Ciddi Pulmoner Hipertansiyonlu Komplet Atriyoventriküler Kanal Defekti Onarımından Sonra Kombine İnhale Nitrik Oksit ve Oral Sildenafil Kullanılması: Vaka Sunumu ve Literature Taraması

Yıl 2017, , 246 - 250, 04.01.2018

Elif Demirbaş , Figen Akalın Alper Kararmaz Selim İsbir Sinan Arsan Koray Ak

https://doi.org/10.31832/smj.320403

Öz

Down
sendromu ve komplet tip atrioventriküler septal defekt (KAVSD)
tanılarıyla takip edilen 12 aylık erkek hasta tam düzeltme
operasyonu sonrası postoperatif dönemde pulmoner hipertansif kriz
yaşadı. Pulmoner hipertansif kriz inhale nitrik oksit (iNO)
tedavisi ile (40-60 ppm) başarılı bir şekilde kontrol edildi.
Takiplerinde methemoglobinemi gelişen hastada iNO dozu 24 saat sonra
azaltılmak zorunda kalındı (10 ppm). Tedaviye sildenafil tablet (6
mg/kg/gün) eklenmesi ile postoperatif pulmoner hipertansif krizler
kontrol altına alındı. Konjenital kalp cerrahisinde pulmoner
hipertansif krizlerin engellenmesinde ve yan etkilerin kontrol
edilmesinde kombine tedaviler etkili yöntemlerdir. 

Anahtar Kelimeler

postoperatif pulmoner hipertansiyon, konjenital kardiyak cerrahi, inhale nitrik oksit, sildenafil

Combined Use of Inhaled Nitric Oxide and Oral Sildenafil After Repair of Complete Atrioventricular Canal Defect with Severe Pulmonary Hypertension : Report of A Case and Review of Literature

Öz

A
12 month old male baby with diagnoses of Down syndrome and complete
atrioventricular canal defect underwent total correction. His early
postoperative course was complicated with pulmonary hypertensive
crises. It was initially treated by 40-60 ppm inhaled nitric oxide
(iNO), but we had to decrease the dosage because of serum increased
methemoglobin levels after 24 hours of treatment (10 ppm). We added
oral sildenafil sitrate as a combination therapy (6 mg/kg/day) which
was seemed to be effective in controlling pulmonary hypertensive
crises. Combined regimens like iNO and sildenafil for postoperative
pulmonary hypertensive crises are beneficial in terms of reducing the
dosage of iNO and preventing rebound pulmonary hypertension.

Anahtar Kelimeler

postoperative pulmonary hypertension, congenital cardiac surgery, inhaled nitric oxide, sildenafil

Kaynakça

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