How common is severe pulmonary hypertension after pediatric cardiac surgery?

Lindberg, Lars; Olsson, Anders; Jögi, Peeter; Jonmarker, Christer

doi:10.1067/mtc.2002.121497

Cited by 123 publications

(125 citation statements)

References 23 publications

Supporting

Mentioning

109

Contrasting

Unclassified

Order By: Relevance

“…While the clinical impact of pre-and postoperative PHT has become considerably less threatening during the last decade, 13 there are some patients who develop marked postoperative PHT associated with hemodynamic compromise. Furthermore, subclinical elevation of PVRI may be associated with prolonged postoperative recovery.…”

Section: Clinical Impact Of Increased Pvr In Children With Congenitalmentioning

confidence: 99%

Intravenous Sildenafil Is a Potent Pulmonary Vasodilator in Children With Congenital Heart Disease

et al. 2003

View full text Add to dashboard Cite

Background-Increased pulmonary vascular resistance (PVR) because of congenital heart disease (CHD) may be caused by a dysfunction in endogenous pulmonary endothelial nitric oxide (NO) production. In other forms of pulmonary vascular disease with increased PVR, an elevated activity of a phosphodiesterase type 5 (PDE-5), responsible for the degradation of cyclic guanidine monophosphate (cGMP), the second messenger of endothelially produced NO, has been demonstrated. This study compares the effects of inhaled NO before and after the specific inhibition of the PDE-5 by intravenous sildenafil (Viagra™) in pre-and postoperative children with increased PVR because of CHD. Methods and Results-12 children with congenital heart disease (age 0.2 to 15.7 years, median 2.4 years) and increased mean pulmonary arterial pressure, and 12 postoperative children (age 0.11 to 0.65 years, median 0.32 years) with increased PVR (8.3Ϯ1.0 Wood Units*m 2 ) were studied during cardiac catheterization ("cath laboratory"), or within 2 hours after return from cardiac surgery ("post op"), respectively. All were sedated, tracheally intubated and paralyzed. During alveolar hyperoxygenation (F i O 2 ϭ0.65), the effects of inhaled NO (20 ppm) were compared before and after the stepwise infusion of sildenafil ("cath laboratory", 1 mg/kg; post op, 0.25 mg/kg). Intravenous sildenafil more effectively reduced PVR than NO (11.5% versus 4.3% in the "cath laboratory" patient group, PϽ0.05, and 25.8% versus 14.6% in the post op patient group, Pϭ0.09. The increase in cGMP in response to NO was potentiated (2-to 2.4-fold) by PDE-5 inhibition. While the vasodilating effects of sildenafil showed pulmonary selectivity, its infusion was associated with increased intrapulmonary shunting in the postoperative patients (Q s / Q t ϭ16.5Ϯ4.7% to 25.5Ϯ18.2% Pϭ0.04). Conclusions-Intravenous sildenafil is as effective as inhaled NO as a pulmonary vasodilator in children with congenital heart disease. Although clinically insignificant in this study, increased intrapulmonary shunting with sildenafil may be disadvantageous in some patients after CHD surgery.

show abstract

Section: Clinical Impact Of Increased Pvr In Children With Congenitalmentioning

confidence: 99%

Intravenous Sildenafil Is a Potent Pulmonary Vasodilator in Children With Congenital Heart Disease

et al. 2003

View full text Add to dashboard Cite

show abstract

“…[10][11][12] Prevention and management strategies for pulmonary hypertensive crises include intraoperative vertical vein opening, deep sedation, muscle paralysis for 24-48 hours, maintaining the pCO 2 between 30 and 35 mmHg, pharmacological therapy (e.g., sildenafil, phenoxybenzamine, ilioprost, and iNO), the use of a selective pulmonary vasodilator, and ECMO life support. [10][11][12] Karaci et al [9] reported that 10% of the patients (n=6) in their study with isolated TAPVR had a pulmonary hypertensive crisis and that in spite of intensive therapy, two of them died. In another study composed of 100 patients, Kelle et al [12] observed a pulmonary hypertensive crisis in 20 patients, and three of these died as a result of the crisis.…”

Section: Discussionmentioning

confidence: 99%

Surgery-related complications and their management in total anomalous pulmonary venous return during intensive care unit stay

Öztürk¹

2015

Turk Gogus Kalp Dama

View full text Add to dashboard Cite

show abstract

“…É uma alteração verificada nos pós-operatórios de crianças que já tinham pressão pulmonar aumentada previamente (acima da metade ou 2/3 da pressão sistêmica) ou que tinham cardiopatias com grande shunt esquerda-direita 17 . Outros fatores como dor, agitação, acidose, hipercapnia e aspirações traqueais podem aumentar a pressão pulmonar.…”

Section: Hipertensão Pulmonarunclassified

Immediate post-operative care following cardiac surgery

João¹,

Faria²

2003

J Pediatr (Rio J)

View full text Add to dashboard Cite

How common is severe pulmonary hypertension after pediatric cardiac surgery?

Cited by 123 publications

References 23 publications

Intravenous Sildenafil Is a Potent Pulmonary Vasodilator in Children With Congenital Heart Disease

Intravenous Sildenafil Is a Potent Pulmonary Vasodilator in Children With Congenital Heart Disease

Surgery-related complications and their management in total anomalous pulmonary venous return during intensive care unit stay

Immediate post-operative care following cardiac surgery

Contact Info

Product

Resources

About