Inhaled nitric oxide reduces the intrapulmonary shunt to ameliorate severe hypoxemia after acute type A aortic dissection surgery

To assess the relationship between the intrapulmonary shunt and PaO2/FiO2 in severe hypoxemic patients after acute type A aortic dissection (ATAAD) surgery and to evaluate the effect of inhaled nitric oxide (iNO) on intrapulmonary shunt. Postoperative ATAAD patients with PaO2/FiO2 ≤ 150 mmHg were en...

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Bibliographic Details
Published in:Nitric oxide 2021-05, Vol.109-110, p.26-32
Main Authors: Hao, Guang-wei, Tu, Guo-wei, Yu, Shen-ji, Luo, Jing-chao, Liu, Kai, Wang, Huan, Ma, Guo-guang, Su, Ying, Hou, Jun-yi, Lai, Hao, Fang, Yan, Luo, Zhe
Format: Article
Language:English
Subjects:
Aortic dissection
Hypoxemia
Inhaled nitric oxide
Intrapulmonary shunt
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Summary:To assess the relationship between the intrapulmonary shunt and PaO2/FiO2 in severe hypoxemic patients after acute type A aortic dissection (ATAAD) surgery and to evaluate the effect of inhaled nitric oxide (iNO) on intrapulmonary shunt. Postoperative ATAAD patients with PaO2/FiO2 ≤ 150 mmHg were enrolled. Intrapulmonary shunt was calculated from oxygen content of different sites (artery [CaO2], mixed venous [CvO2], and alveolar capillary [CcO2]) using the Fick equation, where intrapulmonary shunt = (CcO2-CaO2)/(CcO2-CvO2). Related variables were measured at baseline (positive end expiratory pressure [PEEP] 5 cm H2O), 30 min after increasing PEEP (PEEP 10 cm H2O), 30 min after 5 ppm iNO therapy (PEEP 10 cm H2O + iNO), and 30 min after decreasing PEEP (PEEP 5 cm H2O + iNO). A total of 20 patients were enrolled between April 2019 and December 2019. Intrapulmonary shunt and PaO2/FiO2 were correlated in severe hypoxemic, postoperative ATAAD patients (adjusted R2 = 0.467, p 
ISSN:1089-8603
1089-8611
DOI:10.1016/j.niox.2021.03.001