cardiac surgical procedures
Intra-operative complications
Cardiopulmonary bypass
Vasoconstrictors
Vasoplegia
Vasoplegic syndrome
Resumen

El síndrome vasopléjico constituye un estado de vasodilatación sistémica refractaria al uso de vasopresores en presencia de gasto cardíaco normal. En el presente artículo se revisará la definición, fisiopatología, factores predisponentes el enfoque diagnóstico y terapéutico del mismo. Su ocurrencia es frecuente en el perioperatorio de cirugía cardíaca y se asocia a incrementos en morbimortalidad. Se llevó a cabo una búsqueda en las bases de datos LILACS, MEDLINE y GOOGLE SCHOLAR abarcando los artículos relevantes durante los últimos 18 años.

Se debe identificar los pacientes de riesgo en aras de realizar un diagnóstico y tratamiento precoz con vasopresores con diferentes mecanismos de acción.

Palabras clave:
Procedimientos quirúrgicos cardíacos
Complicaciones intraoperatorias
Derivación cardiopulmonar
Vasoconstrictores
Vasoplejía
Síndrome vasopléjico

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