Hajjar et al. (2017)33 Hajjar LA, Vincent JL, Barbosa Gomes Galas FR, Rhodes A, Landoni G, Osawa EA, Melo RR, Sunding MR, Grande SM, Gaiotto FA, Pomerantzeff PM, Dallan LO, Franco RA, Nakamura RE, Lisboa LA, Almeida JP, Gerent AM, Souza DH, Gaiane MA Fukushima JT, Park CL, Zambolim C, Ferreira GSR, Strabelli TM, Fernande FL, Camara L, Zeferino S, Santos VG, Piccioni MA, Jatene FB, Auler Jr. JOC, Kalil Filho R. Vasopressin versus Norepinephrine in Patients with Vasoplegic Shock after Cardiac Surgery: The VANCS Randomized Controlled Trial. Anesthesiology. 2017;126(1):85–93. https://doi.org/10.1097/aln.0000000000001434 https://doi.org/10.1097/aln.000000000000...
|
Randomized trial |
300 |
Vasopressine (149) |
Cardiac surgery |
Aortic surgery, transplant |
Up to 48 hours CPB output |
Mortality |
Infection, septic shock |
First randomized study vasopressin as first choice |
|
|
|
Norepinephrine (151) |
> 18 years old |
Preoperative vasopressor use |
|
severe complications |
Arrhythmia-atrial fibrillation |
Reduced incidence of serious complications |
|
|
|
|
|
Severe hyponatremia |
|
In 30 days |
Length of stay and intensive unit care |
Shorter length of stay and intensive unit care |
|
|
|
|
|
Re-infarction, mesenteric ischemia |
|
|
Renal Failure |
Reduced incidence of atrial fibrillation |
|
|
|
|
|
|
|
|
|
Vasopressin may be preferable to norepinephrine |
Okamoto et al. (2015)1212 Okamoto Y, Nohmi T, Higa Y, Seki K, Yamashita A. Vasopressin does not raise cardiac enzymes following cardiac surgery: a randomized double-blind clinical trial. J Cardiothorac Vasc Anesth. 2015;29(1):46–51. https://doi.org/10.1053/j.jvca.2014.07.007 https://doi.org/10.1053/j.jvca.2014.07.0...
|
Randomized trial |
92 |
Vasopressine (47) |
Cardiac Surgery > 20 years old |
No intervention |
Intraoperative |
Elevation of cardiac enzymes |
Atrial fibrillation |
Stabilized hemodynamic parameters |
|
|
|
Placebo (45) |
|
Serious adverse event during the surgery |
anesthetic induction |
|
Vasoplegia during surgery |
Did not elevate cardiac enzymes |
|
|
|
|
|
|
Prophylatic |
|
Renal Failure |
Did not change surgical outcome |
|
|
|
|
|
|
|
|
length of stay and intensive unit care |
|
|
|
|
|
|
|
|
|
Mortality |
|
Jahangirifard et al. (2017)1313 Jahangirifard A, Golestani Eraghi M, Fani K, Tafrishinejad A, Dadashpour N, Ahmadi Z, Salajegheh S. Effect of Prophylactic Vasopressin on Hemodynamic Parameters after Coronary Artery Bypass Graft Surgery. J Cell Mol Anesth. 2017;2(3):97–102.
|
Randomized trial |
80 |
Vasopressine (40) |
CRV elective surgery |
Ejection fraction > 50 and < 35% |
30 minutes before |
Intensive unit care stay |
Use of dopamine |
Reduced required dose of dopamine |
|
|
|
Placebo (40) |
|
Renal Failure or hepatic dysfunction |
From the CPB exit |
Hazard ratio and blood pressure measurement |
Vent duration mechanics |
Decreased heart rate |
|
|
|
|
|
Epilepsy |
|
Urinary output |
|
Did not change length of stay |
|
|
|
|
|
emergency surgery |
|
Arrhythmia |
|
|
Dargah et al. (2018)1414 Dargah MS, Vakili N, Isazadefar J, Kebar K, Zade S, Vakili A. Comparative Analysis of the Effects of Vasopersin and Norepinephrine on the Renal Function in Patients Undergoing CABG; a randomized clinical trial. Iran Red Crescent Med J. 2018;20(8):e67026. https://doi.org/10.5812/ircmj.67026 https://doi.org/10.5812/ircmj.67026...
|
Randomized trial |
120 |
Vasopressine (60) |
CRV surgery |
Without RF, Creatinine > 1.5 |
Intraoperative |
Kidney function |
|
Norepinephrine had better result in renal function |
|
|
|
Norepinephrine (60) |
with CPB |
Diabetes |
|
|
|
Sodium, Potassium, Urea and Creatinine levels showed no difference |
|
|
|
|
> 30 years old |
Arterial hypertension |
|
|
|
|
Verma et al. (2022)1515 Verma I, Beelwal P, Verma C, Vyas CK. Hemodynamic Effects of Prophylactic Administration of Vasopressin in Patients Undergoing Off Pump Coronary Artery Bypass Graft Surgery: A Randomized Control Double Blind Interventional Study. Arch Anesth Crit Care. 2022;8(Suppl.):377–82.
|
Randomized trial |
60 |
Vasopressine (30) |
CRV surgery |
Ejection fraction < 30% |
After anesthetic induction |
Hemodynamic monitoring |
Adverse effects |
Prophylactic low-dose infusion is safe |
|
|
|
Placebo (30) |
without CPB |
Emergency surgery |
|
|
Cardiac enzyme elevation |
Cardio and nephroprotective |
|
|
|
|
Age between 30 and 70 years old |
Other surgeries |
|
|
Kidney function |
Better hemodynamic profile and less blood loss |
|
|
|
|
|
Diabetes mellitus, failure liver and renal |
|
|
|
Decreased need for ionotropic drug |
Elgebaly and Sabry (2012)1616 Elgebaly AS, Sabry M. Infusion of low-dose vasopressin improves left ventricular function during separation from cardiopulmonary bypass: a double-blind randomized study. Ann Card Anaesth. 2012;15(2):128–33. https://doi.org/10.4103/0971-9784.95076 https://doi.org/10.4103/0971-9784.95076...
|
Randomized trial |
20 |
Vasopressine (10) |
CRV surgery |
ejection fraction < 30% |
10 minutes before |
Hemodynamic monitoring |
Length of stay and intensive unit care |
Prophylactic low-dose infusion |
|
|
|
Placebo (10) |
ejection fraction between 35 and 50% |
Presence of prior shock |
From the CPB exit |
|
|
Reduce dose of catecholamines |
|
|
|
|
|
Dysfunction hepatic, adrenal and renal |
Holds up to 60 minutes |
|
|
Prevents incidence of vasoplegic shock |
|
|
|
|
|
Carotic stenosis |
from the CPB exit |
|
|
Decreased CPB side effects |
Eissa (2014)1717 Eissa MIA. Prophylactic vasopressin versus norepinephrine in patients receiving the angiotensin-converting enzyme inhibitor undergoing coronary artery bypass graft surgery. AAMJ. 2014;12(4).
|
Randomized trial |
60 |
ACEi + Placebo (20) |
CRV elective surgery |
Valvopathy or congestive heart failure |
20 minutes before start |
Hemodynamic monitoring |
Duration Ventilation mechanics |
Use of vasopressin is more beneficial than norepinephrine |
|
|
|
ACEi + Norepinephrine (20) |
With CPB |
Dysfunction left ventricle moderate or severe |
of the CPB |
|
Length of stay and intensive care unit |
Low-dose vasopressin preventive vasoplegic shock |
|
|
|
ACEi + Vasopressine (20) |
ACEi use (lisinopril) |
Prior shock |
|
|
Need for transfusion |
Decreased time on Ventilation mechanics and intensive care unit stay |
|
|
|
|
Normal LV function or mild disfuction |
Pulmonary hypertension |
|
|
Use of vasoactive drugs |
|
Porhomayon et al. (2015)1818 Porhomayon J, Davari-Farid S, Li CM, Arora P, Pourafkari L, Nader ND. Intraoperative administration of vasopressin during coronary artery bypass surgery is associated with acute postoperative kidney injury. J Crit Care. 2015;30(5):963–8. https://doi.org/10.1016/j.jcrc.2015.06.013 https://doi.org/10.1016/j.jcrc.2015.06.0...
|
Retrospective control case |
483 |
Vasopressine (280) |
CRV surgery |
Other cardiac surgery |
Undefined |
Insufficiency acute renal (AKIN-1) |
Mortality |
99% male patients (Veterans Hospital) |
|
|
|
Without Vasopressina (203) |
|
Off-pump surgery creatinine > 1.5 or RF stage 3 |
Perioperative |
|
Stroke/sepsis E-infarction |
Vasopressin has been associated with greater kidney damage |
Bomberg et al. (2016)1919 Bomberg H, Groesdonk HV, Raffel M, Minko P, Schmied W, Klingele M, Schäfers H-J. Vasopressin as Therapy During Nonocclusive Mesenteric Ischemia. Ann Thorac Surg. 2016;102(3):813–9. https://doi.org/10.1016/j.athoracsur.2016.03.025 https://doi.org/10.1016/j.athoracsur.201...
|
Observational cohort |
78 |
Vasopressine + Norepinephrine (11) |
Mesenteric ischemia |
|
Intensive unit care |
Mortality |
E-infarction |
Data before angiography, after 24 and 48 hours of treatment |
|
|
|
Norepinephrine (67) |
Non-occlusive |
|
|
|
Length of stay and intensive unit care |
Benefit in the use of vasopressin associated with Nora |
|
|
|
|
after heart surgery |
|
|
|
|
Improvement of small intestine perfusion |
Cheng et al. (2018)2020 Cheng Y, Pan T, Ge M, Chen T, Ye J, Lu L, Chen C, Zong Q, Ding Y, Wang D. Evaluation of Vasopressin for Vasoplegic Shock in Patients With Preoperative Left Ventricular Dysfunction After Cardiac Surgery: A Propensity-Score Analysis. Shock. 2018;50(5):519–24. https://doi.org/10.1097/shk.0000000000001114 https://doi.org/10.1097/shk.000000000000...
|
Retrospective cohort |
338 |
Vasopressine (169) |
Cardiac surgery |
|
Intensive unit care admission |
Mortality within 30 days |
Infection, septic shock |
Atrial fibrillation and arrhythmias were higher in the vasopressin group |
|
|
|
Norepinephrine (169) |
> 18 years old |
Congenic cardiopatics |
|
Vent. Mechanics > 48 hours |
Atrial fibrillation |
No improvement of results |
|
|
|
|
Ejection fraction < 35% |
Acute mesenteric ischemia |
|
Cardiac re-operation |
Arrhythmias |
|
|
|
|
|
diameter left ventricular diameter > 60 mm |
Pregnancy, cancer |
|
Stroke and acute kidney injury |
|
|
|
|
|
|
Post operative vasoplegic shock |
Use extracorporeal membrane oxygenation |
|
|
|
|