{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T06:06:42Z","timestamp":1789020402152,"version":"build-2803163510"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Today"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      Tolvaptan sodium phosphate (TSP; Samtas\n                      <jats:sup>\u00ae<\/jats:sup>\n                      , Otsuka Pharmaceutical, Tokyo, Japan) is a novel intravenous aquaretic diuretic; however, evidence for its use in patients after cardiac surgery is limited. We evaluated the early postoperative administration of TSP in patients who underwent cardiac surgery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We enrolled 91 patients who underwent cardiac surgery with cardiopulmonary bypass at our institution. Of these, 46 received TSP immediately after intensive care unit admission, and 45 served as controls. After propensity score matching, 20 matched pairs were analyzed. A subgroup analysis was performed according to the renal function in TSP-treated patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the propensity score-matched cohort, the TSP group showed a trend toward adequate early postoperative urine output and a gradual negative fluid balance. Regarding safety, electrolyte abnormalities did not increase in the TSP group. No patient in either group developed significant acute kidney injury. Similar trends were observed in patients with a reduced renal function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this selected cohort, intravenous TSP administration immediately upon ICU admission after cardiac surgery with cardiopulmonary bypass was feasible and not associated with any major safety concerns, including in patients with a reduced renal function. TSP also tended to reduce day-to-day fluid balance fluctuations with an adequate urine output.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00595-026-03470-2","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:19:36Z","timestamp":1789017576000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Feasibility and safety of intravenous tolvaptan administration immediately upon ICU admission after cardiac surgery with cardiopulmonary bypass"],"prefix":"10.1007","author":[{"given":"Masahiko","family":"Narita","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kentaro","family":"Shirakura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eijiro","family":"Hikasa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hana","family":"Fukuta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuya","family":"Tamaru","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoki","family":"Nakatsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Kadohama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuyuki","family":"Akasaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Kamiya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"issue":"3","key":"3470_CR1","doi-asserted-by":"publisher","first-page":"R99","DOI":"10.1186\/cc11368","volume":"16","author":"A Stein","year":"2012","unstructured":"Stein A, de Souza LV, Belettini CR, Menegazzo WR, Vi\u00e9gas JR, Costa Pereira EM, et al. Fluid overload and changes in serum creatinine after cardiac surgery: predictors of mortality and longer intensive care stay. A prospective cohort study. Crit Care. 2012;16(3):R99.","journal-title":"Crit Care"},{"key":"3470_CR2","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/4836862","author":"V Koc","year":"2020","unstructured":"Koc V, Delmas Benito L, de With E, Boerma EC. The effect of fluid overload on attributable morbidity after cardiac surgery: a retrospective study. Crit Care Res Pract. 2020. https:\/\/doi.org\/10.1155\/2020\/4836862.","journal-title":"Crit Care Res Pract"},{"issue":"6","key":"3470_CR3","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1177\/0267659109105079","volume":"23","author":"E Hirleman","year":"2008","unstructured":"Hirleman E, Larson DF. Cardiopulmonary bypass and edema: physiology and pathophysiology. 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