Inhaled nitric oxide in patients with cystic fibrosis during preoperative evaluation and during anaesthesia for lung transplantation.
BACKGROUND
Inhaled nitric oxide (iNO) has been recently used as pulmonary vasodilator without any systemic effects because of a rapid inactivation by haemoglobin. We studied haemodynamic and oxygenation effects during iNO administration in cystic fibrotic patients during preoperative evaluation and during anaesthesia for lung transplantation.


METHODS
From March 1996 to November 1997, 35 patients received iNO (40 ppm) during preoperative evaluation in spontaneously breathing. 13 patients, who underwent double lung transplantation, received iNO (40 ppm) during the surgical procedures, after pulmonary artery clamping.


RESULTS
In the preoperative evaluation a significant decrease of mean pulmonary artery pressure, pulmonary vascular resistance index and intrapulmonary shunt, with an increase of PaO2/FiO2, were observed during iNO administration, compared to baseline in 100% O2. During lung transplantation a significant decrease in intrapulmonary shunt was noted. All the transplants were successfully performed without cardio-pulmonary bypass. In all procedures, after iNO administration, we observed no modification of systemic haemodynamics. In conclusion, our study confirms the pulmonary effects of iNO without any systemic effects in patients affected by cystic fibrosis during preoperative evaluation and during anaesthesia for lung transplantation.
Della Rocca
G
G
University of Rome La Sapienza, Istituto di Anestesia e Rianimazione.
Coccia
C
C
Pugliese
F
F
Pompei
L
L
Ruberto
F
F
Venuta
F
F
Rendina
E A
EA
Coloni
G F
GF
Ricci
C
C
Gasparetto
A
A
D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D000768:Anesthesia, General; D002648:Child; D003550:Cystic Fibrosis / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008168:Lung / Q000187:drug effects*; D016040:Lung Transplantation; D008297:Male; D009569:Nitric Oxide / Q000008:administration & dosage / Q000494:pharmacology*; D011652:Pulmonary Circulation / Q000187:drug effects; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000494:pharmacology*
D014665:Vasodilator Agents; D009569:Nitric Oxide