Anesthesia Center for Critical Care Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA, 02114.
Anesthesia Center for Critical Care Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA, 02114; Division of Rheumatology, Allergy and Clinical Immunology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA, 02114.
Nitric Oxide. 2020 Apr 1;97:11-15. doi: 10.1016/j.niox.2020.01.009. Epub 2020 Jan 23.
To test the feasibility, safety, and efficacy of intratracheal delivery of nitric oxide (NO) generated from air by pulsed electrical discharge via a Scoop catheter.
We studied healthy 3- to 4-month-old lambs weighing 34 ± 4 kg (mean ± SD, n = 6). A transtracheal Scoop catheter was inserted through a cuffed tracheostomy tube. U46619 was infused to increase mean pulmonary arterial pressure (mPAP) from 16 ± 1 to 32 ± 3 mmHg (mean ± SD). Electrically generated NO was delivered via the Scoop catheter to awake lambs. A sampling line, to monitor NO and nitrogen dioxide (NO) levels, was placed in the distal trachea of the lambs. The effect of varying doses of electrically generated NO, produced continuously, on pulmonary hypertension was assessed.
In awake lambs with acute pulmonary hypertension, NO was continuously delivered via the Scoop catheter at 400 ml/min. NO induced pulmonary vasodilation. NO levels, measured in the trachea, were below 0.5 ppm at intratracheal NO doses of 10-80 ppm. No changes were detected in the levels of methemoglobin in blood samples before and after 5 min of NO breathing.
Continuously delivering electrically generated NO through a Scoop catheter produces vasodilation of the pulmonary vasculature of awake lambs with pulmonary hypertension. Transtracheal NO delivery may provide a long-term treatment for patients with chronic pulmonary hypertension as an outpatient without requiring a mask or tracheal intubation.
测试通过电脉冲放电从空气中生成的一氧化氮（NO）经 Scoop 导管经气管内给药的可行性、安全性和疗效。
我们研究了 3 至 4 月龄、体重 34 ± 4kg（均值 ± 标准差，n = 6）的健康绵羊。通过带套囊的气管切开管插入经气管 Scoop 导管。U46619 输注以将平均肺动脉压（mPAP）从 16 ± 1 增加至 32 ± 3mmHg（均值 ± 标准差）。在清醒的绵羊中经 Scoop 导管输送电生成的 NO。在绵羊的远端气管中放置一条取样线，以监测 NO 和二氧化氮（NO）水平。评估持续产生的不同剂量的电生成的 NO 对肺动脉高压的影响。
在伴有急性肺动脉高压的清醒绵羊中，以 400ml/min 的速度经 Scoop 导管持续输送 NO。NO 诱导肺血管舒张。在气管内 NO 剂量为 10-80ppm 时，测量到的 NO 水平在 0.5ppm 以下。在 5min 的 NO 呼吸前后，血液样本中亚铁血红蛋白水平未发生变化。
通过 Scoop 导管持续输送电生成的 NO 可使伴有肺动脉高压的清醒绵羊的肺血管扩张。经气管 NO 输送可为慢性肺动脉高压患者提供长期治疗，作为门诊患者无需面罩或气管插管。
