Does nitric oxide improve left ventricular dysfunction complicated with refractory hypoxemia after CABG surgery?

ABSTRACT

Nitric oxide [NO] may improve left ventrcular dysfunction after cardiac surgery. We have reported a case of severe left ventricular dysfunction and refractory hypoxemia after a two-vessel coronary artery grafting surgery. Different protective ventilation strategies and circulatory support with infusions of epinephrine and dopamine and intra-aortic balloon pumping failed to induce improvements in the cardiopulmonary function. In light of the worsening myocardial function and refractory hypoxemia, inhaled NO 20 ppm was initiated. This was followed by a progressive rapid improvement in the left ventricular function and oxygenation index, and gradual resolution of radiological lung infiltrates. The use of NO inhalation can be a safe and effective treatment modality for the refractory left ventricular dysfunction and worsening hypoxemia after coronary artery bypass grafting [CABG] surgery