• Keiji Kumon and Naoki Yahagi.
• Surgical Intensive Care Unit, National Cardiovascular Center, 5-7-1 Fujishirodai, 565-8565, Suita, Japan.
• J Anesth. 1998 Dec 1; 12 (4): 180-184.

PurposeThe purpose of this study was to quantify the increase in oxygen delivery (DO2) produced by nitric oxide (NO) inhalation, and to clarify whether NO inhalation might be effective in adult patients after cardiovascular surgery whether or not they have pulmonary hypertension (PH).MethodsThe study was done on 26 adult patients after cardiovascular surgery. The indications for NO inhalation were postoperative hypoxic respiratory failure (POHRF) with or without PH. NO was administered via a premixing system or via a side-stream system. The dose was adjusted to between 1 and 10 (5.7±2.0) (mean±SD) ppm. Data were obtained just before and within 120 min after the initiation of NO inhalation. We initially analyzed the data from all the patients together and then compared data from two groups made up from just 22 of the 26 patients: 14 patients without PH whose PaO2/FiO2 before NO inhalation was less than 200 mmHg (simple POHRF group), and 8 patients who had both POHRF and PH (systolic pulmonary arterial pressure higher than 40 mmHg) (POHRF with PH group).ResultsIn the original group of 26 patients, significant improvements were observed in PaO2, PaO2/FiO2, CI, SPAP, CaO2, DO2I, and SvO2 during NO inhalation. The increase in DO2I was 68 ml·min-1·m-2 (+19.5%). PaO2, PaO2/FiO2, CaO2, DO2I, and SvO2 increased significantly in both groups. The increase in DO2I was 60 ml·min-1·m-2 (+18.9%) in the simple POPHRF group and 79ml·min-1·m-2 (+18.0%) in the POHRF with PH group.ConclusionNO inhalation increases DO2 by approximately 20% in adult patients after cardiovascular surgery, irrespective of whether or not they have pulmonary hypertension.

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