SUMMARY
Vasodilatory shock after cardiac surgery using extracorporeal circulation, characterized by hypotension, low systemic vascular resistance in the presence of normal cardiac output is a frequent complication of cardiovascular surgery. It is associated with a diffuse systemic inflammatory response of the organism, mediated through cell hyperpolarization, high levels of inducible nitric oxide and a relative deficiency of vasopressin.

Cardiosurgery is strong trigger of the vasoplegic syndrome, due to its association with nitric oxide production and vasopressin deficiency. The article provides an overview of current options for the pharmacological treatment of vasodilatory shock. Postoperative vasoplegic shock is managed with vasopressors, of which norepinephrine is considered to be the first-line agent . Recent investigations support the use of noncatecholamine vasopressors, vasopressin in particular, to restore vascular tone. Alternative agents, including methylene blue, hydroxycobalamin, corticosteroids, and angiotensin II, also are capable of restoring vascular tone, but their mechanism of action and effect on survival is unclear.
Key words: pathophysiology of vasodilatory shock, cardiosurgery, extracorporeal circulation, nitric oxide, norepinefrin, vasopressin.
Lek Obz, 2021, 70 (4): 126 – 131

Ivan JOB, Imrich BEER, Miroslav FERENČÍK, Radovan ZACHAROVSKÝ

Oddelenie anestéziológie a intenzívnej medicíny, SÚSCCH, a. s., Banská Bystrica
Oddelenie anestéziológie a intenzívnej medicíny, NsP Prievidza so sídlom v Bojniciach
Klinika kardiochirurgie, SÚSCCH, a. s., Banská Bystrica

Cite:
JOB I., BEER I., FERENČÍK M., ZACHAROVSKÝ R.: Extracorporary circulation as a trigger for vasodilatory shock after cardiac surgery. Lek Obz, 2021, 70 (4): 126 – 131