Vasoplegic syndrome is a common complication after cardiac surgery. Low dose vasopressin can up-regulate blood pressure and improve clinical outcomes compared with norepinephrine (mainly acute kidney injury Anesthesiology 2017; 126:85-93). Pituitrin is used as a substitute for vasopressin in our center, which contains both vasopressin and oxytocin. Oxytocin may alleviate inflammatory process-associated kidney injury (Peptides 2006;27:2249-57). Therefore, the investigators hypothesize Pituitrin may be preferable to norepinephrine in the renal protection of patients with vasoplegic syndrome after cardiac surgery. Moreover, the serum levels of vasopressin, catecholamine, corticosteroid and corticotropin-releasing hormone will be measured.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
120
To begin with 0.02 U/min to maintain mean arterial pressure(MAP) higher than 65 mmHg.
To begin with 0.04 μg/kg.min to maintain mean arterial pressure(MAP) higher than 65 mmHg.
Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University
Beijing, Beijing Municipality, China
RECRUITINGRate of in-hospital acute renal injury
Acute renal injury (AKI) is defined as any of the following: (1) increase in serum creatinine (SCr) by ≥ 26.5lmol/l in 48 hours; (2) increase in SCr to ≥ 1.5 times baseline, which is known or presumed to have occurred within the prior 7 days; or (3) urine output \< 0.5 ml/kg/h for 6 hours (urine output is only assessed when the CRRT machine is absent or with a fluid removal rate of 0 ml/h).
Time frame: 30 days
In-hospital mortality
All-cause mortality
Time frame: 30 days
Rate of new arrhythmias
Rate of new arrhythmias after cardiac surgery
Time frame: 30 days
Hormone levels
Serum hormone levels after cardiac surgery, including vasopressin, catecholamine, corticosteroid and corticotropin-releasing hormone
Time frame: 30 days
Rate of ECMO or LVAD support
Receiving extracorporeal membrane oxygenation (ECMO) or left ventricle assist device (LVAD) support
Time frame: 30 days
Duration on ventilator support
Duration on ventilator support after cardiac surgery
Time frame: 30 days
ICU length of stay
ICU length of stay
Time frame: 30 days
Hospital length of stay after cardiac surgery
Hospital length of stay after cardiac surgery
Time frame: 30 days
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