Heart surgery

Nitric oxide does not improve babies’ recovery after heart surgery

Congenital heart disease affects approximately one in a hundred children born alive. Credit: Kinderspital Zürich

Congenital heart disease affects approximately one in a hundred children born alive. In the United States alone, approximately 40,000 children are born each year with congenital heart disease. About half of these patients require heart surgery within the first few years of life. This type of surgery involves performing cardiopulmonary bypass, or an artificial heart-lung machine, which is necessary for surgeons to operate on the heart.

However, this machine can cause severe inflammation in children, which can last up to several days after surgery. This inflammation is harmful to patients because it weakens the heart and can lead to organ dysfunction and the need for ICU ventilation. To reduce these side effects, adding nitric oxide to the heart-lung machine has been seen as a promising approach.

No difference in ventilation requirements

Researchers from the University of Zurich, University Children’s Hospital Zurich and the University of Queensland (Australia) have now investigated whether adding nitric oxide to heart-lung machines reduces the need for ventilation infants after surgery. “The randomized trial involved 1,371 children at six pediatric cardiac surgery centers in Australia, New Zealand and the Netherlands,” says lead author Luregn Schlapbach of the University Children’s Hospital Zurich.

Posted in JAMA, the results show no difference in the ventilation needs of study participants who received nitric oxide and those who did not after heart surgery. The study authors therefore conclude that the use of nitric oxide in cardiopulmonary bypass surgery does not improve children’s recovery after heart surgery.

The trial was the largest interventional study to date in children with congenital heart disease. “Researchers will now analyze gene activation patterns in study participants to uncover which biological processes might be targeted in the future, including in terms of precision medicine,” Schlapbach says. A cohort follow-up study through school age will also be conducted to understand the true long-term impact of nitric oxide gas intervention.


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More information:
Luregn J. Schlapbach et al, Effect of nitric oxide via cardiopulmonary bypass on ventilator-free days in young children undergoing surgery for congenital heart disease, JAMA (2022). DOI: 10.1001/jama.2022.9376

Provided by the University of Zurich

Quote: Nitric oxide does not improve babies’ recovery after heart surgery (Jun 27, 2022) Retrieved June 29, 2022 from https://medicalxpress.com/news/2022-06-nitric-oxide-babies-recovery- heart.html

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