Effect of Preoperative ACE- Inhibitor and ARBs in Pediatric Patients Undergoing Cardiopulmonary Bypass
In a retrospective cohort study of patients less than 18 years old who underwent cardiopulmonary bypass, intraoperative hemodynamics and vasopressor use were compared between patients who received preoperative ACE inhibitor/ARB therapy and those who did not. Use of preoperative ACE inhibitors and ARBs in pediatric patients undergoing cardiac surgery did not increase the incidence of hypotension after induction of anesthesia and did not increase vasoconstrictor requirements upon weaning from cardiopulmonary bypass.
This goes against the observation of occurrence of vasoplegia.The thing to note is that most pediatric patients receive phenoxybenzamine anyway which can obtund the observation of any difference in vasoplegia.