title: Postoperative nitric oxide therapy in children with congenital heart disease. Can the need be predicted?
abstract: The necessity for postoperative inhaled nitric oxide (NO) therapy and predictive factors for that need were retrospectively analysed in 457 paediatric patients at risk of pulmonary hypertensive events following open-heart surgery for congenital heart disease. Inhaled NO was given postoperatively to 46% of the study group and to 23% of all patients undergoing open-heart surgery during the study period. Factors associated with increased need for postoperative NO were age <1 year, Down's syndrome, preoperative pulmonary hypertension and increased pulmonary vascular resistance. Using a multivariate model based on these factors, 73% of the patients who were given NO were identified. Thus, in a setting with unrestricted access to NO therapy, almost half of the patients with cardiac lesions that commonly give rise to postoperative pulmonary hypertension were given postoperative NO. Seventy-three percent of postoperative NO treatment was associated with a relatively small number of pre- and perioperative patient-related risk factors.
authors.affiliation: Department of Anaesthesiology, Hospital for Children and Adolescents, University of Helsinki, Finland.
authors.forename: P O
authors.initials: PO
authors.lastname: Laitinen
authors.forename: J
authors.initials: J
authors.lastname: Räsänen
authors.forename: H
authors.initials: H
authors.lastname: Sairanen
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005544:Forecasting; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009569:Nitric Oxide / Q000627:therapeutic use*; D011182:Postoperative Care / Q000706:statistics & numerical data*
chemical_list: D009569:Nitric Oxide