Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Gamillscheg, A; Zobel, G; Urlesberger, B; Berger, J; Dacar, D; Stein, JI; Rigler, B; Metzler, H; Beitzke, A.
Inhaled nitric oxide in patients with critical pulmonary perfusion after Fontan-type procedures and bidirectional Glenn anastomosis.
J Thorac Cardiovasc Surg. 1997; 113(3):435-442
Doi: 10.1016/S0022-5223(97)70355-6
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- Führende Autor*innen der Med Uni Graz
- Gamillscheg Andreas
- Co-Autor*innen der Med Uni Graz
- Beitzke Albrecht
- Dacar Drago
- Metzler Helfried
- Rigler Bruno
- Stein Joerg-Ingolf
- Urlesberger Berndt
- Zobel Gerfried
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- Abstract:
- OBJECTIVE: The aim of this study was to evaluate the effects of inhaled nitric oxide in patients with critical pulmonary perfusion after Fontan-type procedures and bidirectional Glenn anastomosis. METHODS: Inhaled nitric oxide (mean 4.1 +/- 0.7 ppm, 1.5 to 10 ppm) was administered in 13 patients (mean age 5.6 +/- 1.6 years, 1.5 to 17 years) with critical pulmonary perfusion (central venous pressure > 20 mm Hg or transpulmonary pressure gradient > 10 mm Hg) in the early postoperative period after total cavopulmonary connection (n = 9) or after bidirectional Glenn anastomosis (n = 4). RESULTS: In patients after total cavopulmonary connection inhaled nitric oxide therapy decreased central venous pressure by 15.3% +/- 1.4% (p = 0.0001) and transpulmonary pressure gradient by 42% +/- 8% (p = 0.0008) and increased mean systemic arterial and left atrial pressures by 12% +/- 3.6% (p = 0.011) and 28% +/- 8% (p = 0.007), respectively. Arterial and venous oxygen saturations improved by 8.2% +/- 1% (p = 0.005) and 14% +/- 4.3% (p = 0.03), respectively. In patients after bidirectional Glenn anastomosis inhaled nitric oxide therapy resulted in a decrease of central venous pressure by 22% +/- 1% and of the transpulmonary pressure gradient by 55% +/- 6% and improved arterial and venous oxygen saturations by 37% +/- 29% and 11% +/- 3%, respectively. Mean systemic arterial and left atrial pressures remained nearly unchanged. No toxic side effect was observed in any patient. CONCLUSION: Inhaled nitric oxide may play an important role in the management of transient critical pulmonary perfusion caused by reactive elevated pulmonary vascular resistance in the early postoperative period after Fontan-type operations and bidirectional Glenn anastomosis.
- Find related publications in this database (using NLM MeSH Indexing)
- Administration, Inhalation -
- Adolescent -
- Child -
- Child, Preschool -
- Female -
- Fontan Procedure -
- Heart Bypass, Right -
- Heart Defects, Congenital - surgery
- Hemodynamics - drug effects
- Humans - drug effects
- Hypertension, Pulmonary - etiology
- Infant - etiology
- Lung - blood supply
- Male - blood supply
- Nitric Oxide - administration and dosage
- Postoperative Complications - drug therapy
- Vascular Resistance - drug therapy