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Effect of the INOmax DS
There are two main effects of connecting and using
the INOmax DS
in a ventilator breathing circuit.
IR
1.The INOmax DS
adds NO/N
IR
breathing circuit in proportion to the NO setting
and the ventilator flowrate. For example, at an NO
setting of 20 ppm with an 800 ppm NO cylinder, the
INOmax DS
adds 2.5% more gas to that delivered
IR
by the ventilator and proportionally less for lower
NO settings.
2.The INOmax DS
subtracts gas from the
IR
breathing circuit via the gas sampling system at a
nominal flow rate of 0.23 L/min.
These two effects of adding and subtracting gas
from the ventilator breathing circuit have the
following effects:
Oxygen Dilution
The INOmax DS
adds gas to the breathing circuit
IR
in proportion to the NO setting as described above.
The NO/N
mixture added to the ventilator gas dilutes
2
the oxygen in proportion to the set INOMAX dose. At
the INOMAX dose setting of 20 ppm, the added gas
is 2.5%. Thus, the O
concentration is reduced by
2
2.5% of its original value. For example, if the original
O
concentration was 60% v/v, then the O
2
injection, at the maximum setting, is 58.5% v/v.
Set Dose (ppm)
800 ppm Cylinder
80
40
20
1-24
in a ventilator circuit
IR
gas to the
2
value after
2
Oxygen Dilution % v/v
10
5
2.5
Minute Volume
When using volume ventilation with the INOmax DS
the measured tidal volume delivered to the patient
shows small changes depending on the NO setting
being used due to the addition and subtraction of
gases by the delivery system. Some minor ventilator
adjustments to the minute volume may be required.
The net result of the INOmax DS
minute ventilation can be calculated as follows:
If the patient's minute ventilation is 10 L/min
(500 cc X 20 breaths/min)
The additional minute volume due to the INOMAX
can be calculated as follows:
INOMAX dose x Minute Volume
Cylinder Concentration -- INOMAX Dose
For a dose of 20 ppm (800 ppm cylinder) the
additional volume would be
(20 X 10 / 800 – 20) = 0.25 L/min
To calculate the net change in minute volume:
0.25 L/min INOMAX added - 0.23 L/min removed
(sample system) = 0.02 L/min (net change)
This formula may be used when calculating the
changes to continuous flow on continuous flow
ventilators as well (using the continuous flow in
place of minute ventilation).
Trigger Sensitivity
The addition and subtraction of gases by the
INOmax DS
may affect the trigger sensitivity of
IR
the ventilator when using synchronized modes of
ventilation. This may cause the ventilator to auto-
trigger in ventilators which have flow trigger modes,
especially where the trigger flow is set to less than
one L/min. The trigger sensitivity of the ventilator
should be checked after connecting the
INOmax DS
delivery system.
IR
,
IR
on the delivered
IR
Additional INOMAX volume
=
added per minute
Part No. 20717 Rev-01
2014-07
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