Annals of vascular surgery · 2018
Safety and Effectiveness of Tolvaptan Administration after Total Arch Replacement.
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Iida Yasunori, Yoshitake Akihiro, Shimizu Hideyuki
Аннотация
BACKGROUND: Postoperative fluid overload in cardiovascular surgery is associated with increased mortality and morbidity. Recently, tolvaptan (TLV), a selective vasopressin V2 antagonist, has been used for perioperative fluid management. This study aimed to validate the safety and effectiveness of TLV administration after total arch replacement (TAR) using selective cerebral perfusion.
METHODS: From August 2016 to December 2016, 11 patients who had undergone TAR for thoracic aortic aneurysm were included in this study. In addition to the conventional diuretics furosemide (20 mg) and spironolactone (25 mg), TLV (7.5 mg) was administered orally.
RESULTS: TLV increased urine output 1-3 days after administration. Body weight was gradually and steadily reduced until discharge. Neither renal nor liver dysfunction was recognized during the TLV administration.
CONCLUSION: The concomitant use of TLV and conventional diuretics is safe and effective for fluid management after TAR using cardiopulmonary bypass, selective cerebral perfusion, and hypothermic circulatory arrest.
METHODS: From August 2016 to December 2016, 11 patients who had undergone TAR for thoracic aortic aneurysm were included in this study. In addition to the conventional diuretics furosemide (20 mg) and spironolactone (25 mg), TLV (7.5 mg) was administered orally.
RESULTS: TLV increased urine output 1-3 days after administration. Body weight was gradually and steadily reduced until discharge. Neither renal nor liver dysfunction was recognized during the TLV administration.
CONCLUSION: The concomitant use of TLV and conventional diuretics is safe and effective for fluid management after TAR using cardiopulmonary bypass, selective cerebral perfusion, and hypothermic circulatory arrest.
Предметные рубрики MeSH
Administration, OralAgedAntidiuretic Hormone Receptor AntagonistsAortic Aneurysm, ThoracicBlood Vessel Prosthesis ImplantationDrug Administration ScheduleDrug Therapy, CombinationFemaleFurosemideHumansMaleMiddle AgedMineralocorticoid Receptor AntagonistsRetrospective StudiesSodium Potassium Chloride Symporter InhibitorsSpironolactoneTime FactorsTolvaptanTreatment OutcomeUrinationWater-Electrolyte BalanceWeight Loss