The role of serotonin blockers in cardiac anesthesia peter

Role of serotonin in the pathogenesis of acute and chronic pulmonary hypertension

“…In a later study of 20 patients, eight of whom had not previously responded to other vasodilator therapy, the same authors found a small but significant decrease in pulmonary vascular resistance in the group as a whole, with a clinically significant response in three patients 172. In addition to conditions previously discussed, studies showing haemodynamic benefits with ketanserin have involved patients with protamine induced pulmonary hypertension,79 respiratory failure,128 and valve surgery 173174 In comparison to nitroprusside, ketanserin usually improved gas exchange 175.…”

Microcirculatory Imaging in Cardiac Anesthesia: Ketanserin Reduces Blood Pressure But Not Perfused Capillary Density

“…By augmenting systemic vascular resistance (SVR), both an increase in circulating catecholamines [10] and serotonin (5-HT) [11] are thought to contribute to increased blood pressure in this setting. Thus, a drug blocking adrenergic and 5-HT receptors may be a logical treatment option.…”

“…Indeed, in Europe, ketanserin, a quinazolinedione derivative with 5-HT-2 receptor and mild 1-α, -β, and -δ adrenoceptor antagonist activity [12], continues to be used successfully in these patients. Intravenous administration reduces systemic blood pressure while moderately increasing heart rate and cardiac output [11].…”

Opening the Microcirculation with Ketanserin I.V. Improves Peripheral Temperature: An Observational Cohort Study

“…In normal endothelium the 5-HT1 effects (vasodilation) are the most prominent [21]. In endothelium that is damaged, which is the case in sepsis, the 5HT2 effects (vasoconstriction) surpass the 5-HT1 effects [22,23]. Blocking the 5-HT2 receptor with ketanserin can attenuate this pathological vasoconstriction.…”