Vitamin C for Vasoplegia After Cardiopulmonary Bypass: A Case Series

A A Pract. 2018 Aug 15;11(4):96-99. doi: 10.1213/XAA.0000000000000752.

Abstract

Cardiac vasoplegia remains a significant contributor of morbidity and mortality in cardiac surgery patients after cardiopulmonary bypass. Effective therapeutic options for vasopressor-refractory vasoplegia are limited. We report 3 patients in whom we administered high-dose intravenous ascorbic acid (vitamin C), a cofactor for endogenous catecholamine synthesis, to treat vasoplegia refractory to epinephrine, vasopressin, and norepinephrine after surgery requiring cardiopulmonary bypass. Reductions in vasopressor requirements were observed in all 3 patients, and, in 2 patients, norepinephrine was completely discontinued within 24 hours. Ascorbic acid is a novel potential therapeutic option for cardiac vasoplegia that warrants rigorous prospective studies.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Aged
  • Ascorbic Acid / therapeutic use*
  • Cardiopulmonary Bypass / adverse effects*
  • Humans
  • Male
  • Norepinephrine / therapeutic use
  • Vasoconstrictor Agents / therapeutic use
  • Vasoplegia / drug therapy*
  • Vasoplegia / etiology
  • Vitamins / therapeutic use*
  • Young Adult

Substances

  • Vasoconstrictor Agents
  • Vitamins
  • Ascorbic Acid
  • Norepinephrine