Inhaled Nitric Oxide Delivery Systems for Mechanically Ventilated and Nonintubated Patients: A Review

Area of Science:

• Biomedical Engineering
• Respiratory Medicine
• Medical Device Technology

Background:

• Nitric oxide (NO) is crucial for treating newborn pulmonary hypertension.
• Current cylinder-based NO delivery systems are bulky, costly, and require extensive supply chains.
• Limitations of existing systems hinder accessibility, particularly in outpatient or low-resource settings.

Purpose of the Study:

• To review and analyze commercially available, non-cylinder-based nitric oxide (NO) generation and delivery systems.
• To explore innovations addressing the limitations of traditional NO therapy delivery.
• To assess the potential of novel systems for broader NO accessibility.

Main Methods:

• Review of electric NO generators utilizing high-voltage discharge.
• Analysis of systems employing NO generation via NO2 reduction with ascorbic acid.
• Examination of NO release from liquid solutions and solid nanoparticles.
• Evaluation of integrated scavenging systems for byproduct reduction (NO2, O3).

Main Results:

• Development of novel NO generators offers alternatives to pressurized cylinders.
• Electric generators produce NO from ambient air, requiring byproduct scavenging.
• Alternative methods include NO2 reduction and release from various matrices.
• Emerging systems are designed for portability, ease of use, and reduced cost.

Conclusions:

• Portable and cost-effective NO delivery systems are emerging.
• These innovations can facilitate NO administration in outpatient and home settings.
• Non-cylinder-based generators promise wider feasibility, especially in resource-limited environments.