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Nitrogen dioxide formation during inhaled nitric oxide therapy.
G M Sokol1, K P Van Meurs, L L Wright
1Department of Pediatrics, Indiana University, Indianapolis, IN 46202, USA.gsokol@iupui.edu
Clinical Chemistry
|March 3, 1999
Summary
Nitrogen dioxide (NO2) formation during inhaled nitric oxide (NO) therapy is quantifiable. This study determined the NO2 formation rate constant, enabling safe delivery of NO in neonatal ventilation.
Area of Science:
- Medical Engineering
- Respiratory Therapy
- Toxicology
Background:
- Nitrogen dioxide (NO2) is a toxic byproduct of inhaled nitric oxide (NO) therapy.
- The precise rate of NO2 formation during NO therapy remains a subject of debate.
Purpose of the Study:
- To accurately quantify the rate of NO2 formation during NO inhalation therapy.
- To establish a reliable method for calculating NO2 levels in clinical settings.
Main Methods:
- NO2 formation was studied using dynamic flows simulating a clinical NO ventilator mixture (80 ppm NO in 90% O2).
- Tunable diode laser absorption spectroscopy was employed to overcome challenges in accurately measuring low NO2 concentrations (<2 ppm).
Main Results:
- A second-order rate constant (k) for NO2 formation was determined to be (1.19 ± 0.11) x 10^-11 ppm^-2s^-1.
- The determined rate constant aligns with established atmospheric chemistry data.
Conclusions:
- Inhaled NO can be safely administered in well-designed neonatal ventilatory circuits.
- NO2 formation can be reliably calculated using the determined rate constant and circuit dwell time, ensuring patient safety.