The Science Journal of the American Association for Respiratory Care

2012 OPEN FORUM Abstracts

DO CHANGES IN RESISTANCE AND COMPLIANCE EFFECT THE AMOUNT OF NITRIC OXIDE DELIVERED VIA THE VDR-4 VENTILATOR.

James Deckman, Cheryl Dominick; ChildrenÂ’s Hospital of Philadelphia, Philadelphia, PA James Deckman BS,RRT-NPS, Cheryl Defalco BS,RRT-NPS, Respiratory Care Department-The ChildrenÂ’s Hospital of Philadelphia, Pa

Background: The therapeutic potential of inhaled nitric oxide as a selective pulmonary vasodilator has been studied at great length for the past decade due to its pharmacologic and physiologic potential. The effective delivery of nitric oxide on the VDR-4 ventilator however has been proven challenging. Patient on this type of ventilator can benefit from nitric oxide for it pulmonary vasodilator effects however because of the bi-directional flow dynamics within the circuit delivering therapeutic dosages according to standard ways is inaccurate. Methods: We used the VDR 4 ventilator with HUB ventilation setup, Ikaria Nitric DSIR system, and Michigan Lung to simulate changes in resistance and compliance. The injector module was connected to inspiratory side of HUB. The Nitric analyzer was placed on inspiratory side of breathing circuit at patient wye. The VDR 4 ventilator causes over delivery of inhaled nitric oxide due to Bi-directional flow through the inspiratory side of the VDR ventilator (see IKARIA bulletin Ref:TB-07005). Nitric set value was set to analyze a value of 20ppm. Results: Vdr ventilator settings were PIP 30, PEEP 10, Convective Rate 20, Percussive Rate 600 and a FI02 of 65%. Results are below: Michigan Lung Resistance Michigan Lung Compliance Nitric Set/Analyzed Value 0 .001 10/20 0 .002 10/20 50 .001 10/20 200 .001 10/20 50 .002 10/20 200 .002 10/20 50 .005 10/20 200 .005 10/20 Conclusion: Changes to resistance and compliance had no effect of the amount of delivered nitric oxide. Nitric oxide can be effectively delivered to a patient on the VDR ventilator via the HUB setup. It must be delivered by setting an amount that will not be consistent with an analyzed amount. Changes in resistance and compliance had no effect on delivered amount Sponsored Research - None