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Vasoplegic syndrome during Whipple procedure.

Tejesh C Anandaswamy1, Geetha C Rajappa1, Harish Krishnamachar2

  • 1Department of Anaesthesiology, MS Ramaiah Medical College and Hospitals, Bangalore, India.

Journal of Clinical Anesthesia
|February 11, 2017
PubMed
Summary

Vasoplegic syndrome, a rare cause of low blood pressure during surgery, was successfully managed using vasopressin. Prompt vasopressin treatment is crucial for patients with refractory hypotension during noncardiac procedures.

Keywords:
Noncardiac surgeryVasoplegic syndromeVasopressin

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Area of Science:

  • Anesthesiology
  • Critical Care Medicine
  • Surgical Oncology

Background:

  • Vasoplegic syndrome (VS) is characterized by refractory hypotension, typically observed post-cardiac surgery.
  • Its occurrence in noncardiac settings, such as major abdominal surgery, is uncommon.
  • Identifying and managing VS promptly is critical for patient outcomes.

Observation:

  • This case report details a patient undergoing a Whipple procedure who developed severe, refractory hypotension.
  • Standard fluid resuscitation and conventional vasopressors were ineffective in stabilizing the patient's blood pressure.
  • The clinical presentation suggested vasoplegic syndrome in a noncardiac surgical context.

Findings:

  • Successful management of vasoplegic syndrome was achieved using a continuous infusion of vasopressin.
  • Vasopressin administration effectively restored hemodynamic stability during the intraoperative period.
  • This highlights vasopressin as a viable therapeutic option for refractory hypotension in VS.

Implications:

  • The findings suggest that a high index of suspicion for vasoplegic syndrome is warranted even in noncardiac surgery.
  • Early recognition and initiation of vasopressin infusion can be life-saving in patients with risk factors for VS.
  • This case expands the understanding of vasoplegic syndrome management beyond cardiac surgery settings.