Inhaled nitric oxide improves oxygen saturation in children with pulmonary arteriovenous malformations after the Fontan procedure.
OBJECTIVE
To report the utility of inhaled nitric oxide to ameliorate excessive hypoxemia in children with pulmonary arteriovenous malformations after the Fontan procedure.


METHODS
Case series.


METHODS
A tertiary pediatric cardiac intensive care unit in a freestanding children's hospital.


METHODS
Three children with complex congenital heart disease and pulmonary arteriovenous malformations who underwent the Fontan procedure.


METHODS
The 3 patients all exhibited moderate-to-severe hypoxemia in the immediate postoperative period. The hypoxemia persisted despite mechanical ventilation and oxygen at an Fio2 of 1.0. Inhaled nitric oxide was initiated with immediate and dramatic improvements in oxygen saturation in all patients. All patients were eventually weaned off inhaled nitric oxide.


CONCLUSIONS
The use of inhaled nitric oxide in patients with pulmonary arteriovenous malformations after having the Fontan procedure improves hypoxemia and may potentially reduce postoperative morbidity, unnecessary testing, and duration of hospital stay.
Carlo
Waldemar F
WF
Division of Pediatric Cardiology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA. wfcarlo@peds.uab.edu
Nelson
David P
DP
D000280:Administration, Inhalation; D001165:Arteriovenous Malformations / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D018729:Fontan Procedure; D006801:Humans; D009569:Nitric Oxide / Q000008:administration & dosage / Q000494:pharmacology*; D010101:Oxygen Consumption / Q000502:physiology*; D011651:Pulmonary Artery / Q000002:abnormalities*
D009569:Nitric Oxide