The Effect Of Inhaling Nitric Oxide On The Lung Function Of Patients With Congenital Heart Diseases And Severe Pulmonary Hypertension After Cardiopulmonary Bypass

BACKGROUD AND OBJECTIVE Pulmonary artery hypertension is the most severe and frequent complication of left-to right congenital cardiopathy,according to the damage of blood vessel endothelium,the incidence rate of pulmonary functional impairment is high after cardiopulmonary bypass because patients are more reliable to be effected by systemic inflammatory reaction syndrome and ischemical-reperfusion injury during cardiopulmonary bypass. the mortality of severe patients is high.so, injury of lungs after cardiopulmonary bypass becomes to be the most formidable difficulties that Cardiovascular surgeon must to be faced with.restraining systemic inflammatoroy reaction syndrome and relieving ischemical -reperfusion injury have become the key management of curing actue lung injury.NO is a kind oflow-molecular with special physiological activation which can restraining systemic inflammatory reaction syndrome and relieving ischemical- reperfusion injury. our stury is to investigate the effect of inhaled nitric oxide on the lung function of patients with congenital heart diseases and pulmonary hypretension after cardiopulmonary bypass.METHODS 20 patients with congenital heart disease and severe pulmonary hypertension were divided into the control group (n=10) and the NO inhaling group (n=10).All of patients'Pp/Ps >0.5 . All of patients undergone open heart suegery under cardiopulmonary bypass .The inhaling NO group inhaled NO (20ppm) as soon as the patients arrive at ICU.control group was mechanical ventilation. Patients'lung function and thermodynamics were monitored and measured at 1,4,6,12h after the NO inhaling therapy. The ventiatory support time , respiratory rate within 12 hours after extubate and respiratory changes were also observed. Stundent't test was used for the analysis of dates.RESULTS Q_s/Q_t,PA-aO₂,Pmax and CVP(p<0.05) decreased significantly in the NO inhaling group than the control group at 1,4,6,12h after the NO inhaling therapy. PO₂/ FiO₂,Cdyn(p<0.05) increased significantly at the same time. The mean systemic artery pressure and heart rate and HR MBP showed no change. NO inhaling group had a shorter ventilation time(p<0.01),lower simultaneous breath frequency and lease rates.Conclusion Inhaling NO could ameliorate the lung function and right ventricular function with congenital heart diseases and pulmonary hypertension after cardiopulmonary bypass.