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

通过高流量鼻插管 (HFNC) 输送电化学产生的吸入一氧化氮 (iNO)

基本信息

批准号：
10637303
负责人：
Gergely Lautner
金额：
$ 46.13万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-04-01 至 2027-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10637303
关键词：
Acute Respiratory Distress Syndrome Adult Air Animals Antimicrobial Effect Bacterial Infections Blood Breathing COVID-19 COVID-19 complications COVID-19 patient Cannulas Chronic Clinical Clinical Treatment Clinical Trials Coupled Custom Disease Drug Delivery Systems Ensure FDA approved Frequencies Future Gases Generations Goals High Pressure Liquid Chromatography Histopathology Hypoxemia Hypoxemic Respiratory Failure In Vitro Inductively Coupled Plasma Mass Spectrometry Inhalation Inhalation Drug Administration Inhalation Therapy Intensive Care Units Intubation Ions Local Anti-Infective Agents Lung Masks Mass Fragmentography Mechanical ventilation Medical Medicine Methemoglobin Methods Modeling Monitor Nitric Oxide Nitrites Nitrogen Dioxide Nose Oxygen Oxygenators Ozone Patients Pattern Performance Phase Pulmonary Fibrosis Pulmonary Hypertension Reaction Refractory Respiratory Disease Respiratory Tract Infections Respiratory distress Risk Safety Sedation procedure Sheep Sodium Nitrite Spectroscopy, Fourier Transform Infrared System Technology Testing Therapeutic Tidal Volume Tube Vasodilator Agents Virus Diseases acute hypoxemic respiratory failure analytical method cost cost effective endotracheal feasibility testing health care settings hemodynamics improved improved outcome in vivo Model inhaled nitric oxide lung failure new technology novel operation pharmacologic porcine model portability pre-clinical prevent prototype research clinical testing respiratory safety assessment sheep model ventilation virtual water vapor

Acute Respiratory Distress Syndrome Adult Air Animals Antimicrobial Effect Bacterial Infections Blood Breathing COVID-19 COVID-19 complications COVID-19 patient Cannulas Chronic Clinical Clinical Treatment Clinical Trials Coupled Custom Disease Drug Delivery Systems Ensure FDA approved Frequencies Future Gases Generations Goals High Pressure Liquid Chromatography Histopathology Hypoxemia Hypoxemic Respiratory Failure In Vitro Inductively Coupled Plasma Mass Spectrometry Inhalation Inhalation Drug Administration Inhalation Therapy Intensive Care Units Intubation Ions Local Anti-Infective Agents Lung Masks Mass Fragmentography Mechanical ventilation Medical Medicine Methemoglobin Methods Modeling Monitor Nitric Oxide Nitrites Nitrogen Dioxide Nose Oxygen Oxygenators Ozone Patients Pattern Performance Phase Pulmonary Fibrosis Pulmonary Hypertension Reaction Refractory Respiratory Disease Respiratory Tract Infections Respiratory distress Risk Safety Sedation procedure Sheep Sodium Nitrite Spectroscopy, Fourier Transform Infrared System Technology Testing Therapeutic Tidal Volume Tube Vasodilator Agents Virus Diseases acute hypoxemic respiratory failure analytical method cost cost effective endotracheal feasibility testing health care settings hemodynamics improved improved outcome in vivo Model inhaled nitric oxide lung failure new technology novel operation pharmacologic porcine model portability pre-clinical prevent prototype research clinical testing respiratory safety assessment sheep model ventilation virtual water vapor

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项目摘要

"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.

“通过高流量鼻套管的电化学产生的吸入一氧化氮（INO）递送（HFNC）”” 抽象的 COVID-19或其他严重呼吸道感染的患者经常出现急性低氧血症呼吸衰竭。改善这些患者的氧合对于改善预后至关重要。作为选择性肺血管扩张剂，遗传的一氧化氮（INO）已经成为密集型的主要支柱护理单位无法改善氧合作用，并且也是一种潜在的杀菌剂。交付通过非侵入性高流量鼻套管（HFNC）方法INO可能会消除对需要的需求并降低与侵入性机械通气相关的风险。我们假设否 HFNC交付的水平达到深肺（没有药物效应的地方）比通过低流量鼻套管传递的明显更大和更好的控制。然而，禁止使用当前INO技术的成本用于高流量吸入疗法。这些费用与NO的长期不稳定和常规无气的有效载荷有限有关圆柱体必须以低浓度（最高800 ppm）存储，以防止不成比例反应。我们已经开发了一种安全且具有成本效益的电化学方法来按需从稳定溶液中生成无机钠钠溶液，用于医疗应用。我们现在建议将这种新技术与HFNC交付结合起来，并证明这项新技术可安全且廉价地交付INO，以治疗相关的肺部通过鼻套管的水平。如果成功，该技术可能会改变INO的范式医疗保健环境中的治疗，可以用来更好地治疗由病毒或细菌感染，例如在Covid-19中。