Pulmonary hypertension is among the causes of low cardiac output syndrome after neonatal
and pediatric cardiac surgery. In the setting of transient postoperative myocardial dysfunction, even a
moderate elevation of pulmonary pressure can result in heart dysfunction and circulatory collapse. Although,
specific pharmacological manipulation of pulmonary vascular resistance is frequently required
in the perioperative period, there is no widely standardized management. In this review, a systematic literature search of
PubMed and MEDLINE databases using relevant terms was performed. All clinical trials and relevant manuscripts, along
with important physiological, pharmacological, and evidence-based considerations involving the use of pulmonary vasodilators
in the management of low cardiac output syndrome after cardiac surgery were reviewed. This article addresses the
fifth of eight topics comprising the special issue entitled “Pharmacologic strategies with afterload reduction in low cardiac
output syndrome after pediatric cardiac surgery”.
Keywords: Congenital heart diseases, pediatric cardiac surgery, pulmonary hypertension, low cardiac output syndrome, nitric
oxide, sildenafil, epoprostenol.
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