Permanent Intraoperative Nitric Oxide Inhalation for Adults with High Pulmonary Hypertension during Heart Valve Surgery with Cardiopulmonary Bypass
- #AN/CAR 01-O-1
- Anaesthesia, Critical Care /Cardiac and Thoracic Surgery. SESSION-1
- Oral
Permanent Intraoperative Nitric Oxide Inhalation for Adults with High Pulmonary Hypertension during Heart Valve Surgery with Cardiopulmonary Bypass
Vladimir Pichugin 1, Stepan Domnin 2, Alexander Medvedev 1, Alishir Gamzaev 2, Ilgiz Seyfetdinov 2
1 Nizhny Novgorod State Medical Academy, Nizhny Novgorod, Russia; 2 Specialized Clinical Cardiosurgical Hospital, Nizhny Novgorod, Russia;
Date, time and location: 2018.05.26 13:30, Press Hall, 2F
Abstract
Objective. The aim of the study was to evaluate the
effectiveness of permanent intraoperative NO inhalation in adults with high
pulmonary hypertension during heart valves surgery with cardiopulmonary bypass.
Material and methods. The study included 67 patients (mean
age 58.9 ± 1.9), underwent replacement or plastic correction of heart valves.
The mean pulmonary artery pressure was 42.2 ±
Results. The onset of NO inhalation resulted in a
significant decrease in mean pulmonary artery pressure, an average of 18.0%, the
left ventricle contractility parameters were stable. Intraoperative NO inhalation
was accompanied by a significantly lower alveolar-arterial oxygen difference
during operation, a significantly higher oxygenation index from the onset of NO
inhalation. A significantly higher oxygenation index, significantly lower
intrapulmonary shunt parameter after CPB, and the preservation of the initial
values of pulmonary compliance at all stages of the operation were registered
in third group. No adverse effects of permanent NO inhalation were observed.
Conclusion. The permanent intraoperative NO inhalation in
combination with pulmonary artery perfusion and ventilation during CPB had a
number of undeniable advantages over NO inhalation before and after CPB
technique. The effectiveness of lungs protection during CPB was better in these
patients, but larger randomized trials are needed for evaluation of this
technique.