Because the phospholipid nanoparticles are volume expanding colloids they can correct absolute hypovolemia in the same manner as standard fluids. In fact VBI-S is superior to standard fluids in the treatment of absolute hypovolemia. The breakthrough is based on the fact that the relative hypovolemia caused primarily by the overproduction of nitric oxide is reversed by VBI-S. The key property is that nitric oxide is a lipophilic molecule which means that  it prefers hydrophobic or oily environments. Vivacelle Bio has created phospholipid nanoparticles (PN) that are hydrophobic (oily). The first of its kind working mechanism is that in septic shock patients the PN are infused IV which creates a hydrophobic space into which nitric oxide is absorbed. This reduces the bioavailability of nitric oxide without stopping its production or interfering with its essential interactions. Moreover, in regions of the microcirculation in which too much nitric oxide is produced it is absorbed by VBI-S and in regions in which not enough nitric oxide is produced the PN can release nitric oxide and increase concentration. The process can be summarized as a redistribution of nitric oxide from one that is consistent with mortality to one that is consistent with survival. The results of our clinical trial in which 100% of the patients responded by meeting the endpoint of an increase in mean arterial pressure of 10 mmHg or more, the reduction of inflammation and improvement of the function of multiple organs are consistent with this mechanism. The high safety profile of VBI-S is supported by the fact that  in the clinical trial no severe adverse events were attributed to VBI-S.