Cardiothoracic & vascular anesthesia
Methemoglobin Formation Reflects Systemic Nitric Oxide Uptake: The Critical Role of Delivery Method—Results from Secondary Analysis of a Randomized Controlled Trial
Authors' conclusion
NO delivery modalities significantly influence metHb formation and systemic NO uptake.
Study context
- Population
- Adults undergoing cardiac surgery with preoperative signs/symptoms suggestive of endothelial dysfunction, receiving 80 ppm inhaled nitric oxide (NO) for 24 hMethemoglobin (metHb) data analysed
- Participants
- 105 adults
- Comparison
- NO delivery via cardiopulmonary bypass (CPB) vs ICU mechanical ventilation (MV) vs nasal cannula (NC)
Methodological detailsretrospective, single-centre
- Retrospective
- Single-centre
Primary result
As reported in the abstract
metHb levels
| Group | Value | Slope of metHb increase (β) | Slope of metHb (β) |
|---|---|---|---|
| CPB | median 0.6% | 3.738 * 10-3 | |
| MV | median 2.1% | 8.354 * 10-3 | |
| NC | median 0.8% | −5.352 * 10-3 |
Value
CPBmedian 0.6%
MVmedian 2.1%
NCmedian 0.8%
Slope of metHb increase (β)
CPB3.738 * 10-3
MV8.354 * 10-3
NC— not stated in the abstract
Slope of metHb (β)
CPB— not stated in the abstract
MV— not stated in the abstract
NC−5.352 * 10-3
- MV vs CPB: P < 0.001 — higher during MV
- NC vs CPB: P < 0.001 — metHb declined during NC
- Duration of NO exposure significantly affected metHb levels
- P < 0.001
Further findings
Median, μmol/min
| Outcome | CPB | MV | P value |
|---|---|---|---|
| Estimated NO delivery rateMV vs CPB · greater with MV | 8.2 | 25.1 | P < 0.001 |
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Methemoglobin Formation Reflects Systemic Nitric Oxide Uptake: The Critical Role of Delivery Method—Results from Secondary Analysis of a Randomized Controlled Trial. J Cardiothorac Vasc Anesth. Published 17 April 2026. doi:10.
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