Abstract
BACKGROUND: Because both high-frequency jet ventilation (HFJV) and nitric oxide (NO) have been shown to be useful in treating persistent pulmonary hypertension of the newborn, we sought to characterize NO delivery by HFJV. METHODS & MATERIALS: In a patient simulation, we measured NO con-centration [NO] at the end of the endotracheal tube, compared results obtained with chemiluminescence (CL) and electrochemical (EC) analyzers, and stud-ied the effects of compliance and resistance changes and different [NO] on NO delivery at different conventional ventilator (CV) pressures and frequencies that did and did not interrupt the jet ventilator flow while jet ventilator vari-ables remained constant. Data were collected at 3 measuring sites, under 3 lung conditions, and with 3 [NO]. RESULTS: The EC read higher than the CL under pressure conditions (17-39%). [NO] at the inspired and expired measuring sites varied from 14-29% when flow from the jet ventilator was not interrupted. NO delivery as measured by the CL improved as compliance and resistance improved when a CV frequency was being delivered. NO deliv-ery was minimal when CV pressures were not interrupting HFJV: NO% = 0.21 (0.129), p < 0.0001. However, NO delivery was adequate when CV pres-sures interrupted HFJV: NO% = 102.72 (0.435) p < 0.0001. When CV fre-quencies were not interrupting HFJV: NO% = 2.25 (0.187) p < 0.0001. When CV frequencies were interrupting HFJV: NO% = 11.53 (0.395) p < 0.0001. CONCLUSIONS: EC yields higher NO values than does CL. Compliance and resistance changes mildly alter NO delivery at the endotracheal tube. NO deliv-ery via HFJV is unreliable and should be avoided. [Respir Care 1996;41(10): 895-902]
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