Unintended inhalation of nitric oxide by contamination of compressed air: Physiologic effects and interference with intended nitric oxide inhalation in acute lung injury
Compressed air from a hospital's central gas supply may contain nitric oxide as a result of air pollution. Inhaled nitric oxide may increase arterial oxygen tension and decrease pulmonary vascular resistance in patients with acute lung injury and acute respiratory distress syndrome. Therefore,...
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| Veröffentlicht in: | Anesthesiology (Philadelphia) 1999-10, Vol.91 (4), p.945-950 |
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| creator | BENZING, A LOOP, T MOLS, T. G GEIGER, K |
| description | Compressed air from a hospital's central gas supply may contain nitric oxide as a result of air pollution. Inhaled nitric oxide may increase arterial oxygen tension and decrease pulmonary vascular resistance in patients with acute lung injury and acute respiratory distress syndrome. Therefore, the authors wanted to determine whether unintentional nitric oxide inhalation by contamination of compressed air influences arterial oxygen tension and pulmonary vascular resistance and interferes with the therapeutic use of nitric oxide.
Nitric oxide concentrations in the compressed air of a university hospital were measured continuously by chemiluminescence during two periods (4 and 2 weeks). The effects of unintended nitric oxide inhalation on arterial oxygen tension (n = 15) and on pulmonary vascular resistance (n = 9) were measured in patients with acute lung injury and acute respiratory distress syndrome by changing the source of compressed air of the ventilator from the hospital's central gas supply to a nitric oxide-free gas tank containing compressed air. In five of these patients, the effects of an additional inhalation of 5 ppm nitric oxide were evaluated.
During working days, compressed air of the hospital's central gas supply contained clinically effective nitric oxide concentrations (> 80 parts per billion) during 40% of the time. Change to gas tank-supplied nitric oxide-free compressed air decreased the arterial oxygen tension by 10% and increased pulmonary vascular resistance by 13%. The addition of 5 ppm nitric oxide had a minimal effect on arterial oxygen tension and pulmonary vascular resistance when added to hospital-supplied compressed air but improved both when added to tank-supplied compressed air.
Unintended inhalation of nitric oxide increases arterial oxygen tension and decreases pulmonary vascular resistance in patients with acute lung injury and acute respiratory distress syndrome. The unintended nitric oxide inhalation interferes with the therapeutic use of nitric oxide. |
| doi_str_mv | 10.1097/00000542-199910000-00013 |
| format | Article |
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Nitric oxide concentrations in the compressed air of a university hospital were measured continuously by chemiluminescence during two periods (4 and 2 weeks). The effects of unintended nitric oxide inhalation on arterial oxygen tension (n = 15) and on pulmonary vascular resistance (n = 9) were measured in patients with acute lung injury and acute respiratory distress syndrome by changing the source of compressed air of the ventilator from the hospital's central gas supply to a nitric oxide-free gas tank containing compressed air. In five of these patients, the effects of an additional inhalation of 5 ppm nitric oxide were evaluated.
During working days, compressed air of the hospital's central gas supply contained clinically effective nitric oxide concentrations (> 80 parts per billion) during 40% of the time. Change to gas tank-supplied nitric oxide-free compressed air decreased the arterial oxygen tension by 10% and increased pulmonary vascular resistance by 13%. The addition of 5 ppm nitric oxide had a minimal effect on arterial oxygen tension and pulmonary vascular resistance when added to hospital-supplied compressed air but improved both when added to tank-supplied compressed air.
Unintended inhalation of nitric oxide increases arterial oxygen tension and decreases pulmonary vascular resistance in patients with acute lung injury and acute respiratory distress syndrome. The unintended nitric oxide inhalation interferes with the therapeutic use of nitric oxide.</description><identifier>ISSN: 0003-3022</identifier><identifier>EISSN: 1528-1175</identifier><identifier>DOI: 10.1097/00000542-199910000-00013</identifier><identifier>PMID: 10519496</identifier><identifier>CODEN: ANESAV</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott</publisher><subject>Administration, Inhalation ; Adult ; Aged ; Aged, 80 and over ; Air - analysis ; Air Pollutants - adverse effects ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Cardiovascular system ; Emergency and intensive respiratory care ; Female ; Humans ; Intensive care medicine ; Male ; Medical sciences ; Middle Aged ; Nitric Oxide - administration & dosage ; Nitric Oxide - adverse effects ; Nitric Oxide - therapeutic use ; Nitrogen Dioxide - adverse effects ; Pharmacology. Drug treatments ; Pulmonary Gas Exchange - drug effects ; Respiratory Distress Syndrome, Adult - blood ; Respiratory Distress Syndrome, Adult - physiopathology ; Respiratory Distress Syndrome, Adult - therapy ; Vascular Resistance - drug effects ; Vasodilator agents. Cerebral vasodilators</subject><ispartof>Anesthesiology (Philadelphia), 1999-10, Vol.91 (4), p.945-950</ispartof><rights>1999 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1969815$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10519496$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>BENZING, A</creatorcontrib><creatorcontrib>LOOP, T</creatorcontrib><creatorcontrib>MOLS, T. G</creatorcontrib><creatorcontrib>GEIGER, K</creatorcontrib><title>Unintended inhalation of nitric oxide by contamination of compressed air: Physiologic effects and interference with intended nitric oxide inhalation in acute lung injury</title><title>Anesthesiology (Philadelphia)</title><addtitle>Anesthesiology</addtitle><description>Compressed air from a hospital's central gas supply may contain nitric oxide as a result of air pollution. Inhaled nitric oxide may increase arterial oxygen tension and decrease pulmonary vascular resistance in patients with acute lung injury and acute respiratory distress syndrome. Therefore, the authors wanted to determine whether unintentional nitric oxide inhalation by contamination of compressed air influences arterial oxygen tension and pulmonary vascular resistance and interferes with the therapeutic use of nitric oxide.
Nitric oxide concentrations in the compressed air of a university hospital were measured continuously by chemiluminescence during two periods (4 and 2 weeks). The effects of unintended nitric oxide inhalation on arterial oxygen tension (n = 15) and on pulmonary vascular resistance (n = 9) were measured in patients with acute lung injury and acute respiratory distress syndrome by changing the source of compressed air of the ventilator from the hospital's central gas supply to a nitric oxide-free gas tank containing compressed air. In five of these patients, the effects of an additional inhalation of 5 ppm nitric oxide were evaluated.
During working days, compressed air of the hospital's central gas supply contained clinically effective nitric oxide concentrations (> 80 parts per billion) during 40% of the time. Change to gas tank-supplied nitric oxide-free compressed air decreased the arterial oxygen tension by 10% and increased pulmonary vascular resistance by 13%. The addition of 5 ppm nitric oxide had a minimal effect on arterial oxygen tension and pulmonary vascular resistance when added to hospital-supplied compressed air but improved both when added to tank-supplied compressed air.
Unintended inhalation of nitric oxide increases arterial oxygen tension and decreases pulmonary vascular resistance in patients with acute lung injury and acute respiratory distress syndrome. The unintended nitric oxide inhalation interferes with the therapeutic use of nitric oxide.</description><subject>Administration, Inhalation</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Air - analysis</subject><subject>Air Pollutants - adverse effects</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Cardiovascular system</subject><subject>Emergency and intensive respiratory care</subject><subject>Female</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nitric Oxide - administration & dosage</subject><subject>Nitric Oxide - adverse effects</subject><subject>Nitric Oxide - therapeutic use</subject><subject>Nitrogen Dioxide - adverse effects</subject><subject>Pharmacology. Drug treatments</subject><subject>Pulmonary Gas Exchange - drug effects</subject><subject>Respiratory Distress Syndrome, Adult - blood</subject><subject>Respiratory Distress Syndrome, Adult - physiopathology</subject><subject>Respiratory Distress Syndrome, Adult - therapy</subject><subject>Vascular Resistance - drug effects</subject><subject>Vasodilator agents. 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G</creator><creator>GEIGER, K</creator><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>19991001</creationdate><title>Unintended inhalation of nitric oxide by contamination of compressed air: Physiologic effects and interference with intended nitric oxide inhalation in acute lung injury</title><author>BENZING, A ; LOOP, T ; MOLS, T. G ; GEIGER, K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c285t-1fc5acd875dabefae65153edb37af522ecb55a3dd3e8a0538964ac20b5234c1b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Administration, Inhalation</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Air - analysis</topic><topic>Air Pollutants - adverse effects</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Cardiovascular system</topic><topic>Emergency and intensive respiratory care</topic><topic>Female</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nitric Oxide - administration & dosage</topic><topic>Nitric Oxide - adverse effects</topic><topic>Nitric Oxide - therapeutic use</topic><topic>Nitrogen Dioxide - adverse effects</topic><topic>Pharmacology. Drug treatments</topic><topic>Pulmonary Gas Exchange - drug effects</topic><topic>Respiratory Distress Syndrome, Adult - blood</topic><topic>Respiratory Distress Syndrome, Adult - physiopathology</topic><topic>Respiratory Distress Syndrome, Adult - therapy</topic><topic>Vascular Resistance - drug effects</topic><topic>Vasodilator agents. Cerebral vasodilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>BENZING, A</creatorcontrib><creatorcontrib>LOOP, T</creatorcontrib><creatorcontrib>MOLS, T. G</creatorcontrib><creatorcontrib>GEIGER, K</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Anesthesiology (Philadelphia)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>BENZING, A</au><au>LOOP, T</au><au>MOLS, T. G</au><au>GEIGER, K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Unintended inhalation of nitric oxide by contamination of compressed air: Physiologic effects and interference with intended nitric oxide inhalation in acute lung injury</atitle><jtitle>Anesthesiology (Philadelphia)</jtitle><addtitle>Anesthesiology</addtitle><date>1999-10-01</date><risdate>1999</risdate><volume>91</volume><issue>4</issue><spage>945</spage><epage>950</epage><pages>945-950</pages><issn>0003-3022</issn><eissn>1528-1175</eissn><coden>ANESAV</coden><abstract>Compressed air from a hospital's central gas supply may contain nitric oxide as a result of air pollution. Inhaled nitric oxide may increase arterial oxygen tension and decrease pulmonary vascular resistance in patients with acute lung injury and acute respiratory distress syndrome. Therefore, the authors wanted to determine whether unintentional nitric oxide inhalation by contamination of compressed air influences arterial oxygen tension and pulmonary vascular resistance and interferes with the therapeutic use of nitric oxide.
Nitric oxide concentrations in the compressed air of a university hospital were measured continuously by chemiluminescence during two periods (4 and 2 weeks). The effects of unintended nitric oxide inhalation on arterial oxygen tension (n = 15) and on pulmonary vascular resistance (n = 9) were measured in patients with acute lung injury and acute respiratory distress syndrome by changing the source of compressed air of the ventilator from the hospital's central gas supply to a nitric oxide-free gas tank containing compressed air. In five of these patients, the effects of an additional inhalation of 5 ppm nitric oxide were evaluated.
During working days, compressed air of the hospital's central gas supply contained clinically effective nitric oxide concentrations (> 80 parts per billion) during 40% of the time. Change to gas tank-supplied nitric oxide-free compressed air decreased the arterial oxygen tension by 10% and increased pulmonary vascular resistance by 13%. The addition of 5 ppm nitric oxide had a minimal effect on arterial oxygen tension and pulmonary vascular resistance when added to hospital-supplied compressed air but improved both when added to tank-supplied compressed air.
Unintended inhalation of nitric oxide increases arterial oxygen tension and decreases pulmonary vascular resistance in patients with acute lung injury and acute respiratory distress syndrome. The unintended nitric oxide inhalation interferes with the therapeutic use of nitric oxide.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott</pub><pmid>10519496</pmid><doi>10.1097/00000542-199910000-00013</doi><tpages>6</tpages></addata></record> |
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| source | MEDLINE; Journals@Ovid Complete; EZB-FREE-00999 freely available EZB journals |
| subjects | Administration, Inhalation Adult Aged Aged, 80 and over Air - analysis Air Pollutants - adverse effects Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Cardiovascular system Emergency and intensive respiratory care Female Humans Intensive care medicine Male Medical sciences Middle Aged Nitric Oxide - administration & dosage Nitric Oxide - adverse effects Nitric Oxide - therapeutic use Nitrogen Dioxide - adverse effects Pharmacology. Drug treatments Pulmonary Gas Exchange - drug effects Respiratory Distress Syndrome, Adult - blood Respiratory Distress Syndrome, Adult - physiopathology Respiratory Distress Syndrome, Adult - therapy Vascular Resistance - drug effects Vasodilator agents. Cerebral vasodilators |
| title | Unintended inhalation of nitric oxide by contamination of compressed air: Physiologic effects and interference with intended nitric oxide inhalation in acute lung injury |
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