Related Experiment Video

Updated: Feb 27, 2026

Continuous IV Infusion is the Choice Treatment Route for Arginine-vasopressin Receptor Blocker Conivaptan in Mice to Study Stroke-evoked Brain Edema
08:44

Continuous IV Infusion is the Choice Treatment Route for Arginine-vasopressin Receptor Blocker Conivaptan in Mice to Study Stroke-evoked Brain Edema

Published on: September 1, 2016

9.4K

Safety and effectiveness of tolvaptan for fluid management after pediatric cardiovascular surgery

Yuzo Katayama1, Tsukasa Ozawa2, Noritsugu Shiono2

  • 1Division of Cardiovascular Surgery, Department of Surgery, Toho University Omori Medical Center, 6-11 Omori-Nishi, Ota-ku, Tokyo, Japan. yuuzou.katayama@med.toho-u.ac.jp.

General Thoracic and Cardiovascular Surgery
|June 26, 2017
PubMed

Insights

Tolvaptan effectively managed fluid retention in pediatric heart surgery patients. This treatment increased urine output and reduced diuretic needs without affecting electrolytes, showing it

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Surgery
  • Pharmacology

Background:

  • Postoperative fluid retention is a significant concern following open heart surgery, particularly in pediatric patients, due to inflammatory responses and increased vascular permeability from cardiopulmonary bypass.
  • Effective fluid management strategies are crucial for optimizing outcomes in these vulnerable patients.

Purpose of the Study:

  • To evaluate the safety and efficacy of tolvaptan in managing postoperative fluid retention in children undergoing congenital heart surgery.
  • To compare the effects of tolvaptan combined with conventional diuretics against diuretics alone.

Main Methods:

  • A retrospective study involving 43 pediatric patients who underwent open heart surgery.
  • Patients were divided into two groups: one receiving conventional oral diuretics and the other receiving conventional diuretics plus a single dose of tolvaptan (0.45 mg/kg).
  • Data on urinary output, additional diuretic requirements, central venous pressure, and electrolyte levels were collected and compared between groups.

Main Results:

  • The tolvaptan group showed a significant increase in urinary output (54.3 ± 4.5 mL/kg) compared to the control group (47.3 ± 19.1 mL/kg; p=0.043).
  • Patients receiving tolvaptan required significantly less additional intravenous diuretic medication (0.26 ± 0.23 mg/kg) versus the control group (0.62 ± 0.48 mg/kg; p=0.001).
  • A smaller decrease in central venous pressure was observed in the tolvaptan group (1.3 ± 2.7 mmHg) compared to the control group (1.9 ± 3.8 mmHg; p=0.019).
  • Electrolyte concentrations in blood and urine remained comparable between the two groups, indicating no significant adverse effects.

Conclusions:

  • Tolvaptan, when added to conventional diuretic therapy, is an effective and safe option for managing postoperative fluid retention in pediatric patients after congenital heart surgery.
  • The findings suggest that tolvaptan can help optimize fluid balance and reduce the need for additional diuretic interventions without compromising electrolyte homeostasis.
Abstract

Keywords:
Congenital heart diseaseDiureticsSurgeryTolvaptan

More Related Videos

Bedside Ultrasound for Guiding Fluid Removal in Patients with Pulmonary Edema: The Reverse-FALLS Protocol07:59

Bedside Ultrasound for Guiding Fluid Removal in Patients with Pulmonary Edema: The Reverse-FALLS Protocol

Published on: July 28, 2018

11.8K
A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings06:59

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

Published on: November 9, 2016

31.4K

Related Concept Videos

Acute Kidney Injury VI: Nursing Management01:22

Acute Kidney Injury VI: Nursing Management

Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
577
Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
400
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
336
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
387
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
381
Hemodialysis III: Nursing Management01:25

Hemodialysis III: Nursing Management

The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this...
1.2K