Document No. 715-7000
Revision E
Page 9 of 63
Suggested “flush” procedure for the delivery portion of the AeroNOx
system:
1.
Set up the AeroNOx
for delivery as outlined in “AeroNOx
Transport Nitric Oxide
Titration & Monitoring System for initial operation”.
2.
Hook up the ventilator to a test lung (patient should be manually ventilated during this
procedure and the ventilator parameters should be set to the patient’s pre-NO gas
settings).
3.
Inactivate the “Safety Shut Off” system by simultaneously depressing the NO and NO
2
alarm silence buttons for 5 seconds or until the display reads “SAFETY OFF”. For more
information on the “Safety Shut Off” system, see “Safety Shut Off” in
SECTION III
.
4.
Turn on the NO gas flow to 2 lpm by turning the knob on the precision metering valve in a
counter-clockwise direction. This knob is located in the bottom right hand quadrant of the
front panel of the AeroNOx
below the LCD flow display. Allow the gas to flow into the
ventilator circuit.
5.
As soon as the NO
2
value has dropped to a stable level, allow the gas to run for an
additional 3 seconds and then adjust the NO flow to the desired level (see
SECTION VII
-
Calculations for NO Delivery to determine flow required for desired NO concentration).
6.
Re-activate the “Safety Shut Off” system by simultaneously depressing the NO and NO
2
alarm silence buttons for at least 5 seconds or until the display reads “SAFETY ON”.
7.
Once the desired NO concentration has been reached, ensure that NO
2
level is
acceptable for patient administration. Below you will find a table which will give you the
approximate NO
2
values you can expect for a given NO concentration and ventilator flow
at an FiO
2
of 1.0.
Minute Volume / Ventilator Flow
[NO]
5
10
15
20
5 ppm
0.5 0.1 0.1 0.1
10 ppm
0.5 0.2 0.2 0.1
20 ppm
0.5 0.3 0.2 0.2
40 ppm
0.8 0.6 0.4 0.4
80 ppm
2.0 1.5 1.2 1.1
NO
2
in PPM
The table above is for reference only.
Factors such as the accuracy of the ventilator flow, percent error in delivery apparatus,
and human error, may all affect the actual delivered patient dose. The calculated NO flow
should be compared with the analyzed NO dose to confirm accurate NO dosing. Should
the actual NO flow differ from the calculated NO flow by more than 10% beyond
published specifications, the cause must be determined and corrected immediately. If the
cause can not be immediately determined, ensure patient safety and contact International
Biomedical at 1-800-433-5615 for further assistance.
8.
Connect the patient to the ventilator and monitor according to study and/or institution
protocol.
CAUTION!
The flush procedure must be performed each time NO therapy is
started. This includes initial therapy starts, tank changes, and re-
starting therapy after trials off NO.