OBJECTIVES To test the feasibility, safety, and efficacy of intratracheal delivery of nitric oxide (NO) generated from air by pulsed electrical discharge via a Scoop catheter. STUDY DESIGN We studied healthy 3- to 4-month-old lambs weighing 34 ± 4 kg (mean ± SD, n = 6). A transtracheal Scoop catheter was inserted through a cuffed tracheostomy tube. U46619 was infused to increase mean pulmonary arterial pressure (mPAP) from 16 ± 1 to 32 ± 3 mmHg (mean ± SD). Electrically generated NO was delivered via the Scoop catheter to awake lambs. A sampling line, to monitor NO and nitrogen dioxide (NO2) levels, was placed in the distal trachea of the lambs. The effect of varying doses of electrically generated NO, produced continuously, on pulmonary hypertension was assessed. RESULTS In awake lambs with acute pulmonary hypertension, NO was continuously delivered via the Scoop catheter at 400 ml/min. NO induced pulmonary vasodilation. NO2 levels, measured in the trachea, were below 0.5 ppm at intratracheal NO doses of 10-80 ppm. No changes were detected in the levels of methemoglobin in blood samples before and after 5 min of NO breathing. CONCLUSIONS Continuously delivering electrically generated NO through a Scoop catheter produces vasodilation of the pulmonary vasculature of awake lambs with pulmonary hypertension. Transtracheal NO delivery may provide a long-term treatment for patients with chronic pulmonary hypertension as an outpatient without requiring a mask or tracheal intubation.

中文翻译：

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气管内通过脉冲放电从空气中产生的一氧化氮，用于治疗清醒的非卧床羔羊的肺动脉高压。

目的测试通过气管导管通过脉冲放电从空气中产生的一氧化氮（NO）在气管内递送的可行性，安全性和有效性。研究设计我们研究了健康的3至4个月大的羔羊，体重34±4 kg（平均±SD，n = 6）。经气管的Scoop导管通过袖口气管造口术管插入。注入U46619可将平均肺动脉压（mPAP）从16±1增加到32±3 mmHg（平均值±SD）。电产生的NO通过勺形导管输送到清醒的羔羊。在小羊的远端气管中放置了一条采样线，以监测NO和二氧化氮（NO2）的水平。评估了不断产生的不断变化的电产生NO剂量对肺动脉高压的影响。结果在急性肺动脉高压的清醒羔羊中，NO通过Scoop导管以400 ml / min的速度连续输送。NO诱导肺血管扩张。在气管内NO剂量为10-80 ppm时，气管中的NO2含量低于0.5 ppm。NO呼吸5分钟之前和之后，血样中高铁血红蛋白水平未检测到变化。结论通过勺状导管连续输送电产生的一氧化氮会导致清醒羔羊的肺血管扩张并伴有肺动脉高压。经气管NO输送可为门诊的慢性肺动脉高压患者提供长期治疗，而无需面罩或气管插管。NO呼吸5分钟之前和之后，血样中高铁血红蛋白水平未检测到变化。结论通过勺状导管连续输送电产生的一氧化氮会导致清醒羔羊的肺血管扩张并伴有肺动脉高压。经气管NO输送可为门诊的慢性肺动脉高压患者提供长期治疗，而无需面罩或气管插管。NO呼吸5分钟之前和之后，血样中高铁血红蛋白水平未检测到变化。结论通过勺状导管连续输送电产生的一氧化氮会导致清醒羔羊的肺血管扩张并伴有肺动脉高压。经气管NO输送可为门诊的慢性肺动脉高压患者提供长期治疗，而无需面罩或气管插管。