EBME Forums Forums Maintenance Technical Assistance And another thing Nitric Oxide Transport Monitors

Please does anyone know of any inhaled Nitric Oxide/Nitrogen dioxide (NO/NO2) monitors suitable for use in a transport situation, (neonatal incubator) with nitric therapy.
We have just been told that our MicroGsa is no longer supported.
I am vaguely aware of one called INOMAX but have no information.
we are looking at PrinterNOX, from Cardinal Health, previously MicroMedical who made the MicroGas. Are there any others out there?
thanks

Hi John
We have been using Inovents for some time to deliver Inomax. This is the name of the gas when used as a drug and i was under the impression only Inomax is licensed for medical use worldwide and had been so for years.
Anyway, the Inovents (Inomax delivery system) are provided by the company (Inotherapeutics) FOC and the drug is stored in a Cylinder with a digital clock on the top that counts the hours the regulator is open, there is then an hourly charge per patient treatment up to 92 hours then its free. Inotherapeutics take care of all the logistics (cylinder collections and deliveries, monitors exchanged once a year etc.) We replace the monitors, a few seals etc annually and c/o a monthly calibration on each Inovent. Although the relatively simple design is aimed at nurse use, we retain cals and pre use checks ourselves because of familiarity. The inovent itself is a wheeled platform containing 2 Inomax cylinders with a monitor on the top and associated accessories. Being not much bigger than an adult ITU ventilator (eg. Servoi) it is potentially portable and contains a back up battery but i'm not sure of backup time, this is to power the monitor only as delivery is just gas driven.
Hope this helps
Topper

Hi, Topper,
thanks for that, but my query related specifically to a monitor for use in transport situations.
We already use INOtherapy INOVent Transport in NICU, and have done since January 2003, they, INO Therapy, have also since that time provided a small (2litre) transport cylinder, and a couple of regulators and hoses, which are from the standard trolley.
However they have never had, and do not currently have, a suitable transport monitor/delivery system.
That is why we have been using, by their agreement, a low flow flowmeter and Microgas analyser. This latter item is now obsolete , and last ime it had new cells, and every occasion prior, I have been suggesting a new monitor.
It seems the only monitor that appears to be available , but which used to have limited battery life, is the PrinterNOX.
I was merely hoping that someone might have experience, or know, of additional alternatives, before we stump up for one of those. The name INOMAX came up in the context of monitors on a Google search, but did not appear to relate to the cylinders.
Thanks again for your comments.
John

John,

We used to use the Printernox to deliver out Nitric Oxide therapy. The Printernox (unless it has been upgraded) is a measurement in PPM only and does not interact with the gas flow from the cylinder. This why it is potentially dangerous as when changes of Tidal volume BPM etc. are made, the gas flow from Nitric cylinder remains the same, which in turn may lead to increased levals of Nitric being delivered.

It may be of use to contact Inomax regarding this as it may be possible to use the Inomax for transport. As you are probably aware the Head of the machine is detachable from the lower part, which is essentially storage for the Nitric cylinders. The Inomax also has battery back up. It would be still be bulky but worth a thought.

Please let us know what you come up with incase this situation arises at New Cross.

Best wishes.

Hi John and all,

I did an internet search recently for the same reason and could find nothing available in the UK better than what we use now; a Printernox for monitoring, and flowmeter for delivery. I believe in America they use Inovent heads for transport, but I suppose everything is bigger there!

You don't mention what vent you are using;if it's for neonates doesn't it have a constant gas flow? If so, a constant flow of NO is fine. I would keep the flowmeter and get a Printernox. It's true the battery life is lousy - best to provide it with on-board power, or turn it on for set-up and periodic checks only. If the patient O2 saturation is OK, the NO delivery must be fine.

Moira

Hi, Paul, Moira, and all.
Thanks for all your comments, the main reasons for not using the INOtherapy INOVent transport Head are the size, and weight, have you ever tried lifting one? I do two service exchanges every year, and I would not want to add that weight to the transport incubator!
Also the battery life is not really for mobile operation.
I have been told about Nox Box from Bedfont who do Smokalyser and exhaled Nitric monitoring amongst other things.
Regarding the lack of servo function, we have lived with that for years, the vent is a BabyPac from Pneupac, and Nitric and NO2 had to be monitored as Moira said, periodically.