Contamination of Hospital Compressed Air with Nitric Oxide

Pinsky, Michael R.; Genc, F; Lee, Kang H.; Delgado, Edgar

doi:10.1378/chest.111.6.1759

Cited by 17 publications

(9 citation statements)

References 14 publications

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“…First, the exhaled NO has been measured using different techniques producing widely different values. The main contributors to these differences are contamination either from nasopharynx production or from ambient NO levels (14,36). In our population, NO contamination from the nasopharynx was prevented by endotracheal intubation and NO contamination from compressed gas used to drive a positive-pressure ventilator was abolished by using filters that effectively scrubbed all NO from the compressed gas.…”

Section: Discussionmentioning

confidence: 88%

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Exhaled and Nasal Nitric Oxide as a Marker of Pneumonia in Ventilated Patients

Adrie

Monchi

Dinh-Xuan

et al. 2001

Am J Respir Crit Care Med

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Because inflammation stimulates the expression of inducible nitric oxide (NO) synthase (iNOS) with an associated increased local NO production, we hypothesized that patients with pneumonia would have increased excretion of NO into their airways. To test this hypothesis, NO was measured in the exhaled air and from the nasal cavities of 49 consecutively intubated and mechanically ventilated patients in our ICU. After excluding NO gas contamination in the inspiratory circuit, nasal NO and end-expiratory and mean exhaled tracheal NO levels and plasma nitrate concentrations were measured using a fast response chemiluminescence analyzer. Twenty-one patients (43%) presented with infectious pneumonia. End- expiratory exhaled NO concentrations were significantly higher in patients with pneumonia as compared with patients without pneumonia (5.9 +/- 1 ppb versus 3.2 +/- 0.5 ppb, p < 0.01). Similarly, mean nasal NO was higher in patients with pneumonia (1039 +/- 138 ppb versus 367 +/- 58 ppb, p = 0.003). Plasma nitrate levels did not differ between patient groups. Threshold values of tracheal or nasal NO were defined and subsequently validated in 60 other patients. Positive and negative values of a maximal tracheal level > 5 ppb for pneumonia were 74% and 89%, respectively. Thus tracheal and nasal NO levels may be of help in distinguishing patients with acute pneumonia from other causes. Furthermore, because these differences in airway NO levels were not paralleled in blood nitrite concentrations, we conclude that pneumonia per se is not associated with systemic NO production.

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Section: Discussionmentioning

confidence: 88%

“…* There are higher levels of nasal or tracheal NO and NO output (V NO ) in patients with pneumonia. Organ dysfunctions were defined accordingly to the definition in the Logistic Organ Dysfunction system(36). † Values are expressed as mean Ϯ SE.…”

mentioning

confidence: 99%

Exhaled and Nasal Nitric Oxide as a Marker of Pneumonia in Ventilated Patients

Adrie

Monchi

Dinh-Xuan

et al. 2001

Am J Respir Crit Care Med

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“…Furthermore, we have previously documented that inadvertent NO delivery due to contamination of hospital gas at levels parallel these ambient levels [12] and that ventilator-dependent subjects with normal lungs given inhaled NO between 2 ppb and 550 ppb demonstrate improved oxygenation [13]. Although this is an interesting observation, its clinical relevance is questionable.…”

Section: Introductionmentioning

confidence: 97%

Nitric oxide contamination of hospital compressed air improves gas exchange in patients with acute lung injury

et al. 2002

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“…The available charcoal lter did not quantitatively remove NO (18). In the results presented, the hospital air concentrations of NO have been subtracted from the exhaled NO concentrations, resulting in a mean of 29.4 § 2.6% lower concentrations than those actually recorded (19).…”

Section: Discussionmentioning

confidence: 93%