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2017 ; 52
(7
): 502-507
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Examining the Use of Sodium Nitroprusside in Coronary Artery Bypass Grafting: Is
the Benefit Worth the Cost?
#MMPMID29276280
Gibson CM
; Davis S
; Bradford D
Hosp Pharm
2017[Jul]; 52
(7
): 502-507
PMID29276280
show ga
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.