Aim:

This study was undertaken to evaluate the results of inhaled NO therapy in patients who had PAH and underwent repair of congenital heart defects over a period of 5 years.

Method:

36 patients mean age 2.6 years were included. Pulmonary and systemic arterial pressures, dose and duration of NO therapy, SaO2, coagulation parameters, methemoglobin levels, hypotension, PAH crisis and rebound PAH were studied.

Results:

The mean duration of NO therapy was 40.7 hours and dose varied from 5-80 ppm. Mean systemic arterial pressure increased from 53.3 mmHg to 67.1 mmHg while mean pulmonary artery pressure reduced from 39.6 mmHg to 31.8 mmHg. The response to the therapy was better in patients operated for TAPVC than those with other complex anomalies. Mortality was 28% (n = 10) and the cause of death being refractory pulmonary arterial hypertension in 4, coagulation disorders and hypoxemia in 1 each and low cardiac output state in 4 patients. Larger does and longer duration of NO therapy and higher serum methemoglobin levels (> 2%) were associated with an increased incidence of complications.

Conclusion:

Inhaled NO therapy is effective in reducing mean PAP without systemic hypotension and can be a useful treatment modality in immediate postoperative management of PAH after cardiac surgery.

NCPCC 2005 - Conference Abstracts. Pediatric Oncall [serial online] 2006 [cited 15 May 2006(Supplement 5)];3. Available from:
http://www.pediatriconcall.com/fordoctor/Conference_abstracts/
nitric_oxide_pah.asp