Successful weaning from cardiopulmonary bypass after cardiac surgery using inhaled nitric oxide.
Two cases of very difficult weaning from cardiopulmonary bypass after cardiac surgery in children with pulmonary hypertension and ventricular dysfunction are reported. Children fail to respond to conventional therapy combining nitrovasodilators and inotropic support and react successfully to combined inhaled nitric oxide (NO) and epinephrine or left atrial infused norepinephrine. Postoperative NO inhalation must be prolonged and no toxicity appears. Pulmonary endothelial function recovers only after several days.
Bichel
T
T
Department of Anaesthesiology, University Hospital of Geneva, Switzerland.
Spahr-Schopfer
I
I
Berner
M
M
Jaeggi
E
E
Velkovski
Y
Y
Friedli
B
B
Kalangos
A
A
Faidutti
B
B
Rouge
J C
JC
D000280:Administration, Inhalation; D000322:Adrenergic Agonists / Q000627:therapeutic use; D001013:Aorta, Thoracic / Q000002:abnormalities / Q000601:surgery; D001020:Aortic Stenosis, Subvalvular / Q000601:surgery; D001993:Bronchodilator Agents / Q000627:therapeutic use; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D002316:Cardiotonic Agents / Q000627:therapeutic use; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000601:surgery; D004730:Endothelium, Vascular / Q000187:drug effects; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D006325:Heart Atria; D006345:Heart Septal Defects, Ventricular / Q000601:surgery; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy / Q000209:etiology; D007223:Infant; D007267:Injections; D008168:Lung / Q000098:blood supply / Q000187:drug effects; D009569:Nitric Oxide / Q000008:administration & dosage / Q000627:therapeutic use*; D009638:Norepinephrine / Q000008:administration & dosage / Q000627:therapeutic use; D019141:Respiratory System Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000627:therapeutic use; D014665:Vasodilator Agents / Q000627:therapeutic use; D018754:Ventricular Dysfunction / Q000188:drug therapy / Q000209:etiology
D000322:Adrenergic Agonists; D001993:Bronchodilator Agents; D002316:Cardiotonic Agents; D019141:Respiratory System Agents; D014662:Vasoconstrictor Agents; D014665:Vasodilator Agents; D009569:Nitric Oxide; D009638:Norepinephrine; D004837:Epinephrine