Why the study?
Does angiotensin II and hemoadsorption therapy improve severe vasoplegic syndrome unresponsive to conventional therapy after cardiac surgery?
Does angiotensin II and hemoadsorption therapy improve severe vasoplegic syndrome unresponsive to conventional therapy after cardiac surgery?
Angiotensin II combined with hemoadsorption therapy may be a successful rescue treatment for severe, refractory vasoplegic syndrome following cardiac surgery.
May support angiotensin II plus hemoadsorption in refractory post-CPB VS; hypothesis-generating case report requiring prospective trials.
Vasoplegic syndrome (VS) is a common complication after cardiac surgery with cardiopulmonary bypass (CPB). The main pathophysiology mechanism of VS includes a systemic inflammatory response syndrome due to surgical trauma, release of pro-inflammatory mediators caused by blood contact with foreign surfaces of heart-lung machine (pump and tubing) and endothelial dysfunction due to loss of pulsatile flow. Preoperative use of angiotensin-converting enzyme inhibitors and beta-blockers, coronary surgery and longer duration of CPB increase the incidence of VS. VS is characterized by hypotension with high cardiac output and low systemic resistance; treatment includes fluid resuscitation and vasopressors. Current authors report a case of cardiac VS, unresponsive to conventional therapy and successfully treated with angiotensin II (ATII) and hemoadsorption therapy.
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Lucchelli et al. (2025) studied this question.
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