Use of Hydroxocobalamin (Vitamin B12a) in Patients With Vasopressor Refractory Hypotension After Cardiopulmonary Bypass: A Case Series.

Hydroxocobalamin (vitamin B12a) is an emerging treatment for vasoplegic syndrome (VS) associated with cardiopulmonary bypass (CPB). Given its cost and scarcity, an institutional guideline for its use as a rescue treatment in cases of suspected VS was developed. Hemodynamic variables and vasopressor requirements were reviewed for a series of 24 post-CPB patients who received B12a. Favorable changes in hemodynamic parameters and vasopressor requirements were seen after B12a administration although guideline criteria for VS were inconsistently met. These findings support the continued study of B12a in patients with CPB-associated VS.

Use of del Nido Cardioplegia in Adult Cardiac Surgery.

UNLABELLED: Background: del Nido cardioplegia was developed to protect pediatric hearts, and similar to pediatric hearts, older adult hearts tolerate ischemia-reperfusion poorly. This study investigates the feasibility of del Nido cardioplegia as an alternative to conventional Buckberg cardioplegia in adult cardiac surgery. METHODS: A total of 142 adult patients undergoing cardiopulmonary bypass with del Nido cardioplegia and conventional Buckberg cardioplegia were retrospectively reviewed. RESULTS: Fewer doses of cardioplegia and fewer defibrillations were noted with del Nido cardioplegia, and there were no significant differences in incidence of postoperative events. CONCLUSION: del Nido cardioplegia may be a feasible alternative to conventional Buckberg cardioplegia.