Hydroxocobalamin administration for treatment of vasoplegic syndrome associated with cardiopulmonary bypass causes red plasma

  title={Hydroxocobalamin administration for treatment of vasoplegic syndrome associated with cardiopulmonary bypass causes red plasma},
  author={Nabiha Huq Saifee and Serena Sedgwick and Yanyun Wu},
A 64-year-old female underwent cardiopulmonary bypass (CPB) for acute ST-elevation myocardial infarction and received a 5 g dose of intravenous hydroxocobalamin (Cyanokit, Meridian Medical Technologies) for treatment of vasoplegic syndrome. Figure 1 shows discolored plasma from a sample received for type and screen testing after surgery. The sample was initially rejected in the Transfusion Service, but discussion with the clinical team revealed that the discoloration was expected due to the… 

Hydroxocobalamin mimicking intravascular hemolysis in therapeutic plasma exchange

A 58-year-old man developed cardiogenic shock 12 months after undergoing orthotopic heart transplant and mixed antibodyand cellular-mediated rejection was diagnosed, and hydroxocobalamin 5000 mg had been administered intravenously approximately 24 hours previously to treat vasoplegic syndrome.



TRANSFUSION MEDICINE ILLUSTRATED: Hydroxocobalamin‐colored plasma

A 77-year-old Hispanic female presented to the emergency department status-post 15 minutes of respiratory arrest in a house fire with bilateral patchy alveolar airspace opacities in the upper lungs consistent with smoke inhalation injury and an intense red-pink hue.

Pediatric Cyanide Poisoning: Causes, Manifestations, Management, and Unmet Needs

The vitamin B12 precursor hydroxocobalamin, which has been used in Europe, may prove to be an attractive alternative to the cyanide antidote kit for pediatric patients and discuss unmet needs in the management of pediatric cyanide poisoning.

The use of high-dose hydroxocobalamin for vasoplegic syndrome.

An unusual cause of red plasma

The clinical scenario for this patient suggests that the unusual coloration of this patient’s body fluids was a consequence of the dark red color of hydroxocobalamin.

Hydroxocobalamin as a Rescue Treatment for Refractory Vasoplegic Syndrome After Prolonged Cardiopulmonary Bypass.

Hydroxocobalamin-colored plasma

  • Transfusion
  • 2009

An unusual case of red plasma

  • Transfusion
  • 2014

Cyanokit package insert. Columbia, MD: Meridian medical technologies

  • 2017