The Science Journal of the American Association for Respiratory Care

2009 OPEN FORUM Abstracts

INTRAOPERATIVE USE OF INHALED NITRIC OXIDE IN PEDIATRIC CARDIAC PATIENTS

Jenni Raake1,2, Catherine Krawczeski2, Peter Manning3, Scott Pettinichi2; 1Cardiac ICU, Cincinnati Childrens Hospital Medical Center, Cincinnati, OH; 2Respiratory Care, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH; 3Cardiothoracic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH

Background: Inhaled Nitric Oxide (INO) has been used in pediatric patients with congenital heart defects, who sometimes suffer from pulmonary hypertension, especially in the early post operative period. There have been reports of INO being initiated while the patient was still in the operating room. We studied our patient population to determine if initiation of INO in the operating room provided better patient outcomes. Methods: After IRB approval, chart reviews were performed on patients initiated on INO in the Operating room and patients initiated on INO in the Cardiac ICU. Data collection focused on: surgical procedures performed length of stay, time on INO, cardiopulmonary bypass time, progression to ECMO, death. Results: During the time frame being studied, 86 patients were initiated on INO while transitioning off Cardiopulmonary Bypass, and 70 were initiated on INO in the CICU postoperatively. The most frequent procedures for which INO was initiated in the operating room were Total Anomalous Pulmonary Venous Return repair (18), followed by Heart Transplant (12), Truncus Arteriosus repair (7), and repair of Atrial and Ventricular Septal Defect combined(6). The most frequent procedures for which INO was initiated in the CICU were Single Ventricle Palliative Procedures (22),Tetralogy of Fallot repair(15), followed by Total Anomalous Pulmonary Venous Return repair(6). Patients initiated on INO in the Operating Room experienced a reduced length of time on mechanical ventilation, a shorter length of stay, and a lower mortality rate. Conclusions: Initiating INO in the operating room may prove to be advantageous in certain congenital heart defects and may be considered as an adjunct to successful transition off of cardiopulmonary bypass. A Multivariate analysis with a larger cohort of patients may yield different results. Sponsored Research - None

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