@Article{chd.12837,
AUTHOR = {Rohit S. Loomba, Saul Flores},
TITLE = {Use of vasoactive agents in postoperative pediatric cardiac patients: Insights from a national database},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {14},
YEAR = {2019},
NUMBER = {6},
PAGES = {1176--1184},
URL = {http://www.techscience.com/schd/v14n6/38905},
ISSN = {3071-1738},
ABSTRACT = {<b>Objective:</b> The main goal of this study is to examine the variation in vasoactive agent 
prescription patterns across a large cohort of patients. In addition, we sought to determine the association between the number of vasoactive agents used during admissions 
and characteristics of admissions utilizing varying numbers of vasoactive agents.<br/>
<b>Methods:</b> This was a multi-institutional, cross-sectional study of the pediatric health 
information system database of patients who underwent congenital heart surgery 
and received vasoactive agents from 2004 to 2015. The international classification 
of disease-9 (ICD-9) codes were used to select admissions to those only pertaining 
to cardiac patients. The vasoactive agents investigated included epinephrine, norepinephrine, dopamine, dobutamine, milrinone, and vasopressin.<br/>
<b>Results:</b> A total of 43 441 postoperative pediatric cardiac admissions were identified 
and included in the final analyses. Of these, a majority used at least one vasoactive 
agent at some point during the admissions with the median being three vasoactives. 
Each vasoactive was utilized with decreasing frequency throughout the study period 
except for vasopressin which increased in frequency of use. After adjusting for multiple confounding factors, only milrinone was associated with decreased inpatient 
mortality in any postoperative subset, while the rest of the vasoactive were associated with increased inpatient mortality in some of the postoperative subsets.<br/>
<b>Conclusion:</b> Vasoactive agents have decreased in frequency of use in postoperative 
pediatric cardiac admissions, except for vasopressin. Only milrinone was found to be 
associated with decreased inpatient mortality in any subset of these patients, while 
all other vasoactive agents were found to be associated with increased inpatient 
mortality at least in one of the subsets.},
DOI = {10.1111/chd.12837}
}