This is a randomized, open label study to investigate vasopressin versus phenylephrine as a first line pressor in cardiac surgery. All patients \>18 years of age presenting for coronary artery bypass graft (CABG), valve surgery, or combined CABG and valve surgery will be screened for inclusion. Patients with ejection fraction \< 35%, \> moderate pulmonary hypertension, \> mild right ventricular dysfunction, a planned radial arterial graft, or circulatory arrest will be excluded. Patients will be randomized to receive either vasopressin or phenylephrine as the first line vasopressor during the perioperative period to maintain mean arterial blood pressure \>65 mmhg. Primary outcome is acute kidney injury. Secondary outcomes are 30-day mortality, stroke, myocardial infarction, re-operation, sternal infection, atrial fibrillation, intensive care unit length of stay, and total vasopressor hours.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
300
Vasopressin titrated 0.01 U/min up to 0.04 U/min for MAP \< 65 mmHg
Phenylephrine titrated 0.25 mcg/kg/min up to 1.0 mcg/kg/min for MAP \< 65 mmHg
Thomas Jefferson Univesity
Philadelphia, Pennsylvania, United States
RECRUITINGNumber of patients with acute kidney injury
KDIGO criteria
Time frame: 5 Days
Number of patients with 30-Day Mortality
Number of patients with 30-Day Mortality
Time frame: 30 Days
Number of patients with reoperation
Number of patients with reoperation
Time frame: 5 Days
Number of patients with sternal Infection
Number of patients with sternal Infection
Time frame: 5 Days
Number of patients with Atrial Fibrilation
Number of patients with Atrial Fibrilation
Time frame: 5 Days
ICU Length of Stay
Total ICU Length of Stay
Time frame: 5 Days
Total Vasopressor Hours
Total Vasopressor Hours
Time frame: 5 Days
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