Effects of inhaled nitric oxide on respiratory system mechanics, hemodynamics, and gas exchange after cardiac surgery
Objective: To evaluate the hemodynamic and respiratory effects of inhaled nitric oxide (NO) in postoperative cardiac patients. Design: A prospective evaluation. Setting: A university hospital intensive care unit. Participants: Fourteen adults with pulmonary hypertension, studied postoperatively. Int...
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| Veröffentlicht in: | Journal of cardiothoracic and vascular anesthesia 1998-04, Vol.12 (2), p.157-161 |
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| creator | Carmona, Maria JoséCarvalho Auler, JoséOtàvio Costa |
| description | Objective:
To evaluate the hemodynamic and respiratory effects of inhaled nitric oxide (NO) in postoperative cardiac patients.
Design:
A prospective evaluation.
Setting:
A university hospital intensive care unit.
Participants:
Fourteen adults with pulmonary hypertension, studied postoperatively.
Interventions:
60 minutes of NO inhalation (20 ppm).
Measurements and Main Results:
Respiratory mechanics were analyzed by inflating the relaxed respiratory system with constant flow, followed by rapid airway occlusion at end-inflation, which was maintained until a plateau in tracheal pressure was obtained. Gas exchange and hemodynamics were evaluated by conventional means. The data were studied using the analysis of variance for repeated measures. Minimum airway resistance (Rmin) increased significantly from 8.87 ± 3.24 cm H
2O/L · s to 9.69 ± 3.22 cm H
2O/L · s at the end of NO inhalation and remained elevated after NO was discontinued. A selective vasodilator effect on pulmonary vasculature was observed in the pulmonarysystemic vascular resistance ratio, which decreased from 0.18 ± 0.11 to 0.13 ± 0.08 at the end of inhalation and returned to baseline values after gas suspension. No significant alterations in oxygenation were observed.
Conclusion:
The effects of NO as a powerful and useful vasodilator agent were confirmed. However, it is important to be aware that the effects observed on respiratory mechanics may interfere with the final response of the respiratory system to NO. |
| doi_str_mv | 10.1016/S1053-0770(98)90323-8 |
| format | Article |
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To evaluate the hemodynamic and respiratory effects of inhaled nitric oxide (NO) in postoperative cardiac patients.
Design:
A prospective evaluation.
Setting:
A university hospital intensive care unit.
Participants:
Fourteen adults with pulmonary hypertension, studied postoperatively.
Interventions:
60 minutes of NO inhalation (20 ppm).
Measurements and Main Results:
Respiratory mechanics were analyzed by inflating the relaxed respiratory system with constant flow, followed by rapid airway occlusion at end-inflation, which was maintained until a plateau in tracheal pressure was obtained. Gas exchange and hemodynamics were evaluated by conventional means. The data were studied using the analysis of variance for repeated measures. Minimum airway resistance (Rmin) increased significantly from 8.87 ± 3.24 cm H
2O/L · s to 9.69 ± 3.22 cm H
2O/L · s at the end of NO inhalation and remained elevated after NO was discontinued. A selective vasodilator effect on pulmonary vasculature was observed in the pulmonarysystemic vascular resistance ratio, which decreased from 0.18 ± 0.11 to 0.13 ± 0.08 at the end of inhalation and returned to baseline values after gas suspension. No significant alterations in oxygenation were observed.
Conclusion:
The effects of NO as a powerful and useful vasodilator agent were confirmed. However, it is important to be aware that the effects observed on respiratory mechanics may interfere with the final response of the respiratory system to NO.</description><identifier>ISSN: 1053-0770</identifier><identifier>EISSN: 1532-8422</identifier><identifier>DOI: 10.1016/S1053-0770(98)90323-8</identifier><identifier>PMID: 9583545</identifier><language>eng</language><publisher>Philadelphia, PA: Elsevier Inc</publisher><subject>Administration, Inhalation ; Adult ; Aged ; Airway Resistance - drug effects ; Biological and medical sciences ; Cardiac Surgical Procedures ; Cardiovascular system ; Female ; hemodynamics ; Hemodynamics - drug effects ; Humans ; Hypertension, Pulmonary - physiopathology ; inhaled nitric oxide ; Male ; Medical sciences ; Middle Aged ; Nitric Oxide - administration & dosage ; Nitric Oxide - pharmacology ; Pharmacology. Drug treatments ; postoperative cardiac surgery ; Postoperative Period ; Pulmonary Circulation - drug effects ; Pulmonary Gas Exchange - drug effects ; Respiration - drug effects ; respiratory mechanics ; Retrospective Studies ; Vascular Resistance - drug effects ; Vasodilator Agents - administration & dosage ; Vasodilator Agents - pharmacology ; Vasodilator agents. Cerebral vasodilators</subject><ispartof>Journal of cardiothoracic and vascular anesthesia, 1998-04, Vol.12 (2), p.157-161</ispartof><rights>1998</rights><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c389t-3ef525c73d304a05e3a119584702d104463551e7f001e6a371a5ebb728f19f7c3</citedby><cites>FETCH-LOGICAL-c389t-3ef525c73d304a05e3a119584702d104463551e7f001e6a371a5ebb728f19f7c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S1053-0770(98)90323-8$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2211529$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9583545$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Carmona, Maria JoséCarvalho</creatorcontrib><creatorcontrib>Auler, JoséOtàvio Costa</creatorcontrib><title>Effects of inhaled nitric oxide on respiratory system mechanics, hemodynamics, and gas exchange after cardiac surgery</title><title>Journal of cardiothoracic and vascular anesthesia</title><addtitle>J Cardiothorac Vasc Anesth</addtitle><description>Objective:
To evaluate the hemodynamic and respiratory effects of inhaled nitric oxide (NO) in postoperative cardiac patients.
Design:
A prospective evaluation.
Setting:
A university hospital intensive care unit.
Participants:
Fourteen adults with pulmonary hypertension, studied postoperatively.
Interventions:
60 minutes of NO inhalation (20 ppm).
Measurements and Main Results:
Respiratory mechanics were analyzed by inflating the relaxed respiratory system with constant flow, followed by rapid airway occlusion at end-inflation, which was maintained until a plateau in tracheal pressure was obtained. Gas exchange and hemodynamics were evaluated by conventional means. The data were studied using the analysis of variance for repeated measures. Minimum airway resistance (Rmin) increased significantly from 8.87 ± 3.24 cm H
2O/L · s to 9.69 ± 3.22 cm H
2O/L · s at the end of NO inhalation and remained elevated after NO was discontinued. A selective vasodilator effect on pulmonary vasculature was observed in the pulmonarysystemic vascular resistance ratio, which decreased from 0.18 ± 0.11 to 0.13 ± 0.08 at the end of inhalation and returned to baseline values after gas suspension. No significant alterations in oxygenation were observed.
Conclusion:
The effects of NO as a powerful and useful vasodilator agent were confirmed. However, it is important to be aware that the effects observed on respiratory mechanics may interfere with the final response of the respiratory system to NO.</description><subject>Administration, Inhalation</subject><subject>Adult</subject><subject>Aged</subject><subject>Airway Resistance - drug effects</subject><subject>Biological and medical sciences</subject><subject>Cardiac Surgical Procedures</subject><subject>Cardiovascular system</subject><subject>Female</subject><subject>hemodynamics</subject><subject>Hemodynamics - drug effects</subject><subject>Humans</subject><subject>Hypertension, Pulmonary - physiopathology</subject><subject>inhaled nitric oxide</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nitric Oxide - administration & dosage</subject><subject>Nitric Oxide - pharmacology</subject><subject>Pharmacology. Drug treatments</subject><subject>postoperative cardiac surgery</subject><subject>Postoperative Period</subject><subject>Pulmonary Circulation - drug effects</subject><subject>Pulmonary Gas Exchange - drug effects</subject><subject>Respiration - drug effects</subject><subject>respiratory mechanics</subject><subject>Retrospective Studies</subject><subject>Vascular Resistance - drug effects</subject><subject>Vasodilator Agents - administration & dosage</subject><subject>Vasodilator Agents - pharmacology</subject><subject>Vasodilator agents. Cerebral vasodilators</subject><issn>1053-0770</issn><issn>1532-8422</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUtv1DAQgC0EKqXwEyr5gBBIpPgRr5MTQlWhSJV6AM7WrD3eNUrsxU5Q8-_xPui1J9uabzwz3xByydkVZ3z16QdnSjZMa_a-7z70TArZdM_IOVdSNF0rxPN6_4-8JK9K-c0Y50rpM3LWq06qVp2T-cZ7tFOhydMQtzCgozFMOViaHoJDmiLNWHYhw5TyQstSJhzpiHYLMdjykW5xTG6JMB5eEB3dQKH4sAc2SMFPmKmF7AJYWua8wby8Ji88DAXfnM4L8uvrzc_r2-bu_tv36y93jZVdPzUSvRLKaukka4EplMB5bb3VTDjO2nYlleKofR0MVyA1B4XrtRad573XVl6Qd8d_dzn9mbFMZgzF4jBAxDQXo_tOc8lYBdURtDmVktGbXQ4j5MVwZva6zUG32bs0fWcOuk1X8y5PBeb1iO4x6-S3xt-e4lAsDD5DtKE8YkLUhYi-Yp-PGFYZfwNmU2zAaNGFXLdjXApPNPIPsM-cjA</recordid><startdate>19980401</startdate><enddate>19980401</enddate><creator>Carmona, Maria JoséCarvalho</creator><creator>Auler, JoséOtàvio Costa</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19980401</creationdate><title>Effects of inhaled nitric oxide on respiratory system mechanics, hemodynamics, and gas exchange after cardiac surgery</title><author>Carmona, Maria JoséCarvalho ; Auler, JoséOtàvio Costa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c389t-3ef525c73d304a05e3a119584702d104463551e7f001e6a371a5ebb728f19f7c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Administration, Inhalation</topic><topic>Adult</topic><topic>Aged</topic><topic>Airway Resistance - drug effects</topic><topic>Biological and medical sciences</topic><topic>Cardiac Surgical Procedures</topic><topic>Cardiovascular system</topic><topic>Female</topic><topic>hemodynamics</topic><topic>Hemodynamics - drug effects</topic><topic>Humans</topic><topic>Hypertension, Pulmonary - physiopathology</topic><topic>inhaled nitric oxide</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nitric Oxide - administration & dosage</topic><topic>Nitric Oxide - pharmacology</topic><topic>Pharmacology. Drug treatments</topic><topic>postoperative cardiac surgery</topic><topic>Postoperative Period</topic><topic>Pulmonary Circulation - drug effects</topic><topic>Pulmonary Gas Exchange - drug effects</topic><topic>Respiration - drug effects</topic><topic>respiratory mechanics</topic><topic>Retrospective Studies</topic><topic>Vascular Resistance - drug effects</topic><topic>Vasodilator Agents - administration & dosage</topic><topic>Vasodilator Agents - pharmacology</topic><topic>Vasodilator agents. Cerebral vasodilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Carmona, Maria JoséCarvalho</creatorcontrib><creatorcontrib>Auler, JoséOtàvio Costa</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiothoracic and vascular anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Carmona, Maria JoséCarvalho</au><au>Auler, JoséOtàvio Costa</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of inhaled nitric oxide on respiratory system mechanics, hemodynamics, and gas exchange after cardiac surgery</atitle><jtitle>Journal of cardiothoracic and vascular anesthesia</jtitle><addtitle>J Cardiothorac Vasc Anesth</addtitle><date>1998-04-01</date><risdate>1998</risdate><volume>12</volume><issue>2</issue><spage>157</spage><epage>161</epage><pages>157-161</pages><issn>1053-0770</issn><eissn>1532-8422</eissn><abstract>Objective:
To evaluate the hemodynamic and respiratory effects of inhaled nitric oxide (NO) in postoperative cardiac patients.
Design:
A prospective evaluation.
Setting:
A university hospital intensive care unit.
Participants:
Fourteen adults with pulmonary hypertension, studied postoperatively.
Interventions:
60 minutes of NO inhalation (20 ppm).
Measurements and Main Results:
Respiratory mechanics were analyzed by inflating the relaxed respiratory system with constant flow, followed by rapid airway occlusion at end-inflation, which was maintained until a plateau in tracheal pressure was obtained. Gas exchange and hemodynamics were evaluated by conventional means. The data were studied using the analysis of variance for repeated measures. Minimum airway resistance (Rmin) increased significantly from 8.87 ± 3.24 cm H
2O/L · s to 9.69 ± 3.22 cm H
2O/L · s at the end of NO inhalation and remained elevated after NO was discontinued. A selective vasodilator effect on pulmonary vasculature was observed in the pulmonarysystemic vascular resistance ratio, which decreased from 0.18 ± 0.11 to 0.13 ± 0.08 at the end of inhalation and returned to baseline values after gas suspension. No significant alterations in oxygenation were observed.
Conclusion:
The effects of NO as a powerful and useful vasodilator agent were confirmed. However, it is important to be aware that the effects observed on respiratory mechanics may interfere with the final response of the respiratory system to NO.</abstract><cop>Philadelphia, PA</cop><pub>Elsevier Inc</pub><pmid>9583545</pmid><doi>10.1016/S1053-0770(98)90323-8</doi><tpages>5</tpages></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Administration, Inhalation Adult Aged Airway Resistance - drug effects Biological and medical sciences Cardiac Surgical Procedures Cardiovascular system Female hemodynamics Hemodynamics - drug effects Humans Hypertension, Pulmonary - physiopathology inhaled nitric oxide Male Medical sciences Middle Aged Nitric Oxide - administration & dosage Nitric Oxide - pharmacology Pharmacology. Drug treatments postoperative cardiac surgery Postoperative Period Pulmonary Circulation - drug effects Pulmonary Gas Exchange - drug effects Respiration - drug effects respiratory mechanics Retrospective Studies Vascular Resistance - drug effects Vasodilator Agents - administration & dosage Vasodilator Agents - pharmacology Vasodilator agents. Cerebral vasodilators |
| title | Effects of inhaled nitric oxide on respiratory system mechanics, hemodynamics, and gas exchange after cardiac surgery |
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