الفهرس 
The Pulmonary CirculationOnly 14 pages are availabe for public view
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Abstract
Nitric oxide has become a useful adjunctive therapy for postoperative management of children with severe pulmonary hypertension. In these children nitric oxide could be used also to determine the degree of additional vasodilator response preoperatively as part of routine investigation. Such information may prove useful when directing postoperative therapy aimed at reducing pulmonary arterial pressure or improving pulmonary vascular flow when this parameter is critical. Inhaled NO and HV are both effective at lowering PAP and PVR in children with pulmonary hypertension after repair of congenital heart
disease. The selective action of iNO on the pulmonary circulation offers advantages over HV because a decrease in cardiac output and an increase in SVR are undesirable in the postoperative period. We found that administration of nitric oxide can be beneficial in
treatment of patients with certain congenital heart defects. However, The small number of patients in our study did not permit any subgroup analysis to determine which congenital heart defects are appropriate for therapy with inhaled nitric oxide. A trial of inhaled NO after cardiac surgery in neonates and infants may be useful to differentiate reversible pulmonary vasoconstriction from fixed anatomic obstruction and may provide useful information if temporary support with extra-corporeal membrane oxygenation is considered. Failure to respond to inhaled NO should prompt further investigations to rule out a residual obstruction. Our results demonstrate that the combination of low-dose inhaled NO and Os may cause a potent selective pulmonary v as o dilatation, with no changes in systemic arterial pressure.