Effect of Nitric Oxide on Oxygenation and Hemodynamics in Infants after Cardiac Surgery

• Published in: Artificial organs 1997-01, Vol.21 (1), p.14-16
• Main Authors: Sadao, Kawasalu, Masahiro, Shinozaki, Toshihiko, Morinaga, Yasuaki, Naito, Yusaku, Takagaki
• Format: Article
• Language: English
• Subjects: Administration, Inhalation; Blood Pressure - drug effects; Cardiac surgery; Cardiac Surgical Procedures - adverse effects; Cardiac Surgical Procedures - mortality; Female; Heart Defects, Congenital - surgery; Humans; Infant; Infant, Newborn; Male; Nitric oxide; Nitric Oxide - administration & dosage; Nitric Oxide - pharmacology; Nitric Oxide - therapeutic use; Oxygen Consumption - drug effects; Postoperative Complications - prevention & control; Pulmonary hypertension; Pulmonary Wedge Pressure - drug effects; Respiratory failure; Trinitro-glycerin
• ISSN: 0160-564X; 1525-1594
• DOI: 10.1111/j.1525-1594.1997.tb00691.x

: We evaluated the effect of nitric oxide (NO) on infants after congenital cardiac surgery. Inhaled NO was administered to 7 infants after congenital cardiac surgery. Inhaled NO concentration ranged from 2.5 to 10 parts per million (ppm). The respiratory index (RI = A‐aDo,/Pao,) decreased from 7.4 ± 2.5 to 4.7 ±3.1 in the high RI group (RI ≥ 3, n = 4) 30 min after NO inhalation. After discontinuation of NO inhalation, RI increased to the preinhalation level. NO inhalation was restarted in 2 patients in the high RI group because of severe worsening of oxygenation. RI was not affected by starting or discontinuing of NO in the low RI group (R1 < 3, n = 3). Systemic blood pressure did not significantly change in the 2 groups. Pulmonary arterial pressure (PAP) was measured in 4 patients, and it decreased by 21, 10, and l0%, respectively, 30 min after NO inhalation in 3 patients, but did not change in the remaining patient. After discontinuation of NO inhalation, PAP increased in all patients, and in 2 cases, PAP was higher than baseline value. NO inhalation is effective in improving oxygenation in infants with a high RI after cardiac surgery. However, careful monitoring of the respiratory and hemodynamic states is required after discontinuing NO inhalation.