Effect of nicardipine on pulmonary hypertension after repair of congenital heart defects in early postoperative period.

We examined the effect of nicardipine and hyperventilatin on pulmonary arterial pressure (PAP) in four patients with pulmonary hypertension in congenital heart defect especially in the early postoperative period. There was a significant positive correlation between the values of arterial carbon dioxide tension (PaCO2) and the ratio of mean PAP to mean systemic arterial pressure (Pp/Ps) in two patients whose Heath Edwards classification was Grade II; one of them also had 20% reduction of mean PAP by nicardipine without changing mean arterial pressure. In the remaining two patients showing no correlation between the values of PaCO2 and Pp/Ps, nicardipine did not reduce PAP. Although nicardipine reduced PAP without changing systemic arterial pressure in only one out of four patients, these results suggest that nicardipine may be a drug for control of PAP during weaning phase from the ventilator especially in patients whose PAP decreases under hyperventilation.