Effect of inhaled nitric oxide on hemodynamics in lambs with 1 1/2 ventricle circulation

Hitoshi Kanamitsu, Yasuhiro Fujii, Luca Centola, Katsushi Kinouchi, Liqun Zhu, Robert K. Riemer, Olaf Reinhartz

Research output: Contribution to journalArticlepeer-review

Abstract

Inhaled nitric oxide (NO) is widely used to treat postoperative pulmonary hypertension in congenital heart disease. It is believed that NO increases cardiac output (CO) by decreasing pulmonary vascular resistance (PVR), leading to increased left ventricular preload. However, the effect of NO on CO in patients with 1 1/2 ventricle circulation remains unclear. To evaluate this, a superior cavopulmonary (SCP) shunt was constructed in 10 juvenile sheep. A PTFE graft was inserted between the superior vena cava (SVC) and the main pulmonary artery (PA). The SVC was clamped at the right atrial junction to establish a 1 1/2 ventricle circulation. Flows, pressures, and arterial blood gases were recorded before and during inhalation of NO. Mean arterial pressure (46.6 ± 5.4 to 44.6 ± 5.9 mm Hg; p = 0.06) and left atrial pressure (4.0 ± 2.5 to 4.0 ± 2.3 mm Hg; p = 1.0) did not change. Mean PA pressure (13.6 ± 2.4 to 11.7 ± 2.9 mm Hg; p = 0.006) and PVR (5.47 ± 2.99 to 4.54 ± 2.61 Wood Units; p = 0.037) decreased significantly. SVC flow (24.8 ± 11.3 to 22.0 ± 9.7 ml/min/kg; p = 0.09) did not change, and CO decreased (140.2 ± 37.2 to 132.1 ± 39.2 ml/min/kg; p = 0.033). Arterial PO2 improved (103.72 ± 29.30 to 132.43 ± 47.02 mm Hg; p = 0.007). In this 1 1/2 ventricle model, NO surprisingly decreased cardiac output (CO) and did not increase left ventricular preload.

Original languageEnglish
Pages (from-to)802-805
Number of pages4
JournalASAIO Journal
Volume64
Issue number6
DOIs
Publication statusPublished - 2018
Externally publishedYes

Keywords

  • cavopulmonary shunt
  • nitric oxide
  • sheep model

ASJC Scopus subject areas

  • Biophysics
  • Bioengineering
  • Biomaterials
  • Biomedical Engineering

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