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Laboratory and Animal InvestigationsDelivery of Inhaled Nitric Oxide Using the Ohmeda INOvent Delivery System
Section snippets
Lung Model
The experimental set-up was used as previously described1 and is shown in Figure 1. A two-chamber lung model (Training Test Lung model 1600; Michigan Instruments; Grand Rapids, Mich) was configured to separate inspired and expired gases. A valve system ensured that the ventilator inflated one chamber during inspiration, while the second chamber was lifted and aspirated room air. At expiration, the NO-containing inspiratory gas was released to atmosphere, and the room air from the second chamber
RESULTS
No differences in the NO delivery patterns were observed between the two delivery systems with the Puritan-Bennett 7200 and Servo 900C. The NO waveform always demonstrated a nearly constant concentration regardless of inspiratory flow pattern. Simulating spontaneous breathing resulted in irregular inspiratory flow patterns without any change in NO delivery pattern. Sample tracings obtained during use of the INOvent and the Puritan-Bennett 7200 are shown in Figure 2. To demonstrate the
DISCUSSION
The INOvent Delivery System reliably delivered NO over a wide range of NO concentrations and ventilator settings. This system provided a constant NO dose regardless of the ventilatory pattern. Premixing NO proximal to the ventilator also resulted in a constant NO delivery, but produced an error as great as 20%, compared with the 11% error observed with the INOvent. When NO was premixed with N2, NO2 formation was low for both systems.
CONCLUSION
The INOvent Delivery System provides an accurate and stable NO concentration. The NO2 production was low, even at high FIo2.
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Pulmonary Hypertension
2022, Cardiology ClinicsNitric oxide and viral infection: Recent developments in antiviral therapies and platforms
2021, Applied Materials TodayCitation Excerpt :Because NO is a key gasotransmitter in homeostasis, the administration route and pharmacokinetics are critical parameters for optimizing therapeutic systems to minimize off-target effects. Gaseous NO therapies are often associated with mechanical ventilation via endotracheal intubation with proprietary gas formulations, such as INOmaxTM, paired with injection systems that have been validated in lung models with external chemiluminescence-based readouts [135]. Since the past thirty years of preclinical and clinical research have focused on using gNO for improving pulmonary vasodilation and oxygenation in ARDS and neonatal hyperplasia, direct dose-response correlations with gNO for preclinical antiviral therapies have yet to be shown [91,105,136].
Nitrogen dioxide reducing ascorbic acid technologies in the ventilator circuit leads to uniform NO concentration during inspiration
2016, Nitric Oxide - Biology and ChemistryCitation Excerpt :Others have proposed using one of several formulations of soda lime in absorbers that could both provide for gas mixing while simultaneously removing NO2, however, these sequester some NO as well [7,17–19]. With the goal of minimizing NO2 inhalation, complex systems were developed to synchronize the injection of NO with inspiration [20,21]. Using a chemiluminescence detector, Imanaka and colleagues demonstrated that constant NO inhalation could be achieved by delivering NO upstream of the ventilator or by timing the injection of NO into the ventilator circuit [4].
Inhaled Nitric Oxide and Inhaled Prostacyclin in Acute Respiratory Distress Syndrome: What is the Evidence?
2011, Critical Care ClinicsCitation Excerpt :This fact added to the scientist’s inability to determine the exact dose of iNO given in research studies has always troubled iNO trials.53 Delivery methods have changed dramatically and eventually the INOvent trademark (INO Therapeutics LLC) was proved a reliable method of delivery.54 It delivers a constant preset amount of iNO with different modes of ventilation.
Use of ultra pure nitric oxide generated by the reduction of nitrogen dioxide to reverse pulmonary hypertension in hypoxemic swine
2011, Nitric Oxide - Biology and ChemistryA prospective, randomized, crossover pilot study of inhaled nitric oxide versus inhaled prostacyclin in heart transplant and lung transplant recipients
2009, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :Inhaled PGI2 offers several advantages over NO that include a relative lack of toxicity and ease of delivery. NO requires specialized delivery systems and has known toxicities, such as methemoglobinemia, which limit the utility of the agent.10,18 However, toxicity caused by methemoglobinemia was not seen in this study.
Supported in part by Ohmeda, Inc., maker of the INOvent Delivery System. Dr. Kirmse was supported in part by a grant from the Deutsche Forschungsgemeinschaft (Ki582/1-1).
Reprint requests: Dean Hess, PhD, RRT, FCCP, Respiratory Care, Ellison 401, Massachusetts General Hospital, Boston, MA 02114