The NO application device from EKU

The NO-A is a high-precision dosing device for the controlled application of nitric oxide (NO) into the ventilatory flow – compatible with a wide range of common ventilators. It enables targeted therapy with NO gas in critically ill patients in intensive care and anaesthesia medicine.

Inhaled NO therapy – clinically relevant & life-saving

Inhaled nitric oxide therapy (iNO) is used to reduce the right-to-left shunt problem, lower cardiac workload, and improve oxygen delivery in ventilated patients. Nitric oxide is added to the inhaled gas to specifically dilate the pulmonary vessels and optimise pulmonary haemodynamics.

EKU Elektronik iNO Therapie — This is how you learn more about inhaled NO therapy: By clicking on the photo you will be transferred to a free German-speaking CME training.

Indications for the NO-A nitric oxide application device

Newborns, children and adults with:
- Pulmonary hypertension
- Neonatal respiratory failure (PPHN)
- Oxygen deficiency / hypoxia
- Pulmonary fibrosis
- Chronic obstructive pulmonary disease (COPD)
- ARDS (Acute respiratory distress syndrome)

Cardiac surgery:
- In heart valve diseases and transplants to reduce pulmonary pressure

Please refer to the information provided in the respective product information sheets of the medicinal products used for NO therapy.

Key features – NO administration with top precision and flexibility

Application & compatibility

Suitable for neonates, children and adults
Direct connection to the ventilator via RS232
Optional flow sensor for enhanced compatibility with ventilation systems from different manufacturers
Compact design and flexible power supply options for intra-hospital transport (mains power, integrated battery)

Gas cylinder management

Dual-cylinder system with automatic flushing and cylinder switching
Compatible with cylinder concentrations ranging from 50 to 1000 ppm

Safe and flexible dosing

Secondary dosing system for fail-safe therapy
Extended concentration range from 0.1 to 99.9 ppm
Selectable mode: triggered or continuous
Dosing trend display (1 hour / 24 hours)
Timer function e.g. for non-responder tests or weaning strategies

Monitoring & interfaces

Integrated gas monitoring
Optional oxygen monitoring
Ambient air monitoring for additional safety
KIS connection via:
- Philips VueLink / IntelliVue
- EKU protocol
- Other systems available upon request

Medical device class IIb according to EC-Directive 93/42/EEC
Notified Body: mdc medical device certification GmbH / CE 0483

Maximum ventilator compatibility with the NO-A - Flexibility meets innovation

The NO-A is designed to integrate seamlessly into almost any ventilation system. With its versatile operating modes and dosing options, it adapts flexibly to a wide range of clinical requirements – from intensive care to anaesthesia.

In addition to the manual mode, which offers experienced users maximum control over the therapy settings, the device offers two automatic operating modes: The intelligent ventilator interface and the precise flow sensor detect conditions in the ventilation circuit and automatically adjust the NO therapy, thus guaranteeing safe and efficient use, even in the dynamic hospital environment.

The dosage can either be continuous or triggered – for on-demand NO administration in real time. In addition, a dosimeter function enables use with semi-closed anaesthesia systems – a key advantage in modern surgical care.

NO-A – The perfect addition to your ventilation solutions

Operating mode: Electronic connection via ventilator interface

EKU Elektronik sets new standards in NO therapy: EKU is the first manufacturer to offer an electronic interface for easy connection with ventilators from leading manufacturers.

This innovative connection enables automated, precise and patient-tailored dosage of nitric oxide – perfectly adjusted to the set target concentration. The required gas volume is delivered in real time – safely, efficiently and fully integrated into the ventilation process.

Efficiency and safety thanks to a direct connection with the ventilator

The direct electronic connection between NO-A and the ventilator provides significant advantages for both users and patients:

Efficient gas consumption
Precise dosing reduces nitric oxide consumption and lowers operating costs.
Wide therapeutic flexibility
Continuous adjustment of the dosing allows use across a wide range of clinical indications.
Automatic response to therapy manoeuvres
Real-time adjustment of NO supply – without manual intervention, even when changes occur in the ventilation pattern.
Minimized NO standby times in breathing gas
Short residence time of the gas reduces the formation of potentially harmful by-products and increases the safety of the therapy.

Available ventilator interfaces

Dräger

Evita dura (from V 3.5): triggered*
Evita 4 (from V4.25): triggered*
Evita XL (from V7.05): triggered*
Evita V300 (from V2.40): triggered, continuous*, **
Evita V500 (from V2.40): triggered, continuous*, **
Evita V600 (from V1.05): triggered, continuous*, **
Evita V800 (from V1.05): triggered, continuous*, **
Babylog 8000 (from V5.0): continuous*, without HFO
Babylog VN500 (from V2.40): triggered, continuous*, **
Babylog VN600 (from V1.05): triggered, continuous*, **
Babylog VN800 (from V1.05): triggered, continuous*, **
Primus (from V04.53.00): Bolus/Dosimetry, only V2* (requires instruction)
Perseus (from V2.01): Bolus/Dosimetry, only V2* (requires instruction)

* Compatibility depends on the SW/HW version of the ventilator. 
** Dosing mode depends on the ventilator mode.

Getinge (MAQUET)

SERVO-i (from V4.00): triggered*
SERVO-s (from V4.00): triggered*
SERVO-U (from V1.02): triggered, without neonate mode, only V2*
SERVO300 (n.a.): continuous
Flow-i (from V4.04.00): Bolus/Dosimetry, only V2* (requires instruction)

* Compatibility depends on the SW/HW version of the ventilator.

Hamilton Medical

HAMILTON-T1/C1 (V2.xx/P 1.0.4, not compatible with V3.x.x): continuous, V2 only*
HAMILTON-C3 (from V2.0.0): continuous, only V2*
HAMILTON-S1/G5 (from V2.6.0/P 1.0.6): continuous, only V2*
HAMILTON-C6 (from V1.1.1): continuous, only V2*

* Compatibility depends on the SW/HW version of the ventilator.

Löwenstein Medical

Leoni plus (from V2.3.30/HULBUS 0.0.4): continuous, only V2*
Elisa (from V1.11.0): continuous, only V2*

* Compatibility depends on the SW/HW version of the ventilator.

Operating mode: Flow measurement via external sensor

In addition, the NO-A offers optional support for nearly all ventilators thanks to the use of a flow sensor.

It is integrated into the ventilation circuit, measures the real flow in the inspiratory branch, and also enables automatic dosing of the required volume.

Known settings with flow sensor

ACUTRONIC Medical Systems

fabian HFO: triggered, V2 only, HFO mode with EKU flow sensor max. 14 Hz

Air Liquide Medical Systems

eXtend XT: triggered

Covidien

Puritan Bennett 840: triggered
CareFusion SensorMedics 3100A/B HFOV: triggered
Avea: triggered
Infant Flow SiPAP: triggered

Dräger

Evita 2 dura: triggered
Evita 4: triggered
Evita XL: triggered
Evita V300: triggered
Evita V500: triggered
Babylog 8000: triggered
Babylog VN500: triggered

GE Healthcare

Engström Workstation: triggered
Centiva/5: triggered

Getinge (MAQUET)

SERVO-i: triggered
SERVO-s: triggered
SERVO-n: triggered
SERVO-U: triggered

Hamilton Medical

HAMILTON-S1/G5: triggered

Löwenstein Medical

Leoni plus: triggered, without HFO

Nihon Kohden

NKV-550: triggered

Novalung

ALPHA100 (HFVO): triggered

SLE

SLE5000: triggered
SLE6000: triggered

Stephan GmbH

EVE: triggered

NO-A variations

In Germany and Europe, the nitric oxide dosing device NO-A is also available in the following variations and is distributed, calibrated and serviced by the cooperation partners listed below:

NO-A with blue front foil

exclusively distributed by MAQUET Vertrieb und Service Deutschland GmbH (now Getinge Deutschland GmbH) 
Countries: Germany, Austria, Switzerland, BeNeLux

CARDINO