[Changes in oxygenation indexes with the use of nitric oxide in the postoperative period of congenital heart disease surgery in patients with severe pulmonary hypertension].
In this clinical study, 7 pediatric patients with severe pulmonary artery hypertension, secondary to congenital heart disease, received inhaled nitric oxide at doses of 20 ppm in the acute postoperative management of congenital heart repair for 3.5 days. Monitoring included oxygenation index, alveoloarterial oxygen difference, pulmonary and systemic pressure, measurements were recorded previous to the NO administration; 1, 6, 12, 24, 36, 48 and 72 hours after treatment with NO, nitrous oxide (NO2) and seric methemoglobin also were monitored.


RESULTS
Average age was 3.6 years. The oxygenation index before inhaling NO was 166 +/- 100, 72 hours following inhalation of NO the oxygenation index was 210 +/- 98. The alveolo-arterial baseline oxygen difference was 270 +/- 145; 72 hours after inhaling NO, it was 163 +/- 167. No decreases in pulmonary and systemic arterial pressure during NO inhalation occured. The levels of NO2 and seric methemoglobin were not toxic.


CONCLUSIONS
Treatment with inhaled NO after cardiac surgery in children with severe pulmonary artery hypertension secondary to congenital heart disease may be useful to improve oxygenation with no changes in pulmonary and systemic arterial pressure. Inhaled NO at 20 ppm did not cause toxicity.
Ramírez Ramírez
L
L
Unidad de Cuidados Intensivos Postquirúrgicos del Instituto Nacional de Cardiología Ignacio Chávez, INCICH, Juan Badiano No. 1, 14080 México, D.F.
Calderón Colmenero
J
J
Zarco Martínez
E
E
García Montes
J A
JA
Molina Méndez
J
J
Fernández de la Reguera
G
G
D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications* / Q000378:metabolism / Q000601:surgery*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology* / Q000378:metabolism; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009569:Nitric Oxide / Q000494:pharmacology*; D010101:Oxygen Consumption / Q000187:drug effects*; D011184:Postoperative Period; D012189:Retrospective Studies; D012720:Severity of Illness Index
D009569:Nitric Oxide