Miller O I, Celermajer D S, Deanfield J E, Macrae D J
Cardiothoracic Unit, Hospital for Sick Children, London, United Kingdom.
J Thorac Cardiovasc Surg. 1994 Sep;108(3):487-94.
Inhaled low-dose nitric oxide (2, 10, 20 ppm), together with high inspired oxygen concentration (0.80), was administered after corrective operations 13 times to 10 infants (median age 6 months) who were at risk of postoperative pulmonary hypertension because of their congenital heart disease and left-to-right shunt. Inhaled nitric oxide, even in a very low dose (2 ppm), caused selective pulmonary vasodilatation. The pulmonary/systemic artery pressure ratio was a predictor of the response to nitric oxide, with a greater response being seen in those with a high ratio (> or = 0.50). In children with a high pulmonary/systemic pressure ratio, the mean pulmonary vascular resistance index fell by 37% to 42%, accompanied by only a 10% fall in the systemic vascular resistance index but a 14% to 16% rise in mean cardiac index. No toxicity was seen in any subject. This exciting new therapy may prove to be an important adjunct in the management of postoperative pulmonary hypertension in the child with congenital heart disease.
对10名（年龄中位数为6个月）因先天性心脏病和左向右分流而有术后肺动脉高压风险的婴儿，在矫正手术后13次给予吸入低剂量一氧化氮（2、10、20 ppm），同时给予高吸入氧浓度（0.80）。吸入一氧化氮，即使是非常低的剂量（2 ppm），也会引起选择性肺血管扩张。肺/体动脉压比值是对一氧化氮反应的一个预测指标，在比值较高（≥0.50）的患者中反应更大。在肺/体压比值高的儿童中，平均肺血管阻力指数下降37%至42%，同时体循环血管阻力指数仅下降10%，但平均心指数上升14%至16%。未在任何受试者中观察到毒性。这种令人兴奋的新疗法可能被证明是先天性心脏病患儿术后肺动脉高压管理中的一项重要辅助手段。
