Issue |
J Extra Corpor Technol
Volume 50, Number 4, December 2018
|
|
---|---|---|
Page(s) | 260 - 264 | |
DOI | https://doi.org/10.1051/ject/201850260 | |
Published online | 15 December 2018 |
Technique Article
The Safe Addition of Nitric Oxide into the Sweep Gas of the Extracorporeal Circuit during Cardiopulmonary Bypass and Extracorporeal Life Support
* Department of Cardiac Surgery, Perfusion Unit, The Royal Children’s Hospital, Parkville, Victoria, Australia
† Department of Biomedical Engineering, The Royal Children’s Hospital, Parkville, Victoria, Australia
‡ Faculty of Medicine, Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia; and
§ Murdoch Children’s Research Institute, Parkville, Victoria, Australia
Address correspondence to: Martin J. Bennett, BAppSc, CCP, Department of Cardiac Surgery, Royal Children’s Hospital Melbourne, Flemington Road, Parkville 3052, Victoria, Australia. E-mail: martin.bennett@rch.org.au
Received:
2
July
2018
Accepted:
17
October
2018
Low cardiac output syndrome and the systemic inflammatory response are consequences of the cardiac surgical perioperative course. The mechanisms responsible are multifactorial, but recent studies have shown that nitric oxide (NO) may be a key component in mitigating some of these processes. Following on from literature reports detailing the use of inhaled NO added to the gas phase of the extracorporeal circuit, we set about developing a technique to perform this addition safely and efficiently. In the setting of cardiopulmonary bypass, the technique was validated in a randomized prospective trial looking at 198 children. The benefits observed in this trial then stimulated the incorporation of NO into all extracorporeal life support (ECLS) circuits. This required additional hardware modifications all of which were able to be performed safely. Initial results from the first series of ECLS patients using NO also appear promising.
Key words: cardiopulmonary bypass / inflammatory response / SIRS / low cardiac output syndrome / LCOS / nitric oxide / ECLS / ECMO
© 2018 AMSECT
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