Terlipressin infusion for prevention of vasoplegic syndrome in patients treated with angiotensin II receptor antagonist


Preoperative use of renin angiotensin system antagonists has been considered an independent risk factor for development of vasoplegic syndrome. The aim of this study was to demonstrate efficacy of prophylactic terlipressin infusion for prevention of vasoplegic syndrome in patients treated

Introduction

Vasoplegic syndrome occurring after weaning from cardiopulmonary bypass (CBP) has become an increasingly recognized perioperative issue in cardiac anesthesia. It is characterized by severe hypotension refractory to vasopressor therapy in the absence of other identifiable causes 

Vasoplegic syndrome could occur in up to 25% of postoperative patients after cardiac surgery. The exact etiology of this syndrome is not clear, and multiple risk factors have been proposed in the development of the vasogenic syndrome. However, preoperative use of renin-angiotensin system antagonists was considered as an independent risk factor for the development of vasogenic syndrome 

Administration of α adrenergic agonists has been considered the standard management for patients with vasoplegic syndrome occurring after weaning from CBP. However, administration of high doses of α adrenergic agonists has been associated with the development of deleterious side effects, including peripheral or mesenteric ischemia 

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