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http://stm.sciencemag.org/content/7/294/294ra107?utm_campaign=email-stm-toc&utm_src=email
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Abstract
Inhalation
of nitric oxide (NO) produces selective pulmonary vasodilation and is
an effective therapy for treating pulmonary hypertension in adults and
children. In the United States, the average cost of 5 days of inhaled NO
for persistent pulmonary hypertension of the newborn is about $14,000.
NO therapy involves gas cylinders and distribution, a complex delivery
device, gas monitoring and calibration equipment, and a trained
respiratory therapy staff. The objective of this study was to develop a
lightweight, portable device to serve as a simple and economical method
of producing pure NO from air for bedside or portable use. Two NO
generators were designed and tested: an offline NO generator and an
inline NO generator placed directly within the inspiratory line. Both
generators use pulsed electrical discharges to produce therapeutic range
NO (5 to 80 parts per million) at gas flow rates of 0.5 to 5
liters/min. NO was produced from air, as well as gas mixtures containing
up to 90% O2 and 10% N2. Potentially toxic gases produced in the plasma, including nitrogen dioxide (NO2) and ozone (O3), were removed using a calcium hydroxide scavenger. An iridium spark electrode produced the lowest ratio of NO2/NO.
In lambs with acute pulmonary hypertension, breathing electrically
generated NO produced pulmonary vasodilation and reduced pulmonary
arterial pressure and pulmonary vascular resistance index. In
conclusion, electrical plasma NO generation produces therapeutic levels
of NO from air. After scavenging to remove NO2 and O3
and filtration to remove particles, electrically produced NO can
provide safe and effective treatment of pulmonary hypertension.
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