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High-Dose Vitamin B12 in Vasodilatory Shock: A Narrative Review. Nutr Clin Pract 2019 Aug;34(4):514-520

Date

06/13/2019

Pubmed ID

31187494

DOI

10.1002/ncp.10327

Scopus ID

2-s2.0-85067343132 (requires institutional sign-in at Scopus site)   17 Citations

Abstract

Vasodilatory shock, as observed in postoperative states and sepsis, is hallmarked by low systemic vascular resistance and low blood pressure compensated by increased cardiac output. Gasotransmitters, such as nitric oxide and hydrogen sulfide, are implicated in the development and perpetuation of vasodilatory shock. Established therapies do not target these physiologic drivers of vasodilation. Due to their nontoxic and pleotropic effects, micronutrients are being used as rescue therapy in postoperative vasoplegia and septic shock. Here, we outline the pathophysiology of vasodilatory shock, describe the rationale for vitamin B12 (hydroxocobalamin) in vasodilatory shock, and identify literature evaluating its use in vasoplegic states.

Author List

Patel JJ, Venegas-Borsellino C, Willoughby R, Freed JK

Authors

Julie K. Freed MD, PhD Vice Chair, Associate Professor in the Anesthesiology department at Medical College of Wisconsin
Rodney E. Willoughby MD Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Humans
Shock, Septic
Vasoplegia
Vitamin B 12
Vitamin B Complex