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Review of Inhaled Nitric Oxide in the Pediatric Cardiac Surgery Setting

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Abstract

Surgical intervention for congenital heart disease (CHD) can be complicated by pulmonary hypertension (PH), which increases morbidity, mortality, and medical burden. Consequently, postoperative management of PH is an important clinical consideration to improve outcomes. Inhaled nitric oxide (iNO) is a widely accepted standard of care for PH and has been studied in the context of cardiac surgery for CHD. However, large randomized, double-blind, placebo-controlled, multicenter clinical trials in pediatric patients are limited. This review will provide an overview of the clinical studies in this setting and will discuss general treatment considerations to facilitate a better understanding of the clinical use of iNO for PH after pediatric cardiac surgery.

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Acknowledgments

The authors acknowledge Peloton Advantage, LLC, for providing editorial support for this article. This editorial support was funded by INO Therapeutics, LLC, a subsidiary of Ikaria, Inc. Editorial support for this article was provided by Peloton Advantage, LLC, and funded by INO Therapeutics, LLC, a subsidiary of Ikaria, Inc.

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Authors and Affiliations

  1. Cardiovascular Intensive Care Unit, Texas Children’s Hospital, Baylor College of Medicine, 6621 Fannin, WT6-006, Houston, TX, 77030, USA

    Paul A. Checchia & Ronald A. Bronicki

  2. Clinical Development Ikaria, Inc., 53 Frontage Road, 3rd Fl., P. O. Box 9001, Hampton, NJ, 08827-9001, USA

    Brahm Goldstein

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  1. Paul A. Checchia
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  2. Ronald A. Bronicki
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  3. Brahm Goldstein
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Correspondence to Paul A. Checchia.

Appendix

Appendix

See Appendix Table 5.

Table 5 List of CHDs in studies of pediatric postoperative iNO use
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Checchia, P.A., Bronicki, R.A. & Goldstein, B. Review of Inhaled Nitric Oxide in the Pediatric Cardiac Surgery Setting. Pediatr Cardiol 33, 493–505 (2012). https://doi.org/10.1007/s00246-012-0172-4

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