Vasoplegia due to inflammatory response in patients after on pump cardiac surgery: a comparative analysis.

Abstract

Introduction and objective: Vasoplegia presents itself as a complex condition in the postoperative period of cardiac surgeries using cardiopulmonary bypass. Associated with systemic inflammatory response syndrome and multifactorial etiology, it is characterized by arterial hypotension refractory to the use of catecholamines. The objective of the present study was to carry out a comparative analysis between literary findings and their clinical applications in the identification and management of vasoplegic syndromes.

Methodology: A questionnaire was developed on Google Forms that containednine questions associated with the vasoplegic conditions described by the interviewees. The questionnaire was sent to a group of perfusionists via the WhatsApp application. For the theoretical framework, topics associated with vasoplegia, cardiac surgery and extracorporeal circulation were investigated in a scientific database.

Results: 3,759 cardiac surgeries were described, of which 115 cases progressed to vasoplegic syndrome and 34 deaths were reported. A lower vasoplegic incidence was observed in professionals who administered prophylactic measures. Regarding the clinical picture for diagnosis, lack of response to catecholamines and arterial hypotension were the most cited. It was not possible to carry out an effective analysis between the medications adopted and the best prognosis.

Conclusion: Considering the complexity of vasoplegia, it is necessary to invest in scientific research aimed at elucidating the mechanisms involved in its progression, preparing professionals for its identification and treatment. Previously it was observed that the adoption of prophylactic measures may be relevant in preventing vasoplegic syndrome.