NITRIC-OXIDE INHALATION IN ACUTE PULMONARY-HYPERTENSION AFTER CARDIAC-SURGERY REDUCES OXYGEN CONCENTRATION AND IMPROVES MECHANICAL VENTILATION BUT NOT MORTALITY

Impaired right-ventricular function may benefit from afterload reducti on. Inhalation of nitric oxide (NO) reduces pulmonary hypertension wit hout systemic circulatory depression. Influence of NO inhalation on ox ygenation, ventilation, and hemodynamic parameters in 10 patients with acute pulmonary hypertension after cardiac surgery was examined in th is study. Ten patients without NO treatment served as a control group. NO patients showed significantly improved oxygenation and recovery of right-ventricular function. Pulmonary artery pressure (12.8%), inspir atory oxygen demand (34.7%), PEEP (13.2%), and inspiration time (18.8% ) decreased significantly during inhalation of nitric oxide. Mortality in both groups was identical. We therefore conclude that NO. by impro ving oxygenation and right-ventricular function, temporarily reduces i nvasiveness of mechanical ventilation. Reduction of invasiveness of ve ntilation did not influence mortality as compared with patients who di d not receive NO. To finally estimate the benefit of NO inhalation, la rger patient groups need to be examined.