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Prolonged Postoperative Vasoplegia in Pediatric Patients on Chronic Angiotensin II Blocker Treatment

Nischal R Pandya1,2, Nelson Alphonso1,2, Quyen Tu3,4

  • 1Pediatric Cardiac Surgery, Lady Cilento Children's Hospital, Brisbane, QLD, Australia.

Frontiers in Cardiovascular Medicine
|September 21, 2018
PubMed

Insights

Angiotensin II receptor blockers (ARBs) can cause prolonged vasoplegia after pediatric cardiac surgery. Discontinuing ARBs before surgery is crucial for managing these young patients effectively.

Area of Science:

  • Pediatric Cardiology
  • Cardiothoracic Surgery
  • Pharmacology

Background:

  • Angiotensin II receptor blockers (ARBs) are increasingly prescribed for pediatric hypertension.
  • Optimal perioperative management of ARBs in pediatric cardiac surgery patients remains unclear.
  • Prolonged postoperative vasoplegia is a known complication in adult cardiac surgery patients on ARBs.

Observation:

  • Two adolescent patients on chronic ARB therapy experienced prolonged vasoplegia after cardiopulmonary bypass.
  • These cases highlight a potential risk associated with ARB use in pediatric cardiac surgery.

Findings:

  • The study identifies a link between chronic ARB use and prolonged vasoplegia in pediatric patients undergoing cardiac surgery.
  • Preoperative cessation of ARBs may be important for mitigating this risk.

Implications:

  • Findings suggest a need for revised guidelines on ARB management in pediatric patients undergoing cardiac surgery.
  • Further research is warranted to establish optimal protocols for ARB discontinuation before pediatric cardiac procedures.
  • This highlights the importance of considering medication history in perioperative care for pediatric cardiac patients.

Keywords:
angiotensin blockerantihypertensivecardiac surgerypediatricvasoplegia

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