Nitrogen Dioxide Formation during Inhaled Nitric Oxide Therapy

Author:

Sokol Gregory M1,Van Meurs Krisa P2,Wright Linda L3,Rivera Oswaldo4,Thorn William J5,Chu Pamela M5,Sams Robert L5

Affiliation:

1. Department of Pediatrics, Indiana University, Indianapolis, IN 46202

2. Department of Pediatrics, Stanford University Medical Center, Stanford, CA 94304

3. Neonatal Network, National Institute of Child Health and Human Development, Bethesda, MD 20892

4. Department of Biomedical Engineering, Children’s Hospital National Medical Center, Washington, DC 20010

5. Analytical Chemistry Division, National Institute of Standards and Technology, Gaithersburg, MD 20899

Abstract

Abstract Background: Nitrogen dioxide (NO2) is a toxic by-product of inhalation therapy with nitric oxide (NO). The rate of NO2 formation during NO therapy is controversial. Methods: The formation of NO2 was studied under dynamic flows emulating a base case NO ventilator mixture containing 80 ppm NO in a 90% oxygen matrix. The difficulty in measuring NO2 concentrations below 2 ppm accurately was overcome by the use of tunable diode laser absorption spectroscopy. Results: Using a second-order model, the rate constant, k, for NO2 formation was determined to be (1.19 ± 0.11) × 10−11 ppm−2s−1, which is in basic agreement with evaluated data from atmospheric literature. Conclusions: Inhaled NO can be delivered safely in a well-designed, continuous flow neonatal ventilatory circuit, and NO2 formation can be calculated reliably using the rate constant and circuit dwell time.

Publisher

Oxford University Press (OUP)

Subject

Biochemistry, medical,Clinical Biochemistry

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