Key result
In a patient with refractory hypotension following cardiac arrest, the addition of vasopressin and hydrocortisone infusions successfully restored vascular tone and allowed for the tapering of high-dose noradrenaline.
Case Report (n=1)
Vasoplegic syndrome should be considered in trauma and post-cardiac arrest patients with refractory hypotension, and a multimodal strategy including vasopressin and steroids can successfully restore vascular tone.
May support adjunctive use in refractory post-arrest shock; hypothesis-generating and requires prospective trials before practice change.
A 26 year old male presented to the emergency department with alleged history of RTA and sustained run over injury to right lower limb. On examination his vitals were HR-132/min. BP-70/42 mmHg SpO2 -97% with room air. He was papery pale, drowsy and arousable to calls. A provisional diagnosis of severe hypovolemic shock was made. 16G Venflon was secured and resuscitation initiated with crystalloids and colloids. Blood samples sent for routine investigations (CBC, RFT) and blood grouping, typing and coagulation parameters. Meanwhile during resuscitation patient had cardiac
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Suresh et al. (2020) conducted a case report in Refractory hypotension / Vasoplegic syndrome (n=1). Vasopressin and hydrocortisone was evaluated on Hemodynamic stability (MAP > 65 mmHg) and tapering of noradrenaline. In a patient with refractory hypotension following cardiac arrest, the addition of vasopressin and hydrocortisone infusions successfully restored vascular tone and allowed for the tapering of high-dose noradrenaline.
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