Ramírez Ramírez L, Calderón Colmenero J, Zarco Martínez E, García Montes J A, Molina Méndez J, Fernández de la Reguera G
Unidad de Cuidados Intensivos Postquirúrgicos del Instituto Nacional de Cardiología Ignacio Chávez, INCICH, Juan Badiano No. 1, 14080 México, D.F.
Arch Cardiol Mex. 2001 Apr-Jun;71(2):121-6.
In this clinical study, 7 pediatric patients with severe pulmonary artery hypertension, secondary to congenital heart disease, received inhaled nitric oxide at doses of 20 ppm in the acute postoperative management of congenital heart repair for 3.5 days. Monitoring included oxygenation index, alveoloarterial oxygen difference, pulmonary and systemic pressure, measurements were recorded previous to the NO administration; 1, 6, 12, 24, 36, 48 and 72 hours after treatment with NO, nitrous oxide (NO2) and seric methemoglobin also were monitored.
Average age was 3.6 years. The oxygenation index before inhaling NO was 166 +/- 100, 72 hours following inhalation of NO the oxygenation index was 210 +/- 98. The alveolo-arterial baseline oxygen difference was 270 +/- 145; 72 hours after inhaling NO, it was 163 +/- 167. No decreases in pulmonary and systemic arterial pressure during NO inhalation occured. The levels of NO2 and seric methemoglobin were not toxic.
Treatment with inhaled NO after cardiac surgery in children with severe pulmonary artery hypertension secondary to congenital heart disease may be useful to improve oxygenation with no changes in pulmonary and systemic arterial pressure. Inhaled NO at 20 ppm did not cause toxicity.
在这项临床研究中，7名患有先天性心脏病继发严重肺动脉高压的儿科患者，在先天性心脏修复术后急性管理中接受了剂量为20 ppm的吸入一氧化氮治疗，持续3.5天。监测包括氧合指数、肺泡动脉氧分压差、肺和体循环压力，在给予一氧化氮之前记录测量值；在用一氧化氮治疗后1、6、12、24、36、48和72小时，还监测了二氧化氮（NO2）和血清高铁血红蛋白。
平均年龄为3.6岁。吸入一氧化氮前的氧合指数为166±100，吸入一氧化氮72小时后的氧合指数为210±98。肺泡动脉基线氧分压差为270±145；吸入一氧化氮72小时后，为163±167。吸入一氧化氮期间肺和体循环动脉压未降低。二氧化氮和血清高铁血红蛋白水平无毒。
先天性心脏病继发严重肺动脉高压的儿童心脏手术后吸入一氧化氮治疗可能有助于改善氧合，而肺和体循环动脉压无变化。20 ppm的吸入一氧化氮未引起毒性。
