Effects of a single bolus of hydroxocobalamin on hemodynamics in vasodilatory shock.
Citation: Journal of Critical Care. 67:66-71, 2022 02.PMID: 34689063Institution: MedStar Washington Hospital CenterDepartment: Surgery/Surgical Critical CareForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Hydroxocobalamin | *Hypotension | Adult | Blood Pressure | Hemodynamics | Humans | Hydroxocobalamin/pd [Pharmacology] | Hydroxocobalamin/tu [Therapeutic Use] | Hypotension/dt [Drug Therapy] | Retrospective StudiesYear: 2022Local holdings: Available online through MWHC library: 2012 - presentISSN:- 0883-9441
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 34689063 | Available | 34689063 |
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.
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