• Kyoko Kageyama, Nobuaki Shime, Munetaka Hirose, Noriko Hiramatsu, Hiromi Ashida, and Satoru Hashimoto.
• Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
• Pediatr Crit Care Me. 2004 Jul 1;5(4):351-5.

ObjectiveTo investigate variables that contribute to successful discontinuation from inhaled nitric oxide (iNO) therapy in children after surgical repair of congenital heart disease.DesignAnalysis of retrospectively collected data.SettingThe pediatric intensive care unit of a university hospital.PatientsA total of 65 pediatric patients receiving iNO therapy for the purpose of pulmonary circulation control after cardiac surgery.InterventionsNone.Measurements And Main ResultsPatients were classified into two groups: those successfully weaned from iNO therapy on the initial attempt (group A, n = 45) and those for whom the initial attempt at weaning failed (group B, n = 20). Variables including intraoperative findings, postoperative hemodynamic and ventilatory variables, medication profiles, and dose and duration of iNO therapy were compared between groups. Using a multivariate logistic regression model, iNO therapy of >72 hrs (odds ratio, 5.6) and NO dose at discontinuation of <2 ppm (odds ratio, 4.1) were found to be significantly associated with successful weaning. Those results could be emphasized in a subgroup of left-to-right shunt cardiac anomaly.ConclusionsLonger continuation (>72 hrs) and lower final concentration (<2 ppm) represent factors contributing to successful discontinuation of iNO therapy in pediatric patients after cardiac surgery, specifically for children with left-to-right shunt correction.

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