Vasopressin in Cardiac Surgery: A Meta-analysis of Randomized Controlled Trials

Journal of Cardiothoracic and Vascular Anesthesia
Martin W DünserWalter R Hasibeder

Abstract

To summarize the results of randomized controlled trials on the use of vasopressin as a vasopressor agent in cardiac surgery. Meta-analysis. Six-hundred-twenty-five adult patients undergoing elective or emergency cardiac surgery. Arginine vasopressin infusion (n = 313) or control/standard therapy (n = 312). The rates of perioperative complications and postoperative mortality were used as primary and secondary endpoints, respectively. Fixed and/or random effects models were used to compare pooled odds ratios. Arginine vasopressin reduced the pooled odds ratio (OR) of perioperative complications (OR, 0.33; 95% confidence interval [CI], 0.2-0.54; p < 0.0001). A sensitivity analysis excluding the largest trial showed an unchanged reduction in perioperative complications (OR, 0.35; 95% CI, 0.18-0.69; p = 0.002). When analyzing each perioperative complication separately, vasopressin reduced the pooled OR of vasodilatory shock (OR, 0.4; 95% CI, 0.16-0.97; p = 0.04) and new-onset atrial fibrillation (OR, 0.42; 95% CI, 0.21-0.82; p = 0.01). The pooled OR of postoperative death was not different between patients treated with arginine vasopressin and those receiving standard therapy or placebo (OR, 0.83; 95% CI, 0.45-1.53; p = 0.55). The ...Continue Reading

Citations

Nov 19, 2019·Critical Care Medicine·Laurence W Busse
Oct 1, 2019·Critical Care Medicine·Hannah FerenchickPeter V Dicpinigaitis
Apr 14, 2020·Journal of Intensive Care Medicine·Jacob C Jentzer, Steven M Hollenberg
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Apr 1, 2020·Journal of Intensive Care Medicine·Mojdeh S HeavnerJonathan H Chow
Nov 29, 2020·Journal of Endocrinological Investigation·D PaseroA S Benso
Sep 15, 2020·Annals of the American Thoracic Society·Emily A VailHannah Wunsch
Dec 15, 2020·Journal of Cardiothoracic and Vascular Anesthesia·Jeroen BoonsLayth Al Tmimi
Dec 19, 2020·Journal of Cardiothoracic and Vascular Anesthesia·Fabio GuarracinoMatthias Heringlake
Dec 29, 2020·Medicina intensiva·J J Jiménez RiveraUNKNOWN en representación del GTCICYRCP

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