Inhaled nitric oxide in the management of congenital heart disease.
Inhaled nitric oxide, with a threshold of perhaps only a few parts per million, is a selective pulmonary vasodilator in patients with congenital heart disease and increased pulmonary vascular resistance. Multiple reports suggest that it may be useful in managing postoperative pulmonary hypertension in the cardiac patient, although it is unknown to what extent inhaled nitric oxide can actually reduce morbidity and mortality in this setting. This agent also holds promise for evaluating patients with pulmonary hypertension prior to heart transplantation. Although special care is needed to avoid toxicity related to excess inhaled nitric oxide or nitric dioxide or increased methemoglobin, the risk of complications with inhaled nitric oxide therapy appears to be very low. Inhaled nitric oxide will likely continue to play a significant role in the pre-and postoperative management of patients with congenital heart disease.
Kulik
T J
TJ
Division of Pediatric Cardiology, C.S. Mott Children's Hospital, University of Michigan Hospitals, Ann Arbor 48109-0204, USA.
D006330:Heart Defects, Congenital / Q000188:drug therapy* / Q000601:surgery; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D009569:Nitric Oxide / Q000494:pharmacology / Q000627:therapeutic use*; D010101:Oxygen Consumption / Q000187:drug effects; D016896:Treatment Outcome; D014655:Vascular Resistance / Q000187:drug effects; D014665:Vasodilator Agents / Q000494:pharmacology / Q000627:therapeutic use; D016276:Ventricular Function / Q000187:drug effects
D014665:Vasodilator Agents; D009569:Nitric Oxide