Inhaled Nitric Oxide Improves Clinical Outcome after Adult Cardiac Surgery: Pulmonary Hypertension and Oxygenation

Fumio Yamana, Toshhiro Ohata, Mutsunori Kitahara

Department of Cardiovascular Surgery, Sakai City Medical Center, Sakai, Japan

Date, time and location: 2018.05.25 15:30, Exhibition area, 1st Floor. Zone – B

Abstract

Objectives: Inhaled nitric oxide (NO) is an agent known to reduce pulmonary vascular resistance and improve hemodynamic variables after cardiac surgery. We evaluated our clinical outcomes of inhaled NO in patients after cardiac surgery.Patients and Methods： Between 2015 and 2017, 4 patients received inhaled NO therapy after cardiac surgery in our hospital. There were severe pulmonary thromboembolism (PTE) in 3 and acute type A aortic dissection (AADA) after aortic root replacement in one. The mean age was 60(48-74) years at operation. All PTE patients was needed preoperative peripheral extracorporeal membrane oxygenation (ECMO). We evaluated the preoperative factors such as mean preoperative systolic & mean PAP, SvO2 and P/F ratio. Results: There was no hospital mortality in this series. Pulmonary hypertension improved (sPAP:63±17 to 59±15, mPAP: 41±6 to 36±9 mmHg), SvO2 increased 41±2 to 50±5%, and P/F ratio increased 145 ±60to 317 ±40mmHg, respectively. All patients weaned inhaled NO therapy, assist circulation and ventilator without any complication. In AADA case, post op. ECMO was not needed because of the improved oxygenation.Conclusions: The clinical outcome of inhaled NO in the patients after cardiac surgery was quiet acceptable. Inhaled NO might be safe and useful in patients with severe pulmonary hypertension, hypoxia and low output after cardiac surgery.