Post-Extubation Inhaled Nitric Oxide Therapy via High-Flow Nasal Cannula After Fontan Procedure

被引：14

作者：

Tominaga, Yuji ^{[1
]}

Iwai, Shigemitsu ^{[1
]}

Yamauchi, Sanae ^{[1
]}

Kyogoku, Miyako ^{[2
]}

Kugo, Yosuke ^{[1
]}

Hasegawa, Moyu ^{[1
]}

Kayatani, Futoshi ^{[3
]}

Takahashi, Kunihiko ^{[3
]}

Aoki, Hisaaki ^{[3
]}

Takeuchi, Muneyuki ^{[2
]}

Tachibana, Kazuya ^{[4
]}

Kawata, Hiroaki ^{[1
]}

机构：

[1] Osaka Womens & Childrens Hosp, Dept Cardiovasc Surg, 840 Murodocho, Izumi, Osaka 5941101, Japan

[2] Osaka Womens & Childrens Hosp, Dept Intens Care Med, 840 Murodocho, Izumi, Osaka 5941101, Japan

[3] Osaka Womens & Childrens Hosp, Dept Pediat Cardiol, 840 Murodocho, Izumi, Osaka 5941101, Japan

[4] Osaka Womens & Childrens Hosp, Dept Anesthesiol, 840 Murodocho, Izumi, Osaka 5941101, Japan

来源：

PEDIATRIC CARDIOLOGY | 2019年 / 40卷 / 05期

关键词：

Inhaled nitric oxide; High-flow nasal cannula; Fontan operation; Pleural drainage; Hospitalization; CARDIAC-SURGERY; RISK-FACTORS; EARLY EXTUBATION; SILDENAFIL; INFANTS;

D O I：

10.1007/s00246-019-02122-2

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

In 2014, our hospital introduced inhaled nitric oxide (iNO) therapy combined with high-flow nasal cannula (HFNC) oxygen therapy after extubation following the Fontan procedure in patients with unstable hemodynamics. We report the benefits of HFNC-iNO therapy in these patients. This was a single-center, retrospective review of 38 patients who underwent the Fontan procedure between January 2010 and June 2016, and required iNO therapy before extubation. The patients were divided into two groups: patients in Epoch 1 (n=24) were treated between January 2010 and December 2013, receiving only iNO therapy; patients in Epoch 2 (n=14) were treated between January 2014 and June 2016, receiving iNO therapy and additional HFNC-iNO therapy after extubation. There were no significant differences between Epoch 1 and 2 regarding preoperative cardiac function, age at surgery, body weight, initial diagnosis (hypoplastic left heart syndrome, 4 vs. 2; total anomalous pulmonary venous return, 5 vs. 4; heterotaxy, 7 vs. 8), intraoperative fluid balance, or central venous pressure upon admission to the intensive care unit. Epoch 2 had a significantly shorter duration of postoperative intubation [7.2 (3.7-49) vs. 3.5 (3.0-4.6) hours, p=0.033], pleural drainage [23 (13-34) vs. 9.5 (8.3-18) days, p=0.007], and postoperative hospitalization [36 (29-49) vs. 27 (22-36) days, p=0.017]. Two patients in Epoch 1 (8.3%), but none in Epoch 2, required re-intubation. Our results suggest that HFNC-iNO therapy reduces the duration of postoperative intubation, pleural drainage, and hospitalization.

引用

页码：1064 / 1071

页数：8

共 23 条

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