Efficacy and safety of tolvaptan after pediatric congenital heart disease surgery
It is not clear whether tolvaptan is safe and effective irrespective of various underlying clinical conditions including the functional ventricle morphology, chromosomal abnormalities, and renal function after complex pediatric congenital heart disease surgery. Also, the appropriate dose of tolvapta...
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| Veröffentlicht in: | Heart and vessels 2021-05, Vol.36 (5), p.717-723 |
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| creator | Kojima, Takuro Kanai, Azusa Yoshiba, Shigeki Kobayashi, Toshiki Sumitomo, Naokata |
| description | It is not clear whether tolvaptan is safe and effective irrespective of various underlying clinical conditions including the functional ventricle morphology, chromosomal abnormalities, and renal function after complex pediatric congenital heart disease surgery. Also, the appropriate dose of tolvaptan in these patients has not been previously identified. We retrospectively assessed the urine volume, body weight, patient clinical characteristics, laboratory data, and vital signs before and on days 1 and 7 of the tolvaptan administration after congenital heart disease surgery. Also, we assessed the relationship between the tolvaptan dose and its effects. A total of 86 patients were included the study. The mean time from the surgery to the tolvaptan administration was 23.5 ± 3.7 days. After administering tolvaptan, the urine volume significantly increased and body weight significantly decreased from baseline by days 1 and 7 (
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| doi_str_mv | 10.1007/s00380-020-01743-5 |
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p
< 0.0001). The urine volume significantly increased more in the survivors than the deceased. Of the 22 patients who had low serum sodium concentrations at baseline, 20 had an increased serum sodium concentration on day 7. The clinical effect of tolvaptan was not affected by the functional ventricle morphology, chromosomal abnormalities, or renal function. There was a positive correlation between the tolvaptan dose and change in the urine volume until a tolvaptan dose of up to 0.3 mg/kg/day but not at more than 0.3 mg/kg/day. Tolvaptan administration is safe and effective after congenital heart disease surgery irrespective of various underlying clinical conditions. Though the urine volume tends to increase until a tolvaptan dose of up to 0.3 mg/kg/day in pediatric congenital heart disease patients, there was no further benefit with more than 0.3 mg/kg/day.</description><identifier>ISSN: 0910-8327</identifier><identifier>EISSN: 1615-2573</identifier><identifier>DOI: 10.1007/s00380-020-01743-5</identifier><identifier>PMID: 33388911</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Abnormalities ; Biomedical Engineering and Bioengineering ; Body weight ; Cardiac & Cardiovascular Systems ; Cardiac Surgery ; Cardiology ; Cardiovascular disease ; Cardiovascular diseases ; Cardiovascular System & Cardiology ; Congenital diseases ; Coronary artery disease ; Heart ; Heart diseases ; Life Sciences & Biomedicine ; Medicine ; Medicine & Public Health ; Morphology ; Original Article ; Patients ; Pediatrics ; Peripheral Vascular Disease ; Renal function ; Science & Technology ; Sodium ; Surgery ; Urine ; Vascular Surgery ; Ventricle</subject><ispartof>Heart and vessels, 2021-05, Vol.36 (5), p.717-723</ispartof><rights>Springer Japan KK, part of Springer Nature 2021</rights><rights>Springer Japan KK, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>2</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000604497000002</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c399t-908b71d865cfffd73b056d3fab9b66de0838837ea5554cd82adbf7249cc49f713</citedby><cites>FETCH-LOGICAL-c399t-908b71d865cfffd73b056d3fab9b66de0838837ea5554cd82adbf7249cc49f713</cites><orcidid>0000-0001-7094-6772</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00380-020-01743-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00380-020-01743-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,39263,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33388911$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kojima, Takuro</creatorcontrib><creatorcontrib>Kanai, Azusa</creatorcontrib><creatorcontrib>Yoshiba, Shigeki</creatorcontrib><creatorcontrib>Kobayashi, Toshiki</creatorcontrib><creatorcontrib>Sumitomo, Naokata</creatorcontrib><title>Efficacy and safety of tolvaptan after pediatric congenital heart disease surgery</title><title>Heart and vessels</title><addtitle>Heart Vessels</addtitle><addtitle>HEART VESSELS</addtitle><addtitle>Heart Vessels</addtitle><description>It is not clear whether tolvaptan is safe and effective irrespective of various underlying clinical conditions including the functional ventricle morphology, chromosomal abnormalities, and renal function after complex pediatric congenital heart disease surgery. Also, the appropriate dose of tolvaptan in these patients has not been previously identified. We retrospectively assessed the urine volume, body weight, patient clinical characteristics, laboratory data, and vital signs before and on days 1 and 7 of the tolvaptan administration after congenital heart disease surgery. Also, we assessed the relationship between the tolvaptan dose and its effects. A total of 86 patients were included the study. The mean time from the surgery to the tolvaptan administration was 23.5 ± 3.7 days. After administering tolvaptan, the urine volume significantly increased and body weight significantly decreased from baseline by days 1 and 7 (
p
< 0.0001). The urine volume significantly increased more in the survivors than the deceased. Of the 22 patients who had low serum sodium concentrations at baseline, 20 had an increased serum sodium concentration on day 7. The clinical effect of tolvaptan was not affected by the functional ventricle morphology, chromosomal abnormalities, or renal function. There was a positive correlation between the tolvaptan dose and change in the urine volume until a tolvaptan dose of up to 0.3 mg/kg/day but not at more than 0.3 mg/kg/day. Tolvaptan administration is safe and effective after congenital heart disease surgery irrespective of various underlying clinical conditions. Though the urine volume tends to increase until a tolvaptan dose of up to 0.3 mg/kg/day in pediatric congenital heart disease patients, there was no further benefit with more than 0.3 mg/kg/day.</description><subject>Abnormalities</subject><subject>Biomedical Engineering and Bioengineering</subject><subject>Body weight</subject><subject>Cardiac & Cardiovascular Systems</subject><subject>Cardiac Surgery</subject><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Cardiovascular System & Cardiology</subject><subject>Congenital diseases</subject><subject>Coronary artery disease</subject><subject>Heart</subject><subject>Heart diseases</subject><subject>Life Sciences & Biomedicine</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Morphology</subject><subject>Original Article</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Peripheral Vascular Disease</subject><subject>Renal function</subject><subject>Science & Technology</subject><subject>Sodium</subject><subject>Surgery</subject><subject>Urine</subject><subject>Vascular Surgery</subject><subject>Ventricle</subject><issn>0910-8327</issn><issn>1615-2573</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>HGBXW</sourceid><recordid>eNqNkV-LFSEYhyWK9rT1BboIoZsgpl51HPUyDtsfWIigrsXR122WOeNJneJ8-9xm26CLSBBvnt_L730k5CmDVwxAvS4AQkMHvF2metHJe2THBiY7LpW4T3ZgGHRacHVGHpVyDcCkYeYhORNCaG0Y25FPFzFO3vkTdUugxUWsJ5oirWn-7o7VLdTFipkeMUyu5slTn5YrXKbqZvoVXa40TAVdQVrWfIX59Jg8iG4u-OT2PSdf3l583r_vLj---7B_c9l5YUztDOhRsaAH6WOMQYkR5BBEdKMZhyEg6FZRKHRSyt4HzV0Yo-K98b43UTFxTl5sc485fVuxVHuYisd5dgumtVjeKwlGgOkb-vwv9DqteWntLJcMuFGD0o3iG-VzKiVjtMc8HVw-WQb2RrjdhNsm3P4SbmULPbsdvY4HDHeR34YboDfgB44pFj_h4vEOA4AB-t4ouDl837TWKS37tC61RV_-f7TRYqNLI9oX5T9L_qP_T_xVq-Y</recordid><startdate>20210501</startdate><enddate>20210501</enddate><creator>Kojima, Takuro</creator><creator>Kanai, Azusa</creator><creator>Yoshiba, Shigeki</creator><creator>Kobayashi, Toshiki</creator><creator>Sumitomo, Naokata</creator><general>Springer Japan</general><general>Springer Nature</general><general>Springer Nature B.V</general><scope>BLEPL</scope><scope>DTL</scope><scope>HGBXW</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7094-6772</orcidid></search><sort><creationdate>20210501</creationdate><title>Efficacy and safety of tolvaptan after pediatric congenital heart disease surgery</title><author>Kojima, Takuro ; Kanai, Azusa ; Yoshiba, Shigeki ; Kobayashi, Toshiki ; Sumitomo, Naokata</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c399t-908b71d865cfffd73b056d3fab9b66de0838837ea5554cd82adbf7249cc49f713</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Abnormalities</topic><topic>Biomedical Engineering and Bioengineering</topic><topic>Body weight</topic><topic>Cardiac & Cardiovascular Systems</topic><topic>Cardiac Surgery</topic><topic>Cardiology</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular diseases</topic><topic>Cardiovascular System & Cardiology</topic><topic>Congenital diseases</topic><topic>Coronary artery disease</topic><topic>Heart</topic><topic>Heart diseases</topic><topic>Life Sciences & Biomedicine</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Morphology</topic><topic>Original Article</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Peripheral Vascular Disease</topic><topic>Renal function</topic><topic>Science & Technology</topic><topic>Sodium</topic><topic>Surgery</topic><topic>Urine</topic><topic>Vascular Surgery</topic><topic>Ventricle</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kojima, Takuro</creatorcontrib><creatorcontrib>Kanai, Azusa</creatorcontrib><creatorcontrib>Yoshiba, Shigeki</creatorcontrib><creatorcontrib>Kobayashi, Toshiki</creatorcontrib><creatorcontrib>Sumitomo, Naokata</creatorcontrib><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Web of Science - Science Citation Index Expanded - 2021</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Heart and vessels</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kojima, Takuro</au><au>Kanai, Azusa</au><au>Yoshiba, Shigeki</au><au>Kobayashi, Toshiki</au><au>Sumitomo, Naokata</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy and safety of tolvaptan after pediatric congenital heart disease surgery</atitle><jtitle>Heart and vessels</jtitle><stitle>Heart Vessels</stitle><stitle>HEART VESSELS</stitle><addtitle>Heart Vessels</addtitle><date>2021-05-01</date><risdate>2021</risdate><volume>36</volume><issue>5</issue><spage>717</spage><epage>723</epage><pages>717-723</pages><issn>0910-8327</issn><eissn>1615-2573</eissn><abstract>It is not clear whether tolvaptan is safe and effective irrespective of various underlying clinical conditions including the functional ventricle morphology, chromosomal abnormalities, and renal function after complex pediatric congenital heart disease surgery. Also, the appropriate dose of tolvaptan in these patients has not been previously identified. We retrospectively assessed the urine volume, body weight, patient clinical characteristics, laboratory data, and vital signs before and on days 1 and 7 of the tolvaptan administration after congenital heart disease surgery. Also, we assessed the relationship between the tolvaptan dose and its effects. A total of 86 patients were included the study. The mean time from the surgery to the tolvaptan administration was 23.5 ± 3.7 days. After administering tolvaptan, the urine volume significantly increased and body weight significantly decreased from baseline by days 1 and 7 (
p
< 0.0001). The urine volume significantly increased more in the survivors than the deceased. Of the 22 patients who had low serum sodium concentrations at baseline, 20 had an increased serum sodium concentration on day 7. The clinical effect of tolvaptan was not affected by the functional ventricle morphology, chromosomal abnormalities, or renal function. There was a positive correlation between the tolvaptan dose and change in the urine volume until a tolvaptan dose of up to 0.3 mg/kg/day but not at more than 0.3 mg/kg/day. Tolvaptan administration is safe and effective after congenital heart disease surgery irrespective of various underlying clinical conditions. Though the urine volume tends to increase until a tolvaptan dose of up to 0.3 mg/kg/day in pediatric congenital heart disease patients, there was no further benefit with more than 0.3 mg/kg/day.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>33388911</pmid><doi>10.1007/s00380-020-01743-5</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-7094-6772</orcidid></addata></record> |
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| subjects | Abnormalities Biomedical Engineering and Bioengineering Body weight Cardiac & Cardiovascular Systems Cardiac Surgery Cardiology Cardiovascular disease Cardiovascular diseases Cardiovascular System & Cardiology Congenital diseases Coronary artery disease Heart Heart diseases Life Sciences & Biomedicine Medicine Medicine & Public Health Morphology Original Article Patients Pediatrics Peripheral Vascular Disease Renal function Science & Technology Sodium Surgery Urine Vascular Surgery Ventricle |
| title | Efficacy and safety of tolvaptan after pediatric congenital heart disease surgery |
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