Gianni Stefano, Carroll Ryan W, Kacmarek Robert M, Berra Lorenzo
Department of Anaesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts.
Harvard Medical School, Boston, Massachusetts.
Respir Care. 2021 Jun;66(6):1021-1028. doi: 10.4187/respcare.08856.
Nitric oxide (NO) is a biologically active molecule approved for the treatment of pulmonary hypertension in newborn patients. Commercially available NO delivery systems use pressurized cylinders as the source of NO and a sensor to control the concentrations of NO and nitrogen dioxide (NO) delivered. Cylinder-based delivery systems are safe and widely used around the world, but they are bulky, expensive, and reliant on a robust supply chain. In the past few years, novel NO generators and delivery systems have been developed to overcome these limitations. Electric NO generators produce NO from ambient air using high-voltage electrical discharge to ionize air, which leads to the formation of NO, NO, and ozone (O). A scavenging system is incorporated to reduce the concentration of the toxic byproducts generated in this type of system. NO can also be generated by the reduction of NO by ascorbic acid or released from liquid solutions or solid nanoparticles. The development of easy-to-use, safe, and portable NO delivery systems may enable the delivery of NO in the out-patient setting or at home. Furthermore, non-cylinder-based NO generators reduce the cost of NO production and storage and may therefore make NO delivery feasible in low-resource settings. Here we review commercially available systems that can generate and administer inhalable NO.
一氧化氮（NO）是一种被批准用于治疗新生儿肺动脉高压的生物活性分子。市售的一氧化氮输送系统使用加压气瓶作为一氧化氮的来源，并使用传感器来控制所输送的一氧化氮和二氧化氮（NO₂）的浓度。基于气瓶的输送系统安全且在全球广泛使用，但它们体积庞大、价格昂贵且依赖强大的供应链。在过去几年中，已开发出新型一氧化氮发生器和输送系统以克服这些局限性。电动一氧化氮发生器利用高压放电使空气电离，从环境空气中产生一氧化氮，这会导致一氧化氮、二氧化氮和臭氧（O₃）的形成。该系统配备了一个清除系统以降低此类系统中产生的有毒副产物的浓度。一氧化氮也可通过抗坏血酸还原一氧化氮₂产生，或从液体溶液或固体纳米颗粒中释放出来。开发易于使用、安全且便携的一氧化氮输送系统可能使在门诊环境或家中输送一氧化氮成为可能。此外，基于非气瓶的一氧化氮发生器降低了一氧化氮生产和储存的成本，因此可能使在资源匮乏地区输送一氧化氮变得可行。在此，我们综述了可产生并施用可吸入一氧化氮的市售系统。
