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Endogenous nitric oxide and low systemic vascular resistance after cardiopulmonary bypass

Version 2 2024-06-03, 23:54
Version 1 2017-05-12, 15:04
journal contribution
posted on 2024-06-03, 23:54 authored by PS Myles, CK Leong, Judy CurreyJudy Currey
OBJECTIVES: To investigate the relationship between excessive endogenous production of nitric oxide (NO) and the low systemic vascular resistance (SVR) syndrome after cardiac surgery. DESIGN: Prospective, case-control. Cases defined by low SVR postoperatively (< 750 dyn/s/cm-5), and matched with controls (> 900 dyn/s/cm-5). SETTING: Cardiothoracic intensive care unit (ICU) in a tertiary care hospital. PARTICIPANTS: Forty-four patients after cardiac surgery. INTERVENTIONS: Collection of plasma and urine samples after identification. MEASUREMENTS AND MAIN RESULTS: Plasma and urine nitrate concentrations were measured as an index of endogenous NO production. Hemodynamic, inotropic, and outcome data were collected. Median nitrate concentrations did not differ between cases and controls (plasma, 58 mumol/L, v 62 mumol/L, p = 0.43; urine, 399 mumol/L v 404 mumol/L, p = 0.38). Times to extubation and intensive care unit (ICU) discharge were prolonged in patients with low SVR (17.8 hours v 8.7 hours, p = 0.021; 2.5 days v 1.2 days, p = 0.019, respectively). CONCLUSIONS: No association between "low SVR syndrome" and endogenous NO production was found. Patients with low SVR after cardiac surgery required a longer period of inotropic and ventilator support, with delay in discharge from the ICU. The risk and cost implications of this syndrome support further research.

History

Journal

Journal of cardiothoracic and vascular anesthesia

Volume

11

Pagination

571-574

Location

Amsterdam, The Netherlands

ISSN

1053-0770

Language

eng

Publication classification

C1.1 Refereed article in a scholarly journal

Copyright notice

1997, by W.B. Saunders Company

Issue

5

Publisher

Elsevier