The effect of vasopressin on the hemodynamics in CABG patients.

BACKGROUND

Vasopressin is widely used to treat various type of hypotension, but the effect of vasopressin on coronary artery bypass grafting surgery (CABG) patients is not clear. This study was to investigate the effect of vasopressin on the hemodynamics in CABG patients.

METHODS

Twenty coronary artery disease (CAD) patients were randomly divided into two groups: norepinephrine group and vasopressin group. During the anesthesia and the operation, the central venous pressure (CVP) and pulmonary capillary wedge pressure (PCWP) were maintained to 8-10cmH2O, and the hemocrit was maintained above 30% through lactate ringer's mixture, artifact colloid and red blood cells. The invasive artery blood pressure (IBP) was maintained by appropriate anesthetic depth and norepinephrine or vasopressin respectively. The target IBP was 70 mmHg, and heart rate (HR) was 60 bpm. The MAP (mean artery pressure), HR, ST-T, CVP, PAP (pulmonary artery pressure), PCWP, SVR (systemic vascular resistance), PVR (pulmonary vascular resistance), CO (cardiac output), urine output, blood gas analysis, surgery duration and blood loss were monitored.

RESULTS

The MAP, HR, and ST-T were stable in either group during the operation. CVP, PCWP and SVR increased but CI deceased during the posterior descending artery (PDA) was grafted in both groups and without any significant difference between them. PAP increased during PDA was grafted in either group and there was significant difference between the two groups. PVR increased during ADA and PDA being grafted in norepinephrine group but not in vasopressin group. Metoprolol usage was 11.2 mg and 5.9 mg in norepinephrine group and vasopressin group respectively.

CONCLUSION

Vasopressin was better than norepinephrine.to keep the hemodynamics stability of patients undergoing CABG surgery.