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Ann Thorac Surg 2007;83:715-723
© 2007 The Society of Thoracic Surgeons

Reviews

Selecting a Vasopressor Drug for Vasoplegic Shock After Adult Cardiac Surgery: A Systematic Literature Review

Moritoki Egi, MDa, Rinaldo Bellomo, MDa,*, Christoph Langenberg, MDa, Michael Haase, MDa, Anja Haase, B Pharma, Laurie Doolan, MDb, George Matalanis, MDc, Siven Seevenayagam, MDc, Brian Buxton, MDc

a Department of Intensive Care and Medicine, University of Melbourne, Austin Hospital, Heidelberg Victoria, Australia
b Department of Anesthesia, Austin Hospital, Heidelberg Victoria, Australia
c Department of Cardiac Surgery, Austin Hospital, Heidelberg Victoria, Australia

* Address correspondence to Dr Bellomo, Department of Intensive Care, Austin Hospital, 145 Studley Rd, Heidelberg Victoria, 3084 Australia. (Email: rinaldo.bellomo{at}austin.org.au).

The choice of vasopressors to treat vasodilatory shock after cardiac surgery is a matter of controversy. We have systematically reviewed the literature and found that the data are insufficient to guide choice of agent. However, we found sufficient evidence that when a target blood pressure can not be achieved with a single agent, addition of another is more likely to help achieve the blood pressure target. We also found that there is no evidence that vasopressors induce organ ischemia. Finally, the lack of high quality data indicate that large multicenter trials are needed in this field.




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J. G.T. Augoustides
Management of Vasoplegia After Cardiopulmonary Bypass: Role of Prostaglandin Inhibition
Ann. Thorac. Surg., November 1, 2007; 84(5): 1796 - 1796.
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M. Egi and R. Bellomo
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Ann. Thorac. Surg., November 1, 2007; 84(5): 1796 - 1796.
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