Feasibility of nitric oxide administration by neonatal helmet-CPAP: a bench study.
BACKGROUND
Inhaled nitric oxide (NO) may have a role in the treatment of preterm infants with respiratory failure. We evaluated the feasibility of administering NO therapy by a new continuous positive airway pressure (CPAP) system (neonatal helmet-CPAP).


METHODS
While maintaining a constant total flow of 8, 10, and 12 l.min(-1), NO concentrations were progressively increased to 5, 10, 20, and 40 p.p.m. in the neonatal helmet-CPAP pressure chamber (5 cmH2O). NO, NO2, and O2 concentrations were measured in the pressure chamber and the immediate external environment.


RESULTS
In the chamber, NO2 levels remained low (<or=0.8 p.p.m.) at inhaled therapeutic NO concentrations (5, 10, 20, and 40 p.p.m.). The lower O2 concentrations were 95% at 40 p.p.m. NO levels. Leakage of NO and NO2 to the surrounding environment was negligible.


CONCLUSIONS
NO administration is safe and feasible using the neonatal helmet-CPAP system. This method allows the delivery of accurate NO levels and high O2 concentrations avoiding NO2 accumulation. Further experimental and clinical studies are needed.
Pediatric Department, Neonatal Intensive Care Unit, Medical School, University of Padova, Azienda Ospedaliera di Padova, Padova, Italy. trevo@pediatria.unipd.it
Daniele
D
Trevisanuto
Nicoletta
N
Doglioni
Massimo
M
Micaglio
Vincenzo
V
Zanardo
D000280:Administration, Inhalation; D001993:Bronchodilator Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D045422:Continuous Positive Airway Pressure; D005240:Feasibility Studies; D006801:Humans; D007231:Infant, Newborn; D009569:Nitric Oxide / Q000008:administration & dosage* / Q000032:analysis / Q000627:therapeutic use*; D010100:Oxygen / Q000032:analysis; D010102:Oxygen Inhalation Therapy / Q000295:instrumentation / Q000379:methods; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy* / Q000503:physiopathology; D013696:Temperature
D001993:Bronchodilator Agents; D009569:Nitric Oxide; D010100:Oxygen