Efficacy of tolvaptan for fluid management after cardiovascular surgery: A systematic review and meta‑analysis of randomized control trials

Chen, Huiling; Jiang, Weihong; Li, Yong; Meng, Zhen; Chen, Huamei; Wang, Jun-Wen; Zhao, Xiexiong

doi:10.3892/etm.2020.9007

Cited by 4 publications

(3 citation statements)

References 33 publications

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“…Here, no differences were seen in the potassium levels over time in the two groups, nor between the groups at the same same time point. A previous meta-analysis of serum potassium in patients on tolvaptan concluded that there was no difference in the mean serum potassium levels in patients with or without tolvaptan (23).…”

Section: Discussionmentioning

confidence: 97%

Efficacy of tolvaptan in postoperative volume therapy for acute Stanford type A aortic dissection

Wang

Gao

et al. 2022

Preprint

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Objective: Despite the increasing application of tolvaptan in cardiac surgery, there is no information on the use of tolvaptan in Stanford patients with type A aortic dissection. The objective of this study is to evaluate the clinical effect of tolvaptan in patients with type A aortic dissection after surgery.Methods: A retrospective analysis was performed on 45 patients treated for type A aortic dissection in our hospital from 2018 to 2020, including 21 patients who were treated with Group T and 24 patients who were not treated with Group L. Perioperative data were collected from the hospital's electronic records.Results: Patients receiving tolvaptan did not differ significantly from those on traditional diuretics in terms of the duration of mechanical ventilation, postoperative blood required, length of catecholamine use, or amount of diuretics received (all P> 0.05). The development of new atrial fibrillation was significantly less in the tolvaptan group (P=0.023). Urine volume was slightly, but non-significantly, higher in patients receiving tolvaptan. Serum levels of potassium, creatinine, and urea nitrogen did not differ between the groups in the week after surgery, while that of sodium was significantly higher in the tolvaptan-treated group on day 7 after transfer from the ICU (P=0.001). Sodium levels were also elevated by day 7 in patients receiving traditional diuretics (P=0.001). The serum creatinine and urea nitrogen levels were raised on both days 3 and 7 in both groups (both P<0.05).Conclusions: For patients after acute Stanford type A aortic dissection, both tolvaptan and traditional diuretics are effective and safe. Tolvaptan is more effective in reducing the incidence of postoperative atrial fibrillation. For patients following Acute Stanford A aortic dissection surgery, tolvaptan did not provide a greater advantage over loop diuretics in terms of fluid clearance, but it may reduce the incidence of postoperative atrial fibrillation.

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Section: Discussionmentioning

confidence: 97%

Efficacy of tolvaptan in postoperative volume therapy for acute Stanford type A aortic dissection

Wang

Gao

et al. 2022

Preprint

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“…Here, no differences were seen in the potassium levels over time in the two groups, nor between the groups simultaneously. A previous meta-analysis of serum potassium in patients on tolvaptan concluded no difference in the mean serum potassium levels in patients with or without tolvaptan [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of tolvaptan in postoperative volume therapy for acute Stanford type A aortic dissection

Wang

Gao

et al. 2023

BMC Cardiovasc Disord

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Background Despite the increasing application of tolvaptan in cardiac surgery, there is no information on the use of tolvaptan in Stanford patients with type A aortic dissection. This study aimed to evaluate the postoperative clinical effects of tolvaptan in patients with type A aortic dissection after tafter surgery. Methods A retrospective analysis was performed on 45 patients treated for type A aortic dissection in our hospital from 2018 to 2020. These included 21 patients who were treated with tolvaptan (Group T) and 24 patients who received traditional diuretics (Group L). The hospital's electronic health records were used to obtain perioperative data. Results Group T did not differ significantly from Group L in terms of the duration of mechanical ventilation, postoperative blood required, length of catecholamine use, or the amount of intravenous diuretic drugs administered (all P > 0.05). The development of postoperative atrial fibrillation was significantly less in the tolvaptan group (P = 0.023). The urine volumes and change in body weight loss were slightly higher in group T than in group L but the differences were non-significant (P > 0.05). Serum potassium, creatinine, and urea nitrogen levels did not differ between the groups in the week after surgery, At the same time, sodium was significantly higher in the Group T group on day 7 after transfer from the ICU (P = 0.001). In Group L, sodium levels were also elevated by day 7 (P = 0.001). On days 3 and 7, serum creatinine and urea nitrogen levels increased in both groups (both P < 0.05). Conclusions Both tolvaptan and traditional diuretics were found to be effective and safe for patients with acute Stanford type A aortic dissection. Moreover, tolvaptan may be associated with reducing the incidence of postoperative atrial fibrillation.

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“…It was listed as a health insurance drug in Japan in 2013 for cases of uid retention in liver cirrhosis for which conventional diuretics had insu cient clinical effects [8,9]. To date, the preventive administration of tolvaptan in patients who undergo cardiac surgery is found to be capable of controlling postoperative increase in body weight signi cantly, without indicating any side effects [10].…”

Section: Introductionmentioning

confidence: 99%

Effect of early administration of tolvaptan on pleural effusion post-hepatectomy

Iida,

Maehira,

Mori

et al. 2023

Langenbecks Arch Surg

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Purpose: In this study, the e cacy of tolvaptan administration at the early stage post-hepatectomy was evaluated to control pleural effusion and improve the postoperative course. Methods: Patients were administered tolvaptan (7.5 mg) and spironolactone (25 mg) from postoperative day 1 to 5 (tolvaptan group, n=68) for 13 months. Early administration of tolvaptan was not given in the control group (n=68) but diuretics were appropriately administered according to the patient's condition.The amount of pleural effusion on computed tomography on postoperative day 5 was compared between the two groups.Results: The amount of pleural effusion and increase in body weight on postoperative day 5 showed signi cant differences in both groups (p<0.001 and p=0.019, respectively). However, the rate of pleural aspiration and the duration of postoperative hospitalization did not show any signi cant differences. The amount of intraoperative blood loss and lack of early administration of tolvaptan were identi ed as independent risk factors contributing to pleural effusionon multivariate analysis. Conclusion:Early administration of tolvaptan to post-hepatectomy patients was found to be capable of controlling postoperative pleural effusion and increase in body weight, but it did not reduce the rate of pleural aspiration or the hospitalization period.

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Efficacy of tolvaptan for fluid management after cardiovascular surgery: A systematic review and meta‑analysis of randomized control trials

Cited by 4 publications

References 33 publications

Efficacy of tolvaptan in postoperative volume therapy for acute Stanford type A aortic dissection

Efficacy of tolvaptan in postoperative volume therapy for acute Stanford type A aortic dissection

Efficacy of tolvaptan in postoperative volume therapy for acute Stanford type A aortic dissection

Effect of early administration of tolvaptan on pleural effusion post-hepatectomy

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