Vasoplegic syndrome

Vasoplegic syndrome or vasoplegia syndrome (VPS) is a postperfusion syndrome characterized by low systemic vascular resistance and a high cardiac output.

Gross pathology of a normal brain and a brain of a patient treated with methylene blue before death in a case of vasoplegic syndrome.

Causes

VPS occurs more frequently after on pump CABG surgery versus off pump CABG surgery.^[1] Hypothermia during surgery may also increase ones risk of developing VPS post operatively.^[2]

Diagnosis

Definition

Vasoplegic syndrome is defined as low systemic vascular resistance (SVR index <1,600 dyn∙sec/cm⁵/m²) and high cardiac output (cardiac index >2.5 L/min/m²) within the first 4 postoperative hours.^[3]

Treatment

There is some evidence to support the use of methylene blue in the treatment of this condition.^[4][5]

Epidemiology

One case series reports a rate of 1 in 120 cases.^[6]