ROLE OF INHALED NITRIC OXIDE THERAPY IN POSTOPERATIVE MANAGEMENT OF PULMONARY ARTERIAL HYPERTENSION IN CONGENITAL HEART DISEASE: A PEDIATRIC CARDIAC INTENSIVE CARE UNIT EXPERIENCE
Sachdev MS*, Suresh kumar R**, Coelho R ***
Institute of Cardiovascular Diseases, Madras Medical Mission, Chennai*, Institute of Cardiovascular Diseases, Madras Medical Mission, Chennai**, Institute of Cardiovascular Diseases, Madras Medical Mission, Chennai***
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.
Methods
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.
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MS S, R k S, R C.. Available From : http://www.pediatriconcall.com/fordoctor/ Conference_abstracts/report.aspx?reportid=313
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