Abstract:
Introduction and Aim:
This observational study aims to find out whether vasopressin improves hemodynamic parameters of the children during ICU stay, compare 30 day survival of vasopressin cohort with the NCHDA data and the adverse effect profile.
Methods:
This study was done retrospectively from the case notes of 5 years from July 2016 till July 2021.
Parameters collected are age, weight, diagnosis, systolic, mean and diastolic blood pressure before initiation of infusion and towards the end of the first 24 hours of infusion, vasoactive inotropic scores before, at the end of first 24 and 48 hours of vasopressin infusion, number of days on vasopressin , length of ICU stay, 30 day mortality and adverse effects.
Results:
Vasopressin caused statistically significant improvement in systolic, mean and diastolic blood pressure by the end of first 24 hours. Vasoactive inotropic score showed statistically significant change by the end of 48 hours. For each days more spent with vasopressin, there is an increase in length of stay between 3.2 and 6.7 days. 26% of the variation in the length of stay can be explained by the number of days on vasopressin infusion. Comparing to NCHDA audit (October 2021) vasopressin did not worsen the mortality. More patient numbers are needed for comparing Norwood , Glenn and Rashkind atrial septostomy. No incidences of necrotizing enterocolitis, hyponatremia, thrombophlebitis, skin necrosis or oliguria in vasopressin cohort.
Discussion and Conclusion:
Vasopressin is a safe vasoactive agent improving hemodynamic profiles but does not reduce the length of stay in ICU.
