一氧化氮和米力农联合应用改善Fontan术后肺循环阻力的疗效

目的 探讨一氧化氮(iNO)与米力农联合应用能否进一步改善肺循环,并降低iNO撤离后反跳发生率.方法 31例改良Fortran术后跨肺压(TPG)>10mm Hg,动脉氧饱和度(sato2)<0.85者,随机分iNO组(iNO 10ppm吸入)15例和iNO+MIL组(iNO 10 ppm吸入后1 h启用米力农0.5 μg·kg-1·min-1静脉维持)16例.比较二组治疗后血流动力学、动脉氧饱和度及NO撤离的反跳发生率.结果 iNO+Mil组与iNO组相比治疗后中心静脉压(CVP)降幅[19.6±3.5)%对(15.2%±4.6)%,P<0.05]、TPG降幅[(18.2±4.8)%对(15.3±2.6)%,P<0.05]、动脉收缩压(SAP)升幅[(8.79±2.7)%对(5.2±3.1)%,P<0.05]和SatO2升幅[(9.3±3.2)%对(6.8±2.8)%,P<0.05]差异有统计学意义.iNO+Mil组NO撤离后反跳发生率明显降低,为1/16例,而iNO组为6/15例,组间差异有统计学意义,P<0.05.结论 一氧化氮与米力农联合应用较单纯NO治疗更进一步改善Fortran术后的肺循环阻力.     

一氧化氮和米力农联合应用改善Fontan术后肺循环阻力的疗效

Objective Inhaled nitric oxide(iNO) has been successful used for patients with increased pulmonary vascular re- slstance (PVR) shortly after Fontan operation, but its withdrawal rebound remains a major concem. We hypothesized that iNO associ- ated with milrinone could provide additive benefits for pulmonary hemodynamics and reduce the occurrence of iNO withdrawal rebound. Methods Thirty-one patieats with high transpulmonary pressure gradient(TPG, >10mmHg) and arterial oxygen saturation(SatO2, 0.85) after modified fenestrated Fontan operation were prospectively randomized into two groups, I.e. , group iNO (iNO at 10 ppm, dynamics, arterial blood oxygenation and occurrence of withdrawal rebound were compared between the two groups.Results Com- bined application achieved following improvenents including (1) decrement of CVP [(19.6±3.5)% vs. (15.2±4.6)% in group iNO, P<0.05] and TPG [(18.2±4.8)% vs. (15.3±2.6)% in group iNO, P<0.05); and increment of systemic aterial pres- sure [(8.7±2.7)% vs. (5.2±3.1)% in group iNO, P<0.05].(2)improvement of arterial oxygen saturation[(9.3±3.2)% vs. (6.8±2.8)% in group iNO, P<0.05)]. (3)occurrence of withdrawal rebound were significantly lower in group iNO+ Mil (1 patient vs. 6 patients in group iNO, P<0.05). Conclusion Combined uae of iNO and milrinone provided additional benefits as compared with exclusive use d iNO for patients with elevated PVR after Fontan procdure.     

一氧化氮和米力农联合应用改善Fontan术后肺循环阻力的疗效

Objective Inhaled nitric oxide(iNO) has been successful used for patients with increased pulmonary vascular re- slstance (PVR) shortly after Fontan operation, but its withdrawal rebound remains a major concem. We hypothesized that iNO associ- ated with milrinone could provide additive benefits for pulmonary hemodynamics and reduce the occurrence of iNO withdrawal rebound. Methods Thirty-one patieats with high transpulmonary pressure gradient(TPG, >10mmHg) and arterial oxygen saturation(SatO2, 0.85) after modified fenestrated Fontan operation were prospectively randomized into two groups, I.e. , group iNO (iNO at 10 ppm, dynamics, arterial blood oxygenation and occurrence of withdrawal rebound were compared between the two groups.Results Com- bined application achieved following improvenents including (1) decrement of CVP [(19.6±3.5)% vs. (15.2±4.6)% in group iNO, P<0.05] and TPG [(18.2±4.8)% vs. (15.3±2.6)% in group iNO, P<0.05); and increment of systemic aterial pres- sure [(8.7±2.7)% vs. (5.2±3.1)% in group iNO, P<0.05].(2)improvement of arterial oxygen saturation[(9.3±3.2)% vs. (6.8±2.8)% in group iNO, P<0.05)]. (3)occurrence of withdrawal rebound were significantly lower in group iNO+ Mil (1 patient vs. 6 patients in group iNO, P<0.05). Conclusion Combined uae of iNO and milrinone provided additional benefits as compared with exclusive use d iNO for patients with elevated PVR after Fontan procdure.     

一氧化氮和米力农联合应用改善Fontan术后肺循环阻力的疗效

Objective Inhaled nitric oxide(iNO) has been successful used for patients with increased pulmonary vascular re- slstance (PVR) shortly after Fontan operation, but its withdrawal rebound remains a major concem. We hypothesized that iNO associ- ated with milrinone could provide additive benefits for pulmonary hemodynamics and reduce the occurrence of iNO withdrawal rebound. Methods Thirty-one patieats with high transpulmonary pressure gradient(TPG, >10mmHg) and arterial oxygen saturation(SatO2, 0.85) after modified fenestrated Fontan operation were prospectively randomized into two groups, I.e. , group iNO (iNO at 10 ppm, dynamics, arterial blood oxygenation and occurrence of withdrawal rebound were compared between the two groups.Results Com- bined application achieved following improvenents including (1) decrement of CVP [(19.6±3.5)% vs. (15.2±4.6)% in group iNO, P<0.05] and TPG [(18.2±4.8)% vs. (15.3±2.6)% in group iNO, P<0.05); and increment of systemic aterial pres- sure [(8.7±2.7)% vs. (5.2±3.1)% in group iNO, P<0.05].(2)improvement of arterial oxygen saturation[(9.3±3.2)% vs. (6.8±2.8)% in group iNO, P<0.05)]. (3)occurrence of withdrawal rebound were significantly lower in group iNO+ Mil (1 patient vs. 6 patients in group iNO, P<0.05). Conclusion Combined uae of iNO and milrinone provided additional benefits as compared with exclusive use d iNO for patients with elevated PVR after Fontan procdure.     

一氧化氮和米力农联合应用改善Fontan术后肺循环阻力的疗效

Objective Inhaled nitric oxide(iNO) has been successful used for patients with increased pulmonary vascular re- slstance (PVR) shortly after Fontan operation, but its withdrawal rebound remains a major concem. We hypothesized that iNO associ- ated with milrinone could provide additive benefits for pulmonary hemodynamics and reduce the occurrence of iNO withdrawal rebound. Methods Thirty-one patieats with high transpulmonary pressure gradient(TPG, >10mmHg) and arterial oxygen saturation(SatO2, 0.85) after modified fenestrated Fontan operation were prospectively randomized into two groups, I.e. , group iNO (iNO at 10 ppm, dynamics, arterial blood oxygenation and occurrence of withdrawal rebound were compared between the two groups.Results Com- bined application achieved following improvenents including (1) decrement of CVP [(19.6±3.5)% vs. (15.2±4.6)% in group iNO, P<0.05] and TPG [(18.2±4.8)% vs. (15.3±2.6)% in group iNO, P<0.05); and increment of systemic aterial pres- sure [(8.7±2.7)% vs. (5.2±3.1)% in group iNO, P<0.05].(2)improvement of arterial oxygen saturation[(9.3±3.2)% vs. (6.8±2.8)% in group iNO, P<0.05)]. (3)occurrence of withdrawal rebound were significantly lower in group iNO+ Mil (1 patient vs. 6 patients in group iNO, P<0.05). Conclusion Combined uae of iNO and milrinone provided additional benefits as compared with exclusive use d iNO for patients with elevated PVR after Fontan procdure.     

一氧化氮和米力农联合应用改善Fontan术后肺循环阻力的疗效

Objective Inhaled nitric oxide(iNO) has been successful used for patients with increased pulmonary vascular re- slstance (PVR) shortly after Fontan operation, but its withdrawal rebound remains a major concem. We hypothesized that iNO associ- ated with milrinone could provide additive benefits for pulmonary hemodynamics and reduce the occurrence of iNO withdrawal rebound. Methods Thirty-one patieats with high transpulmonary pressure gradient(TPG, >10mmHg) and arterial oxygen saturation(SatO2, 0.85) after modified fenestrated Fontan operation were prospectively randomized into two groups, I.e. , group iNO (iNO at 10 ppm, dynamics, arterial blood oxygenation and occurrence of withdrawal rebound were compared between the two groups.Results Com- bined application achieved following improvenents including (1) decrement of CVP [(19.6±3.5)% vs. (15.2±4.6)% in group iNO, P<0.05] and TPG [(18.2±4.8)% vs. (15.3±2.6)% in group iNO, P<0.05); and increment of systemic aterial pres- sure [(8.7±2.7)% vs. (5.2±3.1)% in group iNO, P<0.05].(2)improvement of arterial oxygen saturation[(9.3±3.2)% vs. (6.8±2.8)% in group iNO, P<0.05)]. (3)occurrence of withdrawal rebound were significantly lower in group iNO+ Mil (1 patient vs. 6 patients in group iNO, P<0.05). Conclusion Combined uae of iNO and milrinone provided additional benefits as compared with exclusive use d iNO for patients with elevated PVR after Fontan procdure.     

一氧化氮和米力农联合应用改善Fontan术后肺循环阻力的疗效

Objective Inhaled nitric oxide(iNO) has been successful used for patients with increased pulmonary vascular re- slstance (PVR) shortly after Fontan operation, but its withdrawal rebound remains a major concem. We hypothesized that iNO associ- ated with milrinone could provide additive benefits for pulmonary hemodynamics and reduce the occurrence of iNO withdrawal rebound. Methods Thirty-one patieats with high transpulmonary pressure gradient(TPG, >10mmHg) and arterial oxygen saturation(SatO2, 0.85) after modified fenestrated Fontan operation were prospectively randomized into two groups, I.e. , group iNO (iNO at 10 ppm, dynamics, arterial blood oxygenation and occurrence of withdrawal rebound were compared between the two groups.Results Com- bined application achieved following improvenents including (1) decrement of CVP [(19.6±3.5)% vs. (15.2±4.6)% in group iNO, P<0.05] and TPG [(18.2±4.8)% vs. (15.3±2.6)% in group iNO, P<0.05); and increment of systemic aterial pres- sure [(8.7±2.7)% vs. (5.2±3.1)% in group iNO, P<0.05].(2)improvement of arterial oxygen saturation[(9.3±3.2)% vs. (6.8±2.8)% in group iNO, P<0.05)]. (3)occurrence of withdrawal rebound were significantly lower in group iNO+ Mil (1 patient vs. 6 patients in group iNO, P<0.05). Conclusion Combined uae of iNO and milrinone provided additional benefits as compared with exclusive use d iNO for patients with elevated PVR after Fontan procdure.     

一氧化氮和米力农联合应用改善Fontan术后肺循环阻力的疗效

Objective Inhaled nitric oxide(iNO) has been successful used for patients with increased pulmonary vascular re- slstance (PVR) shortly after Fontan operation, but its withdrawal rebound remains a major concem. We hypothesized that iNO associ- ated with milrinone could provide additive benefits for pulmonary hemodynamics and reduce the occurrence of iNO withdrawal rebound. Methods Thirty-one patieats with high transpulmonary pressure gradient(TPG, >10mmHg) and arterial oxygen saturation(SatO2, 0.85) after modified fenestrated Fontan operation were prospectively randomized into two groups, I.e. , group iNO (iNO at 10 ppm, dynamics, arterial blood oxygenation and occurrence of withdrawal rebound were compared between the two groups.Results Com- bined application achieved following improvenents including (1) decrement of CVP [(19.6±3.5)% vs. (15.2±4.6)% in group iNO, P<0.05] and TPG [(18.2±4.8)% vs. (15.3±2.6)% in group iNO, P<0.05); and increment of systemic aterial pres- sure [(8.7±2.7)% vs. (5.2±3.1)% in group iNO, P<0.05].(2)improvement of arterial oxygen saturation[(9.3±3.2)% vs. (6.8±2.8)% in group iNO, P<0.05)]. (3)occurrence of withdrawal rebound were significantly lower in group iNO+ Mil (1 patient vs. 6 patients in group iNO, P<0.05). Conclusion Combined uae of iNO and milrinone provided additional benefits as compared with exclusive use d iNO for patients with elevated PVR after Fontan procdure.     

一氧化氮和米力农联合应用改善Fontan术后肺循环阻力的疗效

Objective Inhaled nitric oxide(iNO) has been successful used for patients with increased pulmonary vascular re- slstance (PVR) shortly after Fontan operation, but its withdrawal rebound remains a major concem. We hypothesized that iNO associ- ated with milrinone could provide additive benefits for pulmonary hemodynamics and reduce the occurrence of iNO withdrawal rebound. Methods Thirty-one patieats with high transpulmonary pressure gradient(TPG, >10mmHg) and arterial oxygen saturation(SatO2, 0.85) after modified fenestrated Fontan operation were prospectively randomized into two groups, I.e. , group iNO (iNO at 10 ppm, dynamics, arterial blood oxygenation and occurrence of withdrawal rebound were compared between the two groups.Results Com- bined application achieved following improvenents including (1) decrement of CVP [(19.6±3.5)% vs. (15.2±4.6)% in group iNO, P<0.05] and TPG [(18.2±4.8)% vs. (15.3±2.6)% in group iNO, P<0.05); and increment of systemic aterial pres- sure [(8.7±2.7)% vs. (5.2±3.1)% in group iNO, P<0.05].(2)improvement of arterial oxygen saturation[(9.3±3.2)% vs. (6.8±2.8)% in group iNO, P<0.05)]. (3)occurrence of withdrawal rebound were significantly lower in group iNO+ Mil (1 patient vs. 6 patients in group iNO, P<0.05). Conclusion Combined uae of iNO and milrinone provided additional benefits as compared with exclusive use d iNO for patients with elevated PVR after Fontan procdure.     

一氧化氮和米力农联合应用改善Fontan术后肺循环阻力的疗效

Objective Inhaled nitric oxide(iNO) has been successful used for patients with increased pulmonary vascular re- slstance (PVR) shortly after Fontan operation, but its withdrawal rebound remains a major concem. We hypothesized that iNO associ- ated with milrinone could provide additive benefits for pulmonary hemodynamics and reduce the occurrence of iNO withdrawal rebound. Methods Thirty-one patieats with high transpulmonary pressure gradient(TPG, >10mmHg) and arterial oxygen saturation(SatO2, 0.85) after modified fenestrated Fontan operation were prospectively randomized into two groups, I.e. , group iNO (iNO at 10 ppm, dynamics, arterial blood oxygenation and occurrence of withdrawal rebound were compared between the two groups.Results Com- bined application achieved following improvenents including (1) decrement of CVP [(19.6±3.5)% vs. (15.2±4.6)% in group iNO, P<0.05] and TPG [(18.2±4.8)% vs. (15.3±2.6)% in group iNO, P<0.05); and increment of systemic aterial pres- sure [(8.7±2.7)% vs. (5.2±3.1)% in group iNO, P<0.05].(2)improvement of arterial oxygen saturation[(9.3±3.2)% vs. (6.8±2.8)% in group iNO, P<0.05)]. (3)occurrence of withdrawal rebound were significantly lower in group iNO+ Mil (1 patient vs. 6 patients in group iNO, P<0.05). Conclusion Combined uae of iNO and milrinone provided additional benefits as compared with exclusive use d iNO for patients with elevated PVR after Fontan procdure.