Mallinckrodt INOblender 10026, Operation And Maintenance Manual, Page: 22 / 38

Part No. 20732 Rev-02
2014-02
12
Operation
Cautions
:
• When not in use, the oxygen flowmeter and the INOMAX cylinder valve should be turned off.
• When the INOblender is used with an oxygen/air blender:
- The specification for INOMAX delivery when using the INOblender with 100% oxygen is +/- 20% of
setting or 2 ppm (whichever is greater). The use of 100% oxygen at 3.4 bar (50 psig) is the labeled
specification for the INOblender.
- A user may determine that some clinical conditions may necessitate the use of an oxygen/air
blender with the INOblender to achieve FiO
2
levels less than 100%.
- Using oxygen/air mixtures (21% to 95% v/v) will reduce the delivered NO concentration by up to
10% of setting or 1 ppm (whichever is greater) compared to using 100% oxygen alone, resulting in
a cumulative error up to +/- 30% of setting or 3 ppm (which ever is greater).
• Refer to the manufacturer’s procedures when using the manual resuscitator bag.
• When finished, turn the NO cylinder valve OFF and allow the oxygen to flow until the NO pressure gauge
reads zero, then turn the oxygen flow OFF.
WARNINGS:
• The purge procedure must be followed to help ensure NO
2
is purged from the system before the
manual resuscitator bag is connected to the patient.
• The manual bag should be squeezed repeatedly during use to avoid NO
2
from building up in the
bag.
• If the bag is not squeezed repeatedly while delivering INOMAX, the bag should be removed from
the patient and the bag purge procedure performed before continuing.
• The INOblender should be upright when setting the oxygen flowrate for accurate setting.
• Do not use pneumatically powered nebulizers with the INOblender. This will result in significant
over delivery of INOMAX (nitric oxide) for inhalation in excess of 80 ppm (40 ppm with a 400 ppm
cylinder).
- The INOblender outlet pressure has been validated for use up to 400 millibar (5.8 psig)
pressure. The amount of back-pressure generated by pneumatic nebulizers is significantly
greater [1.4 - 2.0 bar (20-30 psig)] and will result in over delivery of INOMAX in excess of
80 ppm with an 800 ppm cylinder (40 ppm with a 400 ppm cylinder). The user adjusted dose
setting on the INOblender will not correlate with, or have an effect on, the actual delivered
dose.
- In addition, the INOblender flowmeter is not back-pressure compensated and will display a
lower than actual flow rate when pressure is applied to the outlet.