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Venoarterial Extracorporeal Membrane Oxygenation for Support of Vasodilatory Shock in Children Due to Toxicological Ingestions.
ASAIO J
January 2025
Division of Pediatric Cardiology, Department of Pediatrics, Heart Institute, Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colorado.
Venoarterial extracorporeal membrane oxygenation (VA ECMO) may provide temporary hemodynamic support for patients with severe vasodilatory shock due to toxicologic ingestion. In a series of 10 cases of children less than 18 years of age who received VA ECMO support for toxicologic-induced vasodilatory shock, there were eight survivors and two nonsurvivors who died of significant neurologic injury. Upon initiation of ECMO support, survivors had decline in Vasoactive-Inotrope Scores (VIS).
View Article and Find Full Text PDFNon-adrenergic vasopressors for vasodilatory shock or perioperative vasoplegia: a meta-analysis of randomized controlled trials.
Crit Care
December 2024
Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Background: Excessive exposure to adrenergic vasopressors may be harmful. Non-adrenergic vasopressors may spare adrenergic agents and potentially improve outcomes. We aimed to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy of non-adrenergic vasopressors in adult patients receiving vasopressor therapy for vasodilatory shock or perioperative vasoplegia.
View Article and Find Full Text PDFMixed Cardiogenic-Vasodilatory Shock: Current Insights and Future Directions.
JACC Adv
January 2025
Division of Cardiology, Department of Medicine, Warren Alpert Medical School of Brown University, and Lifespan Cardiovascular Institute, Providence, Rhode Island, USA.
This state-of-the-art review describes the potential etiologies, pathophysiology, and management of mixed shock in the context of a proposed novel classification system. Cardiogenic-vasodilatory shock occurs when cardiogenic shock is complicated by inappropriate vasodilation, impairing compensatory mechanisms, and contributing to worsening shock. Vasodilatory-cardiogenic shock occurs when vasodilatory shock is complicated by myocardial dysfunction, resulting in low cardiac output.
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