About 30 years ago, there was a step-change in the treatment of patients with cardiac disease. It turned out that the state of the pulmonary circulation vessels and their effect on the function of the right ventricle play a critical role in the development of many diseases. At the end of the last century, inhaled nitric oxide, a potent vasodilator of the pulmonary vasculature, was found to be an emergency treatment for patients with high pulmonary hypertension. Today, inhaled nitric oxide is the basis for treatment of patients in critical conditions: after heart transplantation, with severe primary pulmonary hypertension, with congenital heart defects. It is also used as part of the treatment for severe respiratory failure.
In Russia, only a few enterprises produce this gas. Healthcare facilities receive it in pressurized cylinders. Such a complex logistic system significantly limits the widespread use of nitric oxide.
However, the method for bedside generation of nitric oxide from atmospheric air, recently developed by the All-Russia Research Institute of Experimental Physics, completely eliminates the logistic stage of delivering the nitric oxide, storing it and collecting the empty cylinders. Besides, this production technology contributes to patient safety.
Almazov Centre has been using the nitric oxide device as part of clinical trials since 2019.
“The operating principle of the device is an electrode discharge that generates nitric oxide from atmospheric air. During the testing, we did not see any side effects or complications associated with this technology,” said Andrey Bautin, Head of Anesthesiology and Intensive Care Research Laboratory at Almazov Centre.
Director General of Almazov Centre Evgeny Shlyakhto is convinced that after the completion of clinical trials this technology can be successfully used to treat patients with coronavirus infection.
“One of the major challenges in the treatment of patients with COVID-19 is to prevent serious complications, therefore it is necessary to apply this technique as soon as possible. We very much hope that in the near future hospitals treating coronavirus patients with severe forms of the disease will benefit from this opportunity. This will save many lives,” highlighted Evgeny Shlyakhto.
The advantages of this method over the use of cylinder technology are obvious. Firstly, the device generates from atmospheric air the entire range of therapeutic gas concentrations that patients need. Secondly, unlike similar supply of nitric oxide from cylinders, the device is safer as it has the ability to automatically filter nitrogen dioxide (side effect of inhalation). And finally, thanks to the automatic shut-off option, the possibility of excess concentration of nitric oxide in the patient's airways is virtually non-existent.