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British Journal of Anaesthesia, 2001, Vol. 86, No. 1 138-141
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Reduction of vasopressor requirement by hydrocortisone administration in a patient with cerebral vasospasm

J. A. Alhashemi

Division of Critical Care Medicine, London Health Sciences Centre – University Campus, University of Western Ontario, London, Ontario, Canada N6A 5A5. Present Address: Department of Anesthesia & Critical Care, King Abdulaziz University Hospital, King Abdulaziz University, PO Box 31648, Jeddah 21418, Saudi Arabia

A 67-yr-old female received hypertensive, hypervolaemic treatment for cerebral vasospasm after severe subarachnoid haemorrhage. After 3 days of continuous vasopressor infusion and despite adequate hydration and normal cardiac function, the phenylephrine dose had to be increased to obtain the same systolic blood pressure. This tachyphylaxis to phenylephrine infusion was probably caused by down-regulation of {alpha} adrenoceptors, and was reversed by giving i.v. hydrocortisone.

Br J Anaesth 2001; 86: 138–41


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