This exploratory prospective cohort enrolled 63 consecutive patients undergoing minimally invasive cardiac surgery and evaluated physiological responses to inhaled nitric oxide. Thirty patients (47.6%) received nitric oxide for post-bypass hypoxemia with pulmonary hypertension during one-lung ventilation. After administration, PaO2/FiO2 increased from 70 [61–80] to 85 [72–102] (P=0.011), while mean pulmonary artery pressure did not change significantly, from 24 [23–26] to 25 [22–28] mmHg (P=0.564). Female sex, higher body mass index, and longer bypass time were associated with nitric oxide initiation in multivariable analysis.
Nitric oxide administration was followed by improved oxygenation in this selected surgical cohort. These physiological observations do not establish comparative efficacy or patient-centred benefit.
Study limitation: The small exploratory cohort lacked a randomized comparator and reported physiological responses rather than patient-centred outcomes.
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