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(Chest. 1996;110:1361-1363.)
© 1996 American College of Chest Physicians

Oxygenation Improvement With Nitric Oxide in Right-to-Left Shunt Without Significant Effects on Pulmonary Arterial Pressure

Daniel De Backer MD1; Robert J Kahn MD1; Jean-Louis Vincent MD, PhD, FCCP1; Jean-Marie Moures MD2; Jean-Luc Vachiéry MD3; and Jean-Louis Leclerc MD3

1 From the Departments of Intensive Care, Erasme University Hospital, Free University of Brussels, Brussels, Belgium
2 From the Departments of Anesthesiology, Erasme University Hospital, Free University of Brussels, Brussels, Belgium
3 From the Departments of Cardiac Surgery, Erasme University Hospital, Free University of Brussels, Brussels, Belgium

Following surgical closure of an interventricular commmunication complicating an anterior myocardial infarction, a 74-year-old woman developed severe right ventricular failure and hypoxemia due to the opening of a patent foramen ovale (PFO). Mean pulmonary artery pressure was 24 mm Hg. Treatment with inhaled nitric oxide (5 ppm) increased PaO2 from 47 to 90 mm Hg (FIO21). The present observation points out that nitric oxide inhalation could be useful in the management of severe hypoxemia from a right-to-left shunt due to a PFO even when there is no significant pulmonary hypertension present.

Key Words: cardiac surgery • hypoxemia • myocardial infarction • nitric oxide • patent foramen ovale • postoperative care • respiratory failure • right ventricular failure

Submitted on October 17, 1995
Accepted on May 1, 1996




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Copyright © 1996 by the American College of Chest Physicians.