A prospective, randomized, crossover pilot study of inhaled nitric oxide versus inhaled prostacyclin in heart transplant and lung transplant recipients

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Presentation transcript:

A prospective, randomized, crossover pilot study of inhaled nitric oxide versus inhaled prostacyclin in heart transplant and lung transplant recipients Tanveer A. Khan, MD, Gabriel Schnickel, MD, David Ross, MD, Sam Bastani, DO, Hillel Laks, MD, Fardad Esmailian, MD, Daniel Marelli, MD, Ramin Beygui, MD, Richard Shemin, MD, Larry Watson, BS, Irina Vartapetian, BS, Abbas Ardehali, MD The Journal of Thoracic and Cardiovascular Surgery Volume 138, Issue 6, Pages 1417-1424 (December 2009) DOI: 10.1016/j.jtcvs.2009.04.063 Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Time line for the experimental protocol and data collection. Patients were randomized to a pulmonary vasodilator, shown as Agent A, which was continued for 6 hours. Agent A was then stopped for 30 minutes for washout. Next, the crossover agent, shown as Agent B, was started and continued for 30 minutes. Therapy was then switched back to agent A, which was continued or weaned per the clinicians' decision. Time points (arrows) for collection of hemodynamic and oxygenation parameters. The Journal of Thoracic and Cardiovascular Surgery 2009 138, 1417-1424DOI: (10.1016/j.jtcvs.2009.04.063) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Flow diagram depicting the outcome of all screened and enrolled patients. NO, Nitric oxide; PGI2, prostacyclin. The Journal of Thoracic and Cardiovascular Surgery 2009 138, 1417-1424DOI: (10.1016/j.jtcvs.2009.04.063) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 NO and PGI2 similarly reduce PA pressures at the 6-hour crossover trial. NO and PGI2 showed significant reductions in systolic, diastolic, and mean PA pressures compared with crossover baseline (∗P < .01). NO, Nitric oxide; PA, pulmonary artery; PGI2, prostacyclin. The Journal of Thoracic and Cardiovascular Surgery 2009 138, 1417-1424DOI: (10.1016/j.jtcvs.2009.04.063) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 NO and PGI2 similarly improve hemodynamics at the 6-hour crossover trial. NO and PGI2 therapy decreased CVP and improved cardiac index and Svo2 when compared with crossover baseline values (∗P < .01). NO, Nitric oxide; PGI2, prostacyclin; Svo2, venous oxygen saturation. The Journal of Thoracic and Cardiovascular Surgery 2009 138, 1417-1424DOI: (10.1016/j.jtcvs.2009.04.063) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions