Effect of Prophylactic Vasopressin on Hemodynamic Parameters after Coronary Artery Bypass Graft Surgery

Background: As common complications of coronary artery bypass grafting(CABG), low vascular resistance and hypotension could be life threatening.The aim of present study was to investigate the effect of low-dose vasopressinon hemodynamics in CABG patients.Materials and Methods: In this randomized double-blinded clinical trial, 80patients undergoing selective CABG were randomly divided into two equalcase and control groups (n=40). Case group was received vasopressin 0.03IU/min 30 minutes before the end of cardio-pulmonary bypass (CPB) untilone hour after that. Control group was received normal saline in the samemanner. Dopamine requirement, ICU stay, heart rate (HR), mean arterialblood pressure (MAP), central venues pressure (CVP) and atrial blood acidity(pH) were recorded and compared between groups in 5 phases(0,30,60,90,120 min) after separation of CPB.Results: There was no significant difference between two groups in numberof patients with severe hypotension (11 vs. 12 patients in case and controlgroup respectively). CVP was corrected and then dopamine administrationwas compared in both groups. In vasopressin and the placebo group, 3 vs.11 patients need to dopamine administration immediately after separationfrom CPB (p= 0.018) and 4 vs. 12 patients later in ICU (p=0.024),respectively. The mean needed dose of dopamine in vasopressin andplacebo group immediately after separation from CPB were 7.63±3.42 vs.9.21±2.08 μg/kg/min (p=0.031) and later in ICU were 7.42±2.02 vs.8.66±4.08 μg/kg/min (p=0.045) respectively, which was significantly lowerin vasopressin group in comparison with the placebo group.Conclusion: Based on our results, low-dose vasopressin administrationsignificantly reduced the mean needed dose of required dopamine, 24 hoursurinary output, Duration of mechanical ventilation and patient’s heart rate.

Keywords:

Cardiac , surgical , procedure , Hemodynamics , Vasopressin