title: Effect of nitric oxide on oxygenation and hemodynamics in infants after cardiac surgery.
abstract: 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-aDO2/PaO2) decreased from 7.4 +/- 2.5 to 4.7 +/- 3.1 in the right RI group (RI > or = 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 (RI < 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 10%, 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.
authors.affiliation: Critical Care Medical Center, Wakayama Medical College, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Sadao
authors.forename: S
authors.initials: S
authors.lastname: Masahiro
authors.forename: M
authors.initials: M
authors.lastname: Toshihiko
authors.forename: N
authors.initials: N
authors.lastname: Yasuaki
authors.forename: T
authors.initials: T
authors.lastname: Yusaku
mesh_terms: D000280:Administration, Inhalation; D001794:Blood Pressure / Q000187:drug effects*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000401:mortality; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009569:Nitric Oxide / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D010101:Oxygen Consumption / Q000187:drug effects*; D011183:Postoperative Complications / Q000517:prevention & control; D011669:Pulmonary Wedge Pressure / Q000187:drug effects*
chemical_list: D009569:Nitric Oxide