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Bautin A.E.

Almazov National Medical Research Center

Afanasyeva K.Yu.

Almazov National Medical Research Center

Marichev A.O.

Almazov National Medical Research Centre

Radovskiy A.M.

Almazov National Medical Research Center

Barygin E.K.

Almazov National Medical Research Center

Gusenova A.K.

Almazov National Medical Research Center

Chomakhashvili I.G.

Almazov National Medical Research Center

Badalyan N.V.

Almazov National Medical Research Center

Zhuravleva M.S.

Almazov National Medical Research Center

Pozhidaeva A.M.

Almazov National Medical Research Center

Impact of inhaled gas compound on nitric dioxide release in a model of nitric oxide inhalation therapy (experimental study)

Authors:

Bautin A.E., Afanasyeva K.Yu., Marichev A.O., Radovskiy A.M., Barygin E.K., Gusenova A.K., Chomakhashvili I.G., Badalyan N.V., Zhuravleva M.S., Pozhidaeva A.M.

More about the authors

Journal: Russian Journal of Anesthesiology and Reanimatology. 2024;(1): 23‑30

DOI: 10.17116/anaesthesiology202401123

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To cite this article:

Bautin AE, Afanasyeva KYu, Marichev AO, et al. . Impact of inhaled gas compound on nitric dioxide release in a model of nitric oxide inhalation therapy (experimental study). Russian Journal of Anesthesiology and Reanimatology. 2024;(1):23‑30. (In Russ., In Engl.)
https://doi.org/10.17116/anaesthesiology202401123

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BACKGROUND

Toxic effects of nitric dioxide (NO2) released under nitric oxide (NO) inhalation limit the application of nitric oxide high-dose therapy of clinical conditions accompanied by increased pulmonary vascular resistance.

OBJECTIVE

To identify the combinations of safe NO and O2 concentrations in inhaled gas compound for nitric dioxide release in a model of NO insufflation through the «Tianox» apparatus into respiratory circuit.

MATERIAL AND METHODS

The study was performed on an experimental model. There were 360 measurements of NO2 content in 72 various combinations of NO and O2.

RESULTS

NO2 release depended on NO and O2 content in gas mixture. Multivariate regression analysis confirmed this fact. NO2 concentration <2 ppm was recognized as a safe value. ROC-analysis confirmed predictive ability of NO and O2 regarding toxic NO2 concentrations. In case of inhalation therapy through the «Tianox» apparatus with any NO concentrations (10—80 ppm), O2 content in gas mixture within 21—30% was safe. NO concentration <50 ppm is safe at any O2 content in gas mixture (21—100%).

CONCLUSION

There is a fundamentally new source of NO in the Tianox device (synthesis from atmospheric air). We obtained data on possible safe combinations of inhaled O2 and NO regarding NO2 release for effective clinical use of this device.

Keywords:

nitric oxide
nitric dioxide
“Tianox” device
pulmonary vascular resistance
experimental stand

Authors:

Bautin A.E.

Almazov National Medical Research Center

Afanasyeva K.Yu.

Almazov National Medical Research Center

Marichev A.O.

Almazov National Medical Research Centre

Radovskiy A.M.

Almazov National Medical Research Center

Barygin E.K.

Almazov National Medical Research Center

Gusenova A.K.

Almazov National Medical Research Center

Chomakhashvili I.G.

Almazov National Medical Research Center

Badalyan N.V.

Almazov National Medical Research Center

Zhuravleva M.S.

Almazov National Medical Research Center

Pozhidaeva A.M.

Almazov National Medical Research Center

Received:

03.08.2023

Accepted:

22.09.2023

List of references:

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  2. Avdeev SN, Barbarash OL, Bautin AE, Volkov AV, Veselova TN, Galyavich AS, Goncharova NS, Gorbachevsky SV, Danilov NM, Eremenko AA, Martynyuk TV, Moiseeva OM, Saidova MA, Sergienko VB, Simakova MA, Stukalova OV, Chazova IE, Chernyavsky AM, Shalaev SV, Shmalts AA, Tsareva NA. 2020 Clinical practice guidelines for Pulmonary hypertension, including chronic thromboembolic pulmonary hypertension. Rossijskij kardiologicheskij zhurnal. 2021;26(12):198-267. (In Russ.). https://doi.org/10.15829/1560-4071-2021-4683
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  8. Lindberg L, Rydgren G. Production of nitrogen dioxide during nitric oxide therapy using the Servo Ventilator 300 during volume-controlled ventilation. Acta Anaesthesiologica Scandinavica. 1999;43(3):289-294.  https://doi.org/10.1034/j.1399-6576.1999.430308.x
  9. Buranov SN, Karelin VI, Selemir VD, Shirshin AS. Apparatus for inhalation NO-therapy. Pribory i tekhnika eksperimenta. 2019;5:158-159. (In Russ.). https://doi.org/10.1134/S0032816219040037
  10. Blasina F, Vaamonde L, Silvera F, Solla G, Abin-Carriquiry JA, Gutiérrez C, Beltramo P, Garcia-Gabay I, Martell M. Efficacy and safety of a novel nitric oxide generator for the treatment of neonatal pulmonary hypertension: Experimental and clinical studies. Pulmonary Pharmacology and Therapeutics. 2015;54:68-76.  https://doi.org/10.1016/j.pupt.2018.12.002
  11. Bautin AE, Selemir VD, Shafikova AI, Afanasyeva KYu, Kurskova ES, Etin VL, Marichev AO, Tashkhanov DM, Rubinchik VE, Kasherininov IYu, Morozov KA, Nikiforov VG, Biktasheva LZ, Akhimov PS, Buranov SN, Karelin VI, Shirshin AS, Valueva YuV, Pichugin VV. Evaluation of the clinical efficacy and safety of nitric oxide synthesized from room air in the postoperative period of cardiac surgery. Translyatsionnaya meditsina. 2021;8(1):38-50. (In Russ.). https://doi.org/10.18705/2311-4495-2021-8-1-38-50
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