Key result
High-dose vitamin B12 shows promise as a nontoxic rescue therapy for vasodilatory shock.
Why the study?
Established therapies for vasodilatory shock do not target gasotransmitters that drive vasodilation, prompting interest in micronutrients like vitamin B12 as rescue therapy.
Does high-dose vitamin B12 (hydroxocobalamin) improve outcomes in patients with vasodilatory shock?
Does high-dose vitamin B12 (hydroxocobalamin) improve outcomes in patients with vasodilatory shock?
Answers are grounded in this paper and cite their sources.
This narrative review outlines the pathophysiologic rationale and current literature for using high-dose vitamin B12 (hydroxocobalamin) as a rescue therapy in vasodilatory shock.
Vasodilatory shock, as observed in postoperative states and sepsis, is hallmarked by low systemic vascular resistance and low blood pressure compensated by increased cardiac output. Gasotransmitters, such as nitric oxide and hydrogen sulfide, are implicated in the development and perpetuation of vasodilatory shock. Established therapies do not target these physiologic drivers of vasodilation. Due to their nontoxic and pleotropic effects, micronutrients are being used as rescue therapy in postoperative vasoplegia and septic shock. Here, we outline the pathophysiology of vasodilatory shock, describe the rationale for vitamin B12 (hydroxocobalamin) in vasodilatory shock, and identify literature evaluating its use in vasoplegic states.
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Patel et al. (2019) conducted a review in Vasodilatory shock. Vitamin B12 (hydroxocobalamin) was evaluated. High-dose vitamin B12 (hydroxocobalamin) is being evaluated as a rescue therapy for vasodilatory shock due to its nontoxic and pleotropic effects targeting physiologic drivers of vasodilation.
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