Efficacy of Tolvaptan in Patients with Volume Overload after Cardiac Surgery

Authors

  • Kenichiro Noguchi Aorta Center and Surgery, Shonankamakura General Hospital, Kamakura City, Kanagawa
  • Masashi Tanaka Aorta Center and Surgery, Shonankamakura General Hospital, Kamakura City, Kanagawa
  • Ikuo Katayama Aorta Center and Surgery, Shonankamakura General Hospital, Kamakura City, Kanagawa
  • Tsuyoshi Yamabe Aorta Center and Surgery, Shonankamakura General Hospital, Kamakura City, Kanagawa
  • Daisuke Yuji Aorta Center and Surgery, Shonankamakura General Hospital, Kamakura City, Kanagawa
  • Norikazu Oosiro Aorta Center and Surgery, Shonankamakura General Hospital, Kamakura City, Kanagawa
  • Miyo Sirouzu Aorta Center and Surgery, Shonankamakura General Hospital, Kamakura City, Kanagawa

DOI:

https://doi.org/10.1532/hsf.1470

Abstract

Background: The vasopressin type 2 receptor antagonist tolvaptan (TLV) has recently become available for treating congestion. However, there is no evidence confirming the efficacy of TLV for patients with volume overload after cardiac surgery. Here, we retrospectively studied the efficacy of TLV in patients with volume overload after cardiac surgery.
Methods: We enrolled a total of 39 patients who had volume overload after cardiac surgery and who were treated with our protocol of body fluid management. The primary endpoint of this study was to evaluate the hospitalization period, while the secondary endpoints were to estimate adverse events such as hypotension, electrolyte abnormality, presence or absence of renal dysfunction and liver damage, and the incidence of atrial fibrillation (AF).
Results: The hospitalization period of the T (TLV) and C (furosemide and spironolactone) groups was 12.3 ± 2.6 days and 14.7 ± 4.4 days, respectively (P = .044), the mean urine volume was 2761.5 ± 850.3 mL/day and 2205.2 ± 598.5 mL/day, respectively (P = .024), and the incidence of postoperative AF after diuretics administration was 2/19 (11%) and 9/17 (52%), respectively.
Conclusion: TLV successfully and rapidly improved organ congestion without causing hemodynamic abnormalities (hypotension, arrhythmia development), electrolyte abnormality, liver damage or renal dysfunction, thus significantly reducing the period of hospitalization.

References

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Published

2015-11-24

How to Cite

Noguchi, K., Tanaka, M., Katayama, I., Yamabe, T., Yuji, D., Oosiro, N., & Sirouzu, M. (2015). Efficacy of Tolvaptan in Patients with Volume Overload after Cardiac Surgery. The Heart Surgery Forum, 18(6), E232-E236. https://doi.org/10.1532/hsf.1470

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