paralysis of the blood vessels Vasoplegia
Conditions
Interventions
Treatment with cytokine adsorption in addition to standard treatment.
Sponsors
Medisch Universitair Ziekenhuis Maastricht
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: 1. >= 18 year 2. Post elective cardiac surgery 3. Vasoplegic syndrome occurring within 12 hours after surgery, defined as: a. High vasopressor dose (norepinephrin > 0.25 mcg/kg/min) needed for adequate MAP (> 65 mmHg) despite adequate crystalloid fluid resuscitation (> 30 ml/kg IBW), persisting more than one hour. b. Echocardiographic evidence of adequate cardiac output, defined as cardiac index > 2,5L/min/m2. Stroke volume is calculated as the product of Aortic velocity time integral and left ventricular outflow tract diameter. Cardiac output is calculated by multiplying stroke volume with heart rate. This is then divided by body surface area to obtain cardiac index. , c. IF; a pulmonary artery catheter was already inserted perioperatively: - Cardiac index > 2,5l/min/m2 AND low systemic vascular resistance (SVRI 0.25 mcg/kg/min).
Exclusion criteria
Exclusion criteria: - Severe coagulopathy resulting in hemodynamic instability - Significant bleeding defined as 400 ml/1st hour, 200 ml/ 2nd hour, 100 ml/h; necessitating rethoractomy or transfusion - Severe thrombocytopenia (1000 IU/L - Pregnancy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Cumulative vasopressor need and total amount of fluid administration. | — |
Secondary
| Measure | Time frame |
|---|---|
| Time to hemodynamic stabilization, ICU length of stay, hospital length of stay, mortality, incidence of acute kidney injury and need for renal replacement treatment. | — |
Countries
Netherlands
Outcome results
None listed