[HSF] Post-Op Vasoplegia

[Tea Acuff]

In salvage situations nothing works more than 5% of the time...excepting lies, of course.
tea 


----- Original Message ----
From: Michael Firstenberg <msfirst at gmail.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Friday, September 21, 2007 10:23:53 AM
Subject: Re: [HSF] Post-Op Vasoplegia


Having used M.Blue times - usually in salvage situations, I can say with 95%
confidence - doesn't work (yet, I still use it).  More of what I am asking
about are these patients who are still vasodilated weeks post-op.


-michael


On 9/21/07, mdavalle at aol.com <mdavalle at aol.com> wrote:
>
> Methylene Blue pre pump for patients on ACE inhibitors.
>
>
> -----Original Message-----
> From: Michael Firstenberg <msfirst at gmail.com>
> To: OpenHeart-L at lists.hsforum.com
> Sent: Fri, 21 Sep 2007 9:59 am
> Subject: [HSF] Post-Op Vasoplegia
>
>
>
> Although it is not uncommon is some of our patients to be vasodilated
> right
> after surgery - obviously those on milrinone or pre-op ACEi, but every
> once
> in a while we have a patient who basically has no vascular tone.  These
> days
> often require levo/vasopressin/etc for long periods of time and never seem
> to bounce back.  Unfortunately, most of them seem to not make it and often
> this chronic pressor requirement plays a role.  While sepsis may play an
> obvious role, rarely is there a source and typically these patients tend
> to
> be on/off abx anyhow.
>
> ... and we go thru the work-ups for hypothyroid, testosterone levels,
> adrenal insuff., etc - rarely does anything come up and if it does, fixing
> that problem usually does not help.
>
> Any thoughts?
>
>
> -michael
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