Vasodilatory Shock (VDS) may occur in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB).
Occurrence: 8% of adults undergoing cardiopulmonary bypass
Criteria for vasodilatory shock:
(2) need for vasoconstrictor therapy
(3) normal or high cardiac index
(4) presence of (a) warm peripheral extremities, (b) palpable pulse (1 or 2+) and (c) capillary refill time < 2 seconds
The peak arterial lactate concentration is elevated in the patients.
(1) low preoperative left ventricular ejection fraction (< 35%)
(2) pediatric patient undergoing cardiac transplant especially with use of a ventricular assist device
(3) preoperative therapy with angiotensin-converting enzyme (ACE) inhibitor
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Specialty: Critical Care, Emergency Medicine, Surgery, general, Cardiology