Vasoactive-inotropic agents in pediatric patients undergoing cardiac surgery: A single-center retrospective study

This study aimed to retrospectively summarize the use of vasoactive-inotropic agents in pediatric patients undergoing cardiac surgery at Fuwai Hospital. A total of 401 patients who met the screening criteria were enrolled in this study between April and June 2021 at Fuwai Hospital. We retrospectively summarized the current practices for vasoactive-inotropic agent use across different ages, Risk Adjustment in Cardiac Surgery 1 (RACHS-1) categories, and among various anesthesiologists. Intraoperatively, milrinone was the most commonly used inotrope (327 patients, 81.6%), followed by dopamine (274, 68.3%), dobutamine (263, 65.4%), epinephrine (67, 16.7%), and isoprenaline (11, 2.7%). Vasopressin was mainly administered during the pediatric intensive care unit period, with the highest use rate on postoperative day (POD)-1 (16/401, 3.9%). Furthermore, a combination of dopamine, dobutamine, and milrinone was administered by 52.1% of anesthesiologists intraoperatively and by 30.2% of pediatric intensivists on POD 1. Milrinone, dopamine, and dobutamine were selected by most anesthesiologists (13/14, 92.9%), and their usage rates among different anesthesiologists ranged from 66.67% to 92.68%, 52.94% to 89.66%, and 46.18% to 86.21%, respectively. Moreover, their use in category 4 surgeries was significantly higher than in category 1 to 3 surgeries. Milrinone, dopamine, and dobutamine were the most commonly used vasoactive-inotropic agents, while the other agents represented the diversity of medications used during both the intra- and postoperative periods in pediatric cardiac surgery at Fuwai Hospital.