Diagnosis Of Pulmonary Artery Hypertension

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

Pulmonary hypertension

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Rakesh Kumar, Binay Ranjan, Manjul Vijay Department of Pediatrics, Katihar medical college, Katihar...

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	Specialist Answers
Question
In a small obstetric clinic with about one thousand deliveries per year there is an increasing confirmed diagnosis of pulmonary artery hypertension, most of them 12/15 are babies delivered by CS at or near term all of them did well on dopamine occasionally +doppotamine, and diuretics, alkalination and in two cases digoxin was added,, only one case had PDA and was treated with aspirin as well our anesthetic regims includes induction with penthotal.. continuation of anesthesia with nitrous oxide compared to our previous figures I feel there is steady sharp increase with cases diagnosed is there an explanation with regards A.Kalagi Facharzt f Kinderheilkuende and Neonatalogie
Answer
Nitrous oxide is known to increase the pulmonary vascular resistance. There have been no reports of neonatal pulmonary hypertension with maternal nitrous oxide. Since you have noticed several cases of PAH, one may do a proper clinical trial and prove statistically that the observed discrepancy is true or not. See the following references: 1. Heerdt PM, Caldwell RW. The mechanism of nitrous oxide-induced changes in pulmonary vascular resistance in a dog model of left atrial outflow obstruction.J Cardiothorac Anesth. 1989 Oct;3(5):568-73. 2. Schulte-Sasse U, Hess W, Tarnow J. Pulmonary vascular responses to nitrous oxide in patients with normal and high pulmonary vascular resistance. Anesthesiology. 1982 Jul;57(1):9-13. Back to All Questions

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