Thursday, December 13, 2018

Inhaled epoprostenol and ventilator circuit

Q: What leads to a clogged ventilator circuit filter in an intubated patient due to the administration of continuous INHALED epoprostenol?

Answer: The use of inhaled epoprostenol is still considered off-label. Inhaled epoprostenol is commonly being reconstituted with glycine, which is a very viscous diluent, and may clogged the ventilator circuit. Constant vigilance is required and ventilator circuit should be changed frequently i.e, around every 4 hours. Increase resistance in ventilatory circuit may cause elevated peak airway pressures.



1. Dzierba, AL, Abel, EE, Buckley, MS, Lat, I : A review of inhaled nitric oxide and aerosolized epoprostenol in acute lung injury or acute respiratory distress syndrome. Pharmacotherapy 2014; 34:279–90 

2.  De Wet, CJ, Affleck, DG, Jacobsohn, E, Avidan, MS, Tymkew, H, Hill, LL, Zanaboni, PB, Moazami, N, Smith, JR : Inhaled prostacyclin is safe, effective, and affordable in patients with pulmonary hypertension, right heart dysfunction, and refractory hypoxemia after cardiothoracic surgery. J Thorac Cardiovasc Surg 2004; 127:1058–67 

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