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Epidural/Echo/Coagulation

Inhaled nitric oxide for hypoxia treatment after open heart surgery: 030

Mojasevic, R.; Petrovic, Lj.; Radovanovic, N.

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European Journal of Anaesthesiology: June 2004 - Volume 21 - Issue - p 32-33

Introduction: Arterial hypoxaemia is not a rare complication after open heart surgery. The aim of the study was to evaluate the efficacy of nitric oxide inhalation (INO) in patients with a low index of oxygenation (PaO2/FiO2).

Method: The study included 17pts, 14 males (82.4%) and 3 females (17.6%) with the mean age of 59 years (43-75) who underwent open heart surgery between October 2001 and October 2003 at our Clinic. The mean duration of aortic cross clamping time was 86.4 ± 20.2 minutes and the mean time of cardiopulmonary bypass 94.3 ± 21.4 minutes. Ventilation parameters were the same in all patients: minute volumen 10-12 mL/kg, frequency 12-14/min, I:E ratio 1:1 and positive end-expiratory pressure (PEEP) + 5cmH2O. A low PaO2/FiO2 < 8kPa was the indication for iNO. A pulmonic device was used to deliver NO continuously through the precise mass flow controller to the inspiratory limb of the ventilator. PaO2/FiO2, iNO dose and the duration of mechanical ventilation were observed. The starting dose of 15ppm was gradually decreased by 3ppm. Data is expressed as mean ± SD. Statistical significance was calculated to values before iNO therapy using paired t-test.

Results: Values of PaO2/FiO2 (kPa) during iNO therapy in ICU

Table
Table:
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The average duration of iNO therapy was 50 ± 29 (min = 18, max = 89) hours and mechanical ventilation 51 ± 27 (min = 20, max = 93) hours. All patiens were successfully extubated.

Conclusion: The iNO administration significantly improved arterial oxygenation and was effective in correcting hypoxia in patients after open heart surgery.

Reference:

1 Prendergast B, Scott DH, Mankad PS. Beneficial effects of inhaled nitric oxide in hypoxaemic patients after coronary artery bypass surgery. Eur J Cardiothorac Surg 1998; 14(5): 488-493.
© 2004 European Society of Anaesthesiology