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Research ArticleOriginal Research

Delivery of Inhaled Nitric Oxide During MRI to Ventilated Neonates and Infants

Bradley G Carter, Rachel Swain, Jaime Hislop, Mathilde Escudie and Rachel H Williams
Respiratory Care August 2021, 66 (8) 1254-1262; DOI: https://doi.org/10.4187/respcare.08408
Bradley G Carter
Clinical Technology Service, Neonatal and Paediatric Intensive Care Units, Royal Children’s Hospital, Parkville, Victoria, Australia.
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  • For correspondence: [email protected]
Rachel Swain
Clinical Technology Service, Neonatal and Paediatric Intensive Care Units, Royal Children’s Hospital, Parkville, Victoria, Australia.
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Jaime Hislop
Clinical Technology Service, Neonatal and Paediatric Intensive Care Units, Royal Children’s Hospital, Parkville, Victoria, Australia.
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Mathilde Escudie
Clinical Technology Service, Neonatal and Paediatric Intensive Care Units, Royal Children’s Hospital, Parkville, Victoria, Australia.
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Rachel H Williams
Clinical Technology Service, Neonatal and Paediatric Intensive Care Units, Royal Children’s Hospital, Parkville, Victoria, Australia.
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Abstract

BACKGROUND: Many pediatric and neonatal ICU patients receive nitric oxide (NO), with some also requiring magnetic resonance imaging (MRI) scans. MRI-compatible NO delivery devices are not always available. We describe and bench test a method of delivering NO during MRI using standard equipment in which a NO delivery device was positioned in the MRI control room with the NO blender component connected to oxygen and set to 80 ppm and delivering flow via 12 m of tubing to a MRI-compatible ventilator, set up inside the MRI scanner magnet room.

METHODS: For our bench test, the ventilator was set up normally and connected to an infant test lung to simulate several patients of differing weight (ie, 4 kg, 10 kg, 20 kg). The NO blender delivered flows of 2–10 L/min to the ventilator to achieve a range of NO and oxygen concentrations monitored via extended tubing. The measured values were compared to calculated values.

RESULTS: A range of NO concentrations (12–41 ppm) and FIO2 values (0.67–0.97) were achieved during the bench testing. The additional flow increased delivered peak inspiratory pressure and PEEP by 1–5 cm H2O. Calculated values were within acceptable ranges and were used to create a lookup table.

CONCLUSIONS: In clinical use, this system can safely generate a range of NO flows of 15–42 ppm with an accompanying FIO2 range of 0.34–0.98.

  • nitric oxide
  • magnetic resonance imaging
  • mechanical ventilators
  • critical care
  • infant
  • newborn child

Footnotes

  • Correspondence: Bradley G Carter PhD, Paediatric Intensive Care Unit, Royal Children’s Hospital, Flemington Road, Parkville, Victoria 3052, Australia. E-mail: bradley.carter{at}rch.org.au
  • Supplementary material related to this paper is available at http://www.rcjournal.com.

  • The authors have disclosed no conflicts of interest.

  • Copyright © 2021 by Daedalus Enterprises
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Respiratory Care: 66 (8)
Respiratory Care
Vol. 66, Issue 8
1 Aug 2021
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Delivery of Inhaled Nitric Oxide During MRI to Ventilated Neonates and Infants
Bradley G Carter, Rachel Swain, Jaime Hislop, Mathilde Escudie, Rachel H Williams
Respiratory Care Aug 2021, 66 (8) 1254-1262; DOI: 10.4187/respcare.08408

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Delivery of Inhaled Nitric Oxide During MRI to Ventilated Neonates and Infants
Bradley G Carter, Rachel Swain, Jaime Hislop, Mathilde Escudie, Rachel H Williams
Respiratory Care Aug 2021, 66 (8) 1254-1262; DOI: 10.4187/respcare.08408
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Keywords

  • nitric oxide
  • magnetic resonance imaging
  • mechanical ventilators
  • critical care
  • infant
  • newborn child

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