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Vasopressin in Cardiac Surgery: A Meta-analysis of Randomized Controlled Trials
Martin W Dünser1, Olivier Bouvet2, Hans Knotzer3
1Department of Anesthesiology and Intensive Care Medicine, Kepler University Hospital and Johannes Kepler University Linz, Linz, Austria.
Journal of Cardiothoracic and Vascular Anesthesia
|May 12, 2018
Summary
Arginine vasopressin may reduce perioperative complications in cardiac surgery patients. However, this meta-analysis found no significant difference in postoperative mortality, and further research is needed.
Area of Science:
- Cardiology
- Anesthesiology
- Critical Care Medicine
Background:
- Vasopressors are crucial for hemodynamic support during cardiac surgery.
- Vasodilatory shock and new-onset atrial fibrillation are common complications.
- Arginine vasopressin is increasingly used as an alternative vasopressor.
Purpose of the Study:
- To evaluate the efficacy of arginine vasopressin in reducing perioperative complications in cardiac surgery.
- To assess the impact of arginine vasopressin on postoperative mortality.
Main Methods:
- Meta-analysis of randomized controlled trials.
- Inclusion of 625 adult patients undergoing cardiac surgery.
- Comparison of arginine vasopressin infusion versus standard therapy.
Main Results:
- Arginine vasopressin significantly reduced perioperative complications (OR, 0.33; P < 0.0001).
- Reduced rates of vasodilatory shock and new-onset atrial fibrillation were observed.
- No significant difference in postoperative mortality was found (OR, 0.83; P = 0.55).
Conclusions:
- Arginine vasopressin may decrease perioperative complications in cardiac surgery.
- Postoperative mortality remains unaffected.
- High-quality, multicenter trials are necessary to confirm these findings.
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