Correction of severe hypotension by oral pseudoephedrine in a patient with idiopathic autonomic dysfunction.

The purpose of this case study was to review the use of an oral alpha-adrenergic agent to correct severe vasopressor-dependent hypotension in a patient with idiopathic autonomic dysfunction. Autonomic dysfunction resulting in severe hypotension that requires intravenous vasopressors can present challenges in the treatment of critically ill patients. Most patients are weaned from intravenous vasopressor agents once severe sepsis has resolved. Because of worsening idiopathic autonomic dysfunction during recovery from sepsis, this 76-year-old woman required prolonged care in the intensive care unit. Oral alpha-adrenergic agonist therapy in the form of pseudoephedrine proved to be a valuable treatment option to wean this patient off the vasopressor dependence and allow for placement in a long-term care facility.