Oz Mehmet C, Ardehali Abbas
Columbia University College of Physicians and Surgeons, New York, New York.
Heart Surg Forum. 2004;7(6):E584-9. doi: 10.1532/HSF98.20041136.
Pulmonary arterial hypertension and hypoxemia constitute a significant cause of postoperative right heart failure and mortality. Timely administration of inhaled nitric oxide (iNO) can improve hemodynamic parameters and oxygenation in patients undergoing heart and/or lung transplantation and various high-risk cardiac procedures involving coronary artery bypass grafting and/or left ventricular assist device placement. As a diagnostic tool, iNO can be used to identify heart transplant recipients at high risk of right ventricular failure and patients with primary pulmonary hypertension who may benefit from vasodilator therapy. In addition to its role as a potent and selective pulmonary vasodilator, iNO is a useful intraoperative adjunct in adult cardiac surgery patients that may reduce the need for right ventricular assist device placement. This review focuses on the multiple clinical applications of iNO in perioperative patient care.
肺动脉高压和低氧血症是术后右心衰竭和死亡的重要原因。及时给予吸入一氧化氮（iNO）可改善心脏和/或肺移植患者以及接受冠状动脉搭桥术和/或左心室辅助装置植入等各种高风险心脏手术患者的血流动力学参数和氧合情况。作为一种诊断工具，iNO可用于识别右心室衰竭高危的心脏移植受者以及可能从血管扩张剂治疗中获益的原发性肺动脉高压患者。除了作为一种强效且选择性的肺血管扩张剂外，iNO还是成人心脏手术患者有用的术中辅助手段，可能减少右心室辅助装置植入的需求。本综述重点关注iNO在围手术期患者护理中的多种临床应用。
