{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:30:26Z","timestamp":1786977026397,"version":"build-2736575974"},"reference-count":12,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia Reports"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Chronic cocaine use is associated with complex cardiovascular changes, including catecholamine depletion and dilated cardiomyopathy, predisposing patients to peri\u2010operative haemodynamic instability. We report a 41\u2010year\u2010old man with chronic cocaine use, severe left ventricular dysfunction (left ventricular ejection fraction 20%), type 2 diabetes mellitus and recent myocardial infarction who underwent emergency surgery for perforated appendicitis. After induction of anaesthesia, he developed profound hypotension refractory to fluids and ephedrine, requiring a noradrenaline infusion. The postoperative course was complicated by septic shock and acute kidney injury requiring continuous renal replacement therapy, followed by gradual stabilisation in intensive care. This case highlights that peri\u2010operative hypotension in patients with chronic cocaine use and advanced cardiac dysfunction may reflect catecholamine depletion rather than acute intoxication. Early use of direct acting vasopressors with planned postoperative intensive care monitoring may be crucial in reducing morbidity and mortality.<\/jats:p>","DOI":"10.1002\/anr3.70087","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T02:37:13Z","timestamp":1783651033000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Anaesthetic and intensive care management of refractory hypotension in a high\u2010risk patient with chronic cocaine use*"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0077-3009","authenticated-orcid":false,"given":"G\u00fclg\u00fcn E.","family":"Aksoy","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Reanimation Trabzon Kanuni Training and Research Hospital  Trabzon T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gamze","family":"K\u00fc\u00e7\u00fckosman","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Reanimation Trabzon Kanuni Training and Research Hospital  Trabzon T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esra","family":"Kongur","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Reanimation Trabzon Kanuni Training and Research Hospital  Trabzon T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.05.014"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/heart.83.6.627"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10741\u2010014\u20109418\u2010y"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.110.940569"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/ael221"},{"key":"e_1_2_5_7_1","doi-asserted-by":"crossref","DOI":"10.18356\/9789210028233","volume-title":"World Drug Report 2023","author":"United Nations Office on Drugs and Crime","year":"2023"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2215\u20100366(18)30337\u20107"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/aco.0000000000000932"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/anr3.12177"},{"key":"e_1_2_5_11_1","article-title":"Intra\u2010operative refractory hypotension compounded by chronic cocaine use","volume":"15","author":"Sharma A","year":"2007","journal-title":"Int J Anaesthesiol"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmra1208943"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134\u2010014\u20103367\u20108"}],"container-title":["Anaesthesia Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/anr3.70087","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/anr3.70087","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/anr3.70087","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T02:37:15Z","timestamp":1783651035000},"score":1,"resource":{"primary":{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/10.1002\/anr3.70087"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":12,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1002\/anr3.70087"],"URL":"https:\/\/doi.org\/10.1002\/anr3.70087","archive":["Portico"],"relation":{},"ISSN":["2637-3726","2637-3726"],"issn-type":[{"value":"2637-3726","type":"print"},{"value":"2637-3726","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2026-06-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70087"}}