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Abstract: Poster Presentations |

NITROSYL-COBINAMIDE TREATMENT OF ACUTE HYPERTENSION WITH REAL-TIME MONITORING OF TISSUE PERFUSION USING DIFFUSE OPTICAL SPECTROSCOPY FREE TO VIEW

Steven C. Wong, MD*; Gerry R. Boss, MD; William Blackledge, MD; Jae G. Kim, PhD; Jangwoen Lee, PhD; David Mukai, PhD; Vijay S. Sharma, PhD; Sari B. Mahon, PhD; Matthew Brenner, MD
Author and Funding Information

University of California, Irvine, Irvine, CA


Chest


Chest. 2009;136(4_MeetingAbstracts):43S. doi:10.1378/chest.136.4_MeetingAbstracts.43S-b
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Abstract

PURPOSE:  Nitric oxide-generating agents are used for treating hypertensive crisis, but existing agents are limited by toxicity and tolerance. Nitrosyl-cobinamide (NO-cobinamide), a novel direct NO donor, may overcome these limitations. In addition, there is a need for non-invasive tissue perfusion assessment techniques to optimize antihypertensive therapy.

METHODS:  The blood pressure lowering and tissue perfusion effects of NO-cobinamide were examined initially in five normotensive rabbits at escalating doses. The anti-hypertensive response to NO-cobinamide was then tested in five rabbits made artificially hypertensive with phenylephrine. During each phase of the experiment, diffuse optical spectroscopy (using a prototype device we constructed) and continuous wave near infrared spectroscopy were used to non-invasively monitor oxygenation in peripheral tissues and brain region.

RESULTS:  In normotensive rabbits, NO-cobinamide decreased blood pressure in a dose-related manner beginning at infusion rates of 8.6αg/kg/min. At similar infusion rates, NO-cobinamide decreased blood pressure in phenylephrine-induced hypertensive rabbits. Diffuse optical spectroscopy demonstrated increased deoxyhemoglobin and decreased oxyhemoglobin concentrations at high phenylephrine doses, with NO-cobinamide reversing these trends as blood pressure was lowered.

CONCLUSION:  NO-cobinamide effectively lowered blood pressure in both normotensive and artificially-hypertensive rabbits, with more profound effects noted at higher doses. Diffuse optical spectroscopy successfully monitored tissue oxygenation during dynamic changes in systemic blood pressure.

CLINICAL IMPLICATIONS:  NO-cobinamide, a direct NO donor, shows potential to be an effective alternative to other nitric oxide-generating agents that are limited by tolerance and adverse effects. Diffuse optical spectroscopy may be used to accurately monitor tissue perfusion and guide therapy with minimal invasiveness.

DISCLOSURE:  Steven Wong, No Financial Disclosure Information; No Product/Research Disclosure Information

Tuesday, November 3, 2009

12:45 PM - 2:00 PM


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