Abstract
Objectives: The purpose of this study was to evaluate the efficacy and safety of the inhaled nitric oxide (NO) therapy for the pediatric patients using nasal high-flow oxygen therapy after cardiac surgery. Methods: We retrospectively investigated five patients who received inhaled NO using high-flow nasal cannula (HFNC) after extubation in pediatric cardiac surgery (two cases of correction of tetralogy of Fallot and three cases of Fontan procedure). The median patient age was 27 months (range, 19-40 months) and the median body weight was 12.5 kg (range, 9-16 kg). We measured heart rate, mean blood pressure, P/F ratio, urine output, concentration of NO in the circuit, and concentration of nitrogen dioxide (NO2) in the ICU before and after using inhaled NO. Results: There was no statistically significant difference in heart rate, mean blood pressure, or urine output before and after inhaled NO. However, the P/F ratio increased significantly. The error between the target concentrations and the measured concentrations of NO in the circuits was 4-16% and the concentration of NO2 in the ICU during the study period was 0.010-0.018 ppm. Conclusions: Actual inhaled NO concentration has not been measured, but we supplied a stable concentration of inhaled NO into the circuits using HFNC after pediatric cardiac surgery for congenital heart disease and improved patients' respiratory condition. We also used inhaled NO safely in the ICU, showing that the concentration of NO in the ICU was not above the environmental standard.
