2004 OPEN FORUM Abstracts
UTILIZATION OF THE HiOX™ MASK FOR DELIVERING INHALED NITRIC OXIDE
Don
Renaghan RRT • John E. Hahesy MS, RRT,CPFT
Respiratory
Care Services • Stanford Hospital & Clinics •
Stanford, California
Introduction:
Inhaled nitric oxide (INO) is recognized as a potent agent for
demonstrating pulmonary vasoreactivity in the cardiac catheterization
laboratory. Patient response to INO, from both primary and secondary
causes, provides prognostic and predictive response to other
pulmonary vasodilators for long-term therapy. At our institution,
INO is safely and effectively delivered by mask with the INOvent™
(INOTherapeutics Corporation) to adult patients with the
configuration shown in figure 1. We evaluated the HiOX™
mask (Viasys) as a simplified alternative to the established
configuration for the noninvasive delivery of INO.
Fig.
1
Methods: A volunteer
subject received INO via the standard mask system
(fig. 1) and the HiOX™
mask. The comparative efficacy of the two delivery
systems was determined by sampling at the mask interface to determine
INO response time (from set to measured), nitrogen dioxide (NO2)
accumulation, and FiO2 stabilization (determined by the
maximum FiO2 delivered with a set FiO2
of 1.00). Sampling was compared at: 1). INO @
5ppm with FiO2 = 0.21, 2). INO @ 5ppm with FiO2
= 1.00, 3). INO @ 20ppm with
FiO2 = 0.21, 4). INO @ 20ppm with FiO2 = 1.00.
Results:
Table 1 lists the comparative response times (from set to
measured) between the two mask systems.
| Table 1. | 5ppm @ 0.21 | 5ppm @ 1.00 | 20ppm @ 0.21 | 20ppm @ 1.00 |
| Standard mask | 60 seconds | 60 seconds | 60 seconds | 60 seconds |
| HiOX™ mask | 30 seconds | 30 seconds | 30 seconds | 30 seconds |
Comparative
NO2 accumulation at all settings corresponded to 0.2ppm
with the standard mask system, and 0.1ppm with the HiOX™
mask system. Comparative FiO2 stabilization at 1.00
produced a maximum FiO2 of 0.93 with the standard mask
system, and 0.97 with the HiOX™
mask.
Conclusions:
The HiOX™
mask provided a comparatively faster INO response time, lower NO2
accumulation, higher FiO2 stabilization, and offers
practical advantages secondary to lower total flow requirements and a
simplified configuration. In vivo utilization will determine
anticipated improvement in patient comfort and compliance.