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Vitamin D and Postoperative Vasopressor Use in Cardiopulmonary Bypass
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| Zeitschriftentitel: | Clinical and Applied Thrombosis/Hemostasis |
|---|---|
| Personen und Körperschaften: | , , , |
| In: | Clinical and Applied Thrombosis/Hemostasis, 24, 2018, 8, S. 1322-1326 |
| Format: | E-Article |
| Sprache: | Englisch |
| veröffentlicht: |
SAGE Publications
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| Schlagwörter: |
| author_facet |
Javorski, Michael J. Kerolos, Mina M. Fareed, Jawed Perez-Tamayo, R. Anthony Javorski, Michael J. Kerolos, Mina M. Fareed, Jawed Perez-Tamayo, R. Anthony |
|---|---|
| author |
Javorski, Michael J. Kerolos, Mina M. Fareed, Jawed Perez-Tamayo, R. Anthony |
| spellingShingle |
Javorski, Michael J. Kerolos, Mina M. Fareed, Jawed Perez-Tamayo, R. Anthony Clinical and Applied Thrombosis/Hemostasis Vitamin D and Postoperative Vasopressor Use in Cardiopulmonary Bypass Hematology General Medicine |
| author_sort |
javorski, michael j. |
| spelling |
Javorski, Michael J. Kerolos, Mina M. Fareed, Jawed Perez-Tamayo, R. Anthony 1076-0296 1938-2723 SAGE Publications Hematology General Medicine http://dx.doi.org/10.1177/1076029618772357 <jats:p> The use of cardiopulmonary bypass (CPB) in cardiac surgery often leads to a systemic inflammatory response. Up to 25% of patients undergoing CPB for cardiac surgery are reported to develop vasoplegic syndrome in the acute postoperative period, in which the patients are refractory to vasopressors. The purpose of this study is to assess vitamin D deficiency as a risk factor for vasoplegia after using CPB. We performed a retrospective review of 1322 patients undergoing adult cardiac surgery requiring CPB. Forty-six patients with previously recorded 25-hydroxy vitamin D (25(OH)D) levels within 6 months of surgery met the conditions of this study. The mean level of 25(OH)D was 32.7 ng/mL (standard deviation [SD] = 15.1). The mean age of patients was 67 (SD = 10.1) years old, most were male (63%) and white (78%). Average CPB time was 140 ± 44 minutes. Postoperative vasopressor use was compared to individual preoperative 25(OH)D levels. As a secondary end point, postoperative vasopressor use and vasoplegia were analyzed between 3 groups: Vitamin D deficient defined as 25(OH)D ≤20 ng/mL (n = 7), vitamin D insufficient defined as 25(OH)D between 20 and 29 ng/mL (n = 15), and vitamin D sufficient defined as 25(OH)D ≥30 ng/mL (n = 24). There was no correlation between vitamin D levels and postoperative vasopressor use. The mean doses of postoperative vasopressor use were 0.088 µg/kg/min (standard error of the mean [SEM] = 0.032), 0.085 µg/kg/min (SEM = 0.037), and 0.072 µg/kg/min (SEM = 0.024) of norepinephrine equivalents for the vitamin D deficient, insufficient, and sufficient groups, respectively. Incidence of vasoplegia for each group was the following: 0.143 for vitamin D deficient, 0.067 for vitamin D insufficient, and 0.125 for vitamin D sufficient. In this pilot study, there does not appear to be a relationship between vitamin D and vasopressor use following cardiac surgery utilizing CPB; however, there appears to be a trend toward an increased vasopressor usage in patients with decreased vitamin D levels. A larger sample size and a prospective analysis are warranted to further assess the significance of the relationship between vasoplegia and vitamin D deficiency. With further investigation, vitamin D has the potential to become a low-cost, low-risk therapeutic for improving outcomes in CPB surgery. </jats:p> Vitamin D and Postoperative Vasopressor Use in Cardiopulmonary Bypass Clinical and Applied Thrombosis/Hemostasis |
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| title |
Vitamin D and Postoperative Vasopressor Use in Cardiopulmonary Bypass |
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Vitamin D and Postoperative Vasopressor Use in Cardiopulmonary Bypass |
| title_full |
Vitamin D and Postoperative Vasopressor Use in Cardiopulmonary Bypass |
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Vitamin D and Postoperative Vasopressor Use in Cardiopulmonary Bypass |
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Vitamin D and Postoperative Vasopressor Use in Cardiopulmonary Bypass |
| title_short |
Vitamin D and Postoperative Vasopressor Use in Cardiopulmonary Bypass |
| title_sort |
vitamin d and postoperative vasopressor use in cardiopulmonary bypass |
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Hematology General Medicine |
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http://dx.doi.org/10.1177/1076029618772357 |
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2018 |
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1322-1326 |
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<jats:p> The use of cardiopulmonary bypass (CPB) in cardiac surgery often leads to a systemic inflammatory response. Up to 25% of patients undergoing CPB for cardiac surgery are reported to develop vasoplegic syndrome in the acute postoperative period, in which the patients are refractory to vasopressors. The purpose of this study is to assess vitamin D deficiency as a risk factor for vasoplegia after using CPB. We performed a retrospective review of 1322 patients undergoing adult cardiac surgery requiring CPB. Forty-six patients with previously recorded 25-hydroxy vitamin D (25(OH)D) levels within 6 months of surgery met the conditions of this study. The mean level of 25(OH)D was 32.7 ng/mL (standard deviation [SD] = 15.1). The mean age of patients was 67 (SD = 10.1) years old, most were male (63%) and white (78%). Average CPB time was 140 ± 44 minutes. Postoperative vasopressor use was compared to individual preoperative 25(OH)D levels. As a secondary end point, postoperative vasopressor use and vasoplegia were analyzed between 3 groups: Vitamin D deficient defined as 25(OH)D ≤20 ng/mL (n = 7), vitamin D insufficient defined as 25(OH)D between 20 and 29 ng/mL (n = 15), and vitamin D sufficient defined as 25(OH)D ≥30 ng/mL (n = 24). There was no correlation between vitamin D levels and postoperative vasopressor use. The mean doses of postoperative vasopressor use were 0.088 µg/kg/min (standard error of the mean [SEM] = 0.032), 0.085 µg/kg/min (SEM = 0.037), and 0.072 µg/kg/min (SEM = 0.024) of norepinephrine equivalents for the vitamin D deficient, insufficient, and sufficient groups, respectively. Incidence of vasoplegia for each group was the following: 0.143 for vitamin D deficient, 0.067 for vitamin D insufficient, and 0.125 for vitamin D sufficient. In this pilot study, there does not appear to be a relationship between vitamin D and vasopressor use following cardiac surgery utilizing CPB; however, there appears to be a trend toward an increased vasopressor usage in patients with decreased vitamin D levels. A larger sample size and a prospective analysis are warranted to further assess the significance of the relationship between vasoplegia and vitamin D deficiency. With further investigation, vitamin D has the potential to become a low-cost, low-risk therapeutic for improving outcomes in CPB surgery. </jats:p> |
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| description | <jats:p> The use of cardiopulmonary bypass (CPB) in cardiac surgery often leads to a systemic inflammatory response. Up to 25% of patients undergoing CPB for cardiac surgery are reported to develop vasoplegic syndrome in the acute postoperative period, in which the patients are refractory to vasopressors. The purpose of this study is to assess vitamin D deficiency as a risk factor for vasoplegia after using CPB. We performed a retrospective review of 1322 patients undergoing adult cardiac surgery requiring CPB. Forty-six patients with previously recorded 25-hydroxy vitamin D (25(OH)D) levels within 6 months of surgery met the conditions of this study. The mean level of 25(OH)D was 32.7 ng/mL (standard deviation [SD] = 15.1). The mean age of patients was 67 (SD = 10.1) years old, most were male (63%) and white (78%). Average CPB time was 140 ± 44 minutes. Postoperative vasopressor use was compared to individual preoperative 25(OH)D levels. As a secondary end point, postoperative vasopressor use and vasoplegia were analyzed between 3 groups: Vitamin D deficient defined as 25(OH)D ≤20 ng/mL (n = 7), vitamin D insufficient defined as 25(OH)D between 20 and 29 ng/mL (n = 15), and vitamin D sufficient defined as 25(OH)D ≥30 ng/mL (n = 24). There was no correlation between vitamin D levels and postoperative vasopressor use. The mean doses of postoperative vasopressor use were 0.088 µg/kg/min (standard error of the mean [SEM] = 0.032), 0.085 µg/kg/min (SEM = 0.037), and 0.072 µg/kg/min (SEM = 0.024) of norepinephrine equivalents for the vitamin D deficient, insufficient, and sufficient groups, respectively. Incidence of vasoplegia for each group was the following: 0.143 for vitamin D deficient, 0.067 for vitamin D insufficient, and 0.125 for vitamin D sufficient. In this pilot study, there does not appear to be a relationship between vitamin D and vasopressor use following cardiac surgery utilizing CPB; however, there appears to be a trend toward an increased vasopressor usage in patients with decreased vitamin D levels. A larger sample size and a prospective analysis are warranted to further assess the significance of the relationship between vasoplegia and vitamin D deficiency. With further investigation, vitamin D has the potential to become a low-cost, low-risk therapeutic for improving outcomes in CPB surgery. </jats:p> |
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| spelling | Javorski, Michael J. Kerolos, Mina M. Fareed, Jawed Perez-Tamayo, R. Anthony 1076-0296 1938-2723 SAGE Publications Hematology General Medicine http://dx.doi.org/10.1177/1076029618772357 <jats:p> The use of cardiopulmonary bypass (CPB) in cardiac surgery often leads to a systemic inflammatory response. Up to 25% of patients undergoing CPB for cardiac surgery are reported to develop vasoplegic syndrome in the acute postoperative period, in which the patients are refractory to vasopressors. The purpose of this study is to assess vitamin D deficiency as a risk factor for vasoplegia after using CPB. We performed a retrospective review of 1322 patients undergoing adult cardiac surgery requiring CPB. Forty-six patients with previously recorded 25-hydroxy vitamin D (25(OH)D) levels within 6 months of surgery met the conditions of this study. The mean level of 25(OH)D was 32.7 ng/mL (standard deviation [SD] = 15.1). The mean age of patients was 67 (SD = 10.1) years old, most were male (63%) and white (78%). Average CPB time was 140 ± 44 minutes. Postoperative vasopressor use was compared to individual preoperative 25(OH)D levels. As a secondary end point, postoperative vasopressor use and vasoplegia were analyzed between 3 groups: Vitamin D deficient defined as 25(OH)D ≤20 ng/mL (n = 7), vitamin D insufficient defined as 25(OH)D between 20 and 29 ng/mL (n = 15), and vitamin D sufficient defined as 25(OH)D ≥30 ng/mL (n = 24). There was no correlation between vitamin D levels and postoperative vasopressor use. The mean doses of postoperative vasopressor use were 0.088 µg/kg/min (standard error of the mean [SEM] = 0.032), 0.085 µg/kg/min (SEM = 0.037), and 0.072 µg/kg/min (SEM = 0.024) of norepinephrine equivalents for the vitamin D deficient, insufficient, and sufficient groups, respectively. Incidence of vasoplegia for each group was the following: 0.143 for vitamin D deficient, 0.067 for vitamin D insufficient, and 0.125 for vitamin D sufficient. In this pilot study, there does not appear to be a relationship between vitamin D and vasopressor use following cardiac surgery utilizing CPB; however, there appears to be a trend toward an increased vasopressor usage in patients with decreased vitamin D levels. A larger sample size and a prospective analysis are warranted to further assess the significance of the relationship between vasoplegia and vitamin D deficiency. With further investigation, vitamin D has the potential to become a low-cost, low-risk therapeutic for improving outcomes in CPB surgery. </jats:p> Vitamin D and Postoperative Vasopressor Use in Cardiopulmonary Bypass Clinical and Applied Thrombosis/Hemostasis |
| spellingShingle | Javorski, Michael J., Kerolos, Mina M., Fareed, Jawed, Perez-Tamayo, R. Anthony, Clinical and Applied Thrombosis/Hemostasis, Vitamin D and Postoperative Vasopressor Use in Cardiopulmonary Bypass, Hematology, General Medicine |
| title | Vitamin D and Postoperative Vasopressor Use in Cardiopulmonary Bypass |
| title_full | Vitamin D and Postoperative Vasopressor Use in Cardiopulmonary Bypass |
| title_fullStr | Vitamin D and Postoperative Vasopressor Use in Cardiopulmonary Bypass |
| title_full_unstemmed | Vitamin D and Postoperative Vasopressor Use in Cardiopulmonary Bypass |
| title_short | Vitamin D and Postoperative Vasopressor Use in Cardiopulmonary Bypass |
| title_sort | vitamin d and postoperative vasopressor use in cardiopulmonary bypass |
| title_unstemmed | Vitamin D and Postoperative Vasopressor Use in Cardiopulmonary Bypass |
| topic | Hematology, General Medicine |
| url | http://dx.doi.org/10.1177/1076029618772357 |