Abstract
We evaluated the effect of nitric oxide (NO) on infants after congenital cardiac surgery. Inhaled NO was administered to 7 infants after congenital cardiac surgery. Inhaled NO concentration ranged from 2.5 to 10 parts per million (ppm). The respiratory index (RI = A-aDO2/PaO2) decreased from 7.4 +/- 2.5 to 4.7 +/- 3.1 in the right RI group (RI > or = 3, n = 4) 30 min after NO inhalation. After discontinuation of NO inhalation, RI increased to the preinhalation level. NO inhalation was restarted in 2 patients in the high RI group because of severe worsening of oxygenation. RI was not affected by starting or discontinuing of NO in the low RI group (RI < 3, n = 3). Systemic blood pressure did not significantly change in the 2 groups. Pulmonary arterial pressure (PAP) was measured in 4 patients, and it decreased by 21, 10, and 10%, respectively, 30 min after NO inhalation in 3 patients, but did not change in the remaining patient. After discontinuation of NO inhalation, PAP increased in all patients, and in 2 cases, PAP was higher than baseline value. NO inhalation is effective in improving oxygenation in infants with a high RI after cardiac surgery. However, careful monitoring of the respiratory and hemodynamic states is required after discontinuing NO inhalation.
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