The Science Journal of the American Association for Respiratory Care

1995 OPEN FORUM Abstracts

EFFECT OF INHALED NITRIC OXIDE BEFORE, DURING, AND AFTER CARDIOPULMONARY RESUSCITATION

Miller Chris, BA RRT, Dyer David BSc RRT, Elbarbary Mahmound, MD, Caouette Yvonne, BA RRT, Hill Wrae, BSc RRT, Halees Zohair, MD King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia

Case Study

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An 8 month old, 4 kg, male infant diagnosed with double outflow right ventricle with a subpulmonary ventricular septal defect presented postoperatively with pulmonary arterial pressures (PAP) ranging 50 -70% of systemic arterial pressures (SAP) Moderate oxygenation was achieved with mechanical ventilation over a 48 hour period. During this time three episodes of PAP reaching 80-90% SAP with suprasystemic right ventricular pressures occurred resulting in severe arterial oxygen desaturations. These crisis were managed successfully with manual hyperventilation on 100% oxygen. On the third day, oxygenation worsened and a severe suprasystemic PAP episode resulted in a cardiac arrest. Despite full resuscitative attempts with medicaments and open heart massage, PAP remained 50% suprasystemic with severe hypoxemia (Figure 1) NO therapy was initiated during cardiac resuscitation. Within 10 minutes of the cardiac arrest a dosage of 30 ppm NO was administered via a modified manual bag resuscitator. PAP immediately reversed with a dramatic improvement in oxygenation and stabilization of hemodynamics.(Figure 2)

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OF-95-088

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