TY - JOUR
T1 - Examining the use of sodium nitroprusside in coronary artery bypass grafting
T2 - Is the benefit worth the cost?
AU - Gibson, Caitlin M.
AU - Davis, Sondra
AU - Bradford, Darien
PY - 2017/7/1
Y1 - 2017/7/1
N2 - Purpose: Sodium nitroprusside is a vasodilator frequently used in the coronary artery bypass grafting (CABG) setting. However, the price of a 50-mg vial of sodium nitroprusside increased from $5.00 in 2003 to up to $900 in 2016. The purpose of this review is to help health systems balance high-quality patient care with economic responsibility. Methods: A MEDLINE literature search was performed using the search terms "nitroprusside" and "coronary artery bypass." All English-language trials in human subjects assessing the use of sodium nitroprusside in the setting of CABG were evaluated. The references of these studies were also reviewed. Results: In the setting of CABG, sodium nitroprusside attenuates conduit vasospasm and reduces the incidence of inflammation, atrial fibrillation, and acute kidney injury after surgery. However, other vasodilators are more effective at maintaining postoperative blood pressure at goal. Conclusions: Despite its cost, sodium nitroprusside may be an appropriate agent to use during CABG operations, but other agents should be considered for treatment of postoperative hypertension.
AB - Purpose: Sodium nitroprusside is a vasodilator frequently used in the coronary artery bypass grafting (CABG) setting. However, the price of a 50-mg vial of sodium nitroprusside increased from $5.00 in 2003 to up to $900 in 2016. The purpose of this review is to help health systems balance high-quality patient care with economic responsibility. Methods: A MEDLINE literature search was performed using the search terms "nitroprusside" and "coronary artery bypass." All English-language trials in human subjects assessing the use of sodium nitroprusside in the setting of CABG were evaluated. The references of these studies were also reviewed. Results: In the setting of CABG, sodium nitroprusside attenuates conduit vasospasm and reduces the incidence of inflammation, atrial fibrillation, and acute kidney injury after surgery. However, other vasodilators are more effective at maintaining postoperative blood pressure at goal. Conclusions: Despite its cost, sodium nitroprusside may be an appropriate agent to use during CABG operations, but other agents should be considered for treatment of postoperative hypertension.
KW - CABG
KW - Coronary artery bypass
KW - Postoperative atrial fibrillation
KW - Postoperative hypertension
KW - Sodium nitroprusside
KW - Vasodilators
UR - http://www.scopus.com/inward/record.url?scp=85032456371&partnerID=8YFLogxK
U2 - 10.1177/0018578717722538
DO - 10.1177/0018578717722538
M3 - Article
AN - SCOPUS:85032456371
VL - 52
SP - 502
EP - 507
JO - Hospital Pharmacy
JF - Hospital Pharmacy
SN - 0018-5787
IS - 7
ER -