Methods of administering high concentrations of nitric oxide
View Patent ↗Methods of administering therapeutic gases containing high concentrations of nitric oxide, particularly concentrations above 2,000 ppm. The therapeutic gas may be administered at a certain dosing rate, such as less than 166 micrograms of nitric oxide per second. Also, methods of administering a therapeutic gas containing nitric oxide to a patient, wherein a dose of nitric oxide is administered from a portable device that includes a delivery system and a mini-cylinder. Methods can also include intermittent administration of nitric oxide pulses.
1. A method of treating pulmonary hypertension, the method comprising:
administering a plurality of pulses of therapeutic gas comprising nitric oxide (NO) to a patient in need thereof for a treatment time of at least 72 hours, wherein at least one pulse:
i. comprises a NO delivery concentration of greater than or equal to 4,600 ppm NO,
ii. is administered at a dosing rate of less than or equal to 83 μg NO per second,
iii. is administered at a therapeutic gas flow rate of less than or equal to 0.8 L/min,
iv. has a pulse volume of less than or equal to 1 mL, and
v. comprises less than 420 nmol of NO; and
diluting the pulses of therapeutic gas in the patient's trachea and/or lungs to an alveolar concentration less than the delivery concentration.
2. The method of claim 1 , wherein the delivery concentration is in a range from 4,600 ppm NO to 30,000 ppm NO.
3. The method of claim 1 , wherein the therapeutic gas is administered to the patient every breath.
4. The method of claim 1 , wherein the therapeutic gas is administered to the patient intermittently.
5. The method of claim 1 , wherein the pulmonary hypertension is pulmonary arterial hypertension (PAH).
6. The method of claim 1 , wherein the pulmonary hypertension is assosiated with chronic obstructive pulmonary disease (COPD).
7. The method of claim 1 , wherein the administration of the therapeutic gas provides less nasal irritation than administration of the therapeutic gas with a dosing rate above 83 μg NO per second and/or with more than 420 nmol NO per breath.
8. The method of claim 1 , wherein the plurality of pulses are administered to the patient at a dose in a range from 0.001 to 0.5 mg NO/kg/hr.
9. A method of reducing nasal irritation during nitric oxide administration, the method comprising:
administering a plurality of pulses of therapeutic gas comprising nitric oxide (NO) to a patient in need thereof for a treatment time of at least 72 hours, wherein at least one pulse:
i. comprises a NO delivery concentration of greater than or equal to 4,600 ppm NO,
ii. is administered at a dosing rate of less than or equal to 83 μg NO per second,
iii. is administered at a therapeutic gas flow rate of less than or equal to 0.8 L/min,
iv. has a pulse volume of less than or equal to 1 mL, and
v. comprises less than 420 nmol of NO; and
diluting the pulses of therapeutic gas in the patient's trachea and/or lungs to an alveolar concentration less than the delivery concentration.
10. The method of claim 9 , wherein the delivery concentration is in a range from 4,600 ppm NO to 30,000 ppm NO.
11. A method of delivering nitric oxide to a patient, the method comprising:
providing a therapeutic gas source comprising therapeutic gas having a nitric oxide (NO) concentration greater than or equal to 4,600 ppm NO;
introducing the therapeutic gas into a patient delivery tube having a control valve;
opening the control valve to provide a pulse of therapeutic gas;
delivering the pulse of therapeutic gas to the patient via a nasal cannula or breathing mask; and
diluting the pulse of therapeutic gas in the patient's trachea and/or lungs, wherein the pulse of therapeutic gas:
i. comprises a NO delivery concentration of greater than or equal to 4,600 ppm NO,
ii. is delivered at a dosing rate of less than or equal to 83 μg NO per second,
iii. is delivered at a therapeutic gas flow rate of less than or equal to 0.8 L/min,
iv. has a pulse volume of less than or equal to 1 mL, and
v. comprises less than 420 nmol of NO.
12. The method of claim 11 , wherein a plurality of pulses of the therapeutic gas is delivered to the patient.
13. The method of claim 12 , wherein each pulse of the plurality of pulses of the therapeutic gas:
i. comprises a NO delivery concentration of greater than or equal to 4,600 ppm NO,
ii. is delivered at a dosing rate of less than or equal to 83 μg per second,
iii. is delivered at a therapeutic gas flow rate of less than or equal to 0.8 L/min,
iv. has a pulse volume of less than or equal to 1 mL, and
v. comprises less than 420 nmol of NO.
14. The method of claim 12 , wherein the nitric oxide is delivered for treatment of pulmonary hypertension.
15. The method of claim 14 , wherein the pulmonary hypertension is pulmonary arterial hypertension (PAH).
16. The method of claim 14 , wherein the pulmonary hypertension is associated with chronic obstructive pulmonary disease (COPD).
17. The method of claim 12 , wherein the plurality of pulses is delivered for a treatment time of at least 72 hours.
18. The method of claim 17 , wherein the delivery of the therapeutic gas provides less nasal irritation than delivery of the therapeutic gas with a dosing rate above 83 μg NO per second and/or with more than 420 nmol NO per breath.
19. The method of claim 17 , wherein the therapeutic gas is delivered every breath.
20. The method of claim 17 , wherein the therapeutic gas is delivered intermittently.
21. The method of claim 12 , wherein the plurality of pulses are delivered to the patient at a dose in a range from 0.001 to 0.5 mg NO/kg/hr.
22. The method of claim 11 , wherein the delivery concentration is in a range from 4,600 ppm NO to 30,000 ppm NO.