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Báo cáo y học: " Equipment review: Pulmonary uptake and modes of administration of inhaled nitric oxide in mechanically-ventilated patients"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Equipment review: Pulmonary uptake and modes of administration of inhaled nitric oxide in mechanically-ventilated patients. | Puybasset and Rouby Critical Care 1998 2 9 http ccforum.com c CRITICAL CARE REVIEW Equipment review Pulmonary uptake and modes of administration of inhaled nitric oxide in mechanically-ventilated patients Louis Puybasset Jean-Jacques Rouby 17cc-2-1-009 Introduction Inhaled nitric oxide NO is a selective pulmonary vasodilator which reduces pulmonary artery pressure and increases arterial oxygenation in patients with adult respiratory distress syndrome ARDS . Despite these beneficial effects inhaled NO has not yet been shown to improve outcome. During artificial ventilation it can be administered in the downstream of the ventilator into the inspiratory limb of the ventilatory circuit or can be mixed with oxygen and nitrogen in the upstream part of the system. Because of its simplicity and low cost administration into the inspiratory limb is most commonly used in southern Europe whereas in the United States and northern Europe the system of administration into the upstream is more popular. Each of these systems has its own advantages and disadvantages. Administration of inhaled NO into the upstream of the ventilator Principle The technique of administration of NO into the upstream of the ventilator was first developed in Scandinavia 1 2 . Mass-flow regulators are used to mix oxygen air and NO before their entry into the low pressure inlet of the ventilator NOMIUS system adapted to the Siemen s Servo 900 C ventilator . These flow meters are precise but expensive. They have a variability of 1 from the set value. Each mass-flow regulator is controlled by a microprocessor in order to obtain the desired NO concentration at the point of entry into the ventilator. Most often a system measuring the delivered NO concentration is associated. Surgical Intensive Care Unit Department of Anesthesiology La Pitié-Salpêtrière Hospital 47-89 Boulevard de THôpital 75013 Paris France BioMed Central 1998 Current Science Ltd Advantages When NO is administered into the upstream the interior