title: Efficacy of Tolvaptan in Patients with Volume Overload after Cardiac Surgery.
abstract: BACKGROUND
  The vasopressin type 2 receptor antagonist tolvaptan (TLV) has recently become available for treating congestion. However, there is no evidence confirming the efficacy of TLV for patients with volume overload after cardiac surgery. Here, we retrospectively studied the efficacy of TLV in patients with volume overload after cardiac surgery.
  
  
  METHODS
  We enrolled a total of 39 patients who had volume overload after cardiac surgery and who were treated with our protocol of body fluid management. The primary endpoint of this study was to evaluate the hospitalization period, while the secondary endpoints were to estimate adverse events such as hypotension, electrolyte abnormality, presence or absence of renal dysfunction and liver damage, and the incidence of atrial fibrillation (AF).
  
  
  RESULTS
  The hospitalization period of the T (TLV) and C (furosemide and spironolactone) groups was 12.3 ± 2.6 days and 14.7 ± 4.4 days, respectively (P = .044), the mean urine volume was 2761.5 ± 850.3 mL/day and 2205.2 ± 598.5 mL/day, respectively (P = .024), and the incidence of postoperative AF after diuretics administration was 2/19 (11%) and 9/17 (52%), respectively.
  
  
  CONCLUSIONS
  TLV successfully and rapidly improved organ congestion without causing hemodynamic abnormalities (hypotension, arrhythmia development), electrolyte abnormality, liver damage or renal dysfunction, thus significantly reducing the period of hospitalization.
authors.affiliation: Aorta Center and Surgery, Shonankamakura General Hospital, Kamakura City, Kanagawa, Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Noguchi
authors.affiliation: Aorta Center and Surgery, Shonankamakura General Hospital, Kamakura City, Kanagawa, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: Aorta Center and Surgery, Shonankamakura General Hospital, Kamakura City, Kanagawa, Japan.
authors.forename: Ikuo
authors.initials: I
authors.lastname: Katayama
authors.affiliation: Aorta Center and Surgery, Shonankamakura General Hospital, Kamakura City, Kanagawa, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Yamabe
authors.affiliation: Aorta Center and Surgery, Shonankamakura General Hospital, Kamakura City, Kanagawa, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yuji
authors.affiliation: Aorta Center and Surgery, Shonankamakura General Hospital, Kamakura City, Kanagawa, Japan.
authors.forename: Norikazu
authors.initials: N
authors.lastname: Oosiro
authors.affiliation: Aorta Center and Surgery, Shonankamakura General Hospital, Kamakura City, Kanagawa, Japan.
authors.forename: Miyo
authors.initials: M
authors.lastname: Sirouzu
mesh_terms: D000368:Aged; D065092:Antidiuretic Hormone Receptor Antagonists / Q000627:therapeutic use*; D001552:Benzazepines / Q000627:therapeutic use*; D001834:Body Water / Q000187:drug effects; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy; D012189:Retrospective Studies; D000077602:Tolvaptan
chemical_list: D065092:Antidiuretic Hormone Receptor Antagonists; D001552:Benzazepines; D000077602:Tolvaptan