Katzianer David, Chism Keira, Qureshi Ataul M, Watson Ryan, Massey Howard Todd, Boyle Andrew J, Reeves Gordon, Danelich Ilya
Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Department of Psychiatry and Human Behavior, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
J Cardiol Cases. 2019 Sep 17;20(6):218-220. doi: 10.1016/j.jccase.2019.09.004. eCollection 2019 Dec.
Serotonin syndrome is a potentially lethal complication of antidepressant therapy. Cardiac surgical patients are at particularly high risk of serotonin syndrome due to the prevalence of depression in patients with advanced cardiac disease, many of whom receive multiple serotonergic agents in the perioperative period. Here, we describe a case of postoperative serotonin syndrome following methylene blue administration for perioperative vasoplegia during left ventricular assist device implantation. We additionally describe an institution-specific strategy to minimize future occurrences of serotonin syndrome in this high-risk population. < Antidepressant medication use is prevalent in advanced heart failure patients. With serotonergic antidepressants, perioperative drug interactions may potentiate serious adverse drug events such as serotonin syndrome. In this report, we describe a case of serotonin syndrome following treatment of perioperative vasoplegia with methylene blue and describe steps our institution has implemented to prevent future occurrences.>.
血清素综合征是抗抑郁治疗的一种潜在致命并发症。心脏外科手术患者发生血清素综合征的风险特别高,这是因为晚期心脏病患者中抑郁症患病率高,其中许多人在围手术期接受多种血清素能药物治疗。在此,我们描述了一例在左心室辅助装置植入期间因围手术期血管麻痹给予亚甲蓝后发生的术后血清素综合征病例。我们还描述了一种机构特定策略,以尽量减少这一高危人群未来血清素综合征的发生。<抗抑郁药物在晚期心力衰竭患者中使用普遍。使用血清素能抗抑郁药时,围手术期药物相互作用可能会增强诸如血清素综合征等严重不良药物事件。在本报告中,我们描述了一例用亚甲蓝治疗围手术期血管麻痹后发生血清素综合征的病例,并描述了我们机构为防止未来发生此类情况而采取的措施。>