Nitric oxide delivery using nitric oxide-containing fluid in continuous hemofiltration: an in vitro study

Area of Science:

• Biomedical Engineering
• Nephrology
• Cardiovascular Research

Background:

• Nitrite administration offers therapeutic benefits for ischemic conditions by influencing nitric oxide (NO) production.
• Oxygen-dependent enzymatic pathways are crucial for endogenous NO synthesis.
• Maintaining adequate NO levels is vital for vascular function during critical illnesses.

Purpose of the Study:

• To develop and evaluate a novel supplemental fluid containing nitric oxide (NO) for use in continuous hemofiltration.
• To determine the NO clearance and supply characteristics in pre- and post-dilution hemofiltration modes.
• To assess the biocompatibility of an NO-containing supplemental fluid during continuous renal replacement therapy.

Main Methods:

• Nitric oxide gas was injected into conventional supplemental fluid to create an experimental solution.
• Control solutions contained nitrogen gas.
• In vitro continuous hemofiltration (pre- and post-dilution) was performed using both solutions.
• NO concentrations were measured using an assay kit.
• Ex vivo biocompatibility assessments included blood cell counts and membrane water flux using bovine blood.

Main Results:

• Experimental solutions demonstrated significantly increased nitric oxide concentrations compared to control.
• NO clearance correlated with supplemental and ultrafiltration flow rates.
• NO supply from the experimental fluid mirrored NO clearance trends.
• The NO-containing supplemental fluid maintained intravascular NO without altering biocompatibility markers.

Conclusions:

• A supplemental fluid containing nitric oxide can be effectively utilized in continuous hemofiltration.
• This NO-supplemented fluid successfully maintains intravascular nitric oxide levels during therapy.
• The developed NO-containing fluid exhibits favorable biocompatibility, making it suitable for clinical application in renal replacement therapy.