Role Of Inhaled Nitric Oxides In Pregnancy With Eisenmenger Syndrome

Muhammad Anas, Nenny Triastuti, Muhammad Perdana Airlangga

Abstract

ABSTRACT

Eisenmenger Syndrome (ES) is congenital heart disease with pulmonary hypertension and shunting turning from right to left. The resistance of pulmonary vascular more than 7.5 mmHg/L/min. The right ventricle and pulmonary artery always enlarge. During pregnancy, there will be hemodynamic changes that will affect the ES. It can be understood the possible dangers that can occur, like right heart failure; an increase in pulmonary arteries or the aggravation of pulmonary hypertension because there is no decrease in pulmonary resistance; A sudden decrease in venous return in supine hypotension syndrome can cause a relative increase in pulmonary arterial pressure so as to aggravate pulmonary hypertension and reverse shunting.

Physiological effects of inhaled nitric oxide (INO) therapy cause selective pulmonary vasodilation: Hypoxia alveoli causes reversible vasoconstriction, thereby increasing pulmonary wedge pressure. INO can lower it. Moderate cardiac output and systematic arterial pressure are not affected; Selective in pulmonary because it is activated by hemoglobin; Selective vasodilation in the ventilated area, local hypoxia alveoli constricts the surrounding vascular tissue and redistributes blood flow to the ventilated lungs better and higher intraalveolar oxygen pressure. INO enhances this mechanism by increasing blood flow through a well-ventilated lung; Bronchodilators; Pulmonary surfactant, The combination of high concentrations of inspired oxygen and high concentrations of INO reduces the minimum surfactant surface tension.

Keywords: Inhalation Nitric Oxides, Pregnancy, Eisenmenger Syndrome

Keywords

Inhalation Nitric Oxides, Pregnancy, Eisenmenger Syndrome

Full Text:

PDF

References

Anas, M., & Marlina, U. (2018). Penggunaan Nitrovasodilator Sebagai Donor Oksida Nitrik Pada Preeklamsia. In Proceeding Annual Meeting APKKM Ke 6 Surabaya (pp. 1–27). ID. Retrieved from http://journal.um-surabaya.ac.id/index.php/Pro/search/search?simpleQuery=anas&searchField=query

Anggard, E. (1994). Nitric Oxide: mediator, murderer, and medicine. The Lancet, 343, 1199–1206.

Atz, A. M., & Wessel, D. L. (1997). Inhaled Nitric Oxide in the Neonate with Cardiac Disease. Seminars In Perinatology, 21(5), 441–455.

Barrington, K. J., Finer, N., Pennaforte, T., & Altit, G. (2017). Nitric oxide for respiratory failure in infants born at or near term. Cochrane Database of Systematic Reviews, (1).

Bistch, M., Johansen, C., Wennevold, A., & Osler, M. (1988). Eisenmenger’s Syndrome and Pregnancy. Eur J Obstet Gynecol Repord Biol, 28, 69–74.

Biswas, M. K., & Perloff, D. (1994). Cardiac, hematologic, pulmonary, renal and urinary tract disorders. In Obstetrics & Gynecological Diagnosis & Treatment. East Norwalk: Appleton & Lange (8th Editio, pp. 428–467). Appleton & Lange.

Brennan, K., & Hatch, D. M. (2018). Eisenmenger’s Syndrome. In Consults in Obstetric Anesthesiology (pp. 185–187). Switzerland: Springer Nature.

Buckshee, K., Biswas, A., Mittal, S., & Agarwal, N. (1988). Eisenmenger’s syndrome with pregnancy: a rare obstetrical problem with a successful outcome. Asia‐Oceania Journal of Obstetrics and Gynaecology, 14(3), 323–325.

Cheitlin, M. D., Sokolow, M., & Melroy, M. B. (1993a). Congenital Heart Disease (With Special Reference to Adult Cardiology). In Clinical Cardiology (6th Editon, pp. 386–391). Appleton & Lange.

Cheitlin, M. D., Sokolow, M., & Melroy, M. B. (1993b). Heart Diseases in Pregnancy. In Clinical Cardiology (6th Editon, pp. 693–703). Appleton & Lange.

Chen, C. Nitric Oxide For Newborns Nitric Oxide Proves Effective In Treating Newborns With Life-Threatening Lung Disorder (1997). Retrieved from cwchen@ITSA.UCSF.EDU

Cheung, P. Y., Salas, E., Schulz, R., & Radomski, M. W. (1997). Nitric Oxide and Platelet Function: Implications for pregnancy. Seminars In Perinatology, 21(5), 409–417.

Cunningham, F. G., Leveno, K. J., Bloom, S. L., Spong, C. Y., Dashe, J. S., Hoffman, B. L., … Sheffield, J. S. (2014). CONGENITAL HEART DISEASE. In Williams Obstetrics (24th edition, pp. 973–999). USA: Mc Graw Hill.

D’Alto, M., Merola, A., & Dimopoulos, K. (2005). Pulmonary hypertension related to congenital heart disease. A comprehensive review. Global Cardiology Science and Practice, 13, 42.

De Swiet, M. (1993). Heart Disease. In High-risk Pregnancy (pp. 139–157). Butterworth-Heinemann Ltd.

Finer, N. N., & Barrington, K. J. (1997). Nitric oxide in respiratory failure in the newborn infant. In Seminars in perinatology (Vol. 21, pp. 426–440). Elsevier.

Fishman, A. P. (1994). Pulmonary Hypertension. In The Heart Arteries and Veins (pp. 1857–1874). McGraw-Hill, Inc.

Fremes, S. E., Patterson, G. A., Williams, W. G., Goldman, B. S., Todd, T. R., & Maurer, J. (1990). Single lung transplantation and closure of patent ductus arteriosus for Eisenmenger’s syndrome. Toronto Lung Transplant Group. The Journal of Thoracic and Cardiovascular Surgery, 100(1), 1–5.

Gibbs, C. P. (1988). Anesthetic Management of High-Risk Mother. In Sciarra Gynecology and Obstetrics (pp. 1–11). J.B. Lippincott Company.

Goodwin, T. M., Gherman, R. B., Hameed, A., & Elkayam, U. (1999). Favorable response of Eisenmenger syndrome to inhaled nitric oxide during pregnancy. American Journal of Obstetrics and Gynecology, 180(1 I), 64–67. https://doi.org/10.1016/S0002-9378(99)70151-1

Heytens, L., & Alexander, J. P. (1986). Maternal and neonatal death associated with Eisenmenger’s syndrome. Acta Anaesthesiologica Belgica, 37(1), 45–51.

Jones, O. D., Shore, D. F., Rigby, M. L., Leijala, M., Scallan, J., Shinebourne, E. A., & Lincoln, J. C. (1981). The use of tolazoline hydrochloride as a pulmonary vasodilator in potentially fatal episodes of pulmonary vasoconstriction after cardiac surgery in children. Circulation, 64(2 Pt 2), II134-9.

Karelkina, E., Irtyuga, O., Kokonina, Y., Yakubov, A., Li, O., Mazurok, V., … Moiseeva, O. The pregnancy outcomes and delivery in women with Eisenmenger’s syndrome, 7 Pregnancy 3466 (2019).

Katsurahgi, S., Kamiya, C., Yamanaka, K., Neki, R., Miyoshi, T., Iwanaga, N., … Ikeda, T. (2019). Maternal and fetal outcomes in pregnancy complicated with Eisenmenger syndrome. Taiwanese Journal of Obstetrics and Gynecology, 58(2), 183–187. https://doi.org/10.1016/j.tjog.2019.01.002

Kazue, T. (1995). Effect of low dosage inhaled nitric oxide on pulmonary hypertension in congenital heart disease. The Kurume Medical Journal, 42(4), 281–290.

Kinsella, J. P., & Abman, S. H. (1997). Inhaled nitric oxide in the premature infant: animal models and clinical experience. In Seminars in perinatology (Vol. 21, pp. 418–425). Elsevier.

Lieber, S., Dewilde, P., Huyghens, L., Traey, E., & Gepts, E. (1985). Eisenmenger’s Syndrome and Pregnancy. Acta Cardiologica, 15(4), 421–424.

Lust, K. M., Boots, R. J., Dooris, M., & Wilson, J. (1999). Management of labor in Eisenmenger syndrome with inhaled nitric oxide. American Journal of Obstetrics and Gynecology, 181(2), 419–423. https://doi.org/10.1016/S0002-9378(99)70572-7

McAnulty, J. H., Metcalfe, J., & Ueland, K. (1994). Heart Disease In Pregnancy. In The Heart Arteries and Veins (8th Editio, pp. 2041–2056). McGraw-Hill, Inc.

McCarthy, P. M., Rosenkranz, E. R., White, R. D., Rice, T. W., Sterba, R., Vargo, R., & Mehta, A. C. (1991). Single-Lung transplantation with atrial septal defect repair for Eisenmenger’s syndrome. The Annals of Thoracic Surgery, 52(2), 300–303. https://doi.org/10.1016/0003-4975(91)91359-4

Midwall, J., Jaffin, H., Herman, M. V, & Kupersmith, J. (1978). Shunt flow and pulmonary hemodynamics during labor and delivery in the Eisenmenger syndrome. The American Journal of Cardiology, 42(2), 299–303.

Oechslin, E., Mebus, S., Schulze-Neick, I., Niwa, K., T Trindade, P., Eicken, A., … Kaemmerer, H. (2010). The adult patient with Eisenmenger syndrome: a medical update after Dana Point part III: specific management and surgical aspects. Current Cardiology Reviews, 6(4), 363–372.

Omer, N., Rohilla, A., Rohilla, S., & Kushnoor, A. (2012). Review article nitric oxide : role in human biology. Int. J. Pharma. Sci. Drug Res., 4(2), 105–109.

Pederson, C. M., Hansen, T. G., & Henneberg, S. W. (1997). Persistent Pulmonary Hypertension in Newborn Infants. Ugeskr Laeger, 159(28), 4377–4382.

Pitts, J. A., Crosby, W. M., & Basta, L. L. (1977). Eisenmenger’s syndrome in pregnancy. American Heart Journal, 9, 321–326.

Roberts, N. V, & Keast, P. J. (1990). Pulmonary hypertension and pregnancy–a lethal combination. Anaesthesia and Intensive Care, 18(3), 366–374.

Robinson, J. N., Banerjee, R., Landzberg, M. J., & Thiet, M.-P. (1999). Inhaled nitric oxide therapy in pregnancy complicated by pulmonary hypertension. American Journal of Obstetrics and Gynecology, 180(4), 1045–1046.

Steinhorn, R. H., Morin, F. C., & Fineman, J. R. (1997). Models of persistent pulmonary hypertension of the newborn (PPHN) and the role of cyclic guanosine monophosphate (GMP) in pulmonary vasorelaxation. In Seminars in Perinatology (Vol. 21, pp. 393–408). Elsevier. https://doi.org/10.1016/S0146-0005(97)80005-5

Steudel, W., Hurford, W. E., & Zapol, W. M. (1999). Inhaled Nitric Oxide Basic Biology and Clinical Applications. Anesthesiology: The Journal of the American Society of Anesthesiologists, 91(4), 1090.

Sullivan, J. M., & Ramanathan, K. B. (1988). Heart Disease in Pregnancy. In Sciarra Gynecology and Obstetrics (pp. 1–16). J.B. Lippincott Company.

Ueland, K., & Ferguson, I. J. (1988). Cardiorespiratory Physiology of Pregnancy. In Sciarra Gynecology and Obstetrics (pp. 1–7). 8 Vol 3: J.B. Lippincott Company.

Weiner, C. P., & Thompson, L. P. (1997). Nitric oxide and pregnancy. In Seminars in Perinatology (Vol. 21, pp. 367–380). Elsevier. https://doi.org/10.1016/S0146-0005(97)80003-1

Weiss, B. M., Maggiorini, M., Jenni, R., Lauper, U., Popov, V., Bombeli, T., & Spahn, D. R. (2000). Pregnant patient with primary pulmonary hypertension: inhaled pulmonary vasodilators and epidural anesthesia for cesarean delivery. Anesthesiology: The Journal of the American Society of Anesthesiologists, 92(4), 1191.


DOI: http://dx.doi.org/10.30651/jqm.v4i1.3478