Nitric Oxide (NO) is a medical gas that acts as a selective pulmonary vaso-dilator when used as an inhaled therapy. When introduced into the inspiratory phase of ventilation, Nitric Oxide will 'diffuse from the alveolar gas into the pulmonary vasculature of ventilated lung regions and cause relaxation of pulmonary vascular smooth muscle, thereby decreasing pulmonary hypertension in the presence of increased vascular tone.' The resulting selective vaso-dilation causes the diversion of pulmonary artery blood flow towards well-ventilated alveoli, improving arterial oxygenation.¹

INO Therapy is beneficial as it prolongs the time available for treating the disease or trauma underlying symptoms such as hypoxia and hypertension. NO has a fundamental advantage over infused vaso-dilators in that it acts only in the ventilated areas of the lung. NO is highly chemically reactive, it combines with Oxygen (O₂) to form Nitrogen Dioxide (NO₂), which in turn can combine with water to become damaging nitrous and nitric acid. Delivery of NO should provide monitoring of NO₂ to ensure patient safety. Patients undergoing INO therapy will become dependent on their treatment as after a few days it will prevent the body’s natural production of NO. Patients must be weaned from the therapy gradually. Sudden withdrawal due to, for example, exhaustion of a gas cylinder or supply disconnection can be extremely detrimental, so delivery systems must address this issue.

The NOxBOX^®+ is a stand alone sidestream system, monitoring NO and NO₂ in the inspiration air delivered to the patient. Audible and visual alarms, digital displays and protection against gas surge and water vapour allow for safe treatment of patients.

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Fitted with the NOxBOX^®+, the NOxBOX^®mobile allows both portable delivery and monitoring of NO. To remove the danger caused by sudden cessation of the therapy in order to renew gas supply, the NOxBOX^®mobile can accommodate twin NO gas cylinders, ensuring uninterrupted gas flow and safe, continuous treatment of patients.

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