Sun Yan-Ting, Wang Li-Hong, Yao Yun-Tai
Department of Anesthesiology, Baoji high-tech Hospital, Shaanxi, China.
Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Medicine (Baltimore). 2025 May 2;104(18):e42333. doi: 10.1097/MD.0000000000042333.
This study aimed to retrospectively summarize the use of vasoactive-inotropic agents in pediatric patients undergoing cardiac surgery at Fuwai Hospital. A total of 401 patients who met the screening criteria were enrolled in this study between April and June 2021 at Fuwai Hospital. We retrospectively summarized the current practices for vasoactive-inotropic agent use across different ages, Risk Adjustment in Cardiac Surgery 1 (RACHS-1) categories, and among various anesthesiologists. Intraoperatively, milrinone was the most commonly used inotrope (327 patients, 81.6%), followed by dopamine (274, 68.3%), dobutamine (263, 65.4%), epinephrine (67, 16.7%), and isoprenaline (11, 2.7%). Vasopressin was mainly administered during the pediatric intensive care unit period, with the highest use rate on postoperative day (POD)-1 (16/401, 3.9%). Furthermore, a combination of dopamine, dobutamine, and milrinone was administered by 52.1% of anesthesiologists intraoperatively and by 30.2% of pediatric intensivists on POD 1. Milrinone, dopamine, and dobutamine were selected by most anesthesiologists (13/14, 92.9%), and their usage rates among different anesthesiologists ranged from 66.67% to 92.68%, 52.94% to 89.66%, and 46.18% to 86.21%, respectively. Moreover, their use in category 4 surgeries was significantly higher than in category 1 to 3 surgeries. Milrinone, dopamine, and dobutamine were the most commonly used vasoactive-inotropic agents, while the other agents represented the diversity of medications used during both the intra- and postoperative periods in pediatric cardiac surgery at Fuwai Hospital.
本研究旨在回顾性总结阜外医院接受心脏手术的儿科患者血管活性药物的使用情况。2021年4月至6月期间，共有401名符合筛查标准的患者在阜外医院纳入本研究。我们回顾性总结了不同年龄、心脏手术风险调整1（RACHS-1）类别以及不同麻醉医生使用血管活性药物的当前做法。术中，米力农是最常用的正性肌力药物（327例患者，81.6%），其次是多巴胺（274例，68.3%）、多巴酚丁胺（263例，65.4%）、肾上腺素（67例，16.7%）和异丙肾上腺素（11例，2.7%）。血管加压素主要在儿科重症监护病房期间使用，术后第1天（POD-1）使用率最高（16/401，3.9%）。此外，52.1%的麻醉医生在术中联合使用多巴胺、多巴酚丁胺和米力农，30.2%的儿科重症监护医生在POD 1使用。大多数麻醉医生（13/14，92.9%）选择米力农、多巴胺和多巴酚丁胺，其在不同麻醉医生中的使用率分别为66.67%至92.68%、52.94%至89.66%和46.18%至86.21%。此外，它们在4类手术中的使用显著高于1至3类手术。米力农、多巴胺和多巴酚丁胺是最常用的血管活性药物，而其他药物则代表了阜外医院儿科心脏手术术中及术后使用药物的多样性。
