Abstract: To explore the clinical effect and possible mechanism of nebulized nitroglycerin in treatment of congenital heart disease (CHD) complicated with pulmonary hypertension （PH） after open heart surgery. Methods: Twentyseven patients suffered from CHD with moderate or severe PH were underwent open heart operation, and then they were treated with 4?μg/(kg•min) nebulized nitroglycerin. The radial artery catheterization and SwanGanz catheter insertion through right internal jugular vein were requisite for dynamically or persistently monitor vital signs. The hemodynamics indices, including central venous pressure(CVP), mean arterial pressure(MAP), mean pulmonary arterial pressure(MPAP), pulmonary arterial wedge pressure(PAWP), heart rate(HR), cardiac output(CO), oxygenation index(PO2/FIO2 ) and blood gas analysis were monitored before inhalation treatment (elementary value) and 5, 10, 30 and 60 minutes after inhalation treatment. All the data were statistically analyzed with matchedpairs design sample means comparison. Results: There were no significant difference between the elementary value and 5, 10, 30 or 60 minutes after inhalation in HR， MAP， CVP， and PAWP(P＞0.05); the MPAP and PVR both significantly decreased in 5, 10, 30 and 60 minutes after nebulized nitroglycerin treatment to the elementary value (P＜0.01), and the CO and PO2/FIO2 significantly increased after treatment(P＜0.05). Conclusion: Nebulized nitroglycerin significantly decreases both PAPand PVR and improves pulmonary hemodynamics of PH patients, however, does not influence systemic circulation.

Key words: Nitroglycerin, Nebulizer, Hypertension, pulmonary, Inhalation therapy