Vasopressin-Induced Hyponatremia in Infants Following Cardiovascular Surgery
Background Vasopressin is increasingly used in infants following cardiac surgery. Hyponatremia is a noted adverse event, but incidence and risk factors remain undefined. Objective The primary objective was to identify the incidence of vasopressin-induced hyponatremia. Secondary objectives included c...
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| Veröffentlicht in: | The Annals of pharmacotherapy 2023-03, Vol.57 (3), p.259-266 |
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| creator | Bradford, Caitlyn V. Miller, Jamie L. Ranallo, Courtney D. Neely, Stephen B. Johnson, Peter N. |
| description | Background
Vasopressin is increasingly used in infants following cardiac surgery. Hyponatremia is a noted adverse event, but incidence and risk factors remain undefined.
Objective
The primary objective was to identify the incidence of vasopressin-induced hyponatremia. Secondary objectives included comparing baseline and change in serum sodium concentrations between infants receiving vasopressin with and without hyponatremia, and comparing vasopressin dose, duration, and clinical characteristics in those with and without hyponatremia.
Methods
This Institutional Review Board–approved, retrospective case-control study included infants |
| doi_str_mv | 10.1177/10600280221103576 |
| format | Article |
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Vasopressin is increasingly used in infants following cardiac surgery. Hyponatremia is a noted adverse event, but incidence and risk factors remain undefined.
Objective
The primary objective was to identify the incidence of vasopressin-induced hyponatremia. Secondary objectives included comparing baseline and change in serum sodium concentrations between infants receiving vasopressin with and without hyponatremia, and comparing vasopressin dose, duration, and clinical characteristics in those with and without hyponatremia.
Methods
This Institutional Review Board–approved, retrospective case-control study included infants <6 months following cardiac surgery receiving vasopressin for ≥6 hours at a tertiary care, academic hospital. Patients who developed hyponatremia, cases, were matched to controls in a 1:2 fashion. Demographics and clinical characteristics were collected. Descriptive and inferential statistics were employed. A conditional logistic regression was used to assess odds of hyponatremia.
Results
Of the included 142 infants, 20 (14.1%) developed hyponatremia and were matched with 40 controls. There was significant difference in median nadir between controls and cases, 142.0 versus 128.5 mEq/L (<0.001). A significantly higher number of cases received corticosteroids, loop diuretics, and chlorothiazide versus controls. The regression analysis demonstrated that each additional hour of vasopressin increased the odds of developing hyponatremia by 5% (adjusted odds ratio 1.05 [confidence interval 1-1.1]).
Conclusions and relevance
Vasopressin-induced hyponatremia incidence was <15%. Vasopressin duration was independently associated with hyponatremia development.</description><identifier>ISSN: 1060-0280</identifier><identifier>EISSN: 1542-6270</identifier><identifier>DOI: 10.1177/10600280221103576</identifier><identifier>PMID: 35713009</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Case-Control Studies ; Humans ; Hyponatremia - chemically induced ; Hyponatremia - epidemiology ; Infant ; Retrospective Studies ; Risk Factors ; Vasopressins - adverse effects</subject><ispartof>The Annals of pharmacotherapy, 2023-03, Vol.57 (3), p.259-266</ispartof><rights>The Author(s) 2022</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c222t-b4d088432c1268c02c71561761e65edf72b8da303a54a38c1c862d75dad1052d3</cites><orcidid>0000-0003-3022-4403 ; 0000-0003-2637-2550</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/10600280221103576$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/10600280221103576$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35713009$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bradford, Caitlyn V.</creatorcontrib><creatorcontrib>Miller, Jamie L.</creatorcontrib><creatorcontrib>Ranallo, Courtney D.</creatorcontrib><creatorcontrib>Neely, Stephen B.</creatorcontrib><creatorcontrib>Johnson, Peter N.</creatorcontrib><title>Vasopressin-Induced Hyponatremia in Infants Following Cardiovascular Surgery</title><title>The Annals of pharmacotherapy</title><addtitle>Ann Pharmacother</addtitle><description>Background
Vasopressin is increasingly used in infants following cardiac surgery. Hyponatremia is a noted adverse event, but incidence and risk factors remain undefined.
Objective
The primary objective was to identify the incidence of vasopressin-induced hyponatremia. Secondary objectives included comparing baseline and change in serum sodium concentrations between infants receiving vasopressin with and without hyponatremia, and comparing vasopressin dose, duration, and clinical characteristics in those with and without hyponatremia.
Methods
This Institutional Review Board–approved, retrospective case-control study included infants <6 months following cardiac surgery receiving vasopressin for ≥6 hours at a tertiary care, academic hospital. Patients who developed hyponatremia, cases, were matched to controls in a 1:2 fashion. Demographics and clinical characteristics were collected. Descriptive and inferential statistics were employed. A conditional logistic regression was used to assess odds of hyponatremia.
Results
Of the included 142 infants, 20 (14.1%) developed hyponatremia and were matched with 40 controls. There was significant difference in median nadir between controls and cases, 142.0 versus 128.5 mEq/L (<0.001). A significantly higher number of cases received corticosteroids, loop diuretics, and chlorothiazide versus controls. The regression analysis demonstrated that each additional hour of vasopressin increased the odds of developing hyponatremia by 5% (adjusted odds ratio 1.05 [confidence interval 1-1.1]).
Conclusions and relevance
Vasopressin-induced hyponatremia incidence was <15%. Vasopressin duration was independently associated with hyponatremia development.</description><subject>Case-Control Studies</subject><subject>Humans</subject><subject>Hyponatremia - chemically induced</subject><subject>Hyponatremia - epidemiology</subject><subject>Infant</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Vasopressins - adverse effects</subject><issn>1060-0280</issn><issn>1542-6270</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kM1OwzAQhC0EoqXwAFxQjlxSvJvEdo-oorRSJQ78XCPXdqpUiR3sBNS3x1WBCxKn3dV-M9IMIddApwCc3wFllKKgiAA0Kzg7IWMockwZcnoa9_hPD8CIXISwo5TOAGfnZBRZyOI1Jus3GVznTQi1TVdWD8roZLnvnJW9N20tk9omK1tJ24dk4ZrGfdZ2m8yl17X7kEENjfTJ8-C3xu8vyVklm2CuvueEvC4eXubLdP30uJrfr1OFiH26yTUVIs9QATKhKCoOBQPOwLDC6IrjRmiZ0UwWucyEAiUYal5oqYEWqLMJuT36dt69Dyb0ZVsHZZpGWuOGUCLjIsdZLmhE4Ygq70Lwpio7X7fS70ug5aHE8k-JUXPzbT9sWqN_FT-tRWB6BILcmnLnBm9j3H8cvwDk3XjK</recordid><startdate>202303</startdate><enddate>202303</enddate><creator>Bradford, Caitlyn V.</creator><creator>Miller, Jamie L.</creator><creator>Ranallo, Courtney D.</creator><creator>Neely, Stephen B.</creator><creator>Johnson, Peter N.</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3022-4403</orcidid><orcidid>https://orcid.org/0000-0003-2637-2550</orcidid></search><sort><creationdate>202303</creationdate><title>Vasopressin-Induced Hyponatremia in Infants Following Cardiovascular Surgery</title><author>Bradford, Caitlyn V. ; Miller, Jamie L. ; Ranallo, Courtney D. ; Neely, Stephen B. ; Johnson, Peter N.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c222t-b4d088432c1268c02c71561761e65edf72b8da303a54a38c1c862d75dad1052d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Case-Control Studies</topic><topic>Humans</topic><topic>Hyponatremia - chemically induced</topic><topic>Hyponatremia - epidemiology</topic><topic>Infant</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Vasopressins - adverse effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bradford, Caitlyn V.</creatorcontrib><creatorcontrib>Miller, Jamie L.</creatorcontrib><creatorcontrib>Ranallo, Courtney D.</creatorcontrib><creatorcontrib>Neely, Stephen B.</creatorcontrib><creatorcontrib>Johnson, Peter N.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Annals of pharmacotherapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bradford, Caitlyn V.</au><au>Miller, Jamie L.</au><au>Ranallo, Courtney D.</au><au>Neely, Stephen B.</au><au>Johnson, Peter N.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Vasopressin-Induced Hyponatremia in Infants Following Cardiovascular Surgery</atitle><jtitle>The Annals of pharmacotherapy</jtitle><addtitle>Ann Pharmacother</addtitle><date>2023-03</date><risdate>2023</risdate><volume>57</volume><issue>3</issue><spage>259</spage><epage>266</epage><pages>259-266</pages><issn>1060-0280</issn><eissn>1542-6270</eissn><abstract>Background
Vasopressin is increasingly used in infants following cardiac surgery. Hyponatremia is a noted adverse event, but incidence and risk factors remain undefined.
Objective
The primary objective was to identify the incidence of vasopressin-induced hyponatremia. Secondary objectives included comparing baseline and change in serum sodium concentrations between infants receiving vasopressin with and without hyponatremia, and comparing vasopressin dose, duration, and clinical characteristics in those with and without hyponatremia.
Methods
This Institutional Review Board–approved, retrospective case-control study included infants <6 months following cardiac surgery receiving vasopressin for ≥6 hours at a tertiary care, academic hospital. Patients who developed hyponatremia, cases, were matched to controls in a 1:2 fashion. Demographics and clinical characteristics were collected. Descriptive and inferential statistics were employed. A conditional logistic regression was used to assess odds of hyponatremia.
Results
Of the included 142 infants, 20 (14.1%) developed hyponatremia and were matched with 40 controls. There was significant difference in median nadir between controls and cases, 142.0 versus 128.5 mEq/L (<0.001). A significantly higher number of cases received corticosteroids, loop diuretics, and chlorothiazide versus controls. The regression analysis demonstrated that each additional hour of vasopressin increased the odds of developing hyponatremia by 5% (adjusted odds ratio 1.05 [confidence interval 1-1.1]).
Conclusions and relevance
Vasopressin-induced hyponatremia incidence was <15%. Vasopressin duration was independently associated with hyponatremia development.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>35713009</pmid><doi>10.1177/10600280221103576</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-3022-4403</orcidid><orcidid>https://orcid.org/0000-0003-2637-2550</orcidid></addata></record> |
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| issn | 1060-0280 1542-6270 |
| language | eng |
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| source | MEDLINE; SAGE Complete |
| subjects | Case-Control Studies Humans Hyponatremia - chemically induced Hyponatremia - epidemiology Infant Retrospective Studies Risk Factors Vasopressins - adverse effects |
| title | Vasopressin-Induced Hyponatremia in Infants Following Cardiovascular Surgery |
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