Effects of Inhaled Nitric Oxide on Sublingual Microcirculation in Patients With Right Ventricular Dysfunction After Cardiac Surgery

• Status: COMPLETED
• Trial end date: 2026-09-30

Summary

Right ventricular (RV) dysfunction complicates 0.1-3% of cardiac surgical procedures and is strongly associated with elevated postoperative mortality. Pulmonary hypertension is a key determinant of perioperative RV failure. Inhaled nitric oxide (iNO) is a selective pulmonary vasodilator that reduces pulmonary arterial pressure and has been widely used as adjunctive therapy in this setting. However, whether iNO influences systemic microcirculatory perfusion in these patients remains undefined.

We conducted a single-centre, prospective, interventional study. Adult patients with post-cardiotomy RV dysfunction - defined as central venous pressure (CVP) 15 mmHg combined with a pulmonary artery systolic pressure (PASP) \> 35 mmHg on transthoracic echocardiography - were eligible. On top of standard postoperative care, patients received inhaled NO at 10-20 ppm for 2 hours without any concomitant change in vasoactive support. General characteristics, haemodynamic variables and sublingual microcirculatory parameters were recorded at baseline and again after 2 hours of iNO. The primary endpoint was the change in sublingual perfused vessel density (PVD). Secondary endpoints included mean arterial pressure (MAP), CVP, transthoracic echocardiographic indices, oxygenation index (OI), other sublingual microcirculatory parameters, capillary refill time (CRT), duration of mechanical ventilation and ICU length of stay.

• Phase: PHASE2

Details

• Lead Sponsor: Southeast University, China
• Treatments: Inosine