title: Effects of short-term administration of tolvaptan after open heart surgery.
abstract: BACKGROUND
  Postoperative fluid overload following cardiac surgery is associated with increased morbidity and mortality. Unlike loop diuretics, tolvaptan (TLV) promotes aquaretic effect. Relatively little has been documented regarding the efficacy of TLV after cardiac surgery. The aim of the study was to investigate the effectiveness and safety of tolvaptan for the management of immediately postoperative fluid retention following cardiac surgery.
  
  
  METHODS
  Between January to May 2014, patients undergoing cardiac surgery were randomly assigned to control or TLV group immediately after cardiac surgery. In control group, patients received 20mg of furosemide and 25mg of spironolactone as conventional diuretics. In the TLV group, 7.5mg of TLV was administered in combination with conventional diuretics.
  
  
  RESULTS
  TLV use was associated with increased urine output from postoperative day 1 to 3.Body weight reduction in the TLV group was significantly greater than the control group from postoperative day 2 to 4, and serum creatinine levels decreased to below preoperative values in the TLV group.
  
  
  CONCLUSIONS
  The combination of tolvaptan with conventional diuretics increases urine output without renal dysfunction and can be effective for postoperative fluid management and appropriate body weight reduction.
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Medical University Hospital, 6-7-1 Nishshinjuku Shinjyuku-ku Tokyo, 160-0023, Japan. Electronic address: spgfs112@yahoo.co.jp.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Matsuyama
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Medical University Hospital, 6-7-1 Nishshinjuku Shinjyuku-ku Tokyo, 160-0023, Japan.
authors.forename: Nobusato
authors.initials: N
authors.lastname: Koizumi
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Medical University Hospital, 6-7-1 Nishshinjuku Shinjyuku-ku Tokyo, 160-0023, Japan.
authors.forename: Toshiya
authors.initials: T
authors.lastname: Nishibe
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Medical University Hospital, 6-7-1 Nishshinjuku Shinjyuku-ku Tokyo, 160-0023, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Iwasaki
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Medical University Hospital, 6-7-1 Nishshinjuku Shinjyuku-ku Tokyo, 160-0023, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Iwahasi
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Medical University Hospital, 6-7-1 Nishshinjuku Shinjyuku-ku Tokyo, 160-0023, Japan.
authors.forename: Kayo
authors.initials: K
authors.lastname: Toguchi
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Medical University Hospital, 6-7-1 Nishshinjuku Shinjyuku-ku Tokyo, 160-0023, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Medical University Hospital, 6-7-1 Nishshinjuku Shinjyuku-ku Tokyo, 160-0023, Japan.
authors.forename: Akinari
authors.initials: A
authors.lastname: Iwahori
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Medical University Hospital, 6-7-1 Nishshinjuku Shinjyuku-ku Tokyo, 160-0023, Japan.
authors.forename: Keita
authors.initials: K
authors.lastname: Maruno
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Medical University Hospital, 6-7-1 Nishshinjuku Shinjyuku-ku Tokyo, 160-0023, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ogino
mesh_terms: D000368:Aged; D065092:Antidiuretic Hormone Receptor Antagonists / Q000008:administration & dosage / Q000009:adverse effects; D001552:Benzazepines / Q000008:administration & dosage / Q000009:adverse effects; D001835:Body Weight / Q000187:drug effects / Q000502:physiology; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D004232:Diuretics / Q000008:administration & dosage / Q000009:adverse effects; D016903:Drug Monitoring; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D018495:Fluid Shifts / Q000187:drug effects*; D005665:Furosemide / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D013148:Spironolactone / Q000008:administration & dosage / Q000009:adverse effects; D000077602:Tolvaptan; D016896:Treatment Outcome; D016482:Urinalysis / Q000379:methods
chemical_list: D065092:Antidiuretic Hormone Receptor Antagonists; D001552:Benzazepines; D004232:Diuretics; D000077602:Tolvaptan; D013148:Spironolactone; D005665:Furosemide
keywords: Diuretics; Heart failure; Surgery; Tolvaptan