2010 OPEN FORUM Abstracts
AIR TRANSPORT WITH INHALED NITRIC OXIDE IN CHILE.
Rodrigo S. Adasme; Respiratory Care, Catholic university Hospital, Santiago, Chile
Introduction The inhaled nitric oxide (iNO) system in Chile works in several hospitals and clinics in Santiago (10 centers) and Concepción (2 centers, 500 Kms from Santiago). The services of installation, control, transport, weaning and retirement are provided by only one Respiratory Care team, due to limitations and abuse of the gas time ago. In Chile exist only one neonatal ECMO center (Actually 2 more). By this reason, the quickly and effective transport of the patient who need iNO is suggested in 3 situations, with on-label and off-label use: 1. Patient with iNO (CV or HFOV) and must be transported to ECMO center 2. Patient without iNO (CV or HFOV) and can get clinical benefits of iNO with stability for transport 3. Patient in HFOV and can be supported with CV and iNO for stability in transport Objetive Show our expertise since 2008 to now in Chile of air transport with iNO Materials and methods We make and save all the clinical records of the patients transported with iNO. We transport all patients using the iNOVent (Datex-Ohmeda Inc. Madison, Wi) with two D cylinder or one 88 iNOMax cylinder, with a mechanical ventilator BioMed MVP-10 (BioMed Devices. Guilford, CT) and neonatal circuit. Results We transported 11 patients with iNO from several places of Chile, Concepción 54%(6), Puerto Montt 18,18% (2), La Serena, Valdivia and Antofagasta, each with 9,09% (1). All were neonatal patients, age 16(±27) days, with different pathologies, like persistent pulmonary hypertension (36,4%), meconium aspirative syndrome (9,1%), Congenital Diaphagmatic Hernia (27,2%), pneumonia (27,35%) and respiratory distress syndrome (27,3%). We completed a total of 29,7 flight hours, with a mean of 2,7(±0,74) flight hours. We went in Jet aircraft in 54,5%, and in Turbo aircraft in 45,5%, both compensated cabine. The patients were transported to ECMO center in 81,82% of cases, and to iNO center in 18,18%. 54,55% of patients used ECMO, 45,45% used iNO+HFOV, 9,09% used only HFOV, and 9,09% only used CMV. Only one patient die after 24 hours after the transport, and didnt used ECMO Conclusions iNO can be safely delivered on neonatal air transport. We dont had biggest complications in the transport of critical patients with iNO. Training and practical experience are invaluable regardless to realize this transport. Process guidelines need to be developed to cover normal operation of the delivery systems as well the actions to take in case of a leak or other failure. Sponsored Research - None