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Exhaled nitric oxide and the Systemic Inflammatory Response Syndrome (SIRS) after cardiac surgery

Background. Septic patients produce increased nitric oxide (NO). We postulated increased exhaled nitric oxide (exNO) in SIRS after cardiopulmonary bypass surgery (CPB). / Methods. Forty-two intubated patients were studied postoperatively and at two-hour intervals for eight hours or until extubated. Hemodynamic indices, including indexed systemic vascular resistance (SVRi) and cardiac index (CI) were measured. ExNO was analyzed by ozone chemiluminescence. / Results. Six patients (14%) Manifested SIRS, defined as SVRI <1800 dynes&middot;sec/cm5/m2. ExNO indexed by expired volume of minute ventilation and body surface area (exNO&middot; V&dot;Ei) was less in SIRS patients at each interval. Overall, normal exNO&middot;V&dot;Ei was 4.3 +/- 0.4 nL/min/m2 with a Cl of 2.56 +/- 0.05 L/min/m 2 and an SVRI of 2488 +/- 62 dynes&middot;sec/cm5/m 2, whereas in SIRS exNO&middot;V&dot;Ei was 0.7 +/- 0.3 (p < 0.001) with a Cl of 2.97 +/- 0.09 (p < 0.001) and an SVRi of 1826 +/- 86 (p < 0.001). / Conclusions. Pulmonary production of NO in post-CPB SIRS differs from sepsis and may not be reflective of systemic levels. Increased pulmonary blood flow may scavenge lung production of NO thereby decreasing exhaled levels.

Identiferoai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.31247
Date January 2001
CreatorsKeyser, Eric J.
ContributorsGoldberg, Peter (advisor)
PublisherMcGill University
Source SetsLibrary and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada
LanguageEnglish
Detected LanguageEnglish
TypeElectronic Thesis or Dissertation
Formatapplication/pdf
CoverageMaster of Science (Division of Surgical Research.)
RightsAll items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated.
Relationalephsysno: 001804007, proquestno: MQ70443, Theses scanned by UMI/ProQuest.

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