August 14, 2011

Inhaled nitric oxide after left ventricular assist device implantation: A prospective, randomized, double-blind, multicenter, placebo-controlled trial


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The prophylactic use of inhaled nitric oxide (iNO) to reduce pulmonary vascular resistance (PVR), thereby reducing the likelihood or RV dysfunction is considered routine in many MCS and cardiac transplant centers. This study was a relatively large, prospective, randomized, controlled trial to assess the utility of the prophylactic use of iNO in preventing post-operative RVD in patients undergoing LVAD placement. Although the study was essentially negative in achieving any of the pre-defined primary endpoints, it should be appreciated that there is no international consensus on the definition of RV dysfunction in the perioperative period and there was a non-statistically significant trend in a reduction in the days on mechanical ventilatory support.  It is unclear if the findings of this study will influence the expensive and fairly routine use of prophylactic iNO.

Cardiac Transplantation

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