What Is Refractory Hypotension?

Refractory hypotension is a form circulatory failure of unapparent cause. During or following surgeries, patients appear to have healthy blood flow while the body's circulation is actually inadequate. The mortality rate for the condition is high. Determining the cause of the refractory hypotension is critical for treatment. Empirical study is necessary to discover the cause of the refractory hypotension. Targeted treatment of the cause increases a patient's chances of survival.

Defining Terms

• Hypotension is defined as low blood pressure by the National Heart Lung and Blood Institute. Refractory means not yielding to treatment, according to Medterms.com

Causes

• According to a study by Louis L. Smith and Bruce W. Branson in the Western Journal of Medicine, the causes of refractory hypotension in patients are concealed hemorrhage, cardiovascular catastrophe, pulmonary catastrophe, sepsis with blood stream invasion, electrolyte disorders with or without acid-base changes, acute pancreatitis, vascular impairment of the bowel and acute adrenal insufficiency.

Observation

• Measuring blood volume is less effective in determining the onset of refractory hypotension. The measurements may yield normal readings while the problem persists. Smith and Branson say measuring central venous pressure is a more accurate determinate.

Treatments

• To restore healthy circulation as quickly as possible, Smith and Branson recommend treatments for the short list of potential causes of refractory hypotension. Which treatments are used is determined via medical observation. Treatments suggested are to correct any electrolyte or acid-base disorders, control sepsis, administer blood transfusions, utilize corticosteroid treatments and prescribe vasopressor drugs.

Condition or Complication

• Whether refractory hypotension is a uniquely occurring medical problem or the underlying symptom of another issue is a matter of discussion. Smith and Branson challenge the idea of refractory hypotension being a primary diagnosis that is sometimes defined as irreversible shock, arguing that there are no tests determine if a patient is beyond treatment.