Treatment of refractory shock with vitamin B 12 : A narrative review.

Autor: Wedemire C; Department of Dietitian Services, Abbotsford Regional Hospital, Abbotsford, British Columbia, Canada., Samavat H; Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Newark, New Jersey, USA., Newkirk M; Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Newark, New Jersey, USA., Parker A; Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Newark, New Jersey, USA.
Jazyk: angličtina
Zdroj: Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition [Nutr Clin Pract] 2024 Apr; Vol. 39 (2), pp. 356-365. Date of Electronic Publication: 2023 Nov 29.
DOI: 10.1002/ncp.11095
Abstrakt: High-dose vitamin B 12 is a potential treatment for patients with vasodilatory shock that is refractory to other therapies. Vasodilatory shock is characterized by low blood pressure and low systemic vascular resistance. Nitric oxide and hydrogen sulfide, two potential targets of high-dose vitamin B 12 given as hydroxocobalamin, facilitate this syndrome. This review explores the relationship between high-dose vitamin B 12 and hemodynamic outcomes in adults with vasodilatory shock and provides an update on the literature since a 2019 review on this topic. A literature search of studies published in the past 5 years was conducted in the CINAHL, PubMed, Cochrane, and EMBASE databases in May 2023. After assessing for eligibility, eight studies met this review's inclusion criteria. Seven of the eight studies reported decreased vasopressor requirements for part or all of the study samples after receiving a hydroxocobalamin infusion. However, not all patients responded to hydroxocobalamin. These findings are limited by patient selection and differences in the timing of vasopressor requirement and blood pressure outcome assessments. The current evidence is promising as to whether vitamin B 12 , given as a hydroxocobalamin infusion, may improve hemodynamic outcomes in vasodilatory shock, but the evidence is of low quality. The use of hydroxocobalamin to treat refractory, vasodilatory shock remains investigative. Larger randomized controlled trials are required to elucidate the role of vitamin B 12 in treating refractory, vasodilatory shock, including in conjunction with other alternative therapies such as methylene blue and corticosteroids.
(© 2023 American Society for Parenteral and Enteral Nutrition.)
Databáze: MEDLINE
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