Review Article

Pediatric Cardiology

, Volume 33, Issue 4, pp 493-505

First online:

Review of Inhaled Nitric Oxide in the Pediatric Cardiac Surgery Setting

  • Paul A. ChecchiaAffiliated withCardiovascular Intensive Care Unit, Texas Children’s Hospital, Baylor College of Medicine Email author 
  • , Ronald A. BronickiAffiliated withCardiovascular Intensive Care Unit, Texas Children’s Hospital, Baylor College of Medicine
  • , Brahm GoldsteinAffiliated withClinical Development Ikaria, Inc.

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Abstract

Surgical intervention for congenital heart disease (CHD) can be complicated by pulmonary hypertension (PH), which increases morbidity, mortality, and medical burden. Consequently, postoperative management of PH is an important clinical consideration to improve outcomes. Inhaled nitric oxide (iNO) is a widely accepted standard of care for PH and has been studied in the context of cardiac surgery for CHD. However, large randomized, double-blind, placebo-controlled, multicenter clinical trials in pediatric patients are limited. This review will provide an overview of the clinical studies in this setting and will discuss general treatment considerations to facilitate a better understanding of the clinical use of iNO for PH after pediatric cardiac surgery.

Keywords

Nitric oxide Inhalation Congenital heart disease Pulmonary hypertension Cardiopulmonary bypass Pediatric cardiac surgery