Vasopressin as a postoperative management strategy in Fontan procedure: a comparative study.

IF 0.7 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Indian Journal of Thoracic and Cardiovascular Surgery Pub Date : 2025-04-01 Epub Date: 2024-12-28 DOI:10.1007/s12055-024-01873-9

Shubhadeep Das, Debasis Das, Nilanjan Dutta, Manish Kumar Sharma, Shivani Gajpal, Susovan Halder, Unmesh Chakraborty, Apu Saha, Bharath Saske, Shubham Gupta

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引用次数: 0

Abstract

Purpose: The Fontan procedure is crucial for managing univentricular heart conditions but can lead to prolonged pleural effusions, affecting recovery and hospital stays. This study evaluated the effectiveness of vasopressin in reducing pleural effusion and improving recovery outcomes following Fontan procedure.

Methods: This comparative observational study reviewed patient records from October 2021 to September 2023. Two cohorts were included of 23 patients each: patients who received postoperative vasopressin from October 2022 to September 2023 (VP group) and a historical control group from the previous year (NVP group), excluding those who underwent fenestrated Fontan. Vasopressin was administered postoperatively to the VP group to mitigate pleural effusion. Primary outcomes were the volume and duration of chest tube drainage. Secondary outcomes included hospital and intensive care unit (ICU) stay durations and fluid balance metrics.

Results: There were no significant differences in the primary or secondary outcomes between the vasopressin group and the control group. The median total drain outputs in the VP and NVP groups were 69.4 ml/kg and 53.9 ml/kg, respectively (p = 0.96). The median duration of chest tube stay was 5.5 days for the VP group and 6 days for the NVP group (p = 0.74). Hospital stay duration (p = 0.74) and ICU stay duration (p = 0.82) showed no significant difference.

Conclusion: Vasopressin does not significantly impact chest tube drainage volume or duration, nor does it reduce hospital stays in Fontan patients, suggesting a limited role in managing postoperative pleural effusions. Further research is needed to explore its benefits for specific patient subgroups and acute hemodynamic instabilities postoperatively.

Graphical abstract:

Supplementary information: Below is the link to the electronic supplementary material. 10.1007/s12055-024-01873-9.

查看原文本刊更多论文

加压素作为Fontan手术术后管理策略的比较研究。

目的：Fontan手术对于治疗单室心脏病至关重要，但可能导致胸腔积液延长，影响康复和住院时间。本研究评估加压素在减少Fontan手术后胸腔积液和改善恢复结果方面的有效性。方法：这项比较观察性研究回顾了2021年10月至2023年9月的患者记录。两个队列各包括23例患者：2022年10月至2023年9月接受术后抗利尿激素治疗的患者（VP组）和前一年的历史对照组（NVP组），不包括接受开窗Fontan治疗的患者。VP组术后给予加压素以减轻胸腔积液。主要结局是胸管引流的容量和持续时间。次要结局包括医院和重症监护病房（ICU）的住院时间和体液平衡指标。结果：抗利尿激素组与对照组的主要和次要结局无显著差异。VP组和NVP组的总排液量中位数分别为69.4 ml/kg和53.9 ml/kg （p = 0.96）。VP组的中位胸管停留时间为5.5天，NVP组的中位胸管停留时间为6天（p = 0.74）。住院时间（p = 0.74）和ICU住院时间（p = 0.82）差异无统计学意义。结论：加压素对Fontan患者胸管引流量和持续时间没有显著影响，也没有缩短住院时间，提示加压素对术后胸腔积液的处理作用有限。需要进一步的研究来探索其对特定患者亚组和术后急性血流动力学不稳定的益处。图片摘要：补充资料：以下是电子补充资料的链接。10.1007 / s12055 - 024 - 01873 - 9。

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来源期刊

Indian Journal of Thoracic and Cardiovascular Surgery CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

1.20

自引率

14.30%

发文量

141

期刊介绍： The primary aim of the Indian Journal of Thoracic and Cardiovascular Surgery is education. The journal aims to dissipate current clinical practices and developments in the area of cardiovascular and thoracic surgery. This includes information on cardiovascular epidemiology, aetiopathogenesis, clinical manifestation etc. The journal accepts manuscripts from cardiovascular anaesthesia, cardiothoracic and vascular nursing and technology development and new/innovative products.The journal is the official publication of the Indian Association of Cardiovascular and Thoracic Surgeons which has a membership of over 1000 at present.DescriptionThe journal is the official organ of the Indian Association of Cardiovascular-Thoracic Surgeons. It was started in 1982 by Dr. Solomon Victor and ws being published twice a year up to 1996. From 2000 the editorial office moved to Delhi. From 2001 the journal was extended to quarterly and subsequently four issues annually have been printed out at time and regularly without fail. The journal receives manuscripts from members and non-members and cardiovascular surgeons. The manuscripts are peer reviewed by at least two or sometimes three or four reviewers who are on the panel. The manuscript process is now completely online. Funding the journal comes partially from the organization and from revenue generated by subscription and advertisement.