Successful Management of Severe Life-threatening Hypoxemia Due to Pulmonary Arteriovenous Malformation

Hofer, Anna; Pusch, Michael; Haizinger, Bettina; Mair, Rudolf; Gitter, Roland; Gombotz, Hans

doi:10.1097/00000542-200211000-00041

Cited by 8 publications

(7 citation statements)

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“…The final three reports describe the use of iNO in acquired PAVMs, formed as complications after cavopulmonary shunt operations. In all cases, postoperative hypoxemia was successfully reversed with iNO [10][11][12].…”

Section: Discussionmentioning

confidence: 95%

Inhaled nitric oxide and sildenafil therapy for a pediatric patient with multiple pulmonary arteriovenous malformations

Parsapour

Kon

2015

J Pediatr Intensive Care

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Pulmonary arteriovenous malformations may result in intrapulmonary shunting and hypoxemia, and often are treated by embolization or surgical resection. Previous reports have demonstrated effective treatment of hypoxia with inhaled nitric oxide in the acute setting. In this report, we describe a child with severe hypoxemia secondary to an inoperable pulmonary arteriovenous malformation that was initially managed with the use of nitric oxide followed by long term management with the phosphodiesterase-5 inhibitor, sildenafil.

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Section: Discussionmentioning

confidence: 95%

Inhaled nitric oxide and sildenafil therapy for a pediatric patient with multiple pulmonary arteriovenous malformations

Parsapour

Kon

2015

J Pediatr Intensive Care

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“…Inhaled nitric oxide improves oxygenation as it dilates pulmonary blood vessels in ventilated lung areas, therefore facilitating gas exchange. 13 However, positive pressure ventilation is thought to worsen oxygenation. 5,14 Discussion among the team relating to this case included the matter of prevention and whether or not the operation should have proceeded.…”

Section: Discussionmentioning

confidence: 99%

Fatal Systemic Embolism following Revision of Hip Arthroplasty: A Complication of Pulmonary Arteriovenous Malformation

Battle¹,

Dow

Timperely

2013

Journal of the Intensive Care Society

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A 72-year-old female patient who had a pulmonary arteriovenous malformation (PAVM) suffered systemic emboli causing pulmonary and cerebral infarction following the revision of an infected total hip replacement. Although not ultimately successful in this case, we detail the management of maintaining oxygenation and adequate cardiac output in a critically ill patient with a PAVM. We also discuss techniques that may be employed to minimise the shunt associated with the PAVM, with the aim of reducing the risk of systemic emboli.

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“…Studies of iNO in patients undergoing Fontan and bidirectional Glenn procedures are both prospective and retrospective in design and have included case reports, case series, and observational studies (Table 3) [19,23,31,39,67,[70][71][72]. All studies in which arterial oxygen saturation was measured showed that this hemodynamic parameter increased after iNO administration [19,23,31,67,71,72].…”

Section: Fontan Proceduresmentioning

confidence: 99%

“…All studies in which arterial oxygen saturation was measured showed that this hemodynamic parameter increased after iNO administration [19,23,31,67,71,72]. An early prospective trial by Goldman et al [23] found that arterial oxygen saturation before initiation of iNO therapy was a predictor of response (i.e., a lower baseline arterial oxygen saturation predicted a greater response) and an arterial oxygen saturation[85% predicted no improvement in hemodynamics.…”

Section: Fontan Proceduresmentioning

confidence: 99%

“…Results showed iNO to be effective in decreasing PVR, suggesting that some Fontan patients will benefit from treatments that enhance or replace endogenous NO. A case study in 2002 by Hofer et al [31] reported that extracorporeal membrane oxygenation was avoided in a 4-year-old postoperative Fontan patient by use of iNO. These clinical results demonstrate that iNO may improve hemodynamics and patient outcome after Fontantype procedures; the aforementioned study investigators propose that iNO use may be an important therapy in this pediatric surgical setting [19,23,31,67,[70][71][72].…”

Section: Fontan Proceduresmentioning

confidence: 99%

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Review of Inhaled Nitric Oxide in the Pediatric Cardiac Surgery Setting

Checchia

Bronicki

Goldstein³

2012

Pediatr Cardiol

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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.

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Successful Management of Severe Life-threatening Hypoxemia Due to Pulmonary Arteriovenous Malformation

Cited by 8 publications

References 0 publications

Inhaled nitric oxide and sildenafil therapy for a pediatric patient with multiple pulmonary arteriovenous malformations

Inhaled nitric oxide and sildenafil therapy for a pediatric patient with multiple pulmonary arteriovenous malformations

Fatal Systemic Embolism following Revision of Hip Arthroplasty: A Complication of Pulmonary Arteriovenous Malformation

Review of Inhaled Nitric Oxide in the Pediatric Cardiac Surgery Setting

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