Sunday, April 1, 2012

Inhaled Nitric Oxide Set-up for Nitric Oxide Challenge

One off label use of inhaled nitric oxide is to use it to see if a patients pulmonary hypertension is responsive to vasodilator therapy. 
Due to inhaled nitric oxides quick onset and extremely short half life the "nitric oxide challenge" can be performed safely and efficiently in a cardiac cath lab.  

There are a few standard protocols which I will not go over, however I will go over device and patient interface setup for performing a nitric oxide challenge. 

Perform All Setup Steps for Traditional INOVent Machine use (see operators manual for more detail). 

  1. Low Range Calibration.
  2. Leak Test.
  3. System Purge.
  4. Connecting the quick connect & turning on the gas cylinder. 
  5. Performance Test.
  6. Alarms Test.
Patient interface setup

Connect the other end of the anesthesia gas sampling line to the sampling port on the INOVent.

Use the O2 Blending Equation to administer desired FiO2
100-FiO2 = Air Units
FiO2-20= O2 Units
Example: 40% FiO2 desired
100-40 = 60
40-20= 20

60/20  = 3:1 Blending ratio (3 parts air & 1 part O2) 

note- administer at least 8 lpm due to the non-rebreather interface.  

Confirm delivered FiO2 on the INOVent