• Lívia Arcêncio, Daniella Alves Vento, Solange Bassetto, Paulo R B Evora, and Alfredo José Rodrigues.
• Division of Cardiothoracic Surgery, Department of Surgery and Anatomy, School of Medicine of Ribeirão Preto of the University of São Paulo, São Paulo, Brazil.
• J Crit Care. 2013 Aug 1; 28 (4): 533.e1-7.

PurposeThe purposes of this study are to measure the nitric oxide metabolites nitrite and nitrate (NOx) in the exhaled breath condensates (EBCs) of patients submitted to heart valve surgery and to assess the correlation between NOx levels and postoperative respiratory complications.Materials And MethodsExhaled breath condensate and blood samples were collected from each patient during spontaneous breathing preoperatively, during invasive mechanical ventilation in the fourth hour after surgery and 12, 24, 48, and 72 hours after the operation. Nitrite and nitrate levels in the EBC and serum were measured by chemiluminescence.ResultsThirty-two patients were included in the study. In patients who presented with postoperative respiratory complications, the postoperative levels of NOx were significantly higher in the EBC from the fourth postoperative hour compared with those who experienced uneventful postoperative periods (P = .027). However, the preoperative and postoperative serum levels of NOx were not significantly different in between-group analyses (P = .995).ConclusionOur results suggest that the postoperative NOx level in the EBC is an early marker of respiratory complications after heart valve surgery. Additional studies using large cohorts are necessary to corroborate our results and to better define the clinical usefulness of assessing NOx in the EBC after cardiac surgery.Copyright © 2013 Elsevier Inc. All rights reserved.

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