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Gasotransmitters, such as nitric oxide and hydrogen sulfide, are implicated in the development and perpetuation of vasodilatory shock. Established therapies do not target these physiologic drivers of vasodilation. Due to their nontoxic and pleotropic effects, micronutrients are being used as rescue therapy in postoperative vasoplegia and septic shock. Here, we outline the pathophysiology of vasodilatory shock, describe the rationale for vitamin B12 (hydroxocobalamin) in vasodilatory shock, and identify literature evaluating its use in vasoplegic states.<\/jats:p>","DOI":"10.1002\/ncp.10327","type":"journal-article","created":{"date-parts":[[2019,6,12]],"date-time":"2019-06-12T04:19:36Z","timestamp":1560313176000},"page":"514-520","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["High\u2010Dose Vitamin B12 in Vasodilatory Shock: A Narrative Review"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0663-7670","authenticated-orcid":false,"given":"Jayshil J.","family":"Patel","sequence":"first","affiliation":[{"name":"Division of Pulmonary &amp; Critical Care Medicine Medical College of Wisconsin  Milwaukee WI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Venegas\u2010Borsellino","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine Mayo Clinic  Jacksonville FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney","family":"Willoughby","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Disease Children's Hospital of Wisconsin and the Medical College of Wisconsin  Milwaukee WI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie K.","family":"Freed","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Medical College of Wisconsin  Milwaukee WI USA"},{"name":"Division of Cardiac Anesthesiology Medical College of Wisconsin  Milwaukee WI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,6,12]]},"reference":[{"issue":"21","key":"e_1_2_5_2_1","first-page":"2063","article-title":"Severe sepsis and septic shock","volume":"369","author":"Angus DC","year":"2013","journal-title":"N. 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