title: Evaluation of exhaled nitric oxide in patients undergoing myocardial revascularization with cardiopulmonary bypass.
abstract: OBJECTIVE
  Cardiopulmonary bypass (CPB) can cause pulmonary dysfunction. Inflammatory changes may affect the release of nitric oxide (NO). The objective of this study was to evaluate exhaled NO in patients undergoing myocardial revascularization (MR) with CPB.
  
  
  METHODS
  This is a prospective study with nine adult patients undergoing MR with CPB. Initially, air samples were collected to analyze the presence of NO in the system that feeds the anesthesia equipment. Intravenous anesthesia was then initiated with ethomidate (0.3 mg x kg-1), sufentanil (0.3 microg x kg-1), and pancuronium (0.08 mg x kg-1), and maintained with isoflurane (MAC from 0.5 to 1.0) and sufentanil (5 microg x kg-1 x h-1). Tidal volume was fixed at 8 mL.kg-1 and FiO2 0.6, except during CPB. Thirty minutes after induction and 30 minutes after CPB, three sequential samples of exhaled air were collected for NO analysis by chemiluminescence. Data were analyzed by the Student t test.
  
  
  RESULTS
  The level of NO in room air was 5.05 +/- 3.37 ppb. Levels of exhaled NO decreased after CPB, varying from 11.25 +/- 5.65 ppb to 8.37 +/- 3.71 ppb (p = 0.031).
  
  
  CONCLUSIONS
  The reduction of exhaled NO after CPB observed in this study does not confirm the role of this molecule as a marker of pulmonary lesion. However, the different degrees of pulmonary parenchymal collapse, the method used to collect the data, and the drugs, among others, could have contributed for this reduction.
authors.affiliation: Divisão de Anestesia do Instituto Central do HC-FM/USP, Pós-Graduando Nível de Doutorado pelo Programa de Pós-graduação emAnestesiologia da FM/USP.
authors.forename: Célio Gomes
authors.initials: CG
authors.lastname: de Amorim
authors.forename: Luiz Marcelo
authors.initials: LM
authors.lastname: Sá Malbouisson
authors.forename: Beatriz Mangueira
authors.initials: BM
authors.lastname: Saraiva
authors.forename: Fernanda Maria da Silva
authors.initials: FM
authors.lastname: Pedro
authors.forename: Milton Arruda
authors.initials: MA
authors.lastname: Martins
authors.forename: Maria José Carvalho
authors.initials: MJ
authors.lastname: Carmona
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001944:Breath Tests; D002315:Cardiopulmonary Bypass; D006801:Humans; D008875:Middle Aged; D009204:Myocardial Revascularization; D009569:Nitric Oxide / Q000032:analysis*; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D009569:Nitric Oxide