Acute ventilatory restriction in children after weaning off inhaled nitric oxide: relation to rebound pulmonary hypertension.
OBJECTIVE
To assess the interaction between pulmonary hemodynamics and respiratory mechanics during acute pulmonary hypertension.


METHODS
Ventilated and paralysed children treated with inhaled nitric oxide because of post-operative pulmonary hypertension.


METHODS
Weaning of inhaled nitric oxide.


METHODS
Air flow and airway pressure, calculation of dynamic respiratory system compliance and respiratory system resistance for each breath by multiple linear regression.


RESULTS
In four patients, increases in pulmonary arterial pressure from 26.1 to 56.7 mm Hg (p<0.001) during weaning off nitric oxide were associated with decreases in tidal volume (from 9.7-->8.2 ml/kg, p<0.01) and reductions in dynamic respiratory system compliance (from 0.52-->0.34 cm H20/ml/kg, p<0.001), while respiratory system resistance was unchanged.


CONCLUSIONS
Impaired ventilation during acute pulmonary hypertension is predominantly related to a reduction in respiratory system compliance.
Schulze-Neick
I
I
Abteilung Angeborene Herzfehler, Deutsches Herzzentrum Berlin, Germany. isn@rbh.nthames.nhs.uk
Werner
H
H
Penny
D J
DJ
Alexi-Meskishvili
V
V
Lange
P E
PE
D000280:Administration, Inhalation; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000209:etiology / Q000628:therapy; D007223:Infant; D016014:Linear Models; D008297:Male; D009569:Nitric Oxide / Q000008:administration & dosage / Q000627:therapeutic use*; D011175:Positive-Pressure Respiration; D011183:Postoperative Complications; D015656:Respiratory Mechanics; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015300:Ventilator Weaning
D014665:Vasodilator Agents; D009569:Nitric Oxide