Publication Date
3-1-2022
Journal
The Journal of Thoracic and Cardiovascular Surgery
DOI
10.1016/j.xjon.2022.01.008
PMID
36003471
PMCID
PMC9390553
PubMedCentral® Posted Date
1-22-2022
PubMedCentral® Full Text Version
Post-print
Published Open-Access
yes
Keywords
Norwood procedure, single ventricle, vasopressin, afterload, pulmonary to systemic perfusion ratio, oxygen delivery, near infrared spectroscopy oximetry
Abstract
OBJECTIVES: Arginine vasopressin (AVP) is used to treat hypotension. Because AVP increases blood pressure by increasing systemic vascular resistance, it may have an adverse effect on tissue oxygenation following the Norwood procedure.
METHODS: Retrospective analysis of continuously captured hemodynamic data of neonates receiving AVP following the Norwood procedure.
RESULTS: We studied 64 neonates exposed to AVP within 7 days after the Norwood procedure. For the entire group, AVP significantly increased mean blood pressure (2.5 ± 6.3) and cerebral and renal oxygen extraction ratios (4.1% ± 9.6% and 2.0% ± 4.7%, respectively;
CONCLUSIONS: The right ventricle to pulmonary artery shunt cohort experienced a significant vasopressor response to AVP that was associated with a significant increase in pulmonary perfusion and decrease in cerebral and renal perfusion, whereas the Blalock-Taussig shunt cohort experienced a less significant vasopressor response and no change in pulmonary or systemic perfusion. The influence of AVP on tissue oxygenation following the Norwood procedure may have clinical implications that require further study.
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Cardiology Commons, Cardiovascular Diseases Commons, Congenital, Hereditary, and Neonatal Diseases and Abnormalities Commons, Medical Sciences Commons, Pediatrics Commons