TY - BOOK AU - Ritter, Lindsay A TI - Effects of a single bolus of hydroxocobalamin on hemodynamics in vasodilatory shock SN - 0883-9441 PY - 2022/// KW - *Hydroxocobalamin KW - *Hypotension KW - Adult KW - Blood Pressure KW - Hemodynamics KW - Humans KW - Hydroxocobalamin/pd [Pharmacology] KW - Hydroxocobalamin/tu [Therapeutic Use] KW - Hypotension/dt [Drug Therapy] KW - Retrospective Studies KW - MedStar Washington Hospital Center KW - Surgery/Surgical Critical Care KW - Journal Article N1 - Available online through MWHC library: 2012 - present N2 - 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 UR - https://dx.doi.org/10.1016/j.jcrc.2021.09.024 ER -