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Updated: Nov 5, 2025
A Novel Inhalation Mask System to Deliver High Concentrations of Nitric Oxide Gas in Spontaneously Breathing Subjects
Published on: May 4, 2021
Delivery of Inhaled Nitric Oxide During MRI to Ventilated Neonates and Infants
Bradley G Carter1, Rachel Swain2, Jaime Hislop2
1Clinical Technology Service, Neonatal and Paediatric Intensive Care Units, Royal Children's Hospital, Parkville, Victoria, Australia. bradley.carter@rch.org.au.
Background:
Many pediatric and neonatal ICU patients receive nitric oxide (NO), with some also requiring magnetic resonance imaging (MRI) scans. MRI-compatible NO delivery devices are not always available. We describe and bench test a method of delivering NO during MRI using standard equipment in which a NO delivery device was positioned in the MRI control room with the NO blender component connected to oxygen and set to 80 ppm and delivering flow via 12 m of tubing to a MRI-compatible ventilator, set up inside the MRI scanner magnet room.
Methods:
For our bench test, the ventilator was set up normally and connected to an infant test lung to simulate several patients of differing weight (ie, 4 kg, 10 kg, 20 kg). The NO blender delivered flows of 2-10 L/min to the ventilator to achieve a range of NO and oxygen concentrations monitored via extended tubing. The measured values were compared to calculated values.
Results:
A range of NO concentrations (12-41 ppm) and F values (0.67-0.97) were achieved during the bench testing. The additional flow increased delivered peak inspiratory pressure and PEEP by 1-5 cm H2O. Calculated values were within acceptable ranges and were used to create a lookup table.
Conclusions:
In clinical use, this system can safely generate a range of NO flows of 15-42 ppm with an accompanying F range of 0.34-0.98.
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