Hydroxocobalamin for Vasoplegic Syndrome in Liver Transplantation: Restoration of Blood Pressure Without Vasospasm

Harvey J. Woehlck; Brent T. Boettcher; Kathryn K. Lauer; David C. Cronin; Johnny C. Hong; Michael A. Zimmerman; Joohyun Kim; Motaz Selim

doi:10.1213/XAA.0000000000000398

Hydroxocobalamin for Vasoplegic Syndrome in Liver Transplantation: Restoration of Blood Pressure Without Vasospasm

Harvey J. Woehlck, Brent T. Boettcher, Kathryn K. Lauer, David C. Cronin, Johnny C. Hong, Michael A. Zimmerman, Joohyun Kim, Motaz Selim

Research output: Contribution to journal › Article › peer-review

21 Scopus citations

Abstract

Systemic vasoplegia is common in patients undergoing liver transplantation. In this report, we present a case in which treatment with conventional vasopressors caused peripheral arterial spasm, rendering arterial blood pressure monitoring impossible. Administration of methylene blue resolved the vasospasm; however, concern for toxic dose requirements limited its use. Hydroxocobalamin administration resolved the vasospasm and increased blood pressure without the potential adverse effects seen with methylene blue. This case represents the first report of hydroxocobalamin use in liver transplantation and may represent a new option for the treatment of vasoplegia and the potential vasospasm that may result from traditional vasopressors.

Original language	English (US)
Pages (from-to)	247-250
Number of pages	4
Journal	A & A case reports
Volume	7
Issue number	12
DOIs	https://doi.org/10.1213/XAA.0000000000000398
State	Published - Dec 15 2016

All Science Journal Classification (ASJC) codes

General Medicine

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10.1213/XAA.0000000000000398

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title = "Hydroxocobalamin for Vasoplegic Syndrome in Liver Transplantation: Restoration of Blood Pressure Without Vasospasm",

abstract = "Systemic vasoplegia is common in patients undergoing liver transplantation. In this report, we present a case in which treatment with conventional vasopressors caused peripheral arterial spasm, rendering arterial blood pressure monitoring impossible. Administration of methylene blue resolved the vasospasm; however, concern for toxic dose requirements limited its use. Hydroxocobalamin administration resolved the vasospasm and increased blood pressure without the potential adverse effects seen with methylene blue. This case represents the first report of hydroxocobalamin use in liver transplantation and may represent a new option for the treatment of vasoplegia and the potential vasospasm that may result from traditional vasopressors.",

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TY - JOUR

T1 - Hydroxocobalamin for Vasoplegic Syndrome in Liver Transplantation

T2 - Restoration of Blood Pressure Without Vasospasm

AU - Woehlck, Harvey J.

AU - Boettcher, Brent T.

AU - Lauer, Kathryn K.

AU - Cronin, David C.

AU - Hong, Johnny C.

AU - Zimmerman, Michael A.

AU - Kim, Joohyun

AU - Selim, Motaz

PY - 2016/12/15

Y1 - 2016/12/15

N2 - Systemic vasoplegia is common in patients undergoing liver transplantation. In this report, we present a case in which treatment with conventional vasopressors caused peripheral arterial spasm, rendering arterial blood pressure monitoring impossible. Administration of methylene blue resolved the vasospasm; however, concern for toxic dose requirements limited its use. Hydroxocobalamin administration resolved the vasospasm and increased blood pressure without the potential adverse effects seen with methylene blue. This case represents the first report of hydroxocobalamin use in liver transplantation and may represent a new option for the treatment of vasoplegia and the potential vasospasm that may result from traditional vasopressors.

AB - Systemic vasoplegia is common in patients undergoing liver transplantation. In this report, we present a case in which treatment with conventional vasopressors caused peripheral arterial spasm, rendering arterial blood pressure monitoring impossible. Administration of methylene blue resolved the vasospasm; however, concern for toxic dose requirements limited its use. Hydroxocobalamin administration resolved the vasospasm and increased blood pressure without the potential adverse effects seen with methylene blue. This case represents the first report of hydroxocobalamin use in liver transplantation and may represent a new option for the treatment of vasoplegia and the potential vasospasm that may result from traditional vasopressors.

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Hydroxocobalamin for Vasoplegic Syndrome in Liver Transplantation: Restoration of Blood Pressure Without Vasospasm

Abstract

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