Effects of a single bolus of hydroxocobalamin on hemodynamics in vasodilatory shock.
Effects of a single bolus of hydroxocobalamin on hemodynamics in vasodilatory shock.
- 2022
Available online through MWHC library: 2012 - present
CONCLUSIONS: Although hydroxocobalamin has been observed to cause hypertension in healthy subjects, our results suggest that in patients with shock, hydroxocobalamin may not be effective in improving hemodynamics at 24 h after administration. Copyright (c) 2021 Elsevier Inc. All rights reserved. MATERIALS AND METHODS: Adults in shock who received hydroxocobalamin from 2017 to 2021 were analyzed retrospectively. Hourly hemodynamics from 24 h before and after treatment were collected, and the difference and hourly change of mean arterial pressure (MAP), systolic blood pressure (SBP), diastolic blood pressure (DBP), and norepinephrine-equivalent dose (NED) were examined in mixed-effects models. PURPOSE: Hydroxocobalamin has been observed to cause transient hypertension in healthy subjects, but rigorous studies examining its efficacy are lacking. RESULTS: This study included 3992 hemodynamic data points from 35 patients and is the largest case series to date. In the mixed effects model, there was no difference in MAP 24-h after hydroxocobalamin administration (estimated fixed effect [EFE] -0.2 mmHg, p = 0.89). A two-piecewise mixed model found that the hourly change in MAP was not different from zero in either the pre-administration (EFE 0.0 mmHg/h, p = 0.80) or post-administration segments (EFE 0.0 mmHg/h, p = 0.55). Analysis of the SBP, DBP, and NED also found similar insignificant results.
English
0883-9441
10.1016/j.jcrc.2021.09.024 [doi] S0883-9441(21)00196-9 [pii]
*Hydroxocobalamin
*Hypotension
Adult
Blood Pressure
Hemodynamics
Humans
Hydroxocobalamin/pd [Pharmacology]
Hydroxocobalamin/tu [Therapeutic Use]
Hypotension/dt [Drug Therapy]
Retrospective Studies
MedStar Washington Hospital Center
Surgery/Surgical Critical Care
Journal Article
Available online through MWHC library: 2012 - present
CONCLUSIONS: Although hydroxocobalamin has been observed to cause hypertension in healthy subjects, our results suggest that in patients with shock, hydroxocobalamin may not be effective in improving hemodynamics at 24 h after administration. Copyright (c) 2021 Elsevier Inc. All rights reserved. MATERIALS AND METHODS: Adults in shock who received hydroxocobalamin from 2017 to 2021 were analyzed retrospectively. Hourly hemodynamics from 24 h before and after treatment were collected, and the difference and hourly change of mean arterial pressure (MAP), systolic blood pressure (SBP), diastolic blood pressure (DBP), and norepinephrine-equivalent dose (NED) were examined in mixed-effects models. PURPOSE: Hydroxocobalamin has been observed to cause transient hypertension in healthy subjects, but rigorous studies examining its efficacy are lacking. RESULTS: This study included 3992 hemodynamic data points from 35 patients and is the largest case series to date. In the mixed effects model, there was no difference in MAP 24-h after hydroxocobalamin administration (estimated fixed effect [EFE] -0.2 mmHg, p = 0.89). A two-piecewise mixed model found that the hourly change in MAP was not different from zero in either the pre-administration (EFE 0.0 mmHg/h, p = 0.80) or post-administration segments (EFE 0.0 mmHg/h, p = 0.55). Analysis of the SBP, DBP, and NED also found similar insignificant results.
English
0883-9441
10.1016/j.jcrc.2021.09.024 [doi] S0883-9441(21)00196-9 [pii]
*Hydroxocobalamin
*Hypotension
Adult
Blood Pressure
Hemodynamics
Humans
Hydroxocobalamin/pd [Pharmacology]
Hydroxocobalamin/tu [Therapeutic Use]
Hypotension/dt [Drug Therapy]
Retrospective Studies
MedStar Washington Hospital Center
Surgery/Surgical Critical Care
Journal Article