Chest ACCP Education Calendar
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text Free
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via ISI Web of Science (9)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Imanaka, H.
Right arrow Articles by Ando, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Imanaka, H.
Right arrow Articles by Ando, M.
(Chest. 2000;118:39-46.)
© 2000 American College of Chest Physicians

Effects of Nitric Oxide Inhalation After Pulmonary Thromboendarterectomy for Chronic Pulmonary Thromboembolism*

Hideaki Imanaka, MD; Hiroshi Miyano, MD; Muneyuki Takeuchi, MD,; Keiji Kumon, MD, and Motomi Ando, MD

* From the Surgical Intensive Care Unit, National Cardiovascular Center, Osaka, Japan.

Correspondence to: Hideaki Imanaka, MD, Surgical Intensive Care Unit, National Cardiovascular Center, 5–7-1 Fujishiro-dai, Suita, Osaka, Japan 565-8565; e-mail: imanakah{at}hsp.ncvc.go.jp

Study objectives: To examine the hypothesis that nitric oxide (NO) inhalation improves hemodynamics and gas exchange in patients with chronic pulmonary thromboembolism after pulmonary thromboendarterectomy.

Design: Prospective crossover clinical study.

Setting: Surgical ICU in a national education and research hospital.

Patients: Seven patients (mean age ± SD, 54 ± 11 years) who underwent elective pulmonary thromboendarterectomy for chronic pulmonary thromboembolism.

Interventions: Patients breathed 20 parts per million of NO gas for 30 min at 12-h intervals until extubation of the trachea.

Measurements and results: Hemodynamics and arterial blood gas levels were analyzed before, during, and after NO inhalation. Waveform of pulmonary artery pressure (PAP) was evaluated using fractional pulse pressure (PPf): (systolic PAP - diastolic PAP)/mean PAP. After surgery, pulmonary vascular resistance decreased, PPf decreased, and cardiac index increased significantly. At the first trial, NO inhalation resulted in a slight improvement in arterial oxygen tension (from 173 ± 33 to 196 ± 44 mm Hg; p < 0.05), while hemodynamics did not change significantly. Twelve hours later, NO inhalation decreased pulmonary vascular resistance index (from 312 ± 98 to 277 ± 93 dyne·s·cm-5/m2; p < 0.01), while the change in oxygenation was not significant.

Conclusions: Immediately after pulmonary thromboendarterectomy for chronic pulmonary thromboembolism, NO inhalation improved oxygenation; at 12 h after surgery, NO inhalation resulted in decreased pulmonary vascular resistance, although both changes were small.

Key Words: chronic pulmonary thromboembolism • fractional pulse pressure • nitric oxide inhalation • pulmonary thromboendarterectomy




This article has been cited by other articles:


Home page
 PerfusionHome page
L. Puis, E. Vandezande, L. Vercaemst, P. Janssens, Y. Taverniers, M. Foulon, R. Demeyere, M. Delcroix, and W. Daenen
Pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension
Perfusion, March 1, 2005; 20(2): 101 - 108.
[Abstract] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2000 by the American College of Chest Physicians.