Q: All of the following are the risk factors for refractory vasoplegia after coronary artery bypass grafting (CABG) except?

A) decreased left ejection fraction
B) prolonged aortic cross-clamp times
C) female gender
D) preoperative use of ACE-inhibitors
E) all of the above


Answer: C

Objective of above question is to highlight the dreaded situation of refractory vasoplegia after coronary bypass. Refractory vasoplegia with its domino effect can lead to more complications like postoperative bleeding, acute renal injury (AKI), liver dysfunction, neurologic dysfunction, and prolonged ventilator time.

Males are more prone to vasodilatory shock than females.


References:

1. Kristof AS, Magder S. Low systemic vascular resistance state in patients undergoing cardiopulmonary bypass. Crit Care Med 1999; 27:1121. 

2. Cremer J, Martin M, Redl H, et al. Systemic inflammatory response syndrome after cardiac operations. Ann Thorac Surg 1996; 61:1714.