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A bench study of inhaled nitric oxide delivery during high frequency percussive ventilation
Author(s) -
Branson Richard D.,
Griebel Jeff,
Rodriquez Dario
Publication year - 2018
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.23934
Subject(s) - medicine , venturi effect , anesthesia , injector , oxygen delivery , delivery system , leak , nitric oxide , biomedical engineering , oxygen , mechanical engineering , chemistry , environmental science , organic chemistry , environmental engineering , engineering , inlet
Background Safe and effective delivery of inhaled nitric oxide (INO) requires the appropriate interface of ventilator and INO delivery device. Methods We compared INO delivery using four configurations with the Transport Sinusoidal Bronchotron® and INOmax DSIR Plus ® in a lung model. Ventilator settings and lung model values were held constant. Delivered NO, NO 2 , and inspired oxygen (FIO 2 ) were measured. The mean difference between set and measured NO was calculated and compared using ANOVA. Results Placement of the injector module in line with the sliding venturi resulted in a ventilator failure. With both continuous flow techniques there was no appreciable NO 2 generated and the mean difference between set NO and measured NO at 20 and 40 ppm was −16.5 ppm and −33.2 ppm at flows of 5 and 10 L/min. Placement of the injector module between the sliding venturi and lung model resulted in an increase of NO2 to a peak of 2.4 ppm (mean 2.3 + 0.1) and a mean difference between set and measured NO of + 11.3 ppm and +30 ppm at 20 and 40 ppm, 300 cycles per minute (cpm), and 22.1 ppm and 37.6 ppm, at 20 and 40 ppm, 600 cpm. None of the test configurations delivered INO within 30% of set concentrations. No alarms or interruption of INO delivery occurred. Conclusion The dual gas delivery system of the Bronchotron prevents accurate delivery of INO. The combination of these two devices should be accomplished with caution and vigilance.