Electrochemically Generated Inhaled Nitric Oxide (iNO) delivery via High Flow Nasal Cannula (HFNC)

“电化学产生的吸入一氧化氮(INO)经高流量鼻管输送 (HFNC)“ 摘要 新冠肺炎或其他严重呼吸道感染的患者通常会发生急性低氧血症 呼吸衰竭。改善这些患者的氧合是改善预后的关键。作为一名 选择性肺血管扩张剂、吸入一氧化氮(INO)已成为强化治疗的中流砥柱 用于治疗肺衰竭的护理单元，可改善氧合，也是一种非常有效的防腐剂。正在交付 通过非侵入性高流量鼻插管(HFNC)的INO方法可以潜在地消除对， 并降低与侵入性机械通风相关的风险。我们假设没有 随着HFNC到达肺深部的水平--在那里NO具有药理作用--将 与低流量鼻腔插管给药相比，效果更好，效果更好。然而， 目前iNO技术的成本高得令人望而却步，无法用于高流量吸入疗法。这些成本 与NO的长期不稳定和常规NO气体的有限有效载荷有关 必须在低浓度(高达800ppm)下储存NO以防止不成比例的钢瓶 反应。我们已经开发了一种安全且非常经济高效的按需电化学方法 从医用无机亚硝酸钠稳定溶液中生成纯NO。我们 现在建议将这项新技术与HFNC交付相结合，并论证了 这项新技术安全、廉价地将iNO输送到肺部，具有治疗意义 通过鼻腔插管的药物浓度。如果成功，这项技术可能会改变iNO的范式 在医疗保健环境中的治疗，并可用于更好地治疗由病毒或 细菌感染，如新冠肺炎。

"Electrochemically Generated Inhaled Nitric Oxide (iNO) Delivery via High Flow Nasal Cannula (HFNC)” Abstract Patients with COVID-19 or other severe respiratory tract infections often develop acute hypoxemic respiratory failure. Improving the oxygenation of these patients is critical for improving outcome. As a selective pulmonary vasodilator, inhaled nitric oxide (iNO) has already become a mainstay of intensive care units for lung failure to improve oxygenation and it is also a very potent antiseptic agent. Delivering iNO via a noninvasive high flow nasal cannula (HFNC) method can potentially obviate the need for, and reduce the risks associated with, invasive mechanical ventilation. We hypothesize that the NO levels delivered with HFNC reaching the deep lung - where NO has its pharmacological effect - would be significantly greater and better controlled than NO delivered via low flow nasal cannula. However, the costs of current iNO technologies are prohibitive for use in high flow inhalation therapy. These costs are associated with the long-term instability of NO and the limited payload of conventional NO gas cylinders in which NO must be stored at low concentrations (up to 800 ppm) to prevent disproportion reactions. We have developed a safe and very cost-effective electrochemical method for on-demand generation of pure NO from stable solutions of inorganic sodium nitrite for medical applications. We now propose to combine this novel technology with HFNC delivery and demonstrate the feasibility of this new technology for safe and inexpensive delivery of iNO to the lungs at therapeutically relevant levels via a nasal cannula. If successful, this technology can potentially shift the paradigm of iNO therapy in healthcare settings and could be used to better treat respiratory distress caused by viral or bacterial infections, such as in COVID-19.