Factors contributing to successful discontinuation from inhaled nitric oxide therapy in pediatric patients after congenital cardiac surgery.

Abstract

To investigate variables that contribute to successful discontinuation from inhaled nitric oxide (iNO) therapy in children after surgical repair of congenital heart disease. Analysis of retrospectively collected data. The pediatric intensive care unit of a university hospital. A total of 65 pediatric patients receiving iNO therapy for the purpose of pulmonary circulation control after cardiac surgery. None. Patients were classified into two groups: those successfully weaned from iNO therapy on the initial attempt (group A, n = 45) and those for whom the initial attempt at weaning failed (group B, n = 20). Variables including intraoperative findings, postoperative hemodynamic and ventilatory variables, medication profiles, and dose and duration of iNO therapy were compared between groups. Using a multivariate logistic regression model, iNO therapy of >72 hrs (odds ratio, 5.6) and NO dose at discontinuation of <2 ppm (odds ratio, 4.1) were found to be significantly associated with successful weaning. Those results could be emphasized in a subgroup of left-to-right shunt cardiac anomaly. Longer continuation (>72 hrs) and lower final concentration (<2 ppm) represent factors contributing to successful discontinuation of iNO therapy in pediatric patients after cardiac surgery, specifically for children with left-to-right shunt correction.