Vasopressin cardiac surgery

Hyponatremia has been attributed to vasopressin in children undergoing cardiac surgery (18). 

A 36-week-old 2.3 kg girl undergoing cardiac surgery received vasopressin 0.0003 units/kg/minute, titrated up to a maximum dose of 0.0012 units/kg/minute. After 82 hours vasopressin was discontinued because of hyponatremia (sodium 117 mmol/1). 

A 3.6 kg boy bom at term underwent cardiac surgery and received similar doses of vasopressin, which was discontinued after 60 hours because of a sodium concentration of 119 mmol/1. 

Examination of data from neonates who had xmdergone complex cardiac surgery either with (n = 17) or without (n = 17) the use of vasopressin foxmd that vasopressin treatment was associated with higher urea and creatinine levels, longer period of peritoneal dialysis, reduced platelet coxmts and delayed recovery of lactate concentration [97 ]. The authors suggest that vasopressin infusion should only be used in catecholamine-refractory shock. The potentially dangerous outcomes reported in this study should be assessed carefully in future trials. 

Alten JA, Borasino S, Toms R, Law MA, MoeUinger A, Dabal RJ. Early initiation of arginine vasopressin infusion in neonates after complex cardiac surgery. Pediatr Crit Care Med 2012 13(3) 300-4. Epub 2011/09/20. 

Nishibe S, Tsujita M. The impact of intraoperative vasopressin infusion in complex neonatal cardiac surgery. Interact Cardiovasc Thorac... 

Davalos MC, Barrett R, Seshadri S, Walters HL, Delius RE, Zidan M, et al. H)fponalremia during arginine vasopressin therapy in children following cardiac surgery. Pediatr Crit Care Med 2013 14(3) 290-7. 

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