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Cardiovascular
Concurrent

ABCs of Vasoplegia

Monday, March 23, 2026
9:45 AM - 10:45 AM Central Time
Location: W187

Vasodilatory shock that is resistant to fluid resuscitation and vasopressor initiation can lead to cardiovascular collapse and death. Methylene blue and hydroxocobalamin contribute to decreasing the effects of nitric oxide on vasodilatation, although via different mechanisms. Since 2023, research and case studies have been published referencing the use of both these agents. This session will evaluate the pathophysiology associated with vasodilatory shock along with the pharmaceutical proprieties of each drug. Side effects, timing and frequency of dosing, and cost will be discussed in the this pro/con debate.

Learning Objectives:

  • Discuss pathophysiology that causes vasopressor-resistant vasodilatory shock
  • Explain the mechanisms of methylene blue and hydroxocobalamin in the treatment of vasodilatory shock
  • Discuss side effects, cost, and appropriate dosing of methylene blue and hydroxocobalamin

Presentations:

  • 9:50 AM - 10:05 AM Central Time
    Angiotensin 2

    Patrick M. Wieruszewski, BCCCP, PharmD – Mayo Clinic

  • 10:05 AM - 10:20 AM Central Time
    Methylene Blue: The Better B

    Gretchen Sacha, BCCCP, PharmD, FCCM – Cleveland Clinic

  • 10:20 AM - 10:35 AM Central Time
    Hydroxycobalamin: The Newest B

    Saraschandra Vallabhajosyula, MD, MSc, , FCCM – Warren Alpert School of Medicine