Midodrine in treatment of post coronary revascularization vasoplagia; pilot, open label, assessor blinded randomized clinical trial

Abstract Purpose Post cardiac surgery hypotension and inotrope dependence are among major causes of prolonged intensive care unit (ICU) stay. Besides routine managements, catecholamine inotrope-vasopressors the traditional treatment. However, there is an increasing interest to catecholamine-sparing agents, such as Midodrine, oral alfa1 agonist, in patients with vasoplegia. Up now no randomized study midodrine on post patients. Material method In this pilot, open label, assessor blind, clinical trial from June 2020 December 2021, 65 refractory (more than 24 hours inotropes) after coronary revascularization were included. Patients randomly assigned receive Midodrine add-on therapy (10 mg stat 5 po every 12 hours) or placebo The primary outcome was liberation time IV inotrope-support. Secondary outcomes ICU admission total vasopressor dosage randomization. Results 32 enrolled group, a mean age 60.72, 33 received 63.27. Median 27 group 49 (p=0.022). for groups 115 121 hours, respectively (p=0.990). Total randomization similar two studied groups, 4352 μg 5637 (p=0.405). No adverse event observed group. Conclusion safe medication appropriate compliance admitted surgery, which seems decrease dependent time. Funding Acknowledgement Type funding sources: None.