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.
Trevisanuto
Daniele
D
Pediatric Department, Neonatal Intensive Care Unit, Medical School, University of Padova, Azienda Ospedaliera di Padova, Padova, Italy. trevo@pediatria.unipd.it
Doglioni
Nicoletta
N
Micaglio
Massimo
M
Zanardo
Vincenzo
V
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