Vasoplegic syndrome after cardiac surgery is a common complication after cardiac surgery, with negative impact on patient outcomes and hospital costs. Pathogenesis of vasodilatory phenomenon after cardiac surgery remains a matter of controversy. Loss of vascular tone can be partly explained by the depletion of neurohypophyseal arginine vasopressin stores. The investigators hypothesized that the use of arginine vasopressin would be more effective on treatment of shock after cardiac surgery than norepinephrine, decreasing the composite end point of mortality and severe morbidity.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
300
Blinded Vasopressin will be started if there is persistent hypotension, characterized by mean arterial pressure \<65 mmHg after fluid replacement.
Blinded Norepinephrine will be started if there is persistent hypotension, characterized by mean arterial pressure \<65 mmHg after fluid replacement
Instituto do Coração
São Paulo, São Paulo, Brazil
RECRUITINGComposite endpoint of major morbidity according to Society of Thoracic Surgery
The primary end point is major morbidity according to STS (30-days mortality, mechanical ventilation \> 48 hours, mediastinitis, surgical reexploration, stroke, acute renal failure)
Time frame: 30 days
Hemodynamic effects
the time to attainment of hemodynamic stability ; the changes in hemodynamic variables; and the use of dobutamine or other inotropic agents.
Time frame: 28 days
occurence of adverse events and safety
Adverse events were categorized as arrhythmias, myocardial necrosis, skin necrosis, ischemia in limbs or distal extremities, or secondary infections
Time frame: 28 days
Time on mechanical ventilation
Days on mechanical ventilation during 30-days after surgery.
Time frame: 30 days
Incidence of infecction
Incidence of new infecction, sepsis, severe sepsis or septic shock in 30 days after surgery.
Time frame: 30-days
Length of ICU and Hospital stay
Compare between groups the period of time (days) that patients were in ICU and in Hospital.
Time frame: 90 days
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