Inhaled Nitric Oxide in Patients with Acute Pulmonary Embolism and Pulmonary Hypertension
- #CH/ADU 01-EP-7
- Congenital Heart Surgery/Adult Congenital Cardiac. E-POSTER (ORAL) SESSION
- E-Poster (oral)
Inhaled Nitric Oxide in Patients with Acute Pulmonary Embolism and Pulmonary Hypertension
Alexandra Yarovaya 1, Vladimir Zolkin 2, Alexandr Chuchalin 3
1 Pirogov Russian National Research Medical University, Moscow, Russia; 2 Pirogov Russian National Research Medical University, Moscow, Russia, Moscow, Russia; 3 Pirogov Russian National Research Medical University, Moscow, Russia, Moscow, Russia, Moscow, Russia;
Date, time and location: 2018.05.26 15:30, Exhibition area, 1st Floor. Zone – D
Abstract
Nitric oxide (NO) is a biological mediator, that takes part in a large number of physiological processes in the organism. One of the NO-effects is vasodilating, which is used to treat pulmonary hypertension, including that in acute conditions (acute respiratory distress syndrome, pulmonary embolism (PE)).
Obstruction of 30-50% of the total pulmonary arteries and vasoconstriction in PE leads to increasing of pulmonary vascular resistance, pulmonary artery pressure, overload and dilatation of the right ventricle.
Objective
To study the effectiveness of prolonged use of inhaled NO (iNO) in treatment patients with acute PE and pulmonary hypertension.
Materials and methods
iNO was used in 7 patients with acute PE, who had signs of pulmonary hypertension according to ECHO-CG: increased systolic pulmonary artery pressure (sPAP), increased size of the right atrium and right ventricle. Inhalation of NO was performed with a NO-concentrator (10-20 ppm) during 12-16 hours per day for 4.6±2.1 days. After the course of iNO, the hemodynamic parameters of the small circle of circulation were assessed with ECHO-CG.
Results
We observed no significant complications during inhalation NO. 1 patient hadn’t clinical improvements in hemodynamic parameters, due to the left heart pathology. 6 patients had a positive changes: decreasing of sPAP (64.4±25.0 to 56.5±22.2 mm Hg), size of the right ventricle (41.1±3.5 to 36.8±4.2 mm) and area of the right atrium (20±4.8 to 18.5±4.6 cm2). Patients also had an improvement in the general condition – decreasing of dyspnea (mMRC from 3.2±0.7 to 1.8±0.9 points) and an increasing in physical activity.
Conclusions
iNO is an effective method in treatment patients with acute PE and pulmonary hypertension. Further studies are needed to clarify it influence in acute conditions with pulmonary hypertension.