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Contamination of hospital compressed air with nitric oxide: Unwitting replacement therapy

Pinsky, MR and Genc, F and Lee, KH and Delgado, E (1997) Contamination of hospital compressed air with nitric oxide: Unwitting replacement therapy. Chest, 111 (6). 1759 - 1763. ISSN 0012-3692

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Background: Inhaled nitric oxide (NO) at levels between 5 and 80 ppm has been used experimentally to treat a variety of conditions. NO also is a common environmental air pollutant in industrial regions. As compressed hospital air is drawn from the local environment, we speculated that it may contain NO contamination, which, if present, would provide unwitting inhaled NO therapy to all subjects respiring this compressed gas. Methods: NO levels were measured twice daily from ambient hospital air and compressed gas sources driving positive pressure ventilation from two adjacent hospitals and compared with NO levels reported daily by local Environmental Protection Agency sources. An NO chemiluminescence analyzer (Sievers 270B; Boulder, Colo) sensitive to ≤2 parts per billion was used to measure NO levels in ambient air and compressed gas. Results: NO levels in ambient air and hospital compressed air covaried from day to day, and absolute levels of NO differed between hospitals with the difference never exceeding 1.4 ppm (range, 0 to 1.4 ppm; median, 0.07 ppm). The hospital with the highest usage level of compressed air had the highest levels of NO, which approximated ambient levels of NO. NO levels were lowest on weekends in both hospitals. We also documented inadvertent NO contamination in one hospital occurring over 5 days, which corresponded to welding activity near the intake port for fresh gas. This contamination resulted in systemwide NO levels of 5 to 8 ppm. Conclusion: Hospital compressed air contains highly variable levels of NO that tend to covary with ambient NO levels and to be highest when the rate of usage is high enough to preclude natural degradation of NO in 21% oxygen. Assuming that inhaled NO may alter gas exchange, pulmonary hemodynamics, and outcome from acute lung injury, the role of unwitting variable NO of hospital compressed air needs to be evaluated.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Pinsky, MRpinsky@pitt.eduPINSKY0000-0001-6166-700X
Genc, F
Lee, KH
Delgado, E
Date: 1 January 1997
Date Type: Publication
Journal or Publication Title: Chest
Volume: 111
Number: 6
Page Range: 1759 - 1763
DOI or Unique Handle: 10.1378/chest.111.6.1759
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
ISSN: 0012-3692
PubMed ID: 9187206
Date Deposited: 05 Mar 2012 20:42
Last Modified: 30 Jan 2020 16:55


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