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Clinical Chemistry 45: 382-387, 1999;
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(Clinical Chemistry. 1999;45:382-387.)
© 1999 American Association for Clinical Chemistry, Inc.

Articles

Nitrogen Dioxide Formation during Inhaled Nitric Oxide Therapy

Gregory M. Sokol1,a, Krisa P. Van Meurs2, Linda L. Wright3, Oswaldo Rivera4, William. J. Thorn, III5, Pamela M. Chu5 and Robert L. Sams5

1 Department of Pediatrics, Indiana University, Indianapolis, IN 46202.

2 Department of Pediatrics, Stanford University Medical Center, Stanford, CA 94304.

3 Neonatal Network, National Institute of Child Health and Human Development, Bethesda, MD 20892.

4 Department of Biomedical Engineering, Children's Hospital National Medical Center, Washington, DC 20010.

5 Analytical Chemistry Division, National Institute of Standards and Technology, Gaithersburg, MD 20899.

6 Identification of commercial equipment in this article is to provide as complete a description of the experimental procedures followed as possible. Such identification does not constitute a recommendation or endorsement by NIST of the vendor or equipment.
a Address correspondence to this author at: Division of Neonatal-Perinatal Medicine, Indiana University School of Medicine, 702 Barnhill Drive, Room RR-208, Indianapolis, IN 46202. Fax 317-274-2065; e-mail gsokol{at}iupui.edu

Background: Nitrogen dioxide (NO2) is a toxic by-product of inhalation therapy with nitric oxide (NO). The rate of NO2 formation during NO therapy is controversial.

Methods: The formation of NO2 was studied under dynamic flows emulating a base case NO ventilator mixture containing 80 ppm NO in a 90% oxygen matrix. The difficulty in measuring NO2 concentrations below 2 ppm accurately was overcome by the use of tunable diode laser absorption spectroscopy.

Results: Using a second-order model, the rate constant, k, for NO2 formation was determined to be (1.19 ± 0.11) x 10-11 ppm-2s-1, which is in basic agreement with evaluated data from atmospheric literature.

Conclusions: Inhaled NO can be delivered safely in a well-designed, continuous flow neonatal ventilatory circuit, and NO2 formation can be calculated reliably using the rate constant and circuit dwell time. © 1999 American Association for Clinical Chemistry




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