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DBpia AI
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AI 아이디어
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Citeasy
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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2025.6
- 수록면
- 35 - 38 (4page)
- DOI
- 10.18700/jnc.250008
이용수
초록· 키워드
Background: We report a case of severe vasoplegia that was unresponsive to triple vasopressor therapy but showed marked hemodynamic improvement following intravenous hydroxocobalamin administration in a patient with underlying cirrhosis.Case Report: A 63-year-old Asian woman with no remarkable medical history presented with a 1-week history of headaches and neck stiffness. Imaging revealed an aneurysmal subarachnoid hemorrhage. Shortly after initiating oral nimodipine, she developed profound hypotension that was refractory to fluid resuscitation and high-dose triple vasopressor support. After excluding other causes of distributive shock, she received 5 g of intravenous hydroxocobalamin for suspected nimodipine-induced vasoplegia, which resulted in the rapid stabilization of blood pressure. No adverse effects were observed apart from transient chromaturia. Subsequent workup revealed cirrhosis secondary to chronic hepatitis B infection.Conclusion: Nimodipine remains a mainstay in the management of subarachnoid hemorrhage to prevent delayed cerebral ischemia; however, severe catecholamine-resistant hypotension is an uncommon adverse effect, particularly in patients with impaired hepatic metabolism. Drug-induced vasoplegia should be considered in cases of unexplained vasodilatory shock following nimodipine administration. This case illustrates the successful use of hydroxocobalamin as rescue therapy under such circumstances.
#Vasoplegia
#Nimodipine
#Hydroxocobalamin
#Aneurysmal subarachnoid hemorrhage
#Liver failure
#Cirrhosis
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