Why the study?
Does combined inhaled nitric oxide and epinephrine or norepinephrine improve weaning from cardiopulmonary bypass in children with pulmonary hypertension and ventricular dysfunction?
Does combined inhaled nitric oxide and epinephrine or norepinephrine improve weaning from cardiopulmonary bypass in children with pulmonary hypertension and ventricular dysfunction?
Combined inhaled nitric oxide and inotropes can successfully rescue children with pulmonary hypertension and ventricular dysfunction who fail to wean from cardiopulmonary bypass using conventional therapy.
Supports consideration of combined inhaled nitric oxide and inotropes for refractory pediatric cases; leaves open need for prospective trials.
Two cases of very difficult weaning from cardiopulmonary bypass after cardiac surgery in children with pulmonary hypertension and ventricular dysfunction are reported. Children fail to respond to conventional therapy combining nitrovasodilators and inotropic support and react successfully to combined inhaled nitric oxide (NO) and epinephrine or left atrial infused norepinephrine. Postoperative NO inhalation must be prolonged and no toxicity appears. Pulmonary endothelial function recovers only after several days.
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Bichel et al. (1997) studied this question.
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