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Post-Extubation Inhaled Nitric Oxide Therapy via High-Flow Nasal Cannula After Fontan Procedure.
Pediatr Cardiol. 2019 Jun; 40(5):1064-1071.PC

Abstract

In 2014, our hospital introduced inhaled nitric oxide (iNO) therapy combined with high-flow nasal cannula (HFNC) oxygen therapy after extubation following the Fontan procedure in patients with unstable hemodynamics. We report the benefits of HFNC-iNO therapy in these patients. This was a single-center, retrospective review of 38 patients who underwent the Fontan procedure between January 2010 and June 2016, and required iNO therapy before extubation. The patients were divided into two groups: patients in Epoch 1 (n = 24) were treated between January 2010 and December 2013, receiving only iNO therapy; patients in Epoch 2 (n = 14) were treated between January 2014 and June 2016, receiving iNO therapy and additional HFNC-iNO therapy after extubation. There were no significant differences between Epoch 1 and 2 regarding preoperative cardiac function, age at surgery, body weight, initial diagnosis (hypoplastic left heart syndrome, 4 vs. 2; total anomalous pulmonary venous return, 5 vs. 4; heterotaxy, 7 vs. 8), intraoperative fluid balance, or central venous pressure upon admission to the intensive care unit. Epoch 2 had a significantly shorter duration of postoperative intubation [7.2 (3.7-49) vs. 3.5 (3.0-4.6) hours, p = 0.033], pleural drainage [23 (13-34) vs. 9.5 (8.3-18) days, p = 0.007], and postoperative hospitalization [36 (29-49) vs. 27 (22-36) days, p = 0.017]. Two patients in Epoch 1 (8.3%), but none in Epoch 2, required re-intubation. Our results suggest that HFNC-iNO therapy reduces the duration of postoperative intubation, pleural drainage, and hospitalization.

Authors+Show Affiliations

Department of Cardiovascular Surgery, Osaka Women's and Children's Hospital, 840 Murodocho, Izumi, 594-1101, Osaka, Japan. ytomtomy@gmail.com.Department of Cardiovascular Surgery, Osaka Women's and Children's Hospital, 840 Murodocho, Izumi, 594-1101, Osaka, Japan.Department of Cardiovascular Surgery, Osaka Women's and Children's Hospital, 840 Murodocho, Izumi, 594-1101, Osaka, Japan.Department of Intensive Care Medicine, Osaka Women's and Children's Hospital, 840 Murodocho, Izumi, 594-1101, Osaka, Japan.Department of Cardiovascular Surgery, Osaka Women's and Children's Hospital, 840 Murodocho, Izumi, 594-1101, Osaka, Japan.Department of Cardiovascular Surgery, Osaka Women's and Children's Hospital, 840 Murodocho, Izumi, 594-1101, Osaka, Japan.Department of Pediatric Cardiology, Osaka Women's and children's Hospital, 840 Murodocho, Izumi, 594-1101, Osaka, Japan.Department of Pediatric Cardiology, Osaka Women's and children's Hospital, 840 Murodocho, Izumi, 594-1101, Osaka, Japan.Department of Pediatric Cardiology, Osaka Women's and children's Hospital, 840 Murodocho, Izumi, 594-1101, Osaka, Japan.Department of Intensive Care Medicine, Osaka Women's and Children's Hospital, 840 Murodocho, Izumi, 594-1101, Osaka, Japan.Department of Anesthesiology, Osaka Women's and Children's Hospital, 840 Murodocho, Izumi, 594-1101, Osaka, Japan.Department of Cardiovascular Surgery, Osaka Women's and Children's Hospital, 840 Murodocho, Izumi, 594-1101, Osaka, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31065760

Citation

Tominaga, Yuji, et al. "Post-Extubation Inhaled Nitric Oxide Therapy Via High-Flow Nasal Cannula After Fontan Procedure." Pediatric Cardiology, vol. 40, no. 5, 2019, pp. 1064-1071.
Tominaga Y, Iwai S, Yamauchi S, et al. Post-Extubation Inhaled Nitric Oxide Therapy via High-Flow Nasal Cannula After Fontan Procedure. Pediatr Cardiol. 2019;40(5):1064-1071.
Tominaga, Y., Iwai, S., Yamauchi, S., Kyogoku, M., Kugo, Y., Hasegawa, M., Kayatani, F., Takahashi, K., Aoki, H., Takeuchi, M., Tachibana, K., & Kawata, H. (2019). Post-Extubation Inhaled Nitric Oxide Therapy via High-Flow Nasal Cannula After Fontan Procedure. Pediatric Cardiology, 40(5), 1064-1071. https://doi.org/10.1007/s00246-019-02122-2
Tominaga Y, et al. Post-Extubation Inhaled Nitric Oxide Therapy Via High-Flow Nasal Cannula After Fontan Procedure. Pediatr Cardiol. 2019;40(5):1064-1071. PubMed PMID: 31065760.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Post-Extubation Inhaled Nitric Oxide Therapy via High-Flow Nasal Cannula After Fontan Procedure. AU - Tominaga,Yuji, AU - Iwai,Shigemitsu, AU - Yamauchi,Sanae, AU - Kyogoku,Miyako, AU - Kugo,Yosuke, AU - Hasegawa,Moyu, AU - Kayatani,Futoshi, AU - Takahashi,Kunihiko, AU - Aoki,Hisaaki, AU - Takeuchi,Muneyuki, AU - Tachibana,Kazuya, AU - Kawata,Hiroaki, Y1 - 2019/05/07/ PY - 2019/03/13/received PY - 2019/05/02/accepted PY - 2019/5/9/pubmed PY - 2019/7/10/medline PY - 2019/5/9/entrez KW - Fontan operation KW - High-flow nasal cannula KW - Hospitalization KW - Inhaled nitric oxide KW - Pleural drainage SP - 1064 EP - 1071 JF - Pediatric cardiology JO - Pediatr Cardiol VL - 40 IS - 5 N2 - In 2014, our hospital introduced inhaled nitric oxide (iNO) therapy combined with high-flow nasal cannula (HFNC) oxygen therapy after extubation following the Fontan procedure in patients with unstable hemodynamics. We report the benefits of HFNC-iNO therapy in these patients. This was a single-center, retrospective review of 38 patients who underwent the Fontan procedure between January 2010 and June 2016, and required iNO therapy before extubation. The patients were divided into two groups: patients in Epoch 1 (n = 24) were treated between January 2010 and December 2013, receiving only iNO therapy; patients in Epoch 2 (n = 14) were treated between January 2014 and June 2016, receiving iNO therapy and additional HFNC-iNO therapy after extubation. There were no significant differences between Epoch 1 and 2 regarding preoperative cardiac function, age at surgery, body weight, initial diagnosis (hypoplastic left heart syndrome, 4 vs. 2; total anomalous pulmonary venous return, 5 vs. 4; heterotaxy, 7 vs. 8), intraoperative fluid balance, or central venous pressure upon admission to the intensive care unit. Epoch 2 had a significantly shorter duration of postoperative intubation [7.2 (3.7-49) vs. 3.5 (3.0-4.6) hours, p = 0.033], pleural drainage [23 (13-34) vs. 9.5 (8.3-18) days, p = 0.007], and postoperative hospitalization [36 (29-49) vs. 27 (22-36) days, p = 0.017]. Two patients in Epoch 1 (8.3%), but none in Epoch 2, required re-intubation. Our results suggest that HFNC-iNO therapy reduces the duration of postoperative intubation, pleural drainage, and hospitalization. SN - 1432-1971 UR - https://www.unboundmedicine.com/medline/citation/31065760/Post_Extubation_Inhaled_Nitric_Oxide_Therapy_via_High_Flow_Nasal_Cannula_After_Fontan_Procedure_ L2 - https://dx.doi.org/10.1007/s00246-019-02122-2 DB - PRIME DP - Unbound Medicine ER -