Repair of ventricular septal defect in a child with severe pulmonary hypertension--response to inhaled nitric oxide.
Nitric oxide (NO), was administered successfully, to a child with severe pulmonary hypertension, following surgical repair of a large ventricular septal defect. Inhalation of NO, 20-25 parts per million (ppm) was continued for 24 h, resulting in mean pulmonary artery pressure (PAP) of 25 mmHg and permitting a reduction in both ventilatory and inotropic support. Weaning of NO was commenced. At 5 ppm, administration was discontinued. An immediate and dramatic increase in PAP occurred. A similar pattern resulted on further attempts, demonstrating the extreme sensitivity of the pulmonary vasculature to the effects of inhaled low dose NO and the selectivity of the response.
Cregg
N
N
Department of Anaesthesia, Children's Research Centre, Our Lady's Hospital for Sick Children, Crumlin, Dublin, Ireland.
Casey
W
W
D000280:Administration, Inhalation; D000768:Anesthesia, General / Q000379:methods; D002675:Child, Preschool; D006345:Heart Septal Defects, Ventricular / Q000150:complications / Q000601:surgery*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000628:therapy*; D007430:Intraoperative Care; D008297:Male; D009569:Nitric Oxide / Q000008:administration & dosage*; D011182:Postoperative Care; D011183:Postoperative Complications / Q000628:therapy*; D012121:Respiration, Artificial; D014665:Vasodilator Agents / Q000008:administration & dosage*
D014665:Vasodilator Agents; D009569:Nitric Oxide