Abstract：
:Vasoplegic syndrome (VS) is increasingly recognized as an important clinical entity in perioperative medicine. VS is characterized by significant arterial hypotension, normal or high cardiac output, low systemic vascular resistance, and increased requirements for intravenous volume and vasopressors. Tremendous variations exist regarding incidence reported in the literature and management at different institutions; and the incidence of VS is likely significantly higher than many anesthesiologists believe. Thus the aims of this article are to review the pertinent aspects related to VS and alert clinical anesthesiologists to this under-recognized yet very challenging clinical condition. The potential risk factors include blood transfusion, cardiopulmonary bypass, organ transplantation, trauma and sepsis, and use of specific medications such as angiotensin-converting enzyme inhibitors, Angiotensin-II antagonist, heparin, amiodarone, aprotinin, and protamine. The pathogenesis of VS may have several mechanistic pathways, overproduction of inducible nitric oxide, activation of ATP-dependent K channels, vasopressin V1A-receptor down-regulation, and nuclear factor-κB activation. Current management strategies include intravenous administration of volume and catecholamines, vasopressin, methylene blue and high dose hydroxocobalamin. Other treatment could include ATP-sensitive K channel blocker, nuclear factor-κB inhibitor, indigo carmine, and hyperbaric oxygen therapy. VS is still associated with significantly increased perioperative morbidity and mortality.
journal_name
J Clin Anesthjournal_title
Journal of clinical anesthesiaauthors
Liu H,Yu L,Yang L,Green MSdoi
10.1016/j.jclinane.2017.04.017subject
Has Abstractpub_date
2017-08-01 00:00:00pages
63-71eissn
0952-8180issn
1873-4529pii
S0952-8180(16)30943-6journal_volume
40pub_type
杂志文章,评审abstract：:Opioids decrease the sympathetic and somatic responses to noxious stimulation and can be given in high doses without negative inotropic effects, even in patients with impaired cardiac function. With currently available opioids, precise titration of dose to effect is difficult, and high doses result in drug accumulatio...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,评审
doi：10.1016/s0952-8180(96)00179-1
更新日期：1996-12-01 00:00:00
abstract：STUDY OBJECTIVE:To ascertain if coughing during emergence from general anesthesia can be suppressed with a modified endotracheal tube. DESIGN:Randomized, double-blind, controlled study. SETTING:Operating rooms at a university hospital. PATIENTS:46 adult ASA physical status I, II, and III patients requiring elective ...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0952-8180(01)00299-9
更新日期：2001-09-01 00:00:00
abstract：:The American Society of Anesthesiologists, the Anesthesia Patient Safety Foundation, the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO), and the Patient Safety and Quality Improvement Act of 2005 encourage anesthesiology departments to institute systematic improvements in patient safety, inc...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2008.09.010
更新日期：2009-08-01 00:00:00
abstract：:With the advent of safety needles to prevent inadvertent needle sticks in the operating room (OR), a potentially new issue has arisen. These needles may result in coring, or the shaving off of fragments of the rubber stopper, when the needle is pierced through the rubber stopper of the medication vial. These fragments...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2013.10.007
更新日期：2014-03-01 00:00:00
abstract：STUDY OBJECTIVE:We evaluated the efficacy of a multidisciplinary approach to reduce postoperative complications and 1-year mortality in patients, undergoing hip fracture surgery and the impact of surgical delay on mortality. DESIGN:A non-randomized intervention study with a historical control group (CG). SETTING:Duri...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章
doi：10.1016/j.jclinane.2018.09.029
更新日期：2019-03-01 00:00:00
abstract：STUDY OBJECTIVE:To establish the analgesic effective doses as defined as a visual analog pain scale (VAS) of at least 10 for 95% of parturients (ED95) receiving either epidural fentanyl or sufentanil with bupivacaine 0.125% for labor analgesia. DESIGN:Double-blind, randomized controlled study. SETTING:Two tertiary-ca...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0952-8180(98)00113-5
更新日期：1998-12-01 00:00:00
abstract：STUDY OBJECTIVE:To investigate whether betamethasone decreases the incidence of postoperative nausea/vomiting (PONV) and reduces postoperative pain following partial mastectomy. DESIGN:Prospective randomized, double-blinded study. SETTING:Operating room and Postanesthesia Care Unit of a university hospital. PATIENTS...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jclinane.2014.02.006
更新日期：2014-09-01 00:00:00
abstract：STUDY OBJECTIVE:To assess bispectral index (BIS) monitoring on decision making during cardiac surgery with cardiopulmonary bypass (CPB) by measuring the number of preset standardized comments with and without knowing the BIS value and by classifying the interventions following the BIS data. DESIGN:Prospective, randomi...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jclinane.2004.12.018
更新日期：2005-11-01 00:00:00
abstract：STUDY OBJECTIVE:To evaluate the consequences of opioid use for postoperative pain management and the degree to which these consequences may be reduced or minimized with opioid-sparing or opioid-replacement techniques. DESIGN:Literature review relating to the economics of postoperative pain management. Comparisons betw...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,评审
doi：10.1016/s0952-8180(02)00372-0
更新日期：2002-08-01 00:00:00
abstract：BACKGROUND:Intraoperative remifentanil has been associated with postoperative hyperalgesia, higher visual analogic pain scores, and increased postoperative morphine consumption. However, this has not been investigated from patient's perspective by using a patient-reported outcomes (PROs) approach with a validated quest...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jclinane.2015.12.025
更新日期：2016-06-01 00:00:00
abstract：STUDY OBJECTIVE:To evaluate the efficacy of thoracic epidural analgesia (TEA) in scoliosis surgery. DESIGN:Descriptive clinical study. SETTING:University hospital. PATIENTS:15 ASA physical status I, II, and III patients undergoing thoracolumbar scoliosis correction. INTERVENTIONS:TEA was performed at three to 5 cm ...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2009.10.011
更新日期：2010-09-01 00:00:00
abstract：:A 30-year-old parturient requested epidural analgesia during labor. Immediately after the epidural space was presumably identified using the loss-of-resistance-to-air technique, she reported severe back pain, followed by neck pain, which progressed to severe unrelenting headache. An emergency computerized tomographic ...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/0952-8180(91)90188-s
更新日期：1991-09-01 00:00:00
abstract：STUDY OBJECTIVE:To document the effects of compromised respiratory function on oxygen saturation (SpO2) after cesarean section via the telemetric pulse oximetry network (TPON) for 24 continuous hours. DESIGN:Prospective study. SETTING:Postpartum ward of a university hospital. PATIENTS:ASA physical status I or II par...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/0952-8180(94)90009-4
更新日期：1994-03-01 00:00:00
abstract：:A 21 year old healthy parturient was diagnosed as having a fetus with micrognathia. She was scheduled for an ex-utero intrapartum treatment (EXIT) procedure. General anesthesia consisted of remifentanil, nitrous oxide, and midazolam. Intravenous nitroglycerin was used for uterine relaxation. This technique offered hem...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2009.12.014
更新日期：2011-03-01 00:00:00
abstract：STUDY OBJECTIVE:To report the occurrence of pseudo-hypotension during posterior osteotomy for correction of kyphosis in patients with ankylosing spondylitis. DESIGN:Retrospective case series. SETTING:University-affiliated hospital. MEASUREMENTS:The records of 36 patients with ankylosing spondylitis, who had severe t...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2012.05.001
更新日期：2013-02-01 00:00:00
abstract：:This study aimed to review research on the effects of nonsteroidal anti-inflammatory drugs (NSAIDs) on β-endorphin. NSAIDs are commonly used as anti-inflammatory and analgesic drugs. They are well known for inducing peripheral analgesia by inhibiting cyclooxygenase (COX). However, an increasing number of studies have ...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,评审
doi：10.1016/j.jclinane.2016.12.016
更新日期：2017-02-01 00:00:00
abstract：STUDY OBJECTIVE:To perform a prospective audit of the modified guideline for the management postdural puncture headache (PDPH) and present the results at 6 months. DESIGN:Prospective single-center audit. SETTING:University hospital. PATIENTS:24 adult, ASA physical status 1, 2, and 3 patients presenting with PDPH in ...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,评审
doi：10.1016/j.jclinane.2014.03.006
更新日期：2014-11-01 00:00:00
abstract：:We report two patients with a history of dural puncture who developed paradoxical postural cerebrospinal fluid leak-induced headache. The patients' headache worsened when they were in the recumbent position, and it improved when they were placed upright. Both patients had a history of migraine headache. The patients w...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2008.01.011
更新日期：2008-08-01 00:00:00
abstract：STUDY OBJECTIVE:To determine the postoperative analgesic efficacy of, and the effects on, intraoperative inhalational anesthetic requirements of preincisional caudal epidural block versus postincisional infiltration of local anesthetic following umbilical herniorrhaphy in children. DESIGN:Randomized, double-blind, pro...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0952-8180(96)00171-7
更新日期：1996-12-01 00:00:00
abstract：OBJECTIVE:To evaluate the effects of epidural, spinal, and general anesthesia on pain after lower-limb amputation. DESIGN:Cross-sectional survey. SETTING:Postamputation clinic. PATIENTS:150 patients who were evaluated one to 24 months after their lower-limb amputation. INTERVENTIONS:Patients received epidural, spin...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2006.03.021
更新日期：2006-12-01 00:00:00
abstract：:Presented here is a case of unilateral pulmonary edema following acute subglottic edema after removal of an endotracheal tube. A 3-year-old boy, diagnosed as having nondiphtheric croup and pectus excavatum deformity, was scheduled for repair of a cleft lip. No complication occurred during the operation. After removal ...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/0952-8180(90)90049-9
更新日期：1990-01-01 00:00:00
abstract：STUDY OBJECTIVE:To determine the effects of the McGrath Series 5 video laryngoscope on intraocular pressure (IOP) during laryngoscopy. DESIGN:Prospective, randomized, double blind. SETTING:Operating room. PATIENTS:Eighty adult patients of American Society of Anesthesiologist physical status 1 scheduled for nonophtha...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jclinane.2016.05.015
更新日期：2016-11-01 00:00:00
abstract：:We describe a case of mucoid impaction following nasotracheal intubation in a child with an upper respiratory infection that was successfully treated with a fiberoptic bronchoscope too large to pass through the endotracheal tube lumen. To the best of our knowledge, it is the first report in the anesthesia literature i...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/s0952-8180(98)00037-3
更新日期：1998-06-01 00:00:00
abstract：STUDY OBJECTIVE:The aim of this study is to compare the effects of intravenous single-dose dexketoprofen trometamol and diclofenac sodium 30 minutes before the end of the surgery on relief of postoperative pain in patients undergoing laparoscopic cholecystectomy. DESIGN:A randomized fashion. SETTING AND PATIENTS:Sixt...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jclinane.2016.02.020
更新日期：2016-08-01 00:00:00
abstract：STUDY OBJECTIVE:To ascertain current anesthesia utilization of esophageal and precordial stethoscopes in U.S. anesthesia training programs. DESIGN:Prospective, single-blind, incidence study. SETTING:Operating rooms of three tertiary care hospitals with major academic anesthesiology departments. SUBJECTS:Anesthesia f...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,多中心研究
doi：10.1016/0952-8180(95)00027-f
更新日期：1995-08-01 00:00:00
abstract：:We report a series of successful awake fiberoptic intubations in patients with critical (unstable, difficult) airways using the alpha(2)-agonist, dexmedetomidine. Dexmedetomidine has several desirable pharmacologic properties, including sedation, anxiolysis, hypnosis, analgesia, amnesia, antisialagogue effects, and a ...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2006.09.006
更新日期：2007-08-01 00:00:00
abstract：STUDY OBJECTIVE:To determine if practicing anesthesiologists recommend preoperative evaluations consistent with the 2007 ACC/AHA guidelines on perioperative care. DESIGN:Survey instrument. SETTING:Academic medical center. SUBJECTS:ASA membership. MEASUREMENTS:In this Web-based survey, participants were presented wi...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jclinane.2011.11.007
更新日期：2012-09-01 00:00:00
abstract：STUDY OBJECTIVES:To determine the effect of priming on the intubation and onset times of vecuronium 0.3 mg/kg. DESIGN:Randomized, unblinded study. SETTING:Operating rooms and postanesthetic recovery unit of a university-affiliated general hospital. PATIENTS:Thirty female ASA physical status I and II patients schedul...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/0952-8180(92)90024-u
更新日期：1992-03-01 00:00:00
abstract：:We report the case of a 13 year old patient who received 3.0 mg of remifentanil during a 50-minute surgical procedure as a result of a dosage miscalculation. The patient failed to awaken at the conclusion of the procedure and showed signs of opioid overdose. She recovered spontaneously two hours later. ...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2010.07.005
更新日期：2011-06-01 00:00:00
abstract：:We present the case of a patient who first presented with unexpected difficult laryngoscopy and intubation after induction of general anesthesia. After multiple failed attempts using direct laryngoscopy, tracheal intubation was successfully performed with the Intubating Laryngeal Mask Airway. He returned to the operat...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2007.04.009
更新日期：2007-12-01 00:00:00
