I work at two centers with different approaches. Thank you for your response.
Dear colleague
In clinics where I worked, iNO is used in closed circuit, without the need to exclude lime soda or to modify the intake of volatiles. On the other hand, I observed increasingly tend to use more intravenous hypnotic agents than inhaled, but not because of interaction with iNO. If you have the experience to shift from iNO administration to ECMO in OR, it must be more careful to avoid volatil anesthetic, because they interact with materials of ECMO oxygenator.
An other approach is in ICU, were ventilation machine are with open circuit. iNO can be connected directly to Y-piece, and adjust their concentration depending of minute volume.
I hope my answer will be useful for you.
Greetings from Moldova.
Dr. Veaceslav SAVAN
We use NO in operating room with ventilator which allows not rebreathing ( open) circuit ( Siemens) in pt. for HTX and LTX and pulmonary hypertension pt. We do use it also in hartcath. in children with PH to asses pulmonary vascular bed reactivity. As our ventilators must be changed we now have ventilators from Drager ( Perseus). We asked the company how we should use the NO and suprisingly the did not have the annswer. It lasted about a year to geat the solution. We use now high flow (10- 15 l) and ordered a empty absorption bag without soda lime We started also to look in the literature ansd it seems that it is not necessary to avoid soda lime as it decreases the concetration of NO2 .
Look also article from ISHIBE BJA 1995 Absorpt of NO2 andNO..... Wenman BJA 1997 Reduction of NO2....
Viszont latasra
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