The Science Journal of the American Association for Respiratory Care

1998 OPEN FORUM Abstracts

A COMPARATIVE STUDY EVALUATING ELECTROCHEMICAL FUEL CELL VS. CHEMILUMINESCENCE NITRIC OXIDE ANALYZERS DURING MECHANICAL VENTILATION.

Elizabeth A. Grannan RRT, Alicia A. Prickett CRTT, and Joseph N. Summitt RRT Respiratory Therapy Program Allied Health Sciences School of Medicine Indiana University Purdue University Indianapolis, Indiana

Background. Nitric oxide is extensively used in the treatment of persistent pulmonary hypertension of the newborn and other related disease states. In the delivery of this therapy it is imperative to analyze the delivered nitric oxide level and the level of nitric dioxide that is produced as the gas mixes with oxygen. Chemiluminescence nitric oxide (NO) and nitric dioxide (NO_{2}) analyzers have been exclusively used for this purpose, until recently. Currently new electrochemical fuel cell NO and NO_{2} analyzers are being produced, which are more cost-effective and practical. Accuracy of these devices is imperative for proper use. Methods. We evaluated two NO electrochemical analyzers (Pulmonox II and Ohmeda) in comparison to the Eco-Physics CLD 700 AL Chemiluminescence NO analyzer. All were calibrated and used according to manufacturer's specifications. Using a VIP Bird Ventilator in time-cycled mode, the effects of FIO_{2} and peak inspiratory pressure (PIP) were measured. The Ohmeda I-NO vent delivered serial dilutions of NO for 5, 10, 20, & 40ppm. FIO_{2} settings of 21, 50, and 100% and PIP settings of 10, 20, 30 cmH_{2}O with a PEEP of 5 cmH_{2}O were used. Sample ports were placed on the inspiratory limb of the ventilatory circuit at a fixed distance from the Y-piece distal to the humidifier. Each reading was recorded after a time lapse of 5 minutes per setting change. Results. Using a MANOVA, there was no significant difference between devices with p < 0.05 for the effects of FIO_{2} with PIP constant. A significant difference was found with p < 0.05 for the effects of PIP with FIO_{2} constant. A correlation study was done to show the details of the difference. The higher the pressure and ppm the greater the difference for the Pulmonox II. However, there was no significant difference between the Ohmeda I-NO vent and the chemiluminescence.

Conclusion. The detection of NO by the Pulmonox II did not correlate with the chemiluminescence. Caution should be used with the Pulmonox II when high PIP are anticipated and high ppm of NO are delivered.

The 44th International Respiratory Congress Abstracts-On-DiskĀ®, November 7 - 10, 1998, Atlanta, Georgia.

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