During neonatal mechanical ventilatory support, the delivered nitric oxideconcentration is affected by the ventilatory setting

Citation
N. Yamaguchi et al., During neonatal mechanical ventilatory support, the delivered nitric oxideconcentration is affected by the ventilatory setting, CRIT CARE M, 28(5), 2000, pp. 1607-1611
Citations number
19
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Aneshtesia & Intensive Care
Journal title
CRITICAL CARE MEDICINE
ISSN journal
0090-3493 → ACNP
Volume
28
Issue
5
Year of publication
2000
Pages
1607 - 1611
Database
ISI
SICI code
0090-3493(200005)28:5<1607:DNMVST>2.0.ZU;2-U
Abstract
Objective: To assess whether the delivered nitric oxide (NO) concentration is affected by a change in the ventilatory setting during neonatal mechanic al ventilatory support. Design: Prospective, experimental study. Setting: Laboratory at Nagoya City University Medical School. Interventions: This study was performed by using a pressure-limited, time-c ycled, ventilatory support with a neonatal circuit and a 50-mL silicone tes t lung. NO in N-2 gas was administrated into the inspiratory limb at a dist ance of 4 cm, 80 cm, or 160 cm from the Y piece connected to the adapter of an endotracheal tube. The NO concentration was measured every 0.5 sec by a chemiluminescence analyzer at the Y piece. Measurement and Main Results: NO concentrations were compared with each of the ventilatory settings of peak inspiratory pressure (PIP) (10-30 cm H2O), positive end-expiratory pressure (0-10 cm H2O), ventilatory flow (10, 20, 30 L/min), and ventilatory rate (30, 40, 50, 60, 70 breaths/min), respectiv ely. The NO concentration was significantly lower when NO was added at 4 cm than at 80 cm or 160 cm from Y piece at the same ventilatory setting of PI P, positive end-expiratory pressure and ventilatory flow, respectively, (p < .01), Although the NO concentration was increased as the settled PIP leve l was increased (p < .01 or p < .05), it was not changed when the settled p ositive end-expiratory pressure level was increased. A decrease was seen in the NO concentration as the settled ventilatory flow was increased (p < .0 1), Lastly, the NO concentration fluctuated greatly in association with the settled ventilatory rate. Conclusion: The NO concentration delivered to patients is influenced by the ventilatory setting during neonatal mechanical ventilatory support.