Advent of New perioperative care for fluid management after cardiovascular surgery: A review of current evidence

Nishi, Hiroyuki

doi:10.1016/j.jjcc.2019.12.010

Cited by 10 publications

(13 citation statements)

References 55 publications

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“…One potential bias is the differences in administered medication regimes, especially those affecting hemodynamics (diuretics, 27 , 28 , 29 , 30 inotropes, RAAS antagonists, etc) and therefore, directly or indirectly, impacting RAAS. Among the prescribed contents before surgery, diuretics (7/8 dogs) and amlodipine (6/8 dogs) activate the RAAS, whereas ACEIs (4/8 dogs) and spironolactone (1/8 dogs) suppress the system.…”

Section: Discussionmentioning

confidence: 99%

“…Our data is unique in that RAAS activity was shown to be associated, at least to some extent, with echocardiographic indicators that reflect the severity of the disease. From this perspective, postoperative echocardiographic changes and RAAS might as well be applicable in reverse One potential bias is the differences in administered medication regimes, especially those affecting hemodynamics (diuretics, [27][28][29][30] inotropes, RAAS antagonists, etc) and therefore, directly or indirectly, impacting RAAS. Among the prescribed contents before surgery, diuretics Furthermore, only conventional components of RAAS were considered in this relatively short-term study.…”

Section: Discussionmentioning

confidence: 99%

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Changes in renin‐angiotensin‐aldosterone system during cardiac remodeling after mitral valvuloplasty in dogs

Cheng

Mandour

Yoshida

et al. 2022

Veterinary Internal Medicne

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Background Information regarding changes in renin‐angiotensin‐aldosterone system (RAAS) during cardiac remodeling after mitral valvuloplasty (MVP) in dogs remains lacking. Hypothesis/Objectives To assess the longitudinal effects of MVP on circulating RAAS activity. Animals Eight client‐owned dogs receiving MVP for myxomatous mitral valve disease (MMVD). Methods This is a cohort study. Plasma renin activity (PRA), angiotensin II (AT2), aldosterone (PAC), blood urea nitrogen (BUN), and creatinine concentrations, were measured in these dogs before (baseline) and at 3 consecutive monthly follow‐ups (Post‐1M, Post‐2M, Post‐3M). Echocardiography was concomitantly used to assess the process of cardiac recovery after MVP. Results The echocardiography revealed a significant decrease in LVIDDN, LA/Ao, FS, E velocity, E/A, E′ sep, S′ lat, E′ lat, and A′ lat after MVP compared with baseline (P < .05). There was a significant reduction in the PRA (2.45, 3.05, 2.74 vs 8.8 ng/mL/h; P = .002), AT2 (466, 315, 235 vs 1200 pg/mL; P = .009), and PAC (39.88, 47, 54.62 vs 179.5 pg/mL; P = .01), respectively at Post‐1M, Post‐2M, Post‐3M compared to the baseline. Additionally, BUN and creatinine concentrations decreased from Post‐1M. The RAAS variables showed significant, weak to moderate, relationship with selected echocardiographic variables. Conclusions and Clinical Importance Mitral valvuloplasty contributes to decreased RAAS activity in MMVD dogs, which paralleled the process of cardiac reverse remodeling up to Post‐3M. This information facilitates formulating strategies to optimize clinical outcomes for dogs after MVP.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Changes in renin‐angiotensin‐aldosterone system during cardiac remodeling after mitral valvuloplasty in dogs

Cheng

Mandour

Yoshida

et al. 2022

Veterinary Internal Medicne

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“…While the effectiveness of TLV for ADHF treatment has been well established, long-term TLV administration for CHF treatment remains controversial. Although several recent studies have demonstrated the usefulness of TLV in patients with CHF, most of them had a small sample size and were observational studies [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] . Furthermore, the cost of TLV is much higher than that of other conventional drugs for HF treatment; however, no study has investigated the cost-effectiveness of long-term TLV administration for CHF treatment in Japan.…”

Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness of long-term tolvaptan administration for chronic heart failure treatment in Japan

Nakao

Kawakami

Saito³

et al. 2022

Journal of Cardiology

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“…The use of Deep Hypothermic Circulatory Arrest (DHCA) can prolong cardiopulmonary bypass time, cause vascular endothelial dysfunction, and promote in ammatory responses (7)(8)(9). Therefore, su cient volume is required to avert intravascular hypovolemia soon after surgery, due to the persistence of altered vascular permeability and colloidal osmotic pressure (10). The volume is then reduced after stabilization of in ammation and temperature (11).…”

Section: Introductionmentioning

confidence: 99%

“…To date, there have been numerous reports indicating the usefulness of tolvaptan in managing postoperative uid volumes in patients with cardiac diseases treated with surgery (10). However, despite the acceptance of tolvaptan for various types of cardiovascular conditions treated by surgery, there is limited information on its use after surgery for type A AD.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of tolvaptan in postoperative volume therapy for acute Stanford type A aortic dissection

Wang

Gao

et al. 2022

Preprint

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Objective: Despite the increasing application of tolvaptan in cardiac surgery, there is no information on the use of tolvaptan in Stanford patients with type A aortic dissection. The objective of this study is to evaluate the clinical effect of tolvaptan in patients with type A aortic dissection after surgery.Methods: A retrospective analysis was performed on 45 patients treated for type A aortic dissection in our hospital from 2018 to 2020, including 21 patients who were treated with Group T and 24 patients who were not treated with Group L. Perioperative data were collected from the hospital's electronic records.Results: Patients receiving tolvaptan did not differ significantly from those on traditional diuretics in terms of the duration of mechanical ventilation, postoperative blood required, length of catecholamine use, or amount of diuretics received (all P> 0.05). The development of new atrial fibrillation was significantly less in the tolvaptan group (P=0.023). Urine volume was slightly, but non-significantly, higher in patients receiving tolvaptan. Serum levels of potassium, creatinine, and urea nitrogen did not differ between the groups in the week after surgery, while that of sodium was significantly higher in the tolvaptan-treated group on day 7 after transfer from the ICU (P=0.001). Sodium levels were also elevated by day 7 in patients receiving traditional diuretics (P=0.001). The serum creatinine and urea nitrogen levels were raised on both days 3 and 7 in both groups (both P<0.05).Conclusions: For patients after acute Stanford type A aortic dissection, both tolvaptan and traditional diuretics are effective and safe. Tolvaptan is more effective in reducing the incidence of postoperative atrial fibrillation. For patients following Acute Stanford A aortic dissection surgery, tolvaptan did not provide a greater advantage over loop diuretics in terms of fluid clearance, but it may reduce the incidence of postoperative atrial fibrillation.

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Advent of New perioperative care for fluid management after cardiovascular surgery: A review of current evidence

Cited by 10 publications

References 55 publications

Changes in renin‐angiotensin‐aldosterone system during cardiac remodeling after mitral valvuloplasty in dogs

Changes in renin‐angiotensin‐aldosterone system during cardiac remodeling after mitral valvuloplasty in dogs

Cost-Effectiveness of long-term tolvaptan administration for chronic heart failure treatment in Japan

Efficacy of tolvaptan in postoperative volume therapy for acute Stanford type A aortic dissection

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