Perioperative Use of Pituitrin after Cardiac Defect Repair in Adult Patients with Severe Pulmonary Hypertension

Authors

  • Yuntao Li, MD Department of Cardiac Surgery, Peking University International Hospital, Beijing, China https://orcid.org/0000-0002-4803-0941
  • Mingwui Tung, MD Department of Cardiac Surgery, Peking University International Hospital, Beijing, China
  • Jianping Xu, MD Department of Cardiac Surgery, Peking University International Hospital, Beijing, China
  • Guangyu Pan, MD Department of Cardiac Surgery, Peking University International Hospital, Beijing, China
  • Rui Jiang, MD Adult Cardiac Surgery Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

DOI:

https://doi.org/10.1532/hsf.4569

Keywords:

Pulmonary artery hypertension, congenital heart diseases, vasopressin, pituitrin, hemodynamic

Abstract

Background: Vasopressin can constrict peripheral arteries without constricting the pulmonary artery. Theoretically, vasopressin is suitable for the perioperative treatment of pulmonary hypertension. Few studies have investigated the use of pituitrin (a substitute for vasopressin) after cardiac defect repair surgery. This study aimed to analyze the effect of pituitrin on hemodynamics and to determine whether pituitrin can be used after surgical repair in adult patients with pulmonary arterial hypertension-congenital heart disease (PAH-CHD).

Methods: A pulmonary artery catheter was used in all the patients for hemodynamic monitoring. Hemodynamic parameters were recorded before and at 0.5 h, 1 h, 6 h, 12 h and 24 h after pituitrin administration. The changes in the hemodynamic parameters before and after pituitrin use were analyzed through repeated measures analysis of variance.

Results: A total of 110 patients with PAH-CHD underwent repair surgery; 23 patients were included in further analysis, including 11 with atrial septal defect, 9 with ventricular septal defect, and 3 with patent ductus arteriosus. Ten (43.5%) were men, with a mean age of 29.4 ± 6.8 years. Hemodynamic parameters before and after the oxygen test were as follows: radial artery oxygen saturation, 91.5% ± 4.4 vs. 97.9 ± 2.4%; pulmonary vascular resistance, 10.5 ± 1.8 Wood units (wu) vs. 5 ± 1.2 wu; systemic-pulmonary blood flow ratio (QP/QS), 1.1 ± 0.2 vs. 2.1 ± 0.9. With prolonged use, the systolic blood pressure of the radial artery increased significantly (P = 0.001), that of the pulmonary artery decreased significantly (P = 0.009), and RP/s decreased significantly (P < 0.001).

Conclusion: Pituitrin as an alternative to vasopressin can increase arterial pressure, decrease pulmonary artery pressure, and reduce the pulmonary artery pressure/arterial pressure ratio after repair surgery in adult patients with PAH-CHD.

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Published

2022-04-21

How to Cite

Li, Y., Tung, M. ., Xu, J., Pan, G., & Jiang, R. (2022). Perioperative Use of Pituitrin after Cardiac Defect Repair in Adult Patients with Severe Pulmonary Hypertension. The Heart Surgery Forum, 25(2), E277-E283. https://doi.org/10.1532/hsf.4569

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Section

Articles