Incidence of hyponatremia with vasopressin exposure in critically ill pediatric patients for postoperative cardiac support and shock management: A single-center, retrospective, case–control study
Background: Vasopressin is used adjunctively to catecholamines for cardiovascular support but may be associated with hyponatremia. The objective of this study was to investigate the incidence of hyponatremia in critically ill pediatric patients receiving vasopressin for postoperative cardiac support...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-05-01
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| Series: | Journal of Pediatric Critical Care |
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| Online Access: | https://journals.lww.com/10.4103/jpcc.jpcc_9_25 |
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| author | Gustavo R. Alvira-Arill Nian S. Chang Helen Y. Lee Nicole Tomas Sharmeen Y. Roy Balagangadhar R. Totapally |
| author_facet | Gustavo R. Alvira-Arill Nian S. Chang Helen Y. Lee Nicole Tomas Sharmeen Y. Roy Balagangadhar R. Totapally |
| author_sort | Gustavo R. Alvira-Arill |
| collection | DOAJ |
| description | Background:
Vasopressin is used adjunctively to catecholamines for cardiovascular support but may be associated with hyponatremia. The objective of this study was to investigate the incidence of hyponatremia in critically ill pediatric patients receiving vasopressin for postoperative cardiac support or vasodilatory shock.
Subjects and Methods:
A retrospective and case–control study of pediatric patients who received vasopressin for postoperative cardiac support or vasodilatory shock at a free-standing, pediatric hospital during a 4-year period was performed. The cases were defined by the development of hyponatremia (serum sodium level <130 mmol/L) during vasopressin exposure. Differences in characteristics associated with hyponatremia were assessed through the generalized linear models with binomial distribution.
Results:
In this study, 134 patients who received vasopressin for postoperative cardiac support or shock management were assessed and 28 (21%) patients developed hyponatremia during exposure. Most patients assessed were neonates (90/134 [67.2%]) and received vasopressin for postoperative cardiac support (86/134 [64.2%]). Multivariable analysis identified two factors independently associated with hyponatremia: longer duration of vasopressin infusion (aOR [95% CI]: 1.03 [1.02–1.05]; P ≤ 0.05) and lower serum sodium before exposure (aOR [95% CI]: 0.86 [0.79–0.93]; P ≤ 0.05). Vasopressin exposure of at least 2 days was found to be associated with higher hyponatremia incidence (uOR [95% CI]: 14.67 [5.67–42.24]; P ≤ 0.05).
Conclusions:
This study demonstrated the high incidence of hyponatremia during vasopressin exposure in pediatric patients managed for postoperative cardiac support or vasodilatory shock. Longer duration of vasopressin exposure and lower serum sodium before exposure were independently associated with hyponatremia. |
| format | Article |
| id | doaj-art-e467c9ea7955436cb6dbff348ca310db |
| institution | Kabale University |
| issn | 2349-6592 2455-7099 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Pediatric Critical Care |
| spelling | doaj-art-e467c9ea7955436cb6dbff348ca310db2025-08-20T03:31:41ZengWolters Kluwer Medknow PublicationsJournal of Pediatric Critical Care2349-65922455-70992025-05-011239510110.4103/jpcc.jpcc_9_25Incidence of hyponatremia with vasopressin exposure in critically ill pediatric patients for postoperative cardiac support and shock management: A single-center, retrospective, case–control studyGustavo R. Alvira-ArillNian S. ChangHelen Y. LeeNicole TomasSharmeen Y. RoyBalagangadhar R. TotapallyBackground: Vasopressin is used adjunctively to catecholamines for cardiovascular support but may be associated with hyponatremia. The objective of this study was to investigate the incidence of hyponatremia in critically ill pediatric patients receiving vasopressin for postoperative cardiac support or vasodilatory shock. Subjects and Methods: A retrospective and case–control study of pediatric patients who received vasopressin for postoperative cardiac support or vasodilatory shock at a free-standing, pediatric hospital during a 4-year period was performed. The cases were defined by the development of hyponatremia (serum sodium level <130 mmol/L) during vasopressin exposure. Differences in characteristics associated with hyponatremia were assessed through the generalized linear models with binomial distribution. Results: In this study, 134 patients who received vasopressin for postoperative cardiac support or shock management were assessed and 28 (21%) patients developed hyponatremia during exposure. Most patients assessed were neonates (90/134 [67.2%]) and received vasopressin for postoperative cardiac support (86/134 [64.2%]). Multivariable analysis identified two factors independently associated with hyponatremia: longer duration of vasopressin infusion (aOR [95% CI]: 1.03 [1.02–1.05]; P ≤ 0.05) and lower serum sodium before exposure (aOR [95% CI]: 0.86 [0.79–0.93]; P ≤ 0.05). Vasopressin exposure of at least 2 days was found to be associated with higher hyponatremia incidence (uOR [95% CI]: 14.67 [5.67–42.24]; P ≤ 0.05). Conclusions: This study demonstrated the high incidence of hyponatremia during vasopressin exposure in pediatric patients managed for postoperative cardiac support or vasodilatory shock. Longer duration of vasopressin exposure and lower serum sodium before exposure were independently associated with hyponatremia.https://journals.lww.com/10.4103/jpcc.jpcc_9_25cardiac surgical procedurehyponatremiapediatric intensive care unitvasopressinwater-electrolyte imbalance |
| spellingShingle | Gustavo R. Alvira-Arill Nian S. Chang Helen Y. Lee Nicole Tomas Sharmeen Y. Roy Balagangadhar R. Totapally Incidence of hyponatremia with vasopressin exposure in critically ill pediatric patients for postoperative cardiac support and shock management: A single-center, retrospective, case–control study Journal of Pediatric Critical Care cardiac surgical procedure hyponatremia pediatric intensive care unit vasopressin water-electrolyte imbalance |
| title | Incidence of hyponatremia with vasopressin exposure in critically ill pediatric patients for postoperative cardiac support and shock management: A single-center, retrospective, case–control study |
| title_full | Incidence of hyponatremia with vasopressin exposure in critically ill pediatric patients for postoperative cardiac support and shock management: A single-center, retrospective, case–control study |
| title_fullStr | Incidence of hyponatremia with vasopressin exposure in critically ill pediatric patients for postoperative cardiac support and shock management: A single-center, retrospective, case–control study |
| title_full_unstemmed | Incidence of hyponatremia with vasopressin exposure in critically ill pediatric patients for postoperative cardiac support and shock management: A single-center, retrospective, case–control study |
| title_short | Incidence of hyponatremia with vasopressin exposure in critically ill pediatric patients for postoperative cardiac support and shock management: A single-center, retrospective, case–control study |
| title_sort | incidence of hyponatremia with vasopressin exposure in critically ill pediatric patients for postoperative cardiac support and shock management a single center retrospective case control study |
| topic | cardiac surgical procedure hyponatremia pediatric intensive care unit vasopressin water-electrolyte imbalance |
| url | https://journals.lww.com/10.4103/jpcc.jpcc_9_25 |
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