Exposure of Intensive Care Unit Nurses to Nitric Oxide and Nitrogen Dioxide During Therapeutic Use of Inhaled Nitric Oxide in Adults With Acute Respiratory Distress Syndrome

Enhanced Nitric Oxide Sensing Performance of Conjugated Polymer Films through Incorporation of Graphitic Carbon Nitride

Organic field-effect transistor (OFET) gas sensors based on conjugated polymer films have recently attracted considerable attention for use in environmental monitoring applications. However, the existing devices are limited by their poor sensing performance for gas analytes. This drawback is attributed to the low charge transport in and the limited charge-analyte interaction of the conjugated polymers. Herein, we demonstrate that the incorporation of graphitic carbon nitride (g-C₃N₄) into the conjugated polymer matrix can improve the sensing performance of OFET gas sensors. Moreover, the effect of graphitic carbon nitride (g-C₃N₄) on the gas sensing properties of OFET sensors based on poly(3-hexylthiophene) (P3HT), a conjugated polymer, was systematically investigated by changing the concentration of the g-C₃N₄ in the P3HT/g-C₃N₄ composite films. The obtained films were applied in OFET to detect NO gas at room temperature. In terms of the results, first, the P3HT/g-C₃N₄ composite films containing 10 wt.% g-C₃N₄ exhibited a maximum charge carrier mobility of ~1.1 × 10^-1 cm² V^-1 S^-1, which was approximately five times higher than that of pristine P3HT films. The fabricated P3HT/g-C₃N₄ composite film based OFET sensors presented significantly enhanced NO gas sensing characteristics compared to those of the bare P3HT sensor. In particular, the sensors based on the P3HT/g-C₃N₄ (90/10) composite films exhibited the best sensing performance relative to that of the bare P3HT sensor when exposed to 10 ppm NO gas: responsivity = 40.6 vs. 18.1%, response time = 129 vs. 142 s, and recovery time = 148 vs. 162 s. These results demonstrate the enormous promise of g-C₃N₄ as a gas sensing material that can be hybridized with conjugated polymers to efficiently detect gas analytes.

Correlating the magnetism and gas sensing properties of Mn-doped ZnO films enhanced by UV irradiation

Schematic diagram showing the 2D TOF SIMS overlays of Si⁺, Mn⁺and Zn⁺. The insert corresponds to the correlation between the sensing response and FMR signal as a function of Mn concentration when exposed to various gases.

A comparison of vascular effects from complex and individual air pollutants indicates a role for monoxide gases and volatile hydrocarbons

BACKGROUND

Emerging evidence suggests that the systemic vasculature may be a target of inhaled pollutants of vehicular origin. We have identified several murine markers of vascular toxicity that appear sensitive to inhalation exposures to combustion emissions.

OBJECTIVE

We sought to examine the relative impact of various pollutant atmospheres and specific individual components on these markers of altered vascular transcription and lipid peroxidation.

METHODS

Apolipoprotein E knockout (ApoE(-/-)) mice were exposed to whole combustion emissions (gasoline, diesel, coal, hardwood), biogenically derived secondary organic aerosols (SOAs), or prominent combustion-source gases [nitric oxide (NO), NO(2), carbon monoxide (CO)] for 6 hr/day for 7 days. Aortas were assayed for transcriptional alterations of endothelin-1 (ET-1), matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-2 (TIMP-2), and heme oxygenase-1 (HO-1), along with measures of vascular lipid peroxides (LPOs) and gelatinase activity.

RESULTS

We noted transcriptional alterations with exposures to gasoline and diesel emissions. Interestingly, ET-1 and MMP-9 transcriptional effects could be recreated by exposure to CO and NO, but not NO(2) or SOAs. Gelatinase activity aligned with levels of volatile hydrocarbons and also monoxide gases. Neither gases nor particles induced vascular LPO despite potent effects from whole vehicular emissions.

CONCLUSIONS

In this head-to-head comparison of the effects of several pollutants and pollutant mixtures, we found an important contribution to vascular toxicity from readily bioavailable monoxide gases and possibly from volatile hydrocarbons. These data support a role for traffic-related pollutants in driving cardiopulmonary morbidity and mortality.

Nitric oxide and nursing: a review

AIMS AND OBJECTIVES

This paper, therefore, aimed to review published literature in this area of pharmacological exploitation, to look at the therapeutic applications and clinical relevance and, by so doing, provide an accessible source for nurses to gain insight into the role of nitric oxide in the clinical setting.

BACKGROUND

Nitric oxide is a chemical mediator fundamental in the maintenance of adequate tissue perfusion and effective cardiovascular function; a major endogenous regulator of vascular tone. The use of nitrates are well established as pharmacological agents but it is only recently that it has been recognized that they act as a source of nitric oxide. Although widely addressed within the medical literature, there appears to be a paucity of nursing literature that explores either its physiological action, or its relevance to nursing practice.

CONCLUSIONS

This literature review provides an overview of the use of nitric oxide and its implications for nursing practice and patient outcomes.

RELEVANCE TO CLINICAL PRACTICE

Knowledge of nitric oxide and its action is pertinent to nurses across diverse specialities. It helps in understanding the principles of many nitrogen-derived medications which nurses administer to their patients on a daily basis. In terms of oral medication, this is demonstrated by greater insights into the action of nitrates, the appreciation of surprising developments in medications such as sildenafil and the development of new drug opportunities such as nitric oxide-non-steroidal anti-inflammatory drugs. Equally, the use of inhaled nitric oxide therapy in adult and neonatal critical care units appears to be an increasingly valuable source of treatment. A particular research challenge is found in the attempt at nitric oxide inhibition in the management of septic shock. The authors argue that understanding such esoteric areas of therapeutic developments is increasingly to be part of the repertoire of knowledge and skills for nurses in the 21st century.

Workplace NO and NO2 during combined treatment of infants with nasal CPAP and NO

OBJECTIVE

To determine the workplace concentrations of NO and NO(2) in and around a paediatric incubator during inhaled NO (iNO) treatment and during an accidental emptying of NO cylinders into room air.

DESIGN

We simulated iNO-nasal CPAP treatment in order to assess the impact on the occupational environment. Furthermore, two full NO cylinders for therapy, 1,000 ppm, 20 litres, 150 bar and 400 ppm, 10 litres, 150 bar, were emptied as rapidly as possible into an intensive care unit (ICU) room.

SETTING

University hospital ICU.

MEASUREMENTS AND RESULTS

To correctly gauge the contribution from iNO-CPAP we constructed a system measuring breathing zone and room ventilation inlet-outlet values during a 10-ppm iNO treatment of a simulated infant. Maximal breathing zone values were 17.9 +/- 7.0 (mean +/- 95% CI) ppb for NO and 25.2 +/- 4.8 ppb for NO(2). If room inlet values were subtracted, the contributions to breathing zone values emanating from iNO-CPAP were 14.8 +/- 4.6 ppb for NO and 14.6 +/- 4.6 ppb for NO(2). At the ventilation outlet the maximal contributions were 4.2 +/- 2.9 ppb NO and 9.6 +/- 4.3 ppb NO(2). During rapid total release of a gas cylinder in the ICU room, simulating an accident, we found transient NO levels comparable to the high therapeutic dosing range, but only low NO(2) levels.

CONCLUSIONS

Neither 8-h time-weighted average (TWA) nor 15 min short-term exposure limits (STEL) were exceeded during normal operation or during a simulated accident. The contribution of nitrogen oxides from treatment to workplace air were minor compared to those from ambient air.

The use of nitric oxide in neonatal care

Knowledge of NO and its role in the human body currently is limited. Further scientific research involving this unique molecule will expand its clinical usefulness. It is an exciting era in research,involving numerous body processes and systems. The initial work on pulmonary vascular response in newborns who have PPHN has opened the door to seemingly endless possibilities involving many aspects of health.