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Sample records for home ventilation rate

  1. Association between ventilation rates in 390 Swedish homes and allergic symptoms in children

    DEFF Research Database (Denmark)

    Bornehag, Carl Gustaf; Sundell, Jan; Hagerhed-Engman, L.

    2005-01-01

    in 390 homes, were examined by physicians. Ventilation rates were measured by a passive tracer gas method, and inspections were carried out in the homes. About 60% of the multi-family houses and about 80% of the single-family houses did not fulfill the minimum requirement regarding ventilation rate...

  2. Experiments to Evaluate and Implement Passive Tracer Gas Methods to Measure Ventilation Rates in Homes

    Energy Technology Data Exchange (ETDEWEB)

    Lunden, Melissa [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Faulkner, David [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Heredia, Elizabeth [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Cohn, Sebastian [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Dickerhoff, Darryl [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Noris, Federico [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Logue, Jennifer [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hotchi, Toshifumi [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Singer, Brett [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sherman, Max H. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2012-10-01

    This report documents experiments performed in three homes to assess the methodology used to determine air exchange rates using passive tracer techniques. The experiments used four different tracer gases emitted simultaneously but implemented with different spatial coverage in the home. Two different tracer gas sampling methods were used. The results characterize the factors of the execution and analysis of the passive tracer technique that affect the uncertainty in the calculated air exchange rates. These factors include uncertainties in tracer gas emission rates, differences in measured concentrations for different tracer gases, temporal and spatial variability of the concentrations, the comparison between different gas sampling methods, and the effect of different ventilation conditions.

  3. Ventilation rates and health

    DEFF Research Database (Denmark)

    Sundell, Jan; Levin, H; Nazaroff, W W

    2011-01-01

    and health effects to inform the relationship. Consistency was found across multiple investigations and different epidemiologic designs for different populations. Multiple health endpoints show similar relationships with ventilation rate. There is biological plausibility for an association of health outcomes...... studies of the relationship between ventilation rates and health, especially in diverse climates, in locations with polluted outdoor air and in buildings other than offices. PRACTICAL IMPLICATIONS: Ventilation with outdoor air plays an important role influencing human exposures to indoor pollutants...

  4. Innovation in home mechanical ventilation

    NARCIS (Netherlands)

    Hazenberg, Andrea

    2017-01-01

    Patients on home mechanical ventilation (HMV) are ventilator dependent, usually for the rest of their lives. In the past decades, the number of patients on HMV increased to nearly 3,000 in 2016 in the Netherlands. Current indications for HMV are patients diagnosed with either neuromuscular disease,

  5. Home Ventilator Guide

    Science.gov (United States)

    ... lower cost, and compensation for leaks from masks. Disadvantages include lack of internal batteries, no or few ... www.gerespiratorycarecentral.com/home_care.php Löwenstein Medical Technology GmbH + Co. KG (Weinmann.de) https://loewensteinmedical.de/ ...

  6. Battery life of portable home ventilators: effects of ventilator settings.

    Science.gov (United States)

    Falaize, Line; Leroux, Karl; Prigent, Hélène; Louis, Bruno; Khirani, Sonia; Orlikowski, David; Fauroux, Brigitte; Lofaso, Frédéric

    2014-07-01

    The battery life (BL) of portable home ventilator batteries is reported by manufacturers. The aim of this study was to evaluate the effects of ventilator mode, breathing frequency, PEEP, and leaks on the BL of 5 commercially available portable ventilators. The effects of the ventilator mode (volume controlled-continuous mandatory ventilation [VC-CMV] vs pressure support ventilation [PSV]), PEEP 5 cm H2O, breathing frequency (10, 15, and 20 breaths/min), and leaks during both volume-targeted ventilation and PSV on the BL of 5 ventilators (Elisée 150, Monnal T50, PB560, Vivo 50, and Trilogy 100) were evaluated. Each ventilator was ventilated with a test lung at a tidal volume of 700 ml and an inspiratory time of 1.2 s in the absence of leaks. Switching from PSV to VC-CMV or the addition of PEEP did not significantly change ventilator BL. The increase in breathing frequency from 10 to 20 breaths/min decreased the BL by 18 ± 11% (P = .005). Leaks were associated with an increase in BL during the VC-CMV mode (18 ± 20%, P = .04) but a decrease in BL during the PSV mode (-13 ± 15%, P = .04). The BL of home ventilators depends on the ventilator settings. BL is not affected by the ventilator mode (VC-CMV or PSV) or the addition of PEEP. BL decreases with an increase in breathing frequency and during leaks with a PSV mode, whereas leaks increase the duration of ventilator BL during VC-CMV. Copyright © 2014 by Daedalus Enterprises.

  7. What does built-in software of home ventilators tell us? An observational study of 150 patients on home ventilation.

    Science.gov (United States)

    Pasquina, Patrick; Adler, Dan; Farr, Pamela; Bourqui, Pascale; Bridevaux, Pierre Olivier; Janssens, Jean-Paul

    2012-01-01

    Recent home ventilators are equipped with built-in software which provides data such as compliance, estimations of leaks, tidal volume, minute ventilation, respiratory rate, apnea and apnea-hypopnea indexes, and percentage of inspirations triggered by the patient (or ventilator). However, for many of these variables, there is neither consensus nor documentation as to what is to be expected in a population of stable patients under noninvasive ventilation (NIV). To document the values and distribution of specific items downloaded from ventilator monitoring software, by diagnostic category. Analysis of data downloaded from home ventilators in clinically stable patients under long-term NIV, during elective home visits by specialized nurses. Data were collected from home ventilators of 150 patients with chronic obstructive pulmonary disease (n = 32), overlap syndrome (n = 29), obesity-hypoventilation (n = 38), neuromuscular disorders (n = 19), restrictive disorders (n = 21), and central sleep apnea syndrome (n = 11). On average, leaks were low, being lowest in patients with facial masks (vs. nasal masks), and increased with older age. Compliance was excellent in all groups. Patients with neuromuscular diseases triggered their ventilators less and tended to be 'captured', while other groups triggered at least half of inspiratory cycles. Most patients had a respiratory rate just slightly above the back-up rate. Residual apneas and hypopneas were highest in patients with central apneas. Built-in software of home ventilators provides the clinician with new parameters, some of which are a useful adjunct to recommended tools for monitoring NIV and may contribute to a better understanding of residual hypoventilation and/or desaturations. However, an independent validation of the accuracy of this information is mandatory. Copyright © 2011 S. Karger AG, Basel.

  8. Increasing ventilation as an intervention in homes of asthmatic children

    DEFF Research Database (Denmark)

    Hogaard, Nina Viskum; Rubak, Sune Leisgaard Mørck; Halken, Susanne

    2016-01-01

    in children. We conducted a double-blind, placebo-controlled intervention study with 46 asthmatic, house dust mite allergic children. The aim was to investigate the association between indoor air quality in homes and severity of asthma, in particular the effect of increased ventilation rate and expected lower...... exposure to HDM on medication intake among these children. As a result of the intervention, the ventilation rate increased and the CO2 concentration fell significantly compared to baseline in the intervention group. The analyses of the effect of ventilation on health outcomes are being processed...

  9. Home mechanical ventilation in Canada: a national survey.

    Science.gov (United States)

    Rose, Louise; McKim, Douglas A; Katz, Sherri L; Leasa, David; Nonoyama, Mika; Pedersen, Cheryl; Goldstein, Roger S; Road, Jeremy D

    2015-05-01

    No comprehensive Canadian national data describe the prevalence of and service provision for ventilator-assisted individuals living at home, data critical to health-care system planning for appropriate resourcing. Our objective was to generate national data profiling service providers, users, types of services, criteria for initiation and monitoring, ventilator servicing arrangements, education, and barriers to home transition. Eligible providers delivering services to ventilator-assisted individuals (adult and pediatric) living at home were identified by our national provider inventory and referrals from other providers. The survey was administered via a web link from August 2012 to April 2013. The survey response rate was 152/171 (89%). We identified 4,334 ventilator-assisted individuals: an estimated prevalence of 12.9/100,000 population, with 73% receiving noninvasive ventilation (NIV) and 18% receiving intermittent mandatory ventilation (9% not reported). Services were delivered by 39 institutional providers and 113 community providers. We identified variation in initiation criteria for NIV, with polysomnography demonstrating nocturnal hypoventilation (57%), daytime hypercapnia (38%), and nocturnal hypercapnia (32%) as the most common criteria. Various models of ventilator servicing were reported. Most providers (64%) stated that caregiver competency was a prerequisite for home discharge; however, repeated competency assessment and retraining were offered by only 45%. Important barriers to home transition were: insufficient funding for paid caregivers, equipment, and supplies; a shortage of paid caregivers; and negotiating public funding arrangements. Ventilatory support in the community appears well-established, with most individuals managed with NIV. Although caregiver competency is a prerequisite to discharge, ongoing assessment and retraining were infrequent. Funding and caregiver availability were important barriers to home transition. Copyright © 2015

  10. Measure Guideline: Selecting Ventilation Systems for Existing Homes

    Energy Technology Data Exchange (ETDEWEB)

    Aldrich, Robb [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2014-02-01

    This document addresses adding -or improving - mechanical ventilation systems to existing homes. The purpose of ventilation is to remove contaminants from homes, and this report discusses where, when, and how much ventilation is appropriate in a home, including some discussion of relevant codes and standards. Advantages, disadvantages, and approximate costs of various system types are presented along with general guidelines for implementing the systems in homes. CARB intends for this document to be useful to decision makers and contractors implementing ventilation systems in homes. Choosing the "best" system is not always straightforward; selecting a system involves balancing performance, efficiency, cost, required maintenance, and several other factors. It is the intent of this document to assist contractors in making more informed decisions when selecting systems. Ventilation is an integral part of a high-performance home. With more air-sealed envelopes, a mechanical means of removing contaminants is critical for indoor environmental quality and building durability.

  11. Ventilation in homes infested by house-dust mites.

    Science.gov (United States)

    Sundell, J; Wickman, M; Pershagen, G; Nordvall, S L

    1995-02-01

    Thirty single-family homes with either high (> or = 2000 ng/g) or low (< or = 1000 ng/g) house-dust mite (HDM) allergen levels in mattress dust were examined for ventilation, thermal climate, and air quality (formaldehyde and total volatile organic compounds (TVOC). Elevated concentrations of HDM allergen in mattress and floor dust were associated with the difference in absolute humidity between indoor and outdoor air, as well as with low air-change rates of the home, particularly the bedroom. No correlation was found between concentration of TVOC or formaldehyde in bedroom air and HDM allergen concentration. In regions with a cold winter climate, the air-change rate of the home and the infiltration of outdoor air into the bedroom appear to be important for the infestation of HDM.

  12. Evaluation of the user-friendliness of 11 home mechanical ventilators.

    Science.gov (United States)

    Gonzalez-Bermejo, J; Laplanche, V; Husseini, F E; Duguet, A; Derenne, J-P; Similowski, T

    2006-06-01

    The home ventilator market has grown in size and complexity. The aim of this study was to determine if common home ventilators are user-friendly for trained intensive care unit (ICU) physicians. Eleven ventilator models were tested by 13 ICU physicians without practical experience in home mechanical ventilation. Six tests were defined (start-up, unlocking, mode and setting recognition, mode change, pressure setting and alarm). For each test, the physicians were timed and their performance compared with a reference time established by a technician. The physicians also had to rate their global assessment of each machine on a visual analogue scale. The start-up test was the only test for which there was no significant difference between the physicians and the technician, except for two ventilators. The physicians were slower than the technician to unlock the ventilator and change the ventilatory mode, with some complete failures during these tests and heterogeneous results between physicians and between ventilators. Mistakes occurred in close to 50% of cases during the ventilatory mode and settings recognition test. The mean time for the most rapid of the physicians for all the tests was 58+/-53 s, compared with 15+/-9 s for the technician. In conclusion, trained intensive care unit physicians perform poorly when confronted with home mechanical ventilators without specific prior training. Therefore, it is hypothesised that the user-friendliness of home ventilators for other categories of users might be questionable.

  13. Analysis of a Pediatric Home Mechanical Ventilator Population.

    Science.gov (United States)

    Amirnovin, Rambod; Aghamohammadi, Sara; Riley, Carley; Woo, Marlyn S; Del Castillo, Sylvia

    2018-05-01

    The population of children requiring home mechanical ventilation has evolved over the years and has grown to include a variety of diagnoses and needs that have led to changes in the care of this unique population. The purpose of this study was to provide a descriptive analysis of pediatric patients requiring home mechanical ventilation after hospitalization and how the evolution of this technology has impacted their care. A retrospective, observational, longitudinal analysis of 164 children enrolled in a university-affiliated home mechanical ventilation program over 26 years was performed. Data included each child's primary diagnosis, date of tracheostomy placement, duration of mechanical ventilation during hospitalization that consisted of home mechanical ventilator initiation, total length of pediatric ICU stay, ventilator settings at time of discharge from pediatric ICU, and disposition (home, facility, or died). Univariate, bivariate, and regression analysis was used as appropriate. The most common diagnosis requiring the use of home mechanical ventilation was neuromuscular disease (53%), followed by chronic pulmonary disease (29%). The median length of stay in the pediatric ICU decreased significantly after the implementation of a ventilator ward (70 d [30-142] vs 36 d [18-67], P = .02). The distribution of subjects upon discharge was home (71%), skilled nursing facility (24%), and died (4%), with an increase in the proportion of subjects discharged on PEEP and those going to nursing facilities over time ( P = 0.02). The evolution of home mechanical ventilation has allowed earlier transition out of the pediatric ICU and with increasing disposition to skilled nursing facilities over time. There has also been a change in ventilator management, including increased use of PEEP upon discharge, possibly driven by changes in ventilators and in-patient practice patterns. Copyright © 2018 by Daedalus Enterprises.

  14. Low home ventilation rate in combination with moldy odor from the building structure increase the risk for allergic symptoms in children

    DEFF Research Database (Denmark)

    Hägerhed-Engman, L.; Sigsgaard, T.; Samuelson, I.

    2009-01-01

    There are consistent findings on associations between asthma and allergy symptoms and residential mold and moisture. However, definitions of 'dampness' in studies are diverse because of differences in climate and building construction. Few studies have estimated mold problems inside the building...... ventilation rate in combination with moldy odor along the skirting board further increased the risk for three out of four studied outcomes, indicating that the ventilation rate is an effect modifier for indoor pollutants.This study showed that mold odor at the skirting board level is strongly associated...... with allergic symptoms among children. Such odor at that specific place can be seen as a proxy for some kind of hidden moisture or mold problem in the building structure, such as the foundation or wooden ground beam. In houses with odor along the skirting board, dismantling of the structure is required...

  15. Home Mechanical Ventilation: A 12-Year Population-Based Retrospective Cohort Study.

    Science.gov (United States)

    Povitz, Marcus; Rose, Louise; Shariff, Salimah Z; Leonard, Sean; Welk, Blayne; Jenkyn, Krista Bray; Leasa, David J; Gershon, Andrea S

    2018-04-01

    Increasing numbers of individuals are being initiated on home mechanical ventilation, including noninvasive (bi-level) and invasive mechanical ventilation delivered via tracheostomy due to chronic respiratory failure to enable symptom management and promote quality of life. Given the high care needs of these individuals, a better understanding of the indications for home mechanical ventilation, and health-care utilization is needed. We performed a retrospective cohort study using provincial health administrative data from Ontario, Canada (population ∼13,000,000). Home mechanical ventilation users were characterized using health administrative data to determine the indications for home mechanical ventilation, the need for acute care at the time of ventilation approval, and their health service use and mortality rates following approval. The annual incidence of home mechanical ventilation approval rose from 1.8/100,000 in 2000 to 5.0/100,000 in 2012, or an annual increase of approximately 0.3/100,000 persons/y. The leading indications were neuromuscular disease, thoracic restriction, and COPD. The indication for the remainder could not be determined due to limitations of the administrative databases. Of the 4,670 individuals, 23.0% commenced home mechanical ventilation following an acute care hospitalization. Among individuals who survived at least 1 y, fewer required hospitalization in the year that followed home mechanical ventilation approval (29.9% vs 39.8%) as compared with the year prior. Utilization of home mechanical ventilation is increasing in Ontario, Canada, and further study is needed to clarify the factors contributing to this and to further optimize utilization of health-care resources. Copyright © 2018 by Daedalus Enterprises.

  16. Recommended Ventilation Strategies for Energy-Efficient Production Homes

    Energy Technology Data Exchange (ETDEWEB)

    Roberson, J.; Brown, R.; Koomey, J.; Warner, J.; Greenberg, S.

    1998-12-01

    This report evaluates residential ventilation systems for the U.S. Environmental Protection Agency's (EPA's) ENERGY STAR{reg_sign} Homes program and recommends mechanical ventilation strategies for new, low-infiltration, energy-efficient, single-family, ENERGY STAR production (site-built tract) homes in four climates: cold, mixed (cold and hot), hot humid, and hot arid. Our group in the Energy Analysis Department at Lawrence Berkeley National Lab compared residential ventilation strategies in four climates according to three criteria: total annualized costs (the sum of annualized capital cost and annual operating cost), predominant indoor pressure induced by the ventilation system, and distribution of ventilation air within the home. The mechanical ventilation systems modeled deliver 0.35 air changes per hour continuously, regardless of actual infiltration or occupant window-opening behavior. Based on the assumptions and analysis described in this report, we recommend independently ducted multi-port supply ventilation in all climates except cold because this strategy provides the safety and health benefits of positive indoor pressure as well as the ability to dehumidify and filter ventilation air. In cold climates, we recommend that multi-port supply ventilation be balanced by a single-port exhaust ventilation fan, and that builders offer balanced heat-recovery ventilation to buyers as an optional upgrade. For builders who continue to install forced-air integrated supply ventilation, we recommend ensuring ducts are airtight or in conditioned space, installing a control that automatically operates the forced-air fan 15-20 minutes during each hour that the fan does not operate for heating or cooling, and offering ICM forced-air fans to home buyers as an upgrade.

  17. Home Mechanical Ventilation: A Canadian Thoracic Society Clinical Practice Guideline

    OpenAIRE

    McKim, Douglas A; Road, Jeremy; Avendano, Monica; Abdool, Steve; Côté, Fabien; Duguid, Nigel; Fraser, Janet; Maltais, François; Morrison, Debra L; O’Connell, Colleen; Petrof, Basil J; Rimmer, Karen; Skomro, Robert

    2011-01-01

    Increasing numbers of patients are surviving episodes of prolonged mechanical ventilation or benefitting from the recent availability of user-friendly noninvasive ventilators. Although many publications pertaining to specific aspects of home mechanical ventilation (HMV) exist, very few comprehensive guidelines that bring together all of the current literature on patients at risk for or using mechanical ventilatory support are available. The Canadian Thoracic Society HMV Guideline Committee ha...

  18. Measure Guideline: Selecting Ventilation Systems for Existing Homes

    Energy Technology Data Exchange (ETDEWEB)

    Aldrich, R. [Consortium for Advanced Residential Buildings (CARB), Norwalk, CT (United States)

    2014-02-01

    This report, developed by Building America research team CARB, addresses adding or improving mechanical ventilation systems to existing homes. The goal of this report is to assist decision makers and contractors in making informed decisions when selecting ventilation systems for homes. With more air-sealed envelopes, a mechanical means of removing contaminants is critical for indoor environmental quality and building durability. The purpose of ventilation is to remove contaminants from homes, and this report discusses where, when, and how much ventilation is appropriate in a home, including examination of relevant codes and standards. Choosing the "best" system is not always straightforward; selecting a system involves balancing performance, efficiency, cost, required maintenance, and several other factors.

  19. Ventilation, indoor air quality, and health in homes undergoing weatherization.

    Science.gov (United States)

    Francisco, P W; Jacobs, D E; Targos, L; Dixon, S L; Breysse, J; Rose, W; Cali, S

    2017-03-01

    Ventilation standards, health, and indoor air quality have not been adequately examined for residential weatherization. This randomized trial showed how ASHRAE 62-1989 (n=39 houses) and ASHRAE 62.2-2010 (n=42 houses) influenced ventilation rates, moisture balance, indoor air quality, and self-reported physical and mental health outcomes. Average total airflow was nearly twice as high for ASHRAE 62.2-2010 (79 vs. 39 cfm). Volatile organic compounds, formaldehyde and carbon dioxide were all significantly reduced for the newer standard and first-floor radon was marginally lower, but for the older standard, only formaldehyde significantly decreased. Humidity in the ASHRAE 62.2-2010 group was only about half that of the ASHRAE 62-1989 group using the moisture balance metric. Radon was higher in the basement but lower on the first floor for ASHRAE 62.2-2010. Children in each group had fewer headaches, eczema, and skin allergies after weatherization and adults had improvements in psychological distress. Indoor air quality and health improve when weatherization is accompanied by an ASHRAE residential ventilation standard, and the 2010 ASHRAE standard has greater improvements in certain outcomes compared to the 1989 standard. Weatherization, home repair, and energy conservation projects should use the newer ASHRAE standard to improve indoor air quality and health. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. The Effects of Ventilation in Homes on Health

    DEFF Research Database (Denmark)

    Wargocki, Pawel

    2013-01-01

    and many of them suffer from deficient experimental design, as well as a lack of proper characterization of actual exposures occurring indoors. Based on the available data, in the reviewed studies, it seems likely that health risks may occur when ventilation rates are below 0.4 air changes per hour...... with existing ventilation systems this positive effect was less evident, probably due to poor performance of the system (too low ventilation rates and/or poor maintenance). Studies are recommended in which exposures are much better characterized (by for example measuring the pollutants indicated by the WHO...... Guidelines for Indoor Air Quality and improving ventilation measurements). Exposures should also be controlled using different ventilation methods for comparison. Future studies should also advance the understanding of how ventilation systems should be operated to achieve optimal performance. These data...

  1. A new system for continuous and remote monitoring of patients receiving home mechanical ventilation.

    Science.gov (United States)

    Battista, L

    2016-09-01

    Home mechanical ventilation is the treatment of patients with respiratory failure or insufficiency by means of a mechanical ventilator at a patient's home. In order to allow remote patient monitoring, several tele-monitoring systems have been introduced in the last few years. However, most of them usually do not allow real-time services, as they have their own proprietary communication protocol implemented and some ventilation parameters are not always measured. Moreover, they monitor only some breaths during the whole day, despite the fact that a patient's respiratory state may change continuously during the day. In order to reduce the above drawbacks, this work reports the development of a novel remote monitoring system for long-term, home-based ventilation therapy; the proposed system allows for continuous monitoring of the main physical quantities involved during home-care ventilation (e.g., differential pressure, volume, and air flow rate) and is developed in order to allow observations of different remote therapy units located in different places of a city, region, or country. The developed remote patient monitoring system is able to detect various clinical events (e.g., events of tube disconnection and sleep apnea events) and has been successfully tested by means of experimental tests carried out with pulmonary ventilators typically used to support sick patients.

  2. Accuracy of tidal volume delivered by home mechanical ventilation during mouthpiece ventilation

    Science.gov (United States)

    Prigent, Helene; Falaize, Line; Leroux, Karl; Santos, Dante; Vaugier, Isabelle; Orlikowski, David; Lofaso, Frederic

    2016-01-01

    The aim of our study was to evaluate efficacy and reliability of currently available ventilators for mouthpiece ventilation (MPV). Five life-support home ventilators were assessed in a bench test using different settings simulating the specificities of MPV, such as intermittent circuit disconnection and presence of continuous leaks. The intermittent disconnection of the circuit caused relevant swings in the delivered tidal volume (VT), showing a VT overshoot during the disconnection periods and a VT decrease when the interface was reconnected to the test lung. The five ventilators showed substantial differences in the number of respiratory cycles necessary to reach a stable VT in the volume-controlled setting, ranging from 1.3 ± 0.6 to 7.3 ± 1.2 cycles. These differences were less accentuated in the volume-assisted setting (MPV-dedicated mode, when available). Our data show large differences in the capacity of the different ventilators to deal with the rapidly changing respiratory load features that characterize MPV, which can be further accentuated according to the used ventilator setting. The dedicated MPV modes allow improvement in the performance of ventilators only in some defined situations. This has practical consequences for the choice of the ventilator to be used for MPV in a specific patient. PMID:27146811

  3. Monitoring of noninvasive ventilation by built-in software of home bilevel ventilators: a bench study.

    Science.gov (United States)

    Contal, Olivier; Vignaux, Laurence; Combescure, Christophe; Pepin, Jean-Louis; Jolliet, Philippe; Janssens, Jean-Paul

    2012-02-01

    Current bilevel positive-pressure ventilators for home noninvasive ventilation (NIV) provide physicians with software that records items important for patient monitoring, such as compliance, tidal volume (Vt), and leaks. However, to our knowledge, the validity of this information has not yet been independently assessed. Testing was done for seven home ventilators on a bench model adapted to simulate NIV and generate unintentional leaks (ie, other than of the mask exhalation valve). Five levels of leaks were simulated using a computer-driven solenoid valve (0-60 L/min) at different levels of inspiratory pressure (15 and 25 cm H(2)O) and at a fixed expiratory pressure (5 cm H(2)O), for a total of 10 conditions. Bench data were compared with results retrieved from ventilator software for leaks and Vt. For assessing leaks, three of the devices tested were highly reliable, with a small bias (0.3-0.9 L/min), narrow limits of agreement (LA), and high correlations (R(2), 0.993-0.997) when comparing ventilator software and bench results; conversely, for four ventilators, bias ranged from -6.0 L/min to -25.9 L/min, exceeding -10 L/min for two devices, with wide LA and lower correlations (R(2), 0.70-0.98). Bias for leaks increased markedly with the importance of leaks in three devices. Vt was underestimated by all devices, and bias (range, 66-236 mL) increased with higher insufflation pressures. Only two devices had a bias ventilation must be aware of differences in the estimation of leaks and Vt by ventilator software. Also, leaks are reported in different ways according to the device used.

  4. Home Mechanical Ventilation: A Canadian Thoracic Society Clinical Practice Guideline

    Directory of Open Access Journals (Sweden)

    Douglas A McKim

    2011-01-01

    Full Text Available Increasing numbers of patients are surviving episodes of prolonged mechanical ventilation or benefitting from the recent availability of user-friendly noninvasive ventilators. Although many publications pertaining to specific aspects of home mechanical ventilation (HMV exist, very few comprehensive guidelines that bring together all of the current literature on patients at risk for or using mechanical ventilatory support are available. The Canadian Thoracic Society HMV Guideline Committee has reviewed the available English literature on topics related to HMV in adults, and completed a detailed guideline that will help standardize and improve the assessment and management of individuals requiring noninvasive or invasive HMV. The guideline provides a disease-specific review of illnesses including amyotrophic lateral sclerosis, spinal cord injury, muscular dystrophies, myotonic dystrophy, kyphoscoliosis, post-polio syndrome, central hypoventilation syndrome, obesity hypoventilation syndrome, and chronic obstructive pulmonary disease as well as important common themes such as airway clearance and the process of transition to home. The guidelines have been extensively reviewed by international experts, allied health professionals and target audiences. They will be updated on a regular basis to incorporate any new information.

  5. Home mechanical ventilation: a Canadian Thoracic Society clinical practice guideline.

    Science.gov (United States)

    McKim, Douglas A; Road, Jeremy; Avendano, Monica; Abdool, Steve; Cote, Fabien; Duguid, Nigel; Fraser, Janet; Maltais, Fracois; Morrison, Debra L; O'Connell, Colleen; Petrof, Basil J; Rimmer, Karen; Skomro, Robert

    2011-01-01

    Increasing numbers of patients are surviving episodes of prolonged mechanical ventilation or benefitting from the recent availability of userfriendly noninvasive ventilators. Although many publications pertaining to specific aspects of home mechanical ventilation (HMV) exist, very few comprehensive guidelines that bring together all of the current literature on patients at risk for or using mechanical ventilatory support are available. The Canadian Thoracic Society HMV Guideline Committee has reviewed the available English literature on topics related to HMV in adults, and completed a detailed guideline that will help standardize and improve the assessment and management of individuals requiring noninvasive or invasive HMV. The guideline provides a disease-specific review of illnesses including amyotrophic lateral sclerosis, spinal cord injury, muscular dystrophies, myotonic dystrophy, kyphoscoliosis, post-polio syndrome, central hypoventilation syndrome, obesity hypoventilation syndrome, and chronic obstructive pulmonary disease as well as important common themes such as airway clearance and the process of transition to home. The guidelines have been extensively reviewed by international experts, allied health professionals and target audiences. They will be updated on a regular basis to incorporate any new information.

  6. Performance of mechanical ventilators at the patient's home: a multicentre quality control study.

    Science.gov (United States)

    Farré, R; Navajas, D; Prats, E; Marti, S; Guell, R; Montserrat, J M; Tebe, C; Escarrabill, J

    2006-05-01

    Quality control procedures vary considerably among the providers of equipment for home mechanical ventilation (HMV). A multicentre quality control survey of HMV was performed at the home of 300 patients included in the HMV programmes of four hospitals in Barcelona. It consisted of three steps: (1) the prescribed ventilation settings, the actual settings in the ventilator control panel, and the actual performance of the ventilator measured at home were compared; (2) the different ventilator alarms were tested; and (3) the effect of differences between the prescribed settings and the actual performance of the ventilator on non-programmed readmissions of the patient was determined. Considerable differences were found between actual, set, and prescribed values of ventilator variables; these differences were similar in volume and pressure preset ventilators. The percentage of patients with a discrepancy between the prescribed and actual measured main ventilator variable (minute ventilation or inspiratory pressure) of more than 20% and 30% was 13% and 4%, respectively. The number of ventilators with built in alarms for power off, disconnection, or obstruction was 225, 280 and 157, respectively. These alarms did not work in two (0.9%), 52 (18.6%) and eight (5.1%) ventilators, respectively. The number of non-programmed hospital readmissions in the year before the study did not correlate with the index of ventilator error. This study illustrates the current limitations of the quality control of HMV and suggests that improvements should be made to ensure adequate ventilator settings and correct ventilator performance and ventilator alarm operation.

  7. Formaldehyde and acetaldehyde exposure mitigation in US residences: In-home measurements of ventilation control and source control

    Energy Technology Data Exchange (ETDEWEB)

    Hult, Erin L. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Willem, Henry [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Price, Phillip N. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hotchi, Toshifumi [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Russell, Marion L. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Singer, Brett C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2014-10-01

    Measurements were taken in new US residences to assess the extent to which ventilation and source control can mitigate formaldehyde exposure. Increasing ventilation consistently lowered indoor formaldehyde concentrations. However, at a reference air exchange rate of 0.35 h-1, increasing ventilation was up to 60% less effective than would be predicted if the emission rate were constant. This is consistent with formaldehyde emission rates decreasing as air concentrations increase, as observed in chamber studies. In contrast, measurements suggest acetaldehyde emission was independent of ventilation rate. To evaluate the effectiveness of source control, formaldehyde concentrations were measured in Leadership in Energy and Environmental Design (LEED) certified/Indoor airPLUS homes constructed with materials certified to have low emission rates of volatile organic compounds (VOC). At a reference air exchange rate of 0.35 h-1, and adjusting for home age, temperature and relative humidity, formaldehyde concentrations in homes built with low-VOC materials were 42% lower on average than in reference new homes with conventional building materials. Without adjustment, concentrations were 27% lower in the low-VOC homes. The mean and standard deviation of formaldehyde concentration were 33 μg m-3 and 22 μg m-3 for low-VOC homes and 45 μg m-3 and 30 μg m-3 for conventional.

  8. Bench evaluation of 7 home-care ventilators.

    Science.gov (United States)

    Blakeman, Thomas C; Rodriquez, Dario; Hanseman, Dennis; Branson, Richard D

    2011-11-01

    Portable ventilators continue to decrease in size while increasing in performance. We bench-tested the triggering, battery duration, and tidal volume (V(T)) of 7 portable ventilators: LTV 1000, LTV 1200, Puritan Bennett 540, Trilogy, Vela, iVent 101, and HT50. We tested triggering with a modified dual-chamber test lung to simulate spontaneous breathing with weak, normal, and strong inspiratory effort. We measured battery duration by fully charging the battery and operating the ventilator with a V(T) of 500 mL, a respiratory rate of 20 breaths/min, and PEEP of 5 cm H(2)O until breath-delivery ceased. We tested V(T) accuracy with pediatric ventilation scenarios (V(T) 50 mL or 100 mL, respiratory rate 50 breaths/min, inspiratory time 0.3 s, and PEEP 5 cm H(2)O) and an adult ventilation scenario (V(T) 400 mL, respiratory rate 30 breaths/min, inspiratory time 0.5 s, and PEEP 5 cm H(2)O). We measured and analyzed airway pressure, volume, and flow signals. At the adult settings the measured V(T) range was 362-426 mL. On the pediatric settings the measured V(T) range was 51-182 mL at the set V(T) of 50 mL, and 90-141 mL at the set V(T) of 100 mL. The V(T) delivered by the Vela at both the 50 mL and 100 mL, and by the HT50 at 100 mL, did not meet the American Society for Testing and Materials standard for V(T) accuracy. Triggering response and battery duration ranged widely among the tested ventilators. There was wide variability in battery duration and triggering sensitivity. Five of the ventilators performed adequately in V(T) delivery across several settings. The combination of high respiratory rate and low V(T) presented problems for 2 of the ventilators.

  9. Position paper -- Tank ventilation system design air flow rates

    International Nuclear Information System (INIS)

    Goolsby, G.K.

    1995-01-01

    The purpose of this paper is to document a project position on required ventilation system design air flow rates for the waste storage tanks currently being designed by project W-236A, the Multi-Function Waste Tank Facility (MWTF). The Title 1 design primary tank heat removal system consists of two systems: a primary tank vapor space ventilation system; and an annulus ventilation system. At the conclusion of Title 1 design, air flow rates for the primary and annulus ventilation systems were 960 scfm and 4,400 scfm, respectively, per tank. These design flow rates were capable of removing 1,250,000 Btu/hr from each tank. However, recently completed and ongoing studies have resulted in a design change to reduce the extreme case heat load to 700,000 Btu/hr. This revision of the extreme case heat load, coupled with results of scale model evaporative testing performed by WHC Thermal Hydraulics, allow for a reduction of the design air flow rates for both primary and annulus ventilation systems. Based on the preceding discussion, ICF Kaiser Hanford Co. concludes that the design should incorporate the following design air flow rates: Primary ventilation system--500 scfm maximum and Annulus ventilation system--1,100 scfm maximum. In addition, the minimum air flow rates in the primary and annulus ventilation systems will be investigated during Title 2 design. The results of the Title 2 investigation will determine the range of available temperature control using variable air flows to both ventilation systems

  10. Building America Case Study: Selecting Ventilation Systems for Existing Homes (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    2014-12-01

    This document addresses adding -or improving - mechanical ventilation systems to existing homes. The purpose of ventilation is to remove contaminants from homes, and this report discusses where, when, and how much ventilation is appropriate in a home, including some discussion of relevant codes and standards. Advantages, disadvantages, and approximate costs of various system types are presented along with general guidelines for implementing the systems in homes. CARB intends for this document to be useful to decision makers and contractors implementing ventilation systems in homes. Choosing the "best" system is not always straightforward; selecting a system involves balancing performance, efficiency, cost, required maintenance, and several other factors. It is the intent of this document to assist contractors in making more informed decisions when selecting systems. Ventilation is an integral part of a high-performance home. With more air-sealed envelopes, a mechanical means of removing contaminants is critical for indoor environmental quality and building durability.

  11. Technology Solutions Case Study: Selecting Ventilation Systems for Existing Homes

    Energy Technology Data Exchange (ETDEWEB)

    None

    2014-12-01

    In multifamily buildings, particularly in the Northeast, exhaust ventilation strategies are the norm as a means of meeting both local exhaust and whole-unit mechanical ventilation rates. The issue of where the "fresh" air is coming from is gaining significance as air-tightness standards for enclosures become more stringent, and the normal leakage paths through the building envelope disappear. Researchers from the Consortium for Advanced Residential Buildings (CARB) found that the majority of high performance, new construction, multifamily housing in the Northeast use one of four general strategies for ventilation: continuous exhaust only with no designated supply or make-up air source, continuous exhaust with ducted make-up air to apartments, continuous exhaust with supply through a make-up air device integral to the unit HVAC, and continuous exhaust with supply through a passive inlet device, such as a trickle vent. Insufficient information is available to designers on how these various systems are best applied. In this project, the CARB team evaluated the four different strategies for providing make-up air to multifamily residential buildings and developed guidelines to help contractors and building owners choose the best ventilation systems.

  12. Association between substandard classroom ventilation rates and students' academic achievement.

    Science.gov (United States)

    Haverinen-Shaughnessy, U; Moschandreas, D J; Shaughnessy, R J

    2011-04-01

    This study focuses on the relationship between classroom ventilation rates and academic achievement. One hundred elementary schools of two school districts in the southwest United States were included in the study. Ventilation rates were estimated from fifth-grade classrooms (one per school) using CO(2) concentrations measured during occupied school days. In addition, standardized test scores and background data related to students in the classrooms studied were obtained from the districts. Of 100 classrooms, 87 had ventilation rates below recommended guidelines based on ASHRAE Standard 62 as of 2004. There is a linear association between classroom ventilation rates and students' academic achievement within the range of 0.9-7.1 l/s per person. For every unit (1 l/s per person) increase in the ventilation rate within that range, the proportion of students passing standardized test (i.e., scoring satisfactory or above) is expected to increase by 2.9% (95%CI 0.9-4.8%) for math and 2.7% (0.5-4.9%) for reading. The linear relationship observed may level off or change direction with higher ventilation rates, but given the limited number of observations, we were unable to test this hypothesis. A larger sample size is needed for estimating the effect of classroom ventilation rates higher than 7.1 l/s per person on academic achievement. The results of this study suggest that increasing the ventilation rates toward recommended guideline ventilation rates in classrooms should translate into improved academic achievement of students. More studies are needed to fully understand the relationships between ventilation rate, other indoor environmental quality parameters, and their effects on students' health and achievement. Achieving the recommended guidelines and pursuing better understanding of the underlying relationships would ultimately support both sustainable and productive school environments for students and personnel. © 2010 John Wiley & Sons A/S.

  13. Waste tank ventilation rates measured with a tracer gas method

    International Nuclear Information System (INIS)

    Huckaby, J.L.; Evans, J.C.; Sklarew, D.S.; Mitroshkov, A.V.

    1998-08-01

    Passive ventilation with the atmosphere is used to prevent accumulation of waste gases and vapors in the headspaces of 132 of the 177 high-level radioactive waste Tanks at the Hanford Site in Southeastern Washington State. Measurements of the passive ventilation rates are needed for the resolution of two key safety issues associated with the rates of flammable gas production and accumulation and the rates at which organic salt-nitrate salt mixtures dry out. Direct measurement of passive ventilation rates using mass flow meters is not feasible because ventilation occurs va multiple pathways to the atmosphere (i.e., via the filtered breather riser and unsealed tank risers and pits), as well as via underground connections to other tanks, junction boxes, and inactive ventilation systems. The tracer gas method discussed in this report provides a direct measurement of the rate at which gases are removed by ventilation and an indirect measurement of the ventilation rate. The tracer gas behaves as a surrogate of the waste-generated gases, but it is only diminished via ventilation, whereas the waste gases are continuously released by the waste and may be subject to depletion mechanisms other than ventilation. The fiscal year 1998 tracer studies provide new evidence that significant exchange of air occurs between tanks via the underground cascade pipes. Most of the single-shell waste tanks are connected via 7.6-cm diameter cascade pipes to one or two adjacent tanks. Tracer gas studies of the Tank U-102/U-103 system indicated that the ventilation occurring via the cascade line could be a significant fraction of the total ventilation. In this two-tank cascade, air evidently flowed from Tank U-103 to Tank U-102 for a time and then was observed to flow from Tank U-102 to Tank U-103

  14. Cardiac function associated with home ventilator care in Duchenne muscular dystrophy.

    Science.gov (United States)

    Lee, Sangheun; Lee, Heeyoung; Eun, Lucy Youngmin; Gang, Seung Woong

    2018-02-01

    Cardiomyopathy is becoming the leading cause of death in patients with Duchenne muscular dystrophy because mechanically assisted lung ventilation and assisted coughing have helped resolve respiratory complications. To clarify cardiopulmonary function, we compared cardiac function between the home ventilator-assisted and non-ventilator-assisted groups. We retrospectively reviewed patients with Duchenne muscular dystrophy from January 2010 to March 2016 at Gangnam Severance Hospital. Demographic characteristics, pulmonary function, and echocardiography data were investigated. Fifty-four patients with Duchenne muscular dystrophy were divided into 2 groups: home ventilator-assisted and non-ventilator-assisted. The patients in the home ventilator group were older (16.25±1.85 years) than those in the nonventilator group (14.73±1.36 years) ( P =0.001). Height, weight, and body surface area did not differ significantly between groups. The home ventilator group had a lower seated functional vital capacity (1,038±620.41 mL) than the nonventilator group (1,455±603.12 mL). Mean left ventricular ejection fraction and fractional shortening were greater in the home ventilator group, but the data did not show any statistical difference. The early ventricular filling velocity/late ventricular filling velocity ratio (1.7±0.44) was lower in the home ventilator group than in the nonventilator group (2.02±0.62). The mitral valve annular systolic velocity was higher in the home ventilator group (estimated β, 1.06; standard error, 0.48). Patients with Duchenne muscular dystrophy on a ventilator may have better systolic and diastolic cardiac functions. Noninvasive ventilator assistance can help preserve cardiac function. Therefore, early utilization of noninvasive ventilation or oxygen may positively influence cardiac function in patients with Duchenne muscular dystrophy.

  15. Demand controlled ventilation in single-family homes; Behovstyret ventilation til enfamiliehuse

    Energy Technology Data Exchange (ETDEWEB)

    Rammer Nielsen, T.; Drivsholm, C.; Rudolph Hansen, M.P.; Kragh, J.

    2009-12-15

    This project investigated two different control strategies: A simple and cheap strategy and an advanced and expensive strategy: 1. Simple control: The ventilation rate is varied only on the whole building level giving an average ventilation rate of either 0.1 l/(s m{sup 2}) or 0.35 l/(s m{sup 2}). The air change rate is controlled by sensors in the air handling unit measuring relative humidity, temperature and CO{sub 2}. The control is based on the CO{sub 2}-concentration and absolute humidity in the supply air and exhaust air. A fixed set point for the difference in CO{sub 2}-concentration between the exhaust and supply is used to decide if the ventilation rate is low or high. As supplement to the CO{sub 2} control the difference in absolute humidity between exhaust and supply is used to assure that the ventilation remain at the high level if there is a high level of humidity in the house. 2. Advanced control: The air change rate is varied dynamically for all living rooms giving an average air change for the house between 0.1 l/(s m{sup 2}) and 0.35 l/(s m{sup 2}). The air change rate in the living rooms is controlled by CO{sub 2}-sensors in each room and dampers in the room supply duct. Relative humidity is measured in the rooms with high moisture production to ensure that the highest air exchange is activated if the relative humidity in one of these rooms is too high. Even though the two strategies have been implemented and tested for a long period of time, only the simple control can be recommended. The simple control ensures that the air quality is almost the same as if the house was ventilated constantly at the high ventilation rate. Also the simple control only requires two CO{sub 2} sensors, two relative humidity sensors and two temperature sensors in the air handling unit. These sensors should be checked from time to time e.g. when filters are exchanged. The simple control is today used in meeting rooms, office rooms and daycare facilities in a modified

  16. Transition from in-hospital ventilation to home ventilation: process description and quality indicators

    Directory of Open Access Journals (Sweden)

    Kastrup, Marc

    2017-12-01

    Full Text Available The current demographic development of our society results in an increasing number of elderly patients with chronic diseases being treated in the intensive care unit. A possible long-term consequence of such a treatment is that patients remain dependent on certain invasive organ support systems, such as long-term ventilator dependency. The main goal of this project is to define the transition process between in-hospital and out of hospital (ambulatory ventilator support. A further goal is to identify evidence-based quality indicators to help define and describe this process.This project describes an ideal sequence of processes (process chain, based on the current evidence from the literature. Besides the process chain, key data and quality indicators were described in detail. Due to the limited project timeline, these indicators were not extensively tested in the clinical environment.The results of this project may serve as a solid basis for proof of feasibility and proof of concept investigations, optimize the transition process of ventilator-dependent patients from a clinical to an ambulatory setting, as well as reduce the rate of emergency re-admissions.

  17. Ventilation

    DEFF Research Database (Denmark)

    Nielsen, Toke Rammer; Svendsen, Sv Aa Højgaard

    1999-01-01

    The note concerns ventilation in residential buildings. Describes components in ventilation systems, electric energy consumption and different ventilation systems with heat exchanger.......The note concerns ventilation in residential buildings. Describes components in ventilation systems, electric energy consumption and different ventilation systems with heat exchanger....

  18. Improved air ventilation rate estimation based on a statistical model

    International Nuclear Information System (INIS)

    Brabec, M.; Jilek, K.

    2004-01-01

    A new approach to air ventilation rate estimation from CO measurement data is presented. The approach is based on a state-space dynamic statistical model, allowing for quick and efficient estimation. Underlying computations are based on Kalman filtering, whose practical software implementation is rather easy. The key property is the flexibility of the model, allowing various artificial regimens of CO level manipulation to be treated. The model is semi-parametric in nature and can efficiently handle time-varying ventilation rate. This is a major advantage, compared to some of the methods which are currently in practical use. After a formal introduction of the statistical model, its performance is demonstrated on real data from routine measurements. It is shown how the approach can be utilized in a more complex situation of major practical relevance, when time-varying air ventilation rate and radon entry rate are to be estimated simultaneously from concurrent radon and CO measurements

  19. Paid carers' experiences of caring for mechanically ventilated children at home: implications for services and training.

    Science.gov (United States)

    Maddox, Christina; Pontin, David

    2013-06-01

    UK survival rates for long-term mechanically ventilated children have increased and paid carers are trained to care for them at home, however there is limited literature on carers' training needs and experience of sharing care. Using a qualitative abductive design, we purposively sampled experienced carers to generate data via diaries, semi-structured interviews, and researcher reflexive notes. Research ethics approval was granted from NHS and University committees. Five analytical themes emerged - Parent as expert; Role definition tensions; Training and Continuing Learning Needs; Mixed Emotions; Support Mechanisms highlighting the challenges of working in family homes for carers and their associated learning needs. Further work on preparing carers to share feelings with parents, using burnout prevention techniques, and building confidence is suggested. Carers highlight the lack of clinical supervision during their night-working hours. One solution may be to provide access to registered nurse support when working out-of-office hours.

  20. Measurements of waste tank passive ventilation rates using tracer gases

    International Nuclear Information System (INIS)

    Huckaby, J.L.; Olsen, K.B.; Sklarew, D.S.; Evans, J.C.; Remund, K.M.

    1997-09-01

    This report presents the results of ventilation rate studies of eight passively ventilated high-level radioactive waste tanks using tracer gases. Head space ventilation rates were determined for Tanks A-101, AX-102, AX-103, BY-105, C-107, S-102, U-103, and U-105 using sulfur hexafluoride (SF 6 ) and/or helium (He) as tracer gases. Passive ventilation rates are needed for the resolution of several key safety issues. These safety issues are associated with the rates of flammable gas production and ventilation, the rates at which organic salt-nitrate salt mixtures dry out, and the estimation of organic solvent waste surface areas. This tracer gas study involves injecting a tracer gas into the tank headspace and measuring its concentration at different times to establish the rate at which the tracer is removed by ventilation. Tracer gas injection and sample collection were performed by SGN Eurisys Service Corporation and/or Lockheed Martin Hanford Corporation, Characterization Project Operations. Headspace samples were analyzed for He and SF 6 by Pacific Northwest National Laboratory (PNNL). The tracer gas method was first demonstrated on Tank S-102. Tests were conducted on Tank S-102 to verify that the tracer gas was uniformly distributed throughout the tank headspace before baseline samples were collected, and that mixing was sufficiently vigorous to maintain an approximately uniform distribution of tracer gas in the headspace during the course of the study. Headspace samples, collected from a location about 4 in away from the injection point and 15, 30, and 60 minutes after the injection of He and SF 6 , indicated that both tracer gases were rapidly mixed. The samples were found to have the same concentration of tracer gases after 1 hour as after 24 hours, suggesting that mixing of the tracer gas was essentially complete within 1 hour

  1. The Perspective of Families With a Ventilator-Dependent Child at Home. A Literature Review.

    Science.gov (United States)

    Falkson, Sandra; Knecht, Christiane; Hellmers, Claudia; Metzing, Sabine

    This literature review gives an overview about the existing research concerning the experiences of families with a child with ventilation at home. The number of children with home-ventilation is increasing. Children who receive homecare have the possibility of growing up in their familiar environment and participate in social life. In comparison to children living in institutions, children at home show advantages in their physical, psychological, emotional, social and cognitive development. However, homecare of a child with ventilation places high demands on all family members. Parents assume divergent roles and live with losses. Especially mothers feel isolated, partially through self-imposed isolation. While parents are concerned about this dilemma, talk about their anxieties and strive for stability, children focus on other aspects of their life. They see the ventilator as a positive technique that helps them breathe. The children underline the importance of friends and would like to meet them without nurses in attendance. They strive for normalcy and independence like healthy children, asking for acceptance of themselves and their wishes. There are only few studies about the experience of families with a child with ventilator. Most studies are from the mother's perspective. Parents and children ascribe different importance to the ventilation. Further research should usefully explore the experiences of families with children using home-ventilation. The different perspectives of all family members have to be taken into consideration. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Transitions to Home Mechanical Ventilation: The Experiences of Canadian Ventilator-Assisted Adults and Their Family Caregivers.

    Science.gov (United States)

    Dale, Craig M; King, Judy; Nonoyama, Mika; Carbone, Sarah; McKim, Douglas; Road, Jeremy; Rose, Louise

    2017-12-28

    Several studies have explored the experience of ventilator-assisted individual (VAIs) living at home with family caregivers. However, few explore the experiences of these individuals as they transition from a hospital setting to living at home with a view to identifying modifiable processes that could optimize transition. This descriptive, qualitative study sought to elucidate barriers to, and facilitators of, transition to home mechanical ventilation (HMV) from the perspective of Canadian VAIs and their family caregivers. Participant recruitment occurred through hospital and community respiratory clinicians based in the four Canadian provinces of Alberta, British Columbia, Ontario, and Saskatchewan. Semi-structured telephone or face-to-face interviews at home were undertaken with 33 individuals including 19 VAIs and 14 family caregivers between 3 to 24 months of transitioning to HMV. Interview data was analyzed using content analysis. Formal teaching of knowledge and skills relevant to HMV within the hospital setting prior to transition was perceived as having an immediate and enduring positive impact on transition. However, family-clinician conflict, information gaps, and persistent lack of trained personal support workers (PSWs) to provide care in the home contributed to maladjustment relating to transition. Participants strongly recommended improved transitional care in the form of respiratory health professional telephone support, home outreach, in addition to training of PSWs. Transition to HMV is a complex and demanding process. Extended HMV training and support may be helpful in mediating adjustment challenges thus reducing stress, caregiver burden and improving health related quality of life for VAIs and family caregivers.

  3. Analysis of emergency helpline support for home ventilator dependent patients: risk management and workload

    Directory of Open Access Journals (Sweden)

    M. Chatwin

    2008-04-01

    Full Text Available From a total of 1211 adult & paediatric patients receiving home ventilation (HV supervised by Royal Brompton Hospital between 1/1/06 and 30/6/06 the respiratory support team received an average of 528 daytime calls/month and 14/month out of hours calls to a telephone helpline. Diagnoses included: neuromuscular disease, chest wall disease, COPD, obesity hypoventilation and non-COPD lung disease. 99% received non-invasive ventilation, 1% tracheostomy ventilation. 149 required 2 ventilators for near 24 hour ventilator dependency, the remainder were classified as 1 (17% 2 (33% & 3 (50% night dependency as were able to breathe spontaneously for this period. 50% used bilevel positive pressure ventilators, 48% inspiratory pressure ventilators and 2% volume ventilators. In 188 calls a home visit was carried out because of ventilator or associated equipment-related problems. Despite regular equipment servicing programme, in 188 patients there was a technical problem with the equipment which was solved in the patient's home in 64% or required replacement / parts in 22%. Of the 25 calls in which no fault was found, 13 patients were unwell at home or required hospital admission, 2 patients died within 1 month of identification of no fault. No patient was admitted as a result of technical failure of equipment. Conclusion: There is a significant workload associated with supporting HV patients. Patients / carers all received standard competency training before discharge but other calls may be reduced by a more flexible problem-solving approach. Importantly, reports in which no technical fault is found may indicate deteriorating health in the patient and require close follow-up.

  4. Practical guidebook on the modulation of ventilation flow rates; Guide pratique sur la modulation des debits de ventilation

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    The modulation of ventilation flow rates aims at adapting the flow rate of ventilation systems to the real occupancy of rooms, at maintaining a good indoor air quality and at mastering the energy expenses due to air renewing in rooms. This technical guidebook presents the design of modulated ventilation systems (definition of occupancy areas in buildings, choice of presence sensors (CO{sub 2}, hygrometry, temperature, CO, VOC and other specific probes)), their principle and implementation. (J.S.)

  5. Development of Smart Ventilation Control Algorithms for Humidity Control in High-Performance Homes in Humid U.S. Climates

    Energy Technology Data Exchange (ETDEWEB)

    Less, Brennan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Walker, Iain [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Ticci, Sara [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2017-04-11

    Past field research and simulation studies have shown that high performance homes experience elevated indoor humidity levels for substantial portions of the year in humid climates. This is largely the result of lower sensible cooling loads, which reduces the moisture removed by the cooling system. These elevated humidity levels lead to concerns about occupant comfort, health and building durability. Use of mechanical ventilation at rates specified in ASHRAE Standard 62.2-2013 are often cited as an additional contributor to humidity problems in these homes. Past research has explored solutions, including supplemental dehumidification, cooling system operational enhancements and ventilation system design (e.g., ERV, supply, exhaust, etc.). This project’s goal is to develop and demonstrate (through simulations) smart ventilation strategies that can contribute to humidity control in high performance homes. These strategies must maintain IAQ via equivalence with ASHRAE Standard 62.2-2013. To be acceptable they must not result in excessive energy use. Smart controls will be compared with dehumidifier energy and moisture performance. This work explores the development and performance of smart algorithms for control of mechanical ventilation systems, with the objective of reducing high humidity in modern high performance residences. Simulations of DOE Zero-Energy Ready homes were performed using the REGCAP simulation tool. Control strategies were developed and tested using the Residential Integrated Ventilation (RIVEC) controller, which tracks pollutant exposure in real-time and controls ventilation to provide an equivalent exposure on an annual basis to homes meeting ASHRAE 62.2-2013. RIVEC is used to increase or decrease the real-time ventilation rate to reduce moisture transport into the home or increase moisture removal. This approach was implemented for no-, one- and two-sensor strategies, paired with a variety of control approaches in six humid climates (Miami

  6. Home tracheotomy mechanical ventilation in patients with amyotrophic lateral sclerosis: causes, complications and 1-year survival.

    Science.gov (United States)

    Sancho, Jesús; Servera, Emilio; Díaz, José Luis; Bañuls, Pilar; Marín, Julio

    2011-11-01

    Home tracheotomy mechanical ventilation (HTMV) can prolong survival in patients with amyotrophic lateral sclerosis (ALS) when non-invasive ventilation (NIV) fails, but knowledge about HTMV is scarce. The aim of this study was to determine the causes of tracheotomy and the main issues of 1-year HTMV in a cohort of patients with ALS. A prospective study of all patients needing HTMV was performed in a referral respiratory care unit (RCU) from April 2001 to January 2010. Patients' informed decisions about HTMV were fully respected. Caregivers were trained and could telephone the RCU. Hospital staff made home visits. All patients (n=116) agreed to participate and a tracheotomy was needed for 76, mainly due to bulbar dysfunction. Of the 38 who had a tracheotomy, in 21 it was performed in an acute setting and in 17 as a non-emergency procedure. In 19 patients the tracheotomy was related to the inadequacy of mechanically assisted coughing (MAC) to maintain normal oxygen saturation. During HTMV, 19 patients required hospitalisation, 12 with respiratory problems. The 1-year survival rate was 78.9%, with a mean survival of 10.39 months (95% CI 9.36 to 11.43). Sudden death was the main cause of death (n=9) and only one patient died from respiratory causes. No predictive factors for survival were found. Besides NIV inadequacy, the ineffectiveness of mechanically assisted coughing appears to be a relevant cause of tracheotomy for patients with ALS with severe bulbar dysfunction. Patients choosing HTMV provided by a referral RCU could have a good 1-year survival rate, respiratory problems being the main cause of hospitalisation but not of death.

  7. The IVAIRE project--a randomized controlled study of the impact of ventilation on indoor air quality and the respiratory symptoms of asthmatic children in single family homes.

    Science.gov (United States)

    Lajoie, P; Aubin, D; Gingras, V; Daigneault, P; Ducharme, F; Gauvin, D; Fugler, D; Leclerc, J-M; Won, D; Courteau, M; Gingras, S; Héroux, M-È; Yang, W; Schleibinger, H

    2015-12-01

    A randomized controlled trial was carried out to measure the impact of an intervention on ventilation, indoor air contaminants, and asthma symptoms of children. Eighty-three asthmatic children living in low-ventilated homes were followed over 2 years. Several environmental parameters were measured during the summer, fall, and winter. The children were randomized after Year 1 (43 Intervention; 40 Control). The intervention included the installation of either a Heat Recovery Ventilator (HRV) or Energy Recovery Ventilator (ERV). During the fall and winter seasons, there was a significant increase in the mean ventilation rate in the homes of the intervention group. A statistically significant reduction in mean formaldehyde, airborne mold spores, toluene, styrene, limonene, and α-pinene concentrations was observed in the intervention group. There was no significant group difference in change in the number of days with symptoms per 14 days. However, there was a significant decrease in the proportion of children who experienced any wheezing (≥1 episode) and those with ≥4 episodes in the 12-month period in the intervention group. This study indicates that improved ventilation reduces air contaminants and may prevent wheezing. Due to lack of power, a bigger study is needed. Positive findings from this study include the fact that, upon recruitment, most of the single family homes with asthmatic children were already equipped with a mechanical ventilation system and had relatively good indoor air quality. However, the 8-h indoor guideline for formaldehyde (50 μg/m3) was frequently exceeded and the ventilation rates were low in most of the homes, even those with a ventilation system. Both ERVs and HRVs were equally effective at increasing air exchange rates above 0.30 ACH and at preventing formaldehyde concentrations from exceeding the 50 μg/m3 guideline during the fall and winter seasons. Furthermore, the ERVs were effective at preventing excessively low relative

  8. Effect of a ventilator-focused intervention on the rate of Acinetobacter baumannii infection among ventilated patients.

    Science.gov (United States)

    Cohen, Regev; Shimoni, Zvi; Ghara, Riad; Ram, Ron; Ben-Ami, Ronen

    2014-09-01

    Acinetobacter baumannii is a leading cause of ventilator-associated pneumonia, often as a result of ventilator equipment contamination. Evidence-based guidance on optimal care of ventilator equipment to prevent infection is lacking. Here, we report on a significant and persistent reduction in A baumannii infection rates achieved by introducing a strict policy on ventilator care. We implemented an institution-wide ventilator care policy that included routine exchange of breathing circuits and external bacterial filters (every 7-14 days) and replacement followed by routine sterilization of internal bacterial filters (every 4-8 weeks). We analyzed sputum cultures and patient outcomes among ventilated patients before and after the intervention. Between January 2012 and March 2013, 321 patients ventilated for more than 3 days comprised the study cohort. Health care-associated A baumannii acquisition was significantly reduced during the postintervention period (33% vs 16%; odds ratio, 0.39; 95% confidence interval, 0.23-0.67; P = .0008). Additionally, the median time to A baumannii acquisition was significantly longer postintervention (59 vs 21 days; P < .0001). A baumannii ventilator-associated pneumonia risk was also reduced postintervention (odds ratio, 0.39; P = .005). Implementing a stricter standard of ventilator care than that currently defined in published guidelines can significantly decrease health care-associated A baumannii acquisition and related adverse outcomes among ventilated patients. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  9. On the influence of the ventilation rate to the radiation burden in dwellings

    International Nuclear Information System (INIS)

    Tschurlovits, M.

    1980-01-01

    Calculations on the influence of the ventilation rate to the concentration of radon in dwellings from radioactive material of natural origin in building material are completed with a few examples of measurements. In addition, the optimization of the ventilation rate and the consequences of poorly ventilated dwellings are reported briefly. (author)

  10. [Management of patients receiving home respiratory care with tracheostomy and positive-pressure ventilation].

    Science.gov (United States)

    Aoki, Masashi

    2013-01-01

    On March 11, 2011, the Great East Japan Earthquake occurred and a massive tsunami hit the northeastern coast of Japan. In Miyagi prefecture in Tokoku district, 49 patients with amyotrophic lateral sclerosis were supported by home respiratory care with tracheostomy and positive-pressure ventilation at that time. Among them, two patients were died in the tsunami and 25 patients were forced to evacuate to hospitals. We should hurry to submit a guideline for medical transportation for patients with neuromuscular diseases requiring artificial ventilation. We also should research the disaster medicine in the field of neurology.

  11. Home monitoring of daytime mouthpiece ventilation effectiveness in patients with neuromuscular disease

    Science.gov (United States)

    Nardi, Julie; Leroux, Karl; Orlikowski, David; Prigent, Hélène

    2015-01-01

    Mouthpiece ventilation (MPV) allows patients with neuromuscular disease to receive daytime support from a portable ventilator, which they can disconnect at will, for example, for speaking, eating, swallowing, and coughing. However, MPV carries a risk of underventilation. Our purpose here was to evaluate the effectiveness of daytime MPV under real-life conditions. Eight wheelchair-bound patients who used MPV underwent daytime polygraphy at home with recordings of airflow, mouthpiece pressure, thoracic and abdominal movements, peripheral capillary oxygen saturation (SpO2), and transcutaneous partial pressure of carbon dioxide (PtcCO2). Times and durations of tasks and activities were recorded. The Apnea–Hypopnea Index (AHI) was computed. Patient–ventilator disconnections ≥3 minutes and episodes of hypoventilation defined as PtcCO2>45 mmHg were counted. Patient–ventilator asynchrony events were analyzed. The AHI was >5 hour−1 in two patients. Another patient experienced unexplained 3% drops in arterial oxygen saturations at a frequency of 70 hour−1. Patient–ventilator disconnections ≥3 minutes occurred in seven of eight patients and were consistently associated with decreases in SpO2 and ≥5-mmHg increases in PtcCO2; PtcCO2 rose above 45 mmHg in two patients during these disconnections. The most common type of patient–ventilator asynchrony was ineffective effort. This study confirms that MPV can be effective as long as the patient remains connected to the mouthpiece. However, transient arterial oxygen desaturation and hypercapnia due to disconnection from the ventilator may occur, without inducing unpleasant sensations in the patients. Therefore, an external warning system based on a minimal acceptable value of minute ventilation would probably be useful. PMID:26703922

  12. Effect of dynamic random leaks on the monitoring accuracy of home mechanical ventilators: a bench study.

    Science.gov (United States)

    Sogo, Ana; Montanyà, Jaume; Monsó, Eduard; Blanch, Lluís; Pomares, Xavier; Lujàn, Manel

    2013-12-10

    So far, the accuracy of tidal volume (VT) and leak measures provided by the built-in software of commercial home ventilators has only been tested using bench linear models with fixed calibrated and continuous leaks. The objective was to assess the reliability of the estimation of tidal volume (VT) and unintentional leaks in a single tubing bench model which introduces random dynamic leaks during inspiratory or expiratory phases. The built-in software of four commercial home ventilators and a fifth ventilator-independent ad hoc designed external software tool were tested with two levels of leaks and two different models with excess leaks (inspiration or expiration). The external software analyzed separately the inspiratory and expiratory unintentional leaks. In basal condition, all ventilators but one underestimated tidal volume with values ranging between -1.5 ± 3.3% to -8.7% ± 3.27%. In the model with excess of inspiratory leaks, VT was overestimated by all four commercial software tools, with values ranging from 18.27 ± 7.05% to 35.92 ± 17.7%, whereas the ventilator independent-software gave a smaller difference (3.03 ± 2.6%). Leaks were underestimated by two applications with values of -11.47 ± 6.32 and -5.9 ± 0.52 L/min. With expiratory leaks, VT was overestimated by the software of one ventilator and the ventilator-independent software and significantly underestimated by the other three, with deviations ranging from +10.94 ± 7.1 to -48 ± 23.08%. The four commercial tools tested overestimated unintentional leaks, with values between 2.19 ± 0.85 to 3.08 ± 0.43 L/min. In a bench model, the presence of unintentional random leaks may be a source of error in the measurement of VT and leaks provided by the software of home ventilators. Analyzing leaks during inspiration and expiration separately may reduce this source of error.

  13. : ventilators for noninvasive ventilation

    OpenAIRE

    Fauroux , Brigitte; Leroux , Karl; Desmarais , Gilbert; Isabey , Daniel; Clément , Annick; Lofaso , Frédéric; Louis , Bruno

    2008-01-01

    International audience; The aim of the present study was to evaluate the performance characteristics of all the ventilators proposed for home noninvasive positive-pressure ventilation in children in France. The ventilators (one volume-targeted, 12 pressure-targeted and four dual) were evaluated on a bench which simulated six different paediatric ventilatory patterns. For each ventilator, the quality of the inspiratory and expiratory trigger and the ability to reach and maintain the preset pre...

  14. Optimization of Ventilation Energy Demands and Indoor Air Quality in the ZEBRAlliance Homes

    Energy Technology Data Exchange (ETDEWEB)

    Hun, D. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Jackson, M. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Shrestha, S. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2013-09-01

    High-performance homes require that ventilation energy demands and indoor air quality (IAQ) be simultaneously optimized. In this project, Oak Ridge National Laboratory researchers attempted to bridge these two areas by conducting tests in research houses located in Oak Ridge, TN, that were less than 2 years old, energy-efficient (i.e., expected to consume 50% less energy than a house built per the 2006 IRC), tightly-built, unoccupied, and unfurnished. The team identified air pollutants of concern in the test homes that could generally serve as indicators of IAQ, and conduced field experiments and computer simulations to determine the effectiveness and energy required by various techniques that lessened the concentration of these contaminants. Formaldehyde was selected as the main pollutant of concern from initial air sampling surveys. Field data indicate that concentrations were higher during the summer primarily because emissions from sources rise with increases in temperature. Furthermore, supply ventilation and gas-phase filtration were effective means to reduce formaldehyde concentrations; however, exhaust ventilation had minimal influence on this pollutant. Results from simulations suggest that formaldehyde concentrations obtained while ventilating per ASHRAE 62.2-2010 could be decreased by about 20% from May through September through three strategies: 1) increasing ASHRAE supply ventilation by a factor of two, 2) reducing the thermostat setpoint from 76 to 74°F, or 3) running a gas-phase filtration system while decreasing supply ventilation per ASHRAE by half. In the mixed-humid climate of Oak Ridge, these strategies caused minimal to modest increases in electricity cost of ~$5 to ~$15/month depending on outdoor conditions.

  15. Effect of Room Ventilation Rates in Rodent Rooms with Direct-Exhaust IVC Systems.

    Science.gov (United States)

    Geertsema, Roger S; Lindsell, Claire E

    2015-09-01

    When IVC are directly exhausted from a rodent housing room, the air quality of the room can become independent of the intracage air quality and may reduce the need for high room ventilation rates. This study assessed the effect of decreasing the ventilation rate in rodent rooms using direct-exhaust IVC systems. The study was conducted over 16 wk and compared conditions in 8 rodent rooms that had ventilation rates of 5 to 6 air changes per hour (ACH) with those in rooms at 10 to 12 ACH. At the low ventilation rate, rooms had higher CO₂ concentrations, higher dew point temperature, and lower particulate levels and spent a greater percentage of time above the temperature set point than did rooms at the high rate. The levels of allergens and endotoxins in room air were the same regardless of the ventilation rate. Differences seen in parameters within cages at the 2 ventilation rates were operationally irrelevant. We detected no total volatile organic compounds in the room that were attributable to ammonia, regardless of the ventilation rate. Clearing the air of ethanol after a spill took longer at the low compared with high rate. However, ethanol clearance was faster at the low rate when the demand-control system was activated than at the high ventilation rate alone. Air quality in the room and in the cages were acceptable with room ventilation rates of 5 to 6 ACH in rodent rooms that use direct-exhaust IVC systems.

  16. Indoor air quality, ventilation and respiratory health in elderly residents living in nursing homes in Europe

    DEFF Research Database (Denmark)

    Bentayeb, Malek; Norback, Dan; Bednarek, Micha

    2015-01-01

    cough. Elderly subjects aged ≥80 years were at higher risk. Pollutant effects were more pronounced in the case of poor ventilation. Even at low levels, indoor air quality affected respiratory health in elderly people permanently living in nursing homes, with frailty increasing with age. The effects were......Few data exist on respiratory effects of indoor air quality and comfort parameters in the elderly. In the context of the GERIE study, we investigated for the first time the relationships of these factors to respiratory morbidity among elderly people permanently living in nursing homes in seven...... European countries. 600 elderly people from 50 nursing homes underwent a medical examination and completed a standardised questionnaire. Air quality and comfort parameters were objectively assessed in situ in the nursing home. Mean concentrations of air pollutants did not exceed the existing standards...

  17. The Relationship between Home Nursing Coverage, Sleep and Daytime Functioning in Parents of Ventilator-Assisted Children

    OpenAIRE

    Meltzer, Lisa J.; Boroughs, Deborah S.; Downes, John J.

    2009-01-01

    This descriptive study examined the relationship between home care nursing support, sleep and daytime functioning in familial caregivers of ventilator-assisted children. Thirty-six primary caregivers (27 mothers, seven fathers, one foster mother, and one grandmother) of ventilator-assisted children completed measures of home nursing support, sleep, depression, fatigue, and daytime sleepiness. Daytime nursing coverage was not related to caregiver sleep or daytime functioning, but caregivers wi...

  18. Natural ventilation reduces high TB transmission risk in traditional homes in rural KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Lygizos, Melissa; Shenoi, Sheela V; Brooks, Ralph P; Bhushan, Ambika; Brust, James C M; Zelterman, Daniel; Deng, Yanhong; Northrup, Veronika; Moll, Anthony P; Friedland, Gerald H

    2013-07-01

    Transmission of drug susceptible and drug resistant TB occurs in health care facilities, and community and households settings, particularly in highly prevalent TB and HIV areas. There is a paucity of data regarding factors that may affect TB transmission risk in household settings. We evaluated air exchange and the impact of natural ventilation on estimated TB transmission risk in traditional Zulu homes in rural South Africa. We utilized a carbon dioxide decay technique to measure ventilation in air changes per hour (ACH). We evaluated predominant home types to determine factors affecting ACH and used the Wells-Riley equation to estimate TB transmission risk. Two hundred eighteen ventilation measurements were taken in 24 traditional homes. All had low ventilation at baseline when windows were closed (mean ACH = 3, SD = 3.0), with estimated TB transmission risk of 55.4% over a ten hour period of exposure to an infectious TB patient. There was significant improvement with opening windows and door, reaching a mean ACH of 20 (SD = 13.1, p ventilation conditions (windows/doors open) and window to volume ratio. Expanding ventilation increased the odds of achieving ≥12 ACH by 60-fold. There is high estimated risk of TB transmission in traditional homes of infectious TB patients in rural South Africa. Improving natural ventilation may decrease household TB transmission risk and, combined with other strategies, may enhance TB control efforts.

  19. Adaptive Support Ventilation May Deliver Unwanted Respiratory Rate-Tidal Volume Combinations in Patients with Acute Lung Injury Ventilated According to an Open Lung Concept

    NARCIS (Netherlands)

    Dongelmans, Dave A.; Paulus, Frederique; Veelo, Denise P.; Binnekade, Jan M.; Vroom, Margreeth B.; Schultz, Marcus J.

    2011-01-01

    Background: With adaptive support ventilation, respiratory rate and tidal volume (V(T)) are a function of the Otis least work of breathing formula. We hypothesized that adaptive support ventilation in an open lung ventilator strategy would deliver higher V(T)s to patients with acute lung injury.

  20. Effect of ventilation rate on concentrations of indoor radon and its progenies

    International Nuclear Information System (INIS)

    Wang Chunhong; Liu Yanyang; Liu Fudong; Liu Senlin; Chen Ling

    2012-01-01

    To study concentrations of indoor radon and its progenies, ventilation rates and their corresponding concentrations of indoor radon and its progenies were measured using tracer-gas dilution method. Results show that both ventilation rates and concentrations of indoor radon varied insignificantly and radon concentration were higher than the outdoor environment while doors and windows were all closed with air-conditioner on and off respectively; the concentrations declined and close to the outdoor level when doors and windows were all open with ventilators in operation. Accordingly, in modern life, especially in summer, people's preference for air-conditioners but natural ventilation would result in an increase of indoor radon concentration. (authors)

  1. THE ROLE OF REGIONAL CENTERS AND UNIVERSITY CHILDREN’S HOSPITAL IN DEVELOPMENT OF HOME MECHANICAL VENTILATION NETWORK

    Directory of Open Access Journals (Sweden)

    Rsovac Snezana

    2017-08-01

    Full Text Available Application of home mechanical ventilators represents the future in the treatment of children with chronic respiratory insufficiency. In this way patients are treated in the home environment, they have full support from their families, they are protected against nosocomial infections and their condition is monitored by medical staff. The role of regional centers is very important in the future development of the home mechanical ventilation network. Doctors in these centers under the full support of the University Children's Hospital physicians can assist and monitor the treatment of children on the household respirators.

  2. [Descriptive Analysis of Health Economics of Intensive Home Care of Ventilated Patients].

    Science.gov (United States)

    Lehmann, Yvonne; Ostermann, Julia; Reinhold, Thomas; Ewers, Michael

    2018-05-14

    Long-term ventilated patients in Germany receive intensive care mainly in the patients' home or in assisted-living facilities. There is a lack of knowledge about the nature and extent of resource use and costs associated with care of this small, heterogeneous but overall growing patient group. A sub-study in the context of a research project SHAPE analyzed costs of 29 patients descriptively from a social perspective. Direct and indirect costs of intensive home care over a period of three months were recorded and analyzed retrospectively. Standardized recorded written self-reports from patients and relatives as well as information from the interviewing of nursing staff and from nursing documentation were the basis for this analysis. There was an average total cost of intensive home care for three months per patient of 61194 € (95% CI 53 884-68 504) including hospital stays. The main costs were directly linked to outpatient medical and nursing care provided according to the Code of Social Law V and XI. Services provided by nursing home care service according to § 37(2) Code of Social Law V (65%) were the largest cost item. Approximately 13% of the total costs were attributable to indirect costs. Intensive home care for ventilated patients is resource-intensive and cost-intensive and has received little attention also from a health economics perspective. Valid information and transparency about the cost structures are required for an effective and economic design and management of the long-term care of this patient group. © Georg Thieme Verlag KG Stuttgart · New York.

  3. Effect of leak and breathing pattern on the accuracy of tidal volume estimation by commercial home ventilators: a bench study.

    Science.gov (United States)

    Luján, Manel; Sogo, Ana; Pomares, Xavier; Monsó, Eduard; Sales, Bernat; Blanch, Lluís

    2013-05-01

    New home ventilators are able to provide clinicians data of interest through built-in software. Monitoring of tidal volume (VT) is a key point in the assessment of the efficacy of home mechanical ventilation. To assess the reliability of the VT provided by 5 ventilators in a bench test. Five commercial ventilators from 4 different manufacturers were tested in pressure support mode with the help of a breathing simulator under different conditions of mechanical respiratory pattern, inflation pressure, and intentional leakage. Values provided by the built-in software of each ventilator were compared breath to breath with the VT monitored through an external pneumotachograph. Ten breaths for each condition were compared for every tested situation. All tested ventilators underestimated VT (ranges of -21.7 mL to -83.5 mL, which corresponded to -3.6% to -14.7% of the externally measured VT). A direct relationship between leak and underestimation was found in 4 ventilators, with higher underestimations of the VT when the leakage increased, ranging between -2.27% and -5.42% for each 10 L/min increase in the leakage. A ventilator that included an algorithm that computes the pressure loss through the tube as a function of the flow exiting the ventilator had the minimal effect of leaks on the estimation of VT (0.3%). In 3 ventilators the underestimation was also influenced by mechanical pattern (lower underestimation with restrictive, and higher with obstructive). The inclusion of algorithms that calculate the pressure loss as a function of the flow exiting the ventilator in commercial models may increase the reliability of VT estimation.

  4. Sustained Reduction of Ventilator-Associated Pneumonia Rates Using Real-Time Course Correction With a Ventilator Bundle Compliance Dashboard.

    Science.gov (United States)

    Talbot, Thomas R; Carr, Devin; Parmley, C Lee; Martin, Barbara J; Gray, Barbara; Ambrose, Anna; Starmer, Jack

    2015-11-01

    The effectiveness of practice bundles on reducing ventilator-associated pneumonia (VAP) has been questioned. To implement a comprehensive program that included a real-time bundle compliance dashboard to improve compliance and reduce ventilator-associated complications. DESIGN Before-and-after quasi-experimental study with interrupted time-series analysis. SETTING Academic medical center. In 2007 a comprehensive institutional ventilator bundle program was developed. To assess bundle compliance and stimulate instant course correction of noncompliant parameters, a real-time computerized dashboard was developed. Program impact in 6 adult intensive care units (ICUs) was assessed. Bundle compliance was noted as an overall cumulative bundle adherence assessment, reflecting the percentage of time all elements were concurrently in compliance for all patients. The VAP rate in all ICUs combined decreased from 19.5 to 9.2 VAPs per 1,000 ventilator-days following program implementation (Pdashboard was associated with significant sustained decreases in VAP rates and an increase in bundle compliance among adult ICU patients.

  5. Quality of life in home-ventilated children and their families.

    Science.gov (United States)

    González, Rafael; Bustinza, Amaya; Fernandez, Sarah N; García, Miriam; Rodriguez, Silvia; García-Teresa, Ma Ángeles; Gaboli, Mirella; García, Silvia; Sardón, Olaia; García, Diego; Salcedo, Antonio; Rodríguez, Antonio; Luna, Ma Carmen; Hernández, Arturo; González, Catalina; Medina, Alberto; Pérez, Estela; Callejón, Alicia; Toledo, Juan D; Herranz, Mercedes; López-Herce, Jesús

    2017-10-01

    HMV (home mechanical ventilation) in children has increased over the last years. The aim of the study was to assess perceived quality of life (QOL) of these children and their families as well as the problems they face in their daily life.We performed a multicentric cross-sectional study using a semi-structured interview about the impact of HMV on families and an evaluation questionnaire about perceived QOL by the patient and their families (pediatric quality of life questionnaire (PedsQL4.0)). We studied 41 subjects (mean age 8.2 years). Global scores in PedsQL questionnaire for subjects (median 61.4), and their parents (median 52.2) were below those of healthy children. 24.4% received medical follow-up at home and 71.8% attended school. Mothers were the main caregivers (75.6%), 48.8% of which were fully dedicated to the care of their child. 71.1% consider economic and healthcare resources insufficient. All families were satisfied with the care they provide to their children, even though it was considered emotionally overwhelming (65.9%). Marital conflict and neglect of siblings appeared in 42.1 and 36% of families, respectively. Perceived QOL by children with HMV and their families is lower than that of healthy children. Parents are happy to care for their children at home, even though it negatively affects family life. What is Known: • The use of home mechanical ventilation (HMV) in children has increased over the last years. • Normal family functioning is usually disrupted by HMV. What is New: • The aim of HMV is to provide a lifestyle similar to that of healthy children, but perceived quality of life by these patients and their parents is low. • Most of the families caring for children on HMV agree that support and resources provided by national health institutions is insufficient.

  6. Survival in amyotrophic lateral sclerosis with home mechanical ventilation: the impact of systematic respiratory assessment and bulbar involvement.

    Science.gov (United States)

    Farrero, Eva; Prats, Enric; Povedano, Mónica; Martinez-Matos, J Antonio; Manresa, Frederic; Escarrabill, Joan

    2005-06-01

    To analyze (1) the impact of a protocol of early respiratory evaluation of the indications for home mechanical ventilation (HMV) in patients with amyotrophic lateral sclerosis (ALS), and (2) the effects of the protocol and of bulbar involvement on the survival of patients receiving noninvasive ventilation (NIV). Retrospective study in a tertiary care referral center. HMV was indicated in 86 patients with ALS, with 22 patients (25%) presenting with intolerance to treatment associated with bulbar involvement. Treatment with HMV had been initiated in 15 of 64 patients prior to initiating the protocol (group A) and in the remaining 49 patients after protocol initiation (group B). In group A, the majority of patients began treatment with HMV during an acute episode requiring ICU admission (p = 0.001) and tracheal ventilation (p = 0.025), with a lower percentage of patients beginning HMV treatment without respiratory insufficiency (p = 0.013). No significant differences in survival rates were found between groups A and B among patients treated with NIV. Greater survival was observed in group B (p = 0.03) when patients with bulbar involvement were excluded (96%). Patients without bulbar involvement at the start of therapy with NIV presented a significantly better survival rate (p = 0.03). Multivariate analysis showed bulbar involvement to be an independent prognostic factor for survival (relative risk, 1.6; 95% confidence interval, 1.01 to 2.54; p = 0.04). No significant differences in survival were observed between patients with bulbar involvement following treatment with NIV and those with intolerance, except for the subgroup of patients who began NIV treatment with hypercapnia (p = 0.0002). Early systematic respiratory evaluation in patients with ALS is necessary to improve the results of HMV. Further studies are required to confirm the benefits of NIV treatment in patients with bulbar involvement, especially in the early stages.

  7. Cost-benefit analysis of decreased ventilation rates and radon exhalation from building materials

    International Nuclear Information System (INIS)

    Ericson, S.O.

    1984-01-01

    Decreased ventilation, achieved by weather stripping and other tightening measures, is the most cost effective way to energy conservation. A very low investment can result in a considerable decrease in ventilation rate. For a typical detached house in Sweden this can be equivalent to a decrease in oil consumption of 0.5 m 3 . At present price this corresponds to a saving of SEK 1200, 150 US dollars per annum. The contribution of the building materials to the concentration of radon in indoor air is approximately the inverse to air exchange rate. For a small change in ventilation rate and cost, in SEK/man Sv or US dollar/man Sv, is a function of ventilation rate, exhalation from building materials, the ratio between surface of walls, floor and ceiling to the volume of air. Thus, it is possible to find the specific ventilation rate where the marginal cost for a small increase in ventilation rate and the marginal reduction in radon concentration will give a specific amount of money for each man Sv. Examples are given. Conclusions are that for most building materials in a climate like the Swedish, there are other factors than exhalation of radon from building materials that sets the lower limit of recommendable ventilation rate. (Author)

  8. Elevated corrosion rates and hydrogen sulfide in homes with ‘Chinese Drywall’

    International Nuclear Information System (INIS)

    Allen, Joseph G.; MacIntosh, David L.; Saltzman, Lori E.; Baker, Brian J.; Matheson, Joanna M.; Recht, Joel R.; Minegishi, Taeko; Fragala, Matt A.; Myatt, Theodore A.; Spengler, John D.; Stewart, James H.; McCarthy, John F.

    2012-01-01

    In December 2008, the U.S. Consumer Product Safety Commission (CPSC) began receiving reports about odors, corrosion, and health concerns related to drywall originating from China. In response, a detailed environmental health and engineering evaluation was conducted of 41 complaint and 10 non-complaint homes in the Southeast U.S. Each home investigation included characterization of: 1) drywall composition; 2) indoor and outdoor air quality; 3) temperature, moisture, and building ventilation; and 4) copper and silver corrosion rates. Complaint homes had significantly higher hydrogen sulfide concentrations (mean 0.82 vs. 3 , p 2 S: 476 vs. 2 S: 1472 vs. 389 Å/30 d, p < 0.01). The abundance of carbonate and strontium in drywall was also elevated in complaint homes, and appears to be useful objective marker of problematic drywall in homes that meet other screening criteria (e.g., constructed or renovated in 2006–2007, reports of malodor and accelerated corrosion). This research provides empirical evidence of the direct association between homes constructed with ‘Chinese Drywall’ in 2006–2007 and elevated corrosion rates and hydrogen sulfide concentrations in indoor air. - Highlights: ► Environmental measurements in homes with and without “Chinese Drywall” ► Homes with “Chinese Drywall” had higher hydrogen sulfide concentrations ► Homes with “Chinese Drywall” had elevated corrosion rates ► Study provides empirical evidence of reported associations

  9. Effect of ventilation rate on air cleanliness and energy consumption in operation rooms at rest.

    Science.gov (United States)

    Lee, Shih-Tseng; Liang, Ching-Chieh; Chien, Tsung-Yi; Wu, Feng-Jen; Fan, Kuang-Chung; Wan, Gwo-Hwa

    2018-02-27

    The interrelationships between ventilation rate, indoor air quality, and energy consumption in operation rooms at rest are yet to be understood. We investigate the effect of ventilation rate on indoor air quality indices and energy consumption in ORs at rest. The study investigates the air temperature, relative humidity, concentrations of carbon dioxide, particulate matter (PM), and airborne bacteria at different ventilation rates in operation rooms at rest of a medical center. The energy consumption and cost analysis of the heating, ventilating, and air conditioning (HVAC) system in the operation rooms at rest were also evaluated for all ventilation rates. No air-conditioned operation rooms had very highest PM and airborne bacterial concentrations in the operation areas. The bacterial concentration in the operation areas with 6-30 air changes per hour (ACH) was below the suggested level set by the United Kingdom (UK) for an empty operation room. A 70% of reduction in annual energy cost by reducing the ventilation rate from 30 to 6 ACH was found in the operation rooms at rest. Maintenance of operation rooms at ventilation rate of 6 ACH could save considerable amounts of energy and achieve the goal of air cleanliness.

  10. Adaptive support ventilation may deliver unwanted respiratory rate-tidal volume combinations in patients with acute lung injury ventilated according to an open lung concept.

    Science.gov (United States)

    Dongelmans, Dave A; Paulus, Frederique; Veelo, Denise P; Binnekade, Jan M; Vroom, Margreeth B; Schultz, Marcus J

    2011-05-01

    With adaptive support ventilation, respiratory rate and tidal volume (V(T)) are a function of the Otis least work of breathing formula. We hypothesized that adaptive support ventilation in an open lung ventilator strategy would deliver higher V(T)s to patients with acute lung injury. Patients with acute lung injury were ventilated according to a local guideline advising the use of lower V(T) (6-8 ml/kg predicted body weight), high concentrations of positive end-expiratory pressure, and recruitment maneuvers. Ventilation parameters were recorded when the ventilator was switched to adaptive support ventilation, and after recruitment maneuvers. If V(T) increased more than 8 ml/kg predicted body weight, airway pressure was limited to correct for the rise of V(T). Ten patients with a mean (±SD) Pao(2)/Fio(2) of 171 ± 86 mmHg were included. After a switch from pressure-controlled ventilation to adaptive support ventilation, respiratory rate declined (from 31 ± 5 to 21 ± 6 breaths/min; difference = 10 breaths/min, 95% CI 3-17 breaths/min, P = 0.008) and V(T) increased (from 6.5 ± 0.8 to 9.0 ± 1.6 ml/kg predicted body weight; difference = 2.5 ml, 95% CI 0.4-4.6 ml/kg predicted body weight, P = 0.02). Pressure limitation corrected for the rise of V(T), but minute ventilation declined, forcing the user to switch back to pressure-controlled ventilation. Adaptive support ventilation, compared with pressure-controlled ventilation in an open lung strategy setting, delivers a lower respiratory rate-higher V(T) combination. Pressure limitation does correct for the rise of V(T), but leads to a decline in minute ventilation.

  11. Ventilation rates in the bedrooms of 500 Danish children

    DEFF Research Database (Denmark)

    Bekö, Gabriel; Lund, Torben; Nors, F.

    2010-01-01

    The ongoing "Indoor Environment and Children's Health" (IECH) study investigates the environmental risk factors in homes and their association with asthma and allergy among children aged 1-5 years. As part of the study, the homes of 500 children between 3 and 5 years of age were inspected. The se...

  12. Paediatric tracheostomy and ventilation home care with challenging socio-economic circumstances in South Africa.

    Science.gov (United States)

    Groenendijk, Ilse; Booth, Jane; van Dijk, Monique; Argent, Andrew; Zampoli, Marco

    2016-05-01

    Children discharged home with a tracheostomy need a safe home environment and access to health care. We described the indications, clinical characteristics, socio-economic circumstances and outcomes of children enroled in a tracheostomy home care programme in South Africa. We performed a retrospective chart review of children receiving a tracheostomy and enroled in the Breatheasy programme at the Red Cross War Memorial Children's Hospital, Cape Town. Medical and background characteristics were recorded. Influences of socio-economic variables and underlying medical conditions on length of hospital stay, unplanned readmissions and mortality in the first year after discharge were evaluated. In the period 2008-2012, 157 patients were discharged home with a tracheostomy. Median hospital stay after tracheostomy insertion was significantly longer when parents had incomplete schooling compared to completed secondary school or higher education; 30 days (IQR 21-53) versus 23 days (IQR 16-33), respectively. Unplanned readmissions in the first year were documented for 72 patients (45.9%). The risk for unplanned readmission was 2.6 times higher in families with substance abuse the risk of respiratory infections was two-fold in case of household cigarette smoke exposure (OR 2.3.) Tracheostomy-related mortality was low (1.2%). An underlying medical condition was the only independent significant risk factor for mortality (OR 5.1, 95% CI 1.8-14.3). This study demonstrates that despite difficult socio-economic circumstances, home ventilation of children with a tracheostomy is safe, provided caregivers are adequately trained and supported. Copyright © 2016. Published by Elsevier Ireland Ltd.

  13. Ventilation rate in equilibrium factor measurements with solid state nuclear track detectors (SSNTD)

    International Nuclear Information System (INIS)

    Gil, L.R.; Leitao, R.M.S.; Marques, A.; Rivera, A.

    1994-08-01

    Ventilation rate values are calculated from track density measurements in solid state nuclear track detectors (SSNTD), both when ventilation is the main cause of radioactive disequilibrium in radon progeny and when it shares importance with other agents. The method consists in exposing a SSNTD of high intrinsic efficiency (CR-39) in filtered and unfiltered conditions and, in addition, covered with a thin Aluminium foil, to stop alpha particles from 218 Po and 222 Rn. No calibrations are required but, when necessary, independent measurements of the loss rates of radioactivity to aerosol and to walls have to perform. Ventilation rates depend upon geometry detection efficiencies for alpha particles, here obtained by Monte Carlo simulation, taking into account the space distribution of emission positions. This may lead to sizeable corrections in ventilation and equilibrium factor values. Since geometric detection efficiencies depend upon alpha-particle ranges in air, the influences of barometric variables are also discussed. (author). 7 refs

  14. Communicating with individuals receiving home mechanical ventilation: the experiences of key communication partners.

    Science.gov (United States)

    Laakso, Katja; Markström, Agneta; Havstam, Christina; Idvall, Markus; Hartelius, Lena

    2014-01-01

    The aim of the study was to explore the communication experiences of key communications partners (CPs) of individuals receiving home mechanical ventilation (HMV), with particular emphasis on the possibilities, difficulties and limitations CPs experienced in communication, possible support given to facilitate communication and exploring what made a skilled communicator. A qualitative research design using interviews was used. The participants included 19 key CPs of individuals receiving HMV. The analysis resulted in five themes: Encountering communication limitations, Functional communication strategies, Being a communication facilitator, Role insecurity and Emotional reactions and coping. The findings revealed that CPs needed to develop partly new reference frames for communication. In particular, participants emphasised the need to understand and interpret subtle details in the communicative interaction. The findings are discussed in the light of previous research, in particular an earlier study exploring another perspective; the ventilator-supported individuals' experiences of communication. Issues relating to the educational needs of CPs of individuals receiving HMV are discussed. The results are intended to enhance understanding of the challenges that individuals receiving HMV and their CPs face with communication, which should be of relevance not only to speech therapists, but for all healthcare practitioners in the field of HMV.

  15. Wii, Kinect, and Move. Heart Rate, Oxygen Consumption, Energy Expenditure, and Ventilation due to Different Physically Active Video Game Systems in College Students

    OpenAIRE

    SCHEER, KRISTA S.; SIEBRANT, SARAH M.; BROWN, GREGORY A.; SHAW, BRANDON S.; SHAW, INA

    2014-01-01

    Nintendo Wii, Sony Playstation Move, and Microsoft XBOX Kinect are home video gaming systems that involve player movement to control on-screen game play. Numerous investigations have demonstrated that playing Wii is moderate physical activity at best, but Move and Kinect have not been as thoroughly investigated. The purpose of this study was to compare heart rate, oxygen consumption, and ventilation while playing the games Wii Boxing, Kinect Boxing, and Move Gladiatorial Combat. Heart rate, o...

  16. Home kitchen ventilation, cooking fuels, and lung cancer risk in a prospective cohort of never smoking women in Shanghai, China.

    Science.gov (United States)

    Kim, Christopher; Gao, Yu-Tang; Xiang, Yong-Bing; Barone-Adesi, Francesco; Zhang, Yawei; Hosgood, H Dean; Ma, Shuangge; Shu, Xiao-ou; Ji, Bu-Tian; Chow, Wong-Ho; Seow, Wei Jie; Bassig, Bryan; Cai, Qiuyin; Zheng, Wei; Rothman, Nathaniel; Lan, Qing

    2015-02-01

    Indoor air pollution (IAP) caused by cooking has been associated with lung cancer risk in retrospective case-control studies in developing and rural countries. We report the association of cooking conditions, fuel use, oil use, and risk of lung cancer in a developed urban population in a prospective cohort of women in Shanghai. A total of 71,320 never smoking women were followed from 1996 through 2009 and 429 incident lung cancer cases were identified. Questionnaires collected information on household living and cooking practices for the three most recent residences and utilization of cooking fuel and oil, and ventilation conditions. Cox proportional hazards regression estimated the association for kitchen ventilation conditions, cooking fuels, and use of cooking oils for the risk of lung cancer by hazard ratios (HR) with 95% confidence intervals (95% CI). Ever poor kitchen ventilation was associated with a 49% increase in lung cancer risk (HR: 1.49; 95% CI: 1.15-1.95) compared to never poor ventilation. Ever use of coal was not significantly associated. However, ever coal use with poor ventilation (HR: 1.69; 95% CI: 1.22-2.35) and 20 or more years of using coal with poor ventilation (HR: 2.03; 95% CI: 1.35-3.05) was significantly associated compared to no exposure to coal or poor ventilation. Cooking oil use was not significantly associated. These results demonstrate that IAP from poor ventilation of coal combustion increases the risk of lung cancer and is an important public health issue in cities across China where people may have lived in homes with inadequate kitchen ventilation. © 2014 UICC.

  17. The declined levels of inflammatory cytokines related with weaning rate during period of septic patients using ventilators.

    Science.gov (United States)

    Yang, Chao-Huei; Hsiao, Jung-Lung; Wu, Ming-Feng; Lu, Mei-Hua; Chang, Hui-Ming; Ko, Wang-Sheng; Chiou, Ya-Ling

    2018-02-01

    Approximately 50% of patients with sepsis-induced acute lung injury and acute respiratory distress syndrome require mechanical ventilation. Patients with extended mechanical ventilator use routinely develop reinfections, which increases hospital stay, mortality, and health care cost. Some studies have pointed out inflammatory factors concentrations can affect ventilator weaning, but do not indicate changed inflammatory factors related to ventilator weaning during using ventilators. This study aimed to investigate during period of septic patients using ventilators, the inflammatory cytokines concentrations related with weaning rate. Blood was collected from 35 septic patients before and during ventilator use on days 1, 7, 14, and 21 (or weaning). 58.3% (N = 20) of septic patients with mechanical ventilators were weaned successfully within 21 days (ventilator weaned group, VW), 16.7% (N = 6) did not wean within 21 days (ventilator dependent group, VD), and 25% died (death group) in hospital. Before ventilator use, higher C-reactive protein (CRP), IL-6, and IL-8 levels were measured in the death group than in all other groups (P ventilator use, CRP, IL-6, and IL-8 concentrations declined significantly in VW and VD patients (P ventilators weaning successfully such as disease control, nutritional status, and so on. The declined levels of serum inflammatory cytokines, especially IL-6, improved inflammation status might be one factor of successfully weaning during septic patients on ventilators. © 2016 John Wiley & Sons Ltd.

  18. Risk Assessment of Heating, Ventilating, and Air-Conditioning Strategies in Low-Load Homes

    Energy Technology Data Exchange (ETDEWEB)

    Poerschke, Andrew [IBACOS, Inc., Pittsburgh, PA (United States)

    2016-02-17

    "Modern, energy efficient homes conforming to the Zero Energy Ready Home standard face the challenge of meeting high customer expectations for comfort. Traditional heating, ventilation, and air conditioning (HVAC) sizing and control strategies may be insufficient to adequately condition each zone due to unique load patterns in each room caused by a number of factors. These factors include solar heat gains, occupant-related gains, and gains associated with appliances and electronics. Because of shrinking shell loads, these intermittent factors are having an increasingly significant impact on the thermal load in each zone. Consequently, occupant comfort can be compromised. To evaluate the impact of climate and house geometry, as well as HVAC system and control strategies on comfort conditions, IBACOS analyzed the results of 99 TRNSYS multiple-zone simulations. The results of this analysis indicate that for simple-geometry and single-story plans, a single zone and thermostat can adequately condition the entire house. Demanding house geometry and houses with multiple stories require the consideration of multiple thermostats and multiple zones.

  19. Heart Rate Variability in Patients with Chronic Obstructive Pulmonary Disease Treated by Noninvasive Mechanic Ventilation

    Directory of Open Access Journals (Sweden)

    Zekeriya Küçükdurmaz

    2011-08-01

    Full Text Available Aims: This study aimed to investigate heart rate variability (HRV of patients with severe COPD who are treated by noninvasive mechanic ventilation (NIMV.Patients and Method: Twenty-seven patient (58±8 years, 9 F with severe COPD treated by nocturnal NIMV at home and 23 sex and age matched volunteers (56±8 years, 11 F who has not dyspnea as a control group recruited in the study. Subjects underwent spirometry, blood gas analysis, transthoracic echocardiography, 24 hours ambulatory ECG analysis. Time domain HRV analysis performed from ambulatory ECG records. Results: 52% of patients at NYHA functional class II, 36% at class III, and 12% at class IV when they have been treated by NIMV. Groups were similar for age and sex (p>0.05 for both. Heart rates of patients were higher significantly than controls’ (p0.05. But, systolic pulmonary pressures were higher of COPD group (p<0.01. 24 hours heart rate was higher, and standard deviation of normal R-R intervals (SDNN 24 hours, SDNN night, SDNN day, SDNN index (SDNNI and standard deviation of mean R-R intervals (SDANNI values were lower in COPD group significantly. SDNN was inversely correlated with duration of daily NIMV usage, intensive care unit administration and entubation rate and PaCO2. SDNNI was inversely correlated with functional class, duration of daily NIMV usage, intensive care unit administration rate and PaCO2. Else, SDNNI was correlated with predicted forced vital capacity % (FVC% and predicted forced expiratory volume at 1 second % (FEV1%.Conclusion: Time domain HRV decreases in patients with severe COPD. Decrease is correlated with severity of disease, and it presents in despite of the chronic nocturnal NIMV application. These patients have high risk for cardiovascular morbidity and mortality and should be monitored and manegement for cardiovascular events.

  20. Elevated corrosion rates and hydrogen sulfide in homes with 'Chinese Drywall'

    Energy Technology Data Exchange (ETDEWEB)

    Allen, Joseph G.; MacIntosh, David L. [Environmental Health and Engineering, Inc., 117 Fourth Avenue, Needham, MA (United States); Harvard School of Public Health, 677 Huntington Avenue, Boston, MA (United States); Saltzman, Lori E. [U.S. Consumer Product Safety Commission, Bethesda, MD (United States); Baker, Brian J. [Environmental Health and Engineering, Inc., 117 Fourth Avenue, Needham, MA (United States); Matheson, Joanna M.; Recht, Joel R. [U.S. Consumer Product Safety Commission, Bethesda, MD (United States); Minegishi, Taeko; Fragala, Matt A.; Myatt, Theodore A. [Environmental Health and Engineering, Inc., 117 Fourth Avenue, Needham, MA (United States); Spengler, John D.; Stewart, James H. [Environmental Health and Engineering, Inc., 117 Fourth Avenue, Needham, MA (United States); Harvard School of Public Health, 677 Huntington Avenue, Boston, MA (United States); McCarthy, John F., E-mail: jmcccarthy@eheinc.com [Environmental Health and Engineering, Inc., 117 Fourth Avenue, Needham, MA (United States)

    2012-06-01

    In December 2008, the U.S. Consumer Product Safety Commission (CPSC) began receiving reports about odors, corrosion, and health concerns related to drywall originating from China. In response, a detailed environmental health and engineering evaluation was conducted of 41 complaint and 10 non-complaint homes in the Southeast U.S. Each home investigation included characterization of: 1) drywall composition; 2) indoor and outdoor air quality; 3) temperature, moisture, and building ventilation; and 4) copper and silver corrosion rates. Complaint homes had significantly higher hydrogen sulfide concentrations (mean 0.82 vs. < LOD {mu}g/m{sup 3}, p < 0.05), and significantly greater rates of copper sulfide and silver sulfide corrosion compared to non-complaint homes (Cu{sub 2}S: 476 vs. < 32 A/30 d, p < 0.01; Ag{sub 2}S: 1472 vs. 389 A/30 d, p < 0.01). The abundance of carbonate and strontium in drywall was also elevated in complaint homes, and appears to be useful objective marker of problematic drywall in homes that meet other screening criteria (e.g., constructed or renovated in 2006-2007, reports of malodor and accelerated corrosion). This research provides empirical evidence of the direct association between homes constructed with 'Chinese Drywall' in 2006-2007 and elevated corrosion rates and hydrogen sulfide concentrations in indoor air. - Highlights: Black-Right-Pointing-Pointer Environmental measurements in homes with and without 'Chinese Drywall' Black-Right-Pointing-Pointer Homes with 'Chinese Drywall' had higher hydrogen sulfide concentrations Black-Right-Pointing-Pointer Homes with 'Chinese Drywall' had elevated corrosion rates Black-Right-Pointing-Pointer Study provides empirical evidence of reported associations.

  1. A Chemical-Biological-Radio-Nuclear (CBRN) Filter can be Added to the Air-Outflow Port of a Ventilator to Protect a Home Ventilated Patient From Inhalation of Toxic Industrial Compounds.

    Science.gov (United States)

    Be'eri, Eliezer; Owen, Simon; Beeri, Maurit; Millis, Scott R; Eisenkraft, Arik

    2018-02-21

    Chemical-biological-radio-nuclear (CBRN) gas masks are the standard means for protecting the general population from inhalation of toxic industrial compounds (TICs), for example after industrial accidents or terrorist attacks. However, such gas masks would not protect patients on home mechanical ventilation, as ventilator airflow would bypass the CBRN filter. We therefore evaluated in vivo the safety of adding a standard-issue CBRN filter to the air-outflow port of a home ventilator, as a method for providing TIC protection to such patients. Eight adult patients were included in the study. All had been on stable, chronic ventilation via a tracheostomy for at least 3 months before the study. Each patient was ventilated for a period of 1 hour with a standard-issue CBRN filter canister attached to the air-outflow port of their ventilator. Physiological and airflow measurements were made before, during, and after using the filter, and the patients reported their subjective sensation of ventilation continuously during the trial. For all patients, and throughout the entire study, no deterioration in any of the measured physiological parameters and no changes in measured airflow parameters were detected. All patients felt no subjective difference in the sensation of ventilation with the CBRN filter canister in situ, as compared with ventilation without it. This was true even for those patients who were breathing spontaneously and thus activating the ventilator's trigger/sensitivity function. No technical malfunctions of the ventilators occurred after addition of the CBRN filter canister to the air-outflow ports of the ventilators. A CBRN filter canister can be added to the air-outflow port of chronically ventilated patients, without causing an objective or subjective deterioration in the quality of the patients' mechanical ventilation. (Disaster Med Public Health Preparedness. 2018;page 1 of 5).

  2. Liability aspects of home energy-rating systems

    Energy Technology Data Exchange (ETDEWEB)

    Hendrickson, P.L.

    1983-10-01

    Liability aspects of home energy rating systems are discussed. An introduction to the rating system concept, including types of rating systems, implementation efforts to date, and possible groups to conduct ratings, is also included. The home energy rating system concept involves the periodic rating of the energy efficiency of residential buildings. The rating can provide a relative indication of a home's energy efficiency and also a quantitative estimate of consumption, fuel cost, or both. Primary attention is given to liability issues associated with developing and performing ratings. Secondary attention is given to possible liability associated with misuse of a rating once it has been performed.

  3. Prevalence and variability of use of home mechanical ventilators, positive airway pressure and oxygen devices in the Lombardy region, Italy.

    Science.gov (United States)

    Vitacca, Michele; Barbano, Luca; Colombo, Daniele; Leoni, Olivia; Guffanti, Enrico

    2018-01-29

    Few studies have analyzed the prevalence and accessibility of home mechanical ventilation (HMV) in Italy. We aimed to investigate the prevalence and prescription variability of HMV as well as of long-term oxygen therapy (LTOT) and continuous positive airway pressure (CPAP), in the Lombardy Region. Prescribing rates of HMV (both noninvasive and tracheostomies), CPAP (auto-CPAP, CPAP/other sleep machines) and LTOT (liquid-O2, O2-gas, concentrators) in the 15 Local Healthcare districts of Lombardy were gathered from billing data for 2012 and compared. Crude rates (per 100,000 population) and rates for the different healthcare districts were calculated. In 2012, 6325 patients were on HMV (crude prescription rate: 63/100,000) with a high variation across districts (8/100,000 in Milano 1 vs 150/100,000 in Pavia). There were 14,237 patients on CPAP (crude prescription rate: 142/100,000; CPAP/other sleep machines 95.3% vs auto-CPAP 4.7%) with also high intra-regional variation (56/100,000 in Mantova vs. 260/100,000 in Pavia). There were 21,826 patients on LTOT (prescription rate: 217/100,000 rate; liquid-O2 94%, O2-gas 2.08%, O2-concentrators 3.8%), with again high intra-regional variation (100/100,000 in Bergamo vs 410/100,000 in Valle Camonica). The crude rate of HMV prescriptions in Lombardy is very high, with a high intra-regional variability in prescribing HMV, LTOT and CPAP which is partly explainable by the accessibility to specialist centers with HMV/sleep-study facilities. Analysis of administrative data and variability mapping can help identify areas of reduced access for an improved standardization of services. An audit among Health Payer and prescribers to interpret the described huge variability could be welcomed.

  4. Daily living with distress and enrichment: the moral experience of families with ventilator-assisted children at home.

    Science.gov (United States)

    Carnevale, Franco A; Alexander, Eren; Davis, Michael; Rennick, Janet; Troini, Rita

    2006-01-01

    The growing shift toward home care services assumes that "being home is good" and that this is the most desirable option. Although ethical issues in medical decision-making have been examined in numerous contexts, home care decisions for technology-dependent children and the moral dilemmas that this population confronts remain virtually unknown. This study explored the moral dimension of family experience through detailed accounts of life with a child who requires assisted ventilation at home. This study involved an examination of moral phenomena inherent in (1) the individual experiences of the ventilator-assisted child, siblings, and parents and (2) everyday family life as a whole. A qualitative method based on Richard Zaner's interpretive framework was selected for this study. The population of interest for this study was the families of children who are supported by a ventilator or a positive-pressure device at home. Twelve families (38 family members) were recruited through the Quebec Program for Home Ventilatory Assistance. Children in the study population fell into 4 diagnostic groups: (1) abnormal ventilatory control (eg, central hypoventilation syndrome), (2) neuromuscular disorders, (3) spina bifida, and (4) craniofacial or airway abnormalities resulting in upper airway obstruction. All 4 of these diagnostic groups were included in this study. Among the 12 children recruited, 4 received ventilation via tracheostomies, and 8 received ventilation with face masks. All of the latter received ventilation only at night, except for 1 child, who received ventilation 24 hours a day. Family moral experiences were investigated using semistructured interviews and fieldwork observations conducted in the families' homes. Data analysis identified 6 principal themes. The themes raised by families whose children received ventilation invasively via a tracheostomy were not systematically different or more distressed than were families of children with face masks. The

  5. Effects of Classroom Ventilation Rate and Temperature on Students' Test Scores.

    Directory of Open Access Journals (Sweden)

    Ulla Haverinen-Shaughnessy

    Full Text Available Using a multilevel approach, we estimated the effects of classroom ventilation rate and temperature on academic achievement. The analysis is based on measurement data from a 70 elementary school district (140 fifth grade classrooms from Southwestern United States, and student level data (N = 3109 on socioeconomic variables and standardized test scores. There was a statistically significant association between ventilation rates and mathematics scores, and it was stronger when the six classrooms with high ventilation rates that were indicated as outliers were filtered (> 7.1 l/s per person. The association remained significant when prior year test scores were included in the model, resulting in less unexplained variability. Students' mean mathematics scores (average 2286 points were increased by up to eleven points (0.5% per each liter per second per person increase in ventilation rate within the range of 0.9-7.1 l/s per person (estimated effect size 74 points. There was an additional increase of 12-13 points per each 1°C decrease in temperature within the observed range of 20-25°C (estimated effect size 67 points. Effects of similar magnitude but higher variability were observed for reading and science scores. In conclusion, maintaining adequate ventilation and thermal comfort in classrooms could significantly improve academic achievement of students.

  6. Effects of Classroom Ventilation Rate and Temperature on Students' Test Scores.

    Science.gov (United States)

    Haverinen-Shaughnessy, Ulla; Shaughnessy, Richard J

    2015-01-01

    Using a multilevel approach, we estimated the effects of classroom ventilation rate and temperature on academic achievement. The analysis is based on measurement data from a 70 elementary school district (140 fifth grade classrooms) from Southwestern United States, and student level data (N = 3109) on socioeconomic variables and standardized test scores. There was a statistically significant association between ventilation rates and mathematics scores, and it was stronger when the six classrooms with high ventilation rates that were indicated as outliers were filtered (> 7.1 l/s per person). The association remained significant when prior year test scores were included in the model, resulting in less unexplained variability. Students' mean mathematics scores (average 2286 points) were increased by up to eleven points (0.5%) per each liter per second per person increase in ventilation rate within the range of 0.9-7.1 l/s per person (estimated effect size 74 points). There was an additional increase of 12-13 points per each 1°C decrease in temperature within the observed range of 20-25°C (estimated effect size 67 points). Effects of similar magnitude but higher variability were observed for reading and science scores. In conclusion, maintaining adequate ventilation and thermal comfort in classrooms could significantly improve academic achievement of students.

  7. Effects of Classroom Ventilation Rate and Temperature on Students’ Test Scores

    Science.gov (United States)

    2015-01-01

    Using a multilevel approach, we estimated the effects of classroom ventilation rate and temperature on academic achievement. The analysis is based on measurement data from a 70 elementary school district (140 fifth grade classrooms) from Southwestern United States, and student level data (N = 3109) on socioeconomic variables and standardized test scores. There was a statistically significant association between ventilation rates and mathematics scores, and it was stronger when the six classrooms with high ventilation rates that were indicated as outliers were filtered (> 7.1 l/s per person). The association remained significant when prior year test scores were included in the model, resulting in less unexplained variability. Students’ mean mathematics scores (average 2286 points) were increased by up to eleven points (0.5%) per each liter per second per person increase in ventilation rate within the range of 0.9–7.1 l/s per person (estimated effect size 74 points). There was an additional increase of 12–13 points per each 1°C decrease in temperature within the observed range of 20–25°C (estimated effect size 67 points). Effects of similar magnitude but higher variability were observed for reading and science scores. In conclusion, maintaining adequate ventilation and thermal comfort in classrooms could significantly improve academic achievement of students. PMID:26317643

  8. The influence of opening windows and doors on the natural ventilation rate of a residential building

    Science.gov (United States)

    An analysis of air exchange rates due to intentional window and door openings in a research test house located in a residential environment is presented. These data inform the development of ventilation rate control strategies as building envelopes are tightened to improve the e...

  9. Determining the ventilation and aerosol deposition rates from routine indoor-air measurements.

    Science.gov (United States)

    Halios, Christos H; Helmis, Costas G; Deligianni, Katerina; Vratolis, Sterios; Eleftheriadis, Konstantinos

    2014-01-01

    Measurement of air exchange rate provides critical information in energy and indoor-air quality studies. Continuous measurement of ventilation rates is a rather costly exercise and requires specific instrumentation. In this work, an alternative methodology is proposed and tested, where the air exchange rate is calculated by utilizing indoor and outdoor routine measurements of a common pollutant such as SO2, whereas the uncertainties induced in the calculations are analytically determined. The application of this methodology is demonstrated, for three residential microenvironments in Athens, Greece, and the results are also compared against ventilation rates calculated from differential pressure measurements. The calculated time resolved ventilation rates were applied to the mass balance equation to estimate the particle loss rate which was found to agree with literature values at an average of 0.50 h(-1). The proposed method was further evaluated by applying a mass balance numerical model for the calculation of the indoor aerosol number concentrations, using the previously calculated ventilation rate, the outdoor measured number concentrations and the particle loss rates as input values. The model results for the indoors' concentrations were found to be compared well with the experimentally measured values.

  10. Comparing Public Quality Ratings for Accredited and Nonaccredited Nursing Homes.

    Science.gov (United States)

    Williams, Scott C; Morton, David J; Braun, Barbara I; Longo, Beth Ann; Baker, David W

    2017-01-01

    Compare quality ratings of accredited and nonaccredited nursing homes using the publicly available Centers for Medicare and Medicaid Services (CMS) Nursing Home Compare data set. This cross-sectional study compared the performance of 711 Joint Commission-accredited (TJC-accredited) nursing homes (81 of which also had Post-Acute Care Certification) to 14,926 non-Joint Commission-accredited (non-TJC-accredited) facilities using the Nursing Home Compare data set (as downloaded on April 2015). Measures included the overall Five-Star Quality Rating and its 4 components (health inspection, quality measures, staffing, and RN staffing), the 18 Nursing Home Compare quality measures (5 short-stay measures, 13 long-stay measures), as well as inspection deficiencies, fines, and payment denials. t tests were used to assess differences in rates for TJC-accredited nursing homes versus non-TJC-accredited nursing homes for quality measures, ratings, and fine amounts. Analysis of variance models were used to determine differences in rates using Joint Commission accreditation status, nursing home size based on number of beds, and ownership type. An additional model with an interaction term using Joint Commission accreditation status and Joint Commission Post-Acute Care Certification status was used to determine differences in rates for Post-Acute Care Certified nursing homes. Binary variables (eg, deficiency type, fines, and payment denials) were evaluated using a logistic regression model with the same covariates. After controlling for the influences of facility size and ownership type, TJC-accredited nursing homes had significantly higher star ratings than non-TJC-accredited nursing homes on each of the star rating component subscales (P homes with Post-Acute Care Certification performed statistically better on the overall star rating, as well as 3 of the 4 subscales (P homes had statistically fewer deficiencies than non-TJC-accredited nursing homes (P payment denials (P homes

  11. A preliminary study on the association between ventilation rates in classrooms and student performance.

    Science.gov (United States)

    Shaughnessy, R J; Haverinen-Shaughnessy, U; Nevalainen, A; Moschandreas, D

    2006-12-01

    Poor conditions leading to substandard indoor air quality (IAQ) in classrooms have been frequently cited in the literature over the past two decades. However, there is limited data linking poor IAQ in the classrooms to student performance. Whereas, it is assumed that poor IAQ results in reduced attendance and learning potential, and subsequent poor student performance, validating this hypothesis presents a challenge in today's school environment. This study explores the association between student performance on standardized aptitude tests that are administered to students on a yearly basis, to classroom carbon dioxide (CO2) concentrations, which provide a surrogate of ventilation being provided to each room. Data on classroom CO2 concentrations (over a 4-5 h time span within a typical school day) were recorded in fifth grade classrooms in 54 elementary schools within a school district in the USA. Results from this preliminary study yield a significant (P classroom-level ventilation rate and test results in math. They also indicate that non-linear effects may need to be considered for better representation of the association. A larger sample size is required in order to draw more definitive conclusions. Practical Implications Future studies could focus on (1) gathering more evidence on the possible association between classroom ventilation rates and students' academic performance; (2) the linear/non-linear nature of the association; and (3) whether it is possible to detect 'no observed adverse effect level' for adequate ventilation with respect to academic performance in schools. All of this information could be used to improve guidance and take regulatory actions to ensure adequate ventilation in schools. The high prevalence of low ventilation rates, combined with the growing evidence of the positive impact that sufficient ventilation has on human performance, suggests an opportunity for improving design and management of school facilities.

  12. Combined effects of leaks, respiratory system properties and upper airway patency on the performance of home ventilators: a bench study.

    Science.gov (United States)

    Zhu, Kaixian; Rabec, Claudio; Gonzalez-Bermejo, Jésus; Hardy, Sébastien; Aouf, Sami; Escourrou, Pierre; Roisman, Gabriel

    2017-11-21

    Combined effects of leaks, mechanical property of respiratory system and upper airway (UA) patency on patient-ventilator synchrony (PVA) and the level of clinically "tolerable" leaks are not well established in home ventilators. We comparatively assessed on a bench model, the highest leak level tolerated without inducing significant asynchrony ("critical leak") in three home ventilators (Astral 150, Trilogy 100 and Vivo 60; noted as A150, T100 and V60 respectively) subjected to three simulated diseased respiratory conditions: chronic obstructive pulmonary disease (COPD), obesity hypoventilation (OHS) and neuromuscular disorders (NMD), with both open and closed UA. Also, total leak values in the device reports were compared to the bench-measured values. With open UA, all ventilators were able to avoid asynchrony up to a 30 L/min leak and even to 55 L/min in some cases. UA closure and respiratory diseases especially OHS influenced PVA. With closed UA, the critical leak of A150 and T100 remained higher than 55 L/min in COPD and OHS, while for V60 decreased to 41 and 33 L/min respectively. In NMD with closed UA, only T100 reached a high critical leak of 69 L/min. Besides, inspiratory trigger sensitivity change was often necessary to avoid PVA. Home ventilators were able to avoid PVA in high-level leak conditions. However, asynchrony appeared in cases of abnormal mechanical properties of respiratory system or closed UA. In case of closed UA, the EPAP should be adjusted prior to the inspiratory trigger. Not applicable.

  13. Metronome improves compression and ventilation rates during CPR on a manikin in a randomized trial.

    Science.gov (United States)

    Kern, Karl B; Stickney, Ronald E; Gallison, Leanne; Smith, Robert E

    2010-02-01

    We hypothesized that a unique tock and voice metronome could prevent both suboptimal chest compression rates and hyperventilation. A prospective, randomized, parallel design study involving 34 pairs of paid firefighter/emergency medical technicians (EMTs) performing two-rescuer CPR using a Laerdal SkillReporter Resusci Anne manikin with and without metronome guidance was performed. Each CPR session consisted of 2 min of 30:2 CPR with an unsecured airway, then 4 min of CPR with a secured airway (continuous compressions at 100 min(-1) with 8-10 ventilations/min), repeated after the rescuers switched roles. The metronome provided "tock" prompts for compressions, transition prompts between compressions and ventilations, and a spoken "ventilate" prompt. During CPR with a bag/valve/mask the target compression rate of 90-110 min(-1) was achieved in 5/34 CPR sessions (15%) for the control group and 34/34 sessions (100%) for the metronome group (pmetronome or control group during CPR with a bag/valve/mask. During CPR with a bag/endotracheal tube, the target of both a compression rate of 90-110 min(-1) and a ventilation rate of 8-11 min(-1) was achieved in 3/34 CPR sessions (9%) for the control group and 33/34 sessions (97%) for the metronome group (pMetronome use with the secured airway scenario significantly decreased the incidence of over-ventilation (11/34 EMT pairs vs. 0/34 EMT pairs; pmetronome was effective at directing correct chest compression and ventilation rates both before and after intubation. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

  14. Validation of the Portuguese Severe Respiratory Insufficiency Questionnaire for home mechanically ventilated patients.

    Science.gov (United States)

    Ribeiro, C; Ferreira, D; Conde, S; Oliveira, P; Windisch, W

    The aim of this study was to develop and validate the professional translation and cultural adaptation of the Portuguese Severe Respiratory Insufficiency (SRI) Questionnaire. The sample was composed of 93 patients (50 male patients, 53.8%) with a mean age of 66.3 years. The most frequent diagnostic groups were chronic obstructive pulmonary disease, obesity hypoventilation syndrome and restrictive chest wall disorders. The patients were asked to fill in both the SRI and SF-36 questionnaires. Factor analysis of the SRI questionnaire was performed leading to an explained variance of 73%, and resulted in 13 components. When analyzing the reliability, we obtained values for Cronbach's alpha above 0.70 for most subscales with the reliability of the summary scale being even higher (0.84). This professional translation and cultural adaptation of the Portuguese SRI Questionnaire has good psychometric properties which are similar, not only to the original, but also to other translations. These characteristics make this questionnaire applicable to the Portuguese population receiving home mechanical ventilation for severe respiratory insufficiency. Copyright © 2017 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.

  15. Wii, Kinect, and Move. Heart Rate, Oxygen Consumption, Energy Expenditure, and Ventilation due to Different Physically Active Video Game Systems in College Students.

    Science.gov (United States)

    Scheer, Krista S; Siebrant, Sarah M; Brown, Gregory A; Shaw, Brandon S; Shaw, Ina

    Nintendo Wii, Sony Playstation Move , and Microsoft XBOX Kinect are home video gaming systems that involve player movement to control on-screen game play. Numerous investigations have demonstrated that playing Wii is moderate physical activity at best, but Move and Kinect have not been as thoroughly investigated. The purpose of this study was to compare heart rate, oxygen consumption, and ventilation while playing the games Wii Boxing, Kinect Boxing, and Move Gladiatorial Combat. Heart rate, oxygen consumption, and ventilation were measured at rest and during a graded exercise test in 10 males and 9 females (19.8 ± 0.33 y, 175.4 ± 2.0 cm, 80.2 ± 7.7 kg,). On another day, in a randomized order, the participants played Wii Boxing, K inect Boxing, and Move Gladiatorial Combat while heart rate, ventilation, and oxygen consumption were measured. There were no differences in heart rate (116.0 ± 18.3 vs. 119.3 ± 17.6 vs. 120.1 ± 17.6 beats/min), oxygen consumption (9.2 ± 3.0 vs. 10.6 ± 2.4 vs. 9.6 ± 2.4 ml/kg/min), or minute ventilation (18.9 ± 5.7 vs. 20.8 ± 8.0 vs. 19.7 ± 6.4 L/min) when playing Wii boxing, Kinect boxing, or Move Gladiatorial Combat (respectively). Playing Nintendo Wii Boxing, XBOX Kinect Boxing, and Sony PlayStation Move Gladiatorial Combat all increase heart rate, oxygen consumption, and ventilation above resting levels but there were no significant differences between gaming systems. Overall, playing a "physically active" home video game system does not meet the minimal threshold for moderate intensity physical activity, regardless of gaming system.

  16. Effects of respiratory rate and tidal volume on gas exchange in total liquid ventilation.

    Science.gov (United States)

    Bull, Joseph L; Tredici, Stefano; Fujioka, Hideki; Komori, Eisaku; Grotberg, James B; Hirschl, Ronald B

    2009-01-01

    Using a rabbit model of total liquid ventilation (TLV), and in a corresponding theoretical model, we compared nine tidal volume-respiratory rate combinations to identify a ventilator strategy to maximize gas exchange, while avoiding choked flow, during TLV. Nine different ventilation strategies were tested in each animal (n = 12): low [LR = 2.5 breath/min (bpm)], medium (MR = 5 bpm), or high (HR = 7.5 bpm) respiratory rates were combined with a low (LV = 10 ml/kg), medium (MV = 15 ml/kg), or high (HV = 20 ml/kg) tidal volumes. Blood gases and partial pressures, perfluorocarbon gas content, and airway pressures were measured for each combination. Choked flow occurred in all high respiratory rate-high volume animals, 71% of high respiratory rate-medium volume (HRMV) animals, and 50% of medium respiratory rate-high volume (MRHV) animals but in no other combinations. Medium respiratory rate-medium volume (MRMV) resulted in the highest gas exchange of the combinations that did not induce choke. The HRMV and MRHV animals that did not choke had similar or higher gas exchange than MRMV. The theory predicted this behavior, along with spatial and temporal variations in alveolar gas partial pressures. Of the combinations that did not induce choked flow, MRMV provided the highest gas exchange. Alveolar gas transport is diffusion dominated and rapid during gas ventilation but is convection dominated and slow during TLV. Consequently, the usual alveolar gas equation is not applicable for TLV.

  17. Measurement of the Air Chance Rate and Ventilation Characteristics During Short Term Transient Phenomena

    DEFF Research Database (Denmark)

    Heiselberg, Per Kvols; Perino, M.

    2004-01-01

    Different measurement procedures are available for the experimental assessment of air change rates inside ventilated enclosures. These mainly consist of tracer gas techniques and can usually be applied to steady-state or moderately transient conditions and when a continous mixing of the indoor air...... ventilation. The results are critically compared with the air flow rates assessed through anemometric measurements. The measurement features, limitations, shortcomings and uncertainties are also discussed....... is assured throughout the test. However, due to the relatively slow response of the gas analysers, none of these procedures can usually be applied to fast transient phenomena that last 15 minutes or less. Moreover in many cases of natural ventilation strategies, the continuous mixing of the indoor air would...

  18. Measurement and Modelling of Air Flow Rate in a Naturally Ventilated Double Skin Facade

    DEFF Research Database (Denmark)

    Heiselberg, Per; Kalyanova, Olena; Jensen, Rasmus Lund

    2008-01-01

    Air flow rate in a naturally ventilated double skin façade (DSF) is extremely difficult to measure due to the stochastic nature of wind, and as a consequence non-uniform and dynamic flow conditions. This paper describes the results of two different methods to measure the air flow in a full...... by the thermal simulation program, BSim, based on measured weather boundary conditions are compared to the measured air temperature, temperature gradient and mass flow rate in the DSF cavity. The results show that it is possible to predict the temperature distribution and airflow in the DSF although some......-scale outdoor test facility with a naturally ventilated double skin façade. Although both methods are difficult to use under such dynamic air flow conditions, they show reasonable agreement and can be used for experimental validation of numerical models of natural ventilation air flow in DSF. Simulations...

  19. "Fighting the system": Families caring for ventilator-dependent children and adults with complex health care needs at home

    Directory of Open Access Journals (Sweden)

    Nielsen Erik W

    2011-07-01

    Full Text Available Abstract Background An increasing number of individuals with complex health care needs now receive life-long and life-prolonging ventilatory support at home. Family members often take on the role of primary caregivers. The aim of this study was to explore the experiences of families giving advanced care to family members dependent on home mechanical ventilation. Methods Using qualitative research methods, a Grounded Theory influenced approach was used to explore the families' experiences. A total of 15 family members with 11 ventilator-dependent individuals (three children and eight adults were recruited for 10 in-depth interviews. Results The core category, "fighting the system," became the central theme as family members were asked to describe their experiences. In addition, we identified three subcategories, "lack of competence and continuity", "being indispensable" and "worth fighting for". This study revealed no major differences in the families' experiences that were dependent on whether the ventilator-dependent individual was a child or an adult. Conclusions These findings show that there is a large gap between family members' expectations and what the community health care services are able to provide, even when almost unlimited resources are available. A number of measures are needed to reduce the burden on these family members and to make hospital care at home possible. In the future, the gap between what the health care can potentially provide and what they can provide in real life will rapidly increase. New proposals to limit the extremely costly provision of home mechanical ventilation in Norway will trigger new ethical dilemmas that should be studied further.

  20. Everything safe? – Risk situations in advanced home care from the point of view of ventilated patients and their relatives

    Science.gov (United States)

    Ewers, Michael; Schaepe, Christiane; Lehmann, Yvonne

    2017-01-01

    Background: The number of home mechanically ventilated (HMV) patients has been growing for years. However, little is known about requirements, processes and effects of advanced home care, provided in distance from clinics and doctors. To date, safety related aspects of the above mentioned issues have scarcely been examined. Aim: Users of advanced home care were asked about their experiences and about situations in which they felt safe or unsafe. The aim was to gain insights into the daily care provision, explore safety risks from the users’ point of view, and to develop new approaches to enhance patient safety in home care for the severely ill. Method: A qualitative explorative study has been carried out, based on semi-structured interviews (ventilated patients N = 21; relatives N = 15). Sampling, data collecting and data analysis were guided by principles of Grounded Theory. Results: Risk situations occur when (non-)verbal communication offers of HMV patients are overseen or misunderstood, patient- or technology related monitoring tasks are neglected, if coordination and collaboration requirements are undervalued and if negotiation processes as well as education and supervision needs are disregarded. Furthermore, nurses’ lack of competence, self-confidence and professionalism may produce risk situations. Conclusion: Listen carefully to patients and relatives can help to identify quality shortcomings in advanced home care, to prevent risk situations and to develop patient-centered safety concepts for this particular setting.

  1. Ventilation Control of Volatile Organic Compounds in New U.S. Homes: Results of a Controlled Field Study in Nine Residential Units

    Energy Technology Data Exchange (ETDEWEB)

    Willem, Henry [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hult, Erin L. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hotchi, Toshifumi [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Russell, Marion L. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Maddalena, Randy L. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Singer, Brett C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2013-01-01

    In order to optimize strategies to remove airborne contaminants in residences, it is necessary to determine how contaminant concentrations respond to changes in the air exchange rate. The impact of air exchange rate on the indoor concentrations of 39 target volatile organic compounds (VOCs) was assessed by measuring air exchange rates and VOC concentrations at three ventilation settings in nine residences. Active sampling methods were used for VOC concentration measurements, and passive perfluorocarbon tracer gas emitters with active sampling were used to determine the overall air exchange rate corresponding to the VOC measurements at each ventilation setting. The concentration levels and emission rates of the target VOCs varied by as much as two orders of magnitude across sites. Aldehyde and terpene compounds were typically the chemical classes with highest concentrations, followed by alkanes, aromatics, and siloxanes. For each home, VOC concentrations tended to decrease as the air exchange rate was increased, however, measurement uncertainty was significant. The indoor concentration was inversely proportional to air exchange rate for most compounds. For a subset of compounds including formaldehyde, however, the indoor concentration exhibited a non-linear dependence on the timescale for air exchange

  2. Ventilation Control of Volatile Organic Compounds in New U.S. Homes: Results of a Controlled Field Study in Nine Residential Units

    Energy Technology Data Exchange (ETDEWEB)

    Willem, Henry [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hult, Erin L. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hotchi, Toshifumi [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Russell, Marion L. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Maddalena, Randy L. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Singer, Brett C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2013-01-23

    In order to optimize strategies to remove airborne contaminants in residences, it is necessary to determine how contaminant concentrations respond to changes in the air exchange rate. The impact of air exchange rate on the indoor concentrations of 39 target volatile organic compounds (VOCs) was assessed by measuring air exchange rates and VOC concentrations at three ventilation settings in nine residences. Active sampling methods were used for VOC concentration measurements, and passive perfluorocarbon tracer gas emitters with active sampling were used to determine the overall air exchange rate corresponding to the VOC measurements at each ventilation setting. The concentration levels and emission rates of the target VOCs varied by as much as two orders of magnitude across sites. Aldehyde and terpene compounds were typically the chemical classes with highest concentrations, followed by alkanes, aromatics, and siloxanes. For each home, VOC concentrations tended to decrease as the air exchange rate was increased, however, measurement uncertainty was significant. The indoor concentration was inversely proportional to air exchange rate for most compounds. For a subset of compounds including formaldehyde, however, the indoor concentration exhibited a non-linear dependence on the timescale for air exchange.

  3. Effect of ventilation rate and board loading on formaldehyde concentration : a critical review of the literature

    Science.gov (United States)

    George E. Myers

    1984-01-01

    A critical literature review has been carried out on the influence of ventilation rate (N, hr.-1) and board loading (L, m2/m3) on steady state formaldehyde concentrations (Cs, ppm) resulting from particleboard and plywood emissions. Large differences exist among boards in the extent to which their formaldehyde concentrations change with N or L in laboratory chambers....

  4. Emission of formaldehyde by particleboard : effect of ventilation rate and loading on air-contamination levels

    Science.gov (United States)

    George E. Myers; Muneo Nagaoka

    1981-01-01

    Dynamic tests for determining the formaldehyde emission behavior of UF-bonded boards involve the measurement of formaldehyde concentration in the air within a vessel which contains a specified board loading L (m2 of board area per m3 of vessel free volume) and is being ventilated at a specified air exchange rate N (hr.-1). Such tests constitute a primary...

  5. A Technical Basis for Employing Facility Ventilation Air Exchange Rates in the Decision to Downpost

    CERN Document Server

    Mantooth, D S

    2001-01-01

    Utilizing the ventilation exchange rate as a basis for the decision to downpost a location within a facility from an airborne radiation area (ARA) based on initial air count(DAC). Not used in the case of a confirmed or suspected contamination release.

  6. Ventilation rates indicate stress-coping styles in Nile tilapia

    Indian Academy of Sciences (India)

    increase and act in an active (e.g. high-level aggression or avoidance) manner in ... hand, VR can be linked to metabolic rates (Alvarenga and. Volpato 1995). ... dry pellets (22% protein, Purina® Ltd, Campinas, SP, Brazil). Leftover food was ... food offered, but this technique guaranteed fish were able to eat until satiation.

  7. Indoor radon concentration and its possible dependence on ventilation rate and flooring type

    International Nuclear Information System (INIS)

    Ashok, G. V.; Nagaiah, N.; Shiva Prasad, N. G.

    2012-01-01

    The results of radon concentration measurements carried out in dwellings with natural ventilation for 1 y in Bangalore are reported. Measurements, covering three sessions of the day (morning, afternoon, night) were performed two times in a month for 1 y at a fixed place of each dwelling at a height of 1 m above the ground surface in selected dwellings. The low-level radon detection system (LLRDS), an active method, was used for the estimation of radon concentration. The measurements were aimed to understand the diurnal variation and the effect of ventilation rate and flooring type on indoor radon concentration. The geometric mean (±geometric standard deviation) of indoor radon concentration from about 500 measurements carried out in 20 dwellings is found to be 25.4 ±1.54 Bq m -3 . The morning, afternoon and night averages were found to be 42.6 ±2.05, 15.3 ±2.18 and 28.5 ±2.2 Bq m -3 , respectively. The approximate natural ventilation rates of the dwellings were calculated using the PHPAIDA-the on-line natural ventilation, mixed mode and air infiltration rate calculation algorithm and their effects on indoor radon concentrations were studied. The inhalation dose and the lung cancer risk due to indoor radon exposure were found to be 0.66 mSv y -1 and 11.9 per 10 6 persons, respectively. The gamma exposure rate was also measured in all the dwellings and its correlation with the inhalation dose rate was studied. (authors)

  8. Gender differences in patients starting long-term home mechanical ventilation due to obesity hypoventilation syndrome.

    Science.gov (United States)

    Palm, Andreas; Midgren, Bengt; Janson, Christer; Lindberg, Eva

    2016-01-01

    Obesity hypoventilation syndrome (OHS) is often diagnosed late. The aim of this study was to analyse gender differences at initiation of long-term mechanical ventilation (LTMV) in patients with (OHS), to analyse gender differences in treatment effect and to study how the prescription of LTMV due to OHS has changed over time. Data on patients on LTMV due to OHS between 1996 and 2014 were obtained from Swedevox, a nationwide health quality registry of patients on LTMV in Sweden. When starting LTMV, women were generally older (age 64.4 ± 11.2 vs. 60.1 ± 12.1 years, p obese (BMI 43.0 ± 8.2 vs. 41.5 ± 7.9 kg/m2, p differ. During the study period, the age of patients at the initiation of LTMV rose by 3.4 years/decade (P = 0.001) in women and with 1.9 years/decade (P = 0.048) in men but there were no significant changes in BMI (P = 0.425). Diagnosis of OHS is more delayed in women and as a consequence the disease is more advanced when diagnosed. In spite of this, there is no gender difference in survival rate in patients with OHS treated with LTMV. More and older patients with OHS nowadays gain access to LTMV. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Measurement of Air Flow Rate in a Naturally Ventilated Double Skin Facade

    DEFF Research Database (Denmark)

    Kalyanova, Olena; Jensen, Rasmus Lund; Heiselberg, Per

    2007-01-01

    Air flow rate in a naturally ventilated space is extremely difficult to measure due to the stochastic nature of wind, and as a consequence non-uniform and dynamic flow conditions. This paper describes three different methods to measure the air flow in a full-scale outdoor test facility...... with a naturally ventilated double skin façade. In the first method, the air flow in the cavity is estimated on the basis of six measured velocity profiles. The second method is represented by constant injection of tracer gas and in the third method a measured relation in the laboratory is used to estimate...... the flow rate on the basis of continues measurement of the pressure difference between the surface pressure at the opening and inside pressure of the double skin façade. Although all three measurement methods are difficult to use under such dynamic air flow conditions, two of them show reasonable agreement...

  10. Radon concentration; source strength and ventilation rate: how well do we know the connections

    International Nuclear Information System (INIS)

    Ring, J.W.

    1984-01-01

    The simple steady state model which is frequently used to relate radon concentration (C), source strength (S) and ventilation rate (l/'tau') is expressed in the equation C=S'tau'. The assumptions of this model are given and their validity explored in this paper. In particular the assumption of steady state conditions fot the ventilation rate is studied experimentally in a simple one chamber building, the Solar Classroom at Hamilton College. Even in this simple case variations are found of a factor of three or more in 'tau' which can be attributed to wind and stack effects. Studies of other houses are cited which show that variations of 'tau' between houses can be as large as factor of sixty or more. The implications of these results for developing ventilation standards or for mitigating the indoor radon problem are suggested. Individual houses can be understood and mitigating strategies implemented in them on a case by case basis but a statistical treatment of houses in general does not seem to be a fruitful approach. (Author)

  11. Experimental verification of air flow rate measurement for representative isokinetic air sampling in ventilation stacks

    International Nuclear Information System (INIS)

    Okruhlica, P.; Mrtvy, M.; Kopecky, Z.

    2009-01-01

    Nuclear facilities are obliged to monitor their discharge's influence on environment. Main monitored factions in NPP's ventilation stacks are usually noble gasses, particulates and iodine. These factions are monitored in air sampled from ventilation stack by means of sampling rosette and bypass followed with on-line measuring monitors and balance sampling devices with laboratory evaluations. Correct air flow rate measurement and representative iso-kinetic air sampling system is essential for physical correct and metrological accurate evaluation of discharge influence on environment. Pairs of measuring sensors (Anemometer, pressure gauge, thermometer and humidity meter) are symmetrically placed in horizontal projection of stack on positions based on measured air flow velocity distribution characteristic, Analogically diameter of sampling rosette nozzles and their placement in the middle of 6 - 7 annuluses are calculated for assurance of representative iso-kinetic sampling. (authors)

  12. Experimental verification of air flow rate measurement for representative isokinetic air sampling in ventilation stacks

    International Nuclear Information System (INIS)

    Okruhlica, P.; Mrtvy, M.; Kopecky, Z.

    2008-01-01

    Nuclear facilities are obliged to monitor their discharge's influence on environment. Main monitored factions in NPP's ventilation stacks are usually noble gasses, particulates and iodine. These factions are monitored in air sampled from ventilation stack by means of sampling rosette and bypass followed with on-line measuring monitors and balance sampling devices with laboratory evaluations. Correct air flow rate measurement and representative iso-kinetic air sampling system is essential for physical correct and metrological accurate evaluation of discharge influence on environment. Pairs of measuring sensors (Anemometer, pressure gauge, thermometer and humidity meter) are symmetrically placed in horizontal projection of stack on positions based on measured air flow velocity distribution characteristic, Analogically diameter of sampling rosette nozzles and their placement in the middle of 6- 7 annuluses are calculated for assurance of representative iso-kinetic sampling. (authors)

  13. A bench evaluation of fraction of oxygen in air delivery and tidal volume accuracy in home care ventilators available for hospital use

    Science.gov (United States)

    Baboi, Loredana; Subtil, Fabien

    2016-01-01

    Background Turbine-powered ventilators are not only designed for long-term ventilation at home but also for hospital use. It is important to verify their capabilities in delivering fraction of oxygen in air (FIO2) and tidal volume (VT). Methods We assessed the FIO2 accuracy and the VT delivery in four home care ventilators (HCV) on the bench. The four HCV were Astral 150, Elisée 150, Monnal T50 and Trilogy 200 HCV, which were connected to a lung model (ASL 5000). For assessing FIO2 accuracy, lung model was set to mimic an obstructive lung and HCV were set in volume controlled mode (VC). They supplied with air, 3 or 15 L/min oxygen and FIO2 was measured by using a ventilator tester (Citrex H4TM). For the VT accuracy, the lung model was set in a way to mimic three adult configurations (normal, obstructive, or restrictive respiratory disorder) and one pediatric configuration. Each HCV was set in VC. Two VT (300 and 500 mL) in adult lung configuration and one 50 mL VT in pediatric lung configuration, at two positive end expiratory pressures 5 and 10 cmH2O, were tested. VT accuracy was measured as volume error (the relative difference between set and measured VT). Statistical analysis was performed by suing one-factor ANOVA with a Bonferroni correction for multiple tests. Results For Astral 150, Elisée 150, Monnal T50 and Trilogy 200, FIO2 averaged 99.2%, 93.7%, 86.3%, and 62.1%, respectively, at 15 L/min oxygen supplementation rate (P<0.001). Volume error was 0.5%±0%, −38%±0%, −9%±0%, −29%±0% and −36%±0% for pediatric lung condition (P<0.001). In adult lung configurations, Monnal T50 systematically over delivered VT and Trilogy 150 was sensitive to lung configuration when VT was set to 300 mL at either positive end-expiratory pressure (PEEP). Conclusions HCV are different in terms of FIO2 efficiency and VT delivery. PMID:28149559

  14. Respiratory induced heart rate variability during slow mechanical ventilation Marker to exclude brain death patients

    Czech Academy of Sciences Publication Activity Database

    Jurák, Pavel; Halámek, Josef; Vondra, Vlastimil; Kružliak, P.; Šrámek, V.; Cundrle, I.; Leinveber, P.; Adamek, M.; Zvoníček, V.

    2017-01-01

    Roč. 129, 7-8 (2017), s. 251-258 ISSN 0043-5325 R&D Projects: GA ČR GAP103/11/0933; GA MŠk(CZ) LO1212; GA MŠk ED0017/01/01; GA MZd NS10105 Institutional support: RVO:68081731 Keywords : critical illness * sedation * brain death * respiratory rate variability * heart rate variability * mechanical ventilation Subject RIV: FS - Medical Facilities ; Equipment OBOR OECD: Medical engineering Impact factor: 0.974, year: 2016

  15. Whole house particle removal and clean air delivery rates for in-duct and portable ventilation systems.

    Science.gov (United States)

    Macintosh, David L; Myatt, Theodore A; Ludwig, Jerry F; Baker, Brian J; Suh, Helen H; Spengler, John D

    2008-11-01

    A novel method for determining whole house particle removal and clean air delivery rates attributable to central and portable ventilation/air cleaning systems is described. The method is used to characterize total and air-cleaner-specific particle removal rates during operation of four in-duct air cleaners and two portable air-cleaning devices in a fully instrumented test home. Operation of in-duct and portable air cleaners typically increased particle removal rates over the baseline rates determined in the absence of operating a central fan or an indoor air cleaner. Removal rates of 0.3- to 0.5-microm particles ranged from 1.5 hr(-1) during operation of an in-duct, 5-in. pleated media filter to 7.2 hr(-1) for an in-duct electrostatic air cleaner in comparison to a baseline rate of 0 hr(-1) when the air handler was operating without a filter. Removal rates for total particulate matter less than 2.5 microm in aerodynamic diameter (PM2.5) mass concentrations were 0.5 hr(-1) under baseline conditions, 0.5 hr(-1) during operation of three portable ionic air cleaners, 1 hr(-1) for an in-duct 1-in. media filter, 2.4 hr(-1) for a single high-efficiency particle arrestance (HEPA) portable air cleaner, 4.6 hr(-1) for an in-duct 5-in. media filter, 4.7 hr(-1) during operation of five portable HEPA filters, 6.1 hr(-1) for a conventional in-duct electronic air cleaner, and 7.5 hr(-1) for a high efficiency in-duct electrostatic air cleaner. Corresponding whole house clean air delivery rates for PM2.5 attributable to the air cleaner independent of losses within the central ventilation system ranged from 2 m3/min for the conventional media filter to 32 m3/min for the high efficiency in-duct electrostatic device. Except for the portable ionic air cleaner, the devices considered here increased particle removal indoors over baseline deposition rates.

  16. Antibiotic consumption and ventilator-associated pneumonia rates, some parallelism but some discrepancies.

    Science.gov (United States)

    Nora, David; Póvoa, Pedro

    2017-11-01

    Ventilator-associated pneumonia (VAP) is a common infection in intensive care units (ICUs) but its clinical definition is neither sensitive nor specific and lacks accuracy and objectivity. New defining criteria were proposed in 2013 by the National Healthcare Safety Network (NHSN) in order to more accurately conduct surveillance and track prevention progress. Although there is a consistent trend towards a decrease in VAP incidence during the last decade, significant differences in VAP rates have been reported and are persistently lower in NHSN and other American reports (0.0 to 4.4 VAP per 1,000 ventilator-days in 2012) compared to the European Centre for Disease Prevention and Control (ECDC) data (10 VAP per 1,000 ventilator-days in 2014). In the United States, VAP has been proposed as an indicator of quality of care in public reporting, and the threat of financial penalties for this diagnosis has put pressure on hospitals to minimize VAP rates that may lead to artificial lower values, independently of patient care. Although prevention bundles may contribute for encouraging reductions in VAP incidence, both pathophysiologic and epidemiologic factors preclude a zero-VAP rate. It would be expected from the trend of reduction of VAP incidence that the consumption of antibiotics would also decrease in particular in those hospitals with lowest VAP rates. However, ICU reports show a steadily use of antibiotics for nosocomial pneumonia in 15% of patients and both ECDC and NHSN data on antibiotic consumption showed no significant trend. Knowledge of bacterial epidemiology and resistance profiles for each ICU has great relevance in order to understand trends of antibiotic use. The new NHSN criteria provide a more objective and quantitative data based VAP definition, including an antibiotic administration criterion, allowing, in theory, a more comprehensive assessment and a reportable benchmark of the observed VAP and antibiotic consumption variability.

  17. Ventilator use, respiratory problems, and caregiver well-being in korean patients with amyotrophic lateral sclerosis receiving home-based care.

    Science.gov (United States)

    Kim, Chul-Hoon; Kim, Myoung Soo

    2014-10-01

    The purpose of this study was to describe the status of ventilator use, respiratory problems, and caregiver well-being relating to patients with amyotrophic lateral sclerosis (ALS) using a home-based ventilator as well as to examine the relationship among ventilator use, respiratory problems, and caregiver well-being. Patients with ALS (n = 141) registered in the Severe-Rare Disease Center of the Korean Center for Disease Control and their caregivers (n = 83) were surveyed from August 2008 to April 2009. Trained research assistants visited patient homes; collected data using questionnaires; and then performed analyses with descriptive statistics, χ test, and t test as well as partial correlation analysis using SPSS WIN 18.0. Thirty-two patients used noninvasive ventilation (NIV), and 109 used tracheostomy and mechanical ventilation (TMV). One hundred of the TMV patients used the ventilator 24 hours per day. The ventilator circuit exchange cycle was 0.96 times per month for NIV patients and 1.17 times per month for TMV patients (t = -4.91, p NIV patients had a higher level of tidal volume than TMV patients (t = 3.34, p = .001). Approximately 22% of NIV patients and 24% of TMV patients used one or more physiotherapies for airway clearance. There was a significant relationship between hypoventilation symptoms and caregiver burden (r = .31, p = .006). Hypoventilation symptoms were positively related to physiotherapy (r = .24, p = .042), and physiotherapy was positively related to caregiver burden (r = .24, p = .043). On the basis of the findings of this study, care management for patients with ALS with a home-based ventilator as well as their caregiver's well-being was relatively inappropriate. We recommend that community-based support programs and burden relief programs be considered as managerial interventions.

  18. Increasing rate of middle ear ventilation tube insertion in children in denmark

    DEFF Research Database (Denmark)

    Djurhuus, Bjarki Ditlev; Skytthe, Axel; Christensen, Kaare

    2014-01-01

    ventilation tube insertions distributed among 269,459 different children were identified. From 1997 to 2010 the age standardized incidence rate in 0-15-year-olds increased from 26 to 40 per 1000 person years with an estimated annual increase of 2.0% (95% confidence interval 1.9-2.1%). The largest increase...... in incidence rate was found in 1-year-olds with an annual increase of 4.5% (95% confidence interval 4.4-4.6%). Age-specific incidence rates remained at maximum around the age of 14 months throughout the period. The cumulative incidence proportion for the 2010 birth cohort by the time they reach the age of 5......OBJECTIVE: To study the incidence rates of middle ear ventilation tube insertion in children aged 0 to 15 years in Denmark from 1997 to 2010. METHODS: Using two national registers, the Danish National Health Service Register and the Danish National Patient Register, practically all cases of middle...

  19. Impact of the humidification device on intubation rate during noninvasive ventilation with ICU ventilators: results of a multicenter randomized controlled trial.

    Science.gov (United States)

    Lellouche, François; L'Her, E; Abroug, F; Deye, N; Rodriguez, P O; Rabbat, A; Jaber, S; Fartoukh, M; Conti, G; Cracco, C; Richard, J C; Ricard, J D; Mal, H; Mentec, H; Loisel, F; Lacherade, J C; Taillé, S; Brochard, L

    2014-02-01

    The use of heat and moisture exchangers (HME) during noninvasive ventilation (NIV) can increase the work of breathing, decrease alveolar ventilation, and deliver less humidity in comparison with heated humidifiers (HH). We tested the hypothesis that the use of HH during NIV with ICU ventilators for patients with acute respiratory failure would decrease the rate of intubation (primary endpoint) as compared with HME. We conducted a multicenter randomized controlled study in 15 centers. After stratification by center and type of respiratory failure (hypoxemic or hypercapnic), eligible patients were randomized to receive NIV with HH or HME. Of the 247 patients included, 128 patients were allocated to the HME group and 119 to the HH group. Patients were comparable at baseline. The intubation rate was not significantly different: 29.7% in the HME group and 36.9% in the HH group (p = 0.28). PaCO2 did not significantly differ between the two arms, even in the subgroup of hypercapnic patients. No significant difference was observed for NIV duration, ICU and hospital LOS, or ICU mortality (HME 14.1 vs. HH 21.5%, p = 0.18). In this study, the short-term physiological benefits of HH in comparison with HME during NIV with ICU ventilators were not observed, and no difference in intubation rate was found. The physiologic effects may have been obscured by leaks or other important factors in the clinical settings. This study does not support the recent recommendation favoring the use of HH during NIV with ICU ventilators.

  20. A Prospective Study of Ventilation Rates and Illness Absence in California Office Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Eliseeva, Ekaterina A. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Spears, Michael [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Chan, Wanyu R. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Cohn, Sebastian [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sullivan, Douglas P. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Fisk, William J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2014-10-07

    Background – This study investigated the associations of ventilation rates (VRs), estimated from indoor CO2 concentrations, in offices with the amount of respiratory infections, illness absences, and building-related health symptoms in occupants. Methods – Office buildings were recruited from three California climate zones. In one or more study spaces within each building, real-time logging sensors measured carbon dioxide, temperature, and relative humidity for one year. Ventilation rates were estimated using daily peak CO2 levels, and also using an alternative metric. Data on occupants and health outcomes were collected through web-based surveys every three months. Multivariate models were used to assess relationships between metrics of ventilation rate or CO2 and occupant outcomes. For all outcomes, negative associations were hypothesized with VR metrics, and positive associations with CO2 metrics. Results – Difficulty recruiting buildings and low survey response limited sample size and study power. In 16 studied spaces within 9 office buildings, VRs were uniformly high over the year, from twice to over nine times the California office VR standard (7 L/s or 15 cfm per person). VR and CO2 metrics had no statistically significant relationships with occupant outcomes, except for a small significantly positive association of the alternative VR metric with respiratory illness-related absence, contrary to hypotheses. Conclusions– The very high time-averaged VRs in the California office buildings studied presumably resulted from “economizer cycles” bringing in large volumes of outdoor air; however, in almost all buildings even the estimated minimum VRs supplied (without the economizer) substantially exceeded the minimum required VR. These high VRs may explain the absence of hypothesized relationships with occupant outcomes. Among uniformly high VRs, little variation in contaminant concentration and occupant effects would be expected. These findings may

  1. Numerical investigation on the gas entrainment rate on ventilated supercavity body

    Directory of Open Access Journals (Sweden)

    WuGang Yang

    2016-12-01

    Full Text Available The supercavitation technique provides a means of significantly increasing the velocity of an underwater vehicle. This technique involves essentially the creation of stable supercavity shape. The method of artificial ventilation is most effective for generating and dominating the supercavity. This paper focuses on the numerical simulation of flow field around three-dimensional body. The method is based on the multiphase computational fluid dynamics model combined with the turbulence model and the full cavity model. The fundamental similarity parameters of ventilated supercavity flows that include cavitation number, Froude number Fr, entrainment rate CQ, and drag coefficient Cx are all investigated numerically in the case of steady flow and gravity field. We discuss the following simulations results in three parts: (1 the variations of the cavitation number and the supercavity’s relative diameter with entrainment rate; (2 the drag coefficient versus the cavitation number; and (3 deformation of supercavity axis caused by gravitational effect for three different fixed three Froude numbers. In the full paper, we give the comparison results of the drag reduction ratio among numerical simulation and experiment conducted in hydrodynamic tunnel and towing tank, respectively. We summarize our discussion of gravitational effect on the axis deformation of supercavity as follows: in the case of smaller Froude number, the inclination of the cavity axis increases monotonously with increasing horizontal length and reaches its maximal value at the end of supercavity; this deformation can be almost completely negligible when the Froude number Fr is larger than 7.0. The comparisons with the experimental data in the hydrodynamic tunnel and the towing tank indicate that the present method is effective for predicting the flows around ventilated supercavity; that the numerical results is in good agreement with the experimental ones and that the maximal value of the

  2. Ventilation effectiveness

    CERN Document Server

    Mathisen, Hans Martin; Nielsen, Peter V; Moser, Alfred

    2004-01-01

    Improving the ventilation effectiveness allows the indoor air quality to be significantly enhanced without the need for higher air changes in the building, thereby avoiding the higher costs and energy consumption associated with increasing the ventilation rates. This Guidebook provides easy-to-understand descriptions of the indices used to mesure the performance of a ventilation system and which indices to use in different cases.

  3. Evaluation of ventilators for mouthpiece ventilation in neuromuscular disease.

    Science.gov (United States)

    Khirani, Sonia; Ramirez, Adriana; Delord, Vincent; Leroux, Karl; Lofaso, Frédéric; Hautot, Solène; Toussaint, Michel; Orlikowski, David; Louis, Bruno; Fauroux, Brigitte

    2014-09-01

    Daytime mouthpiece ventilation is a useful adjunct to nocturnal noninvasive ventilation (NIV) in patients with neuromuscular disease. The aims of the study were to analyze the practice of mouthpiece ventilation and to evaluate the performance of ventilators for mouthpiece ventilation. Practice of mouthpiece ventilation was assessed by a questionnaire, and the performance of 6 home ventilators with mouthpiece ventilation was assessed in a bench test using 24 different conditions per ventilator: 3 mouthpieces, a child and an adult patient profile, and 4 ventilatory modes. Questionnaires were obtained from 30 subjects (mean age 33 ± 11 y) using NIV for 12 ± 7 y. Fifteen subjects used NIV for > 20 h/day, and 11 were totally ventilator-dependent. The subject-reported benefits of mouthpiece ventilation were a reduction in dyspnea (73%) and fatigue (93%) and an improvement in speech (43%) and eating (27%). The bench study showed that none of the ventilators, even those with mouthpiece ventilation software, were able to deliver mouthpiece ventilation without alarms and/or autotriggering in each condition. Alarms and/or ineffective triggering or autotriggering were observed in 135 of the 198 conditions. The occurrence of alarms was more common with a large mouthpiece without a filter compared to a small mouthpiece with a filter (P ventilator. Subjects are satisfied with mouthpiece ventilation. Alarms are common with home ventilators, although less common in those with mouthpiece ventilation software. Improvements in home ventilators are needed to facilitate the expansion of mouthpiece ventilation. Copyright © 2014 by Daedalus Enterprises.

  4. Distanciation in Ricoeur's theory of interpretation: narrations in a study of life experiences of living with chronic illness and home mechanical ventilation

    DEFF Research Database (Denmark)

    Dreyer, Pia S.; Pedersen, Birthe D

    2009-01-01

    , and this concept of distanciation will be illustrated with reference to narrations from a study of patient's life experiences living with chronic illness and home mechanical ventilation in Denmark. Distanciation in the interpretation objectifies the text, and narration in a poetic language creates a particular...

  5. Test Plan for Measuring Ventilation Rates and Combustible Gas Levels in TWRS Active Catch Tanks

    Energy Technology Data Exchange (ETDEWEB)

    NGUYEN, D.M.

    1999-10-25

    The purpose of this sampling activity is to obtain data to support an initial evaluation of potential hazards due to the presence of combustible gas in catch tanks that are currently operated by the River Protection Project (RPP). Results of the hazard analysis will be used to support closure of the flammable gas unreviewed safety question for these facilities. The data collection will be conducted in accordance with the Tank Safety Screening Data Quality Objective (Dukelow et al. 1995). Combustible gas, ammonia, and organic vapor levels in the headspace of the catch tanks will be field-measured using hand-held instruments. If a combustible gas level measurement in a tank exceeds an established threshold, gas samples will he collected in SUMMA' canisters for more extensive laboratory analysis. In addition, ventilation rates of some catch tanks will be measured to evaluate removal of flammable gas by air flowing through the tanks. This test plan identifies the sample collection, laboratory analysis, quality assurance, and reporting objectives for this data collection effort. The plan also provides the procedures for field measurement of combustible gas concentrations and ventilation rates.

  6. Effect of solar chimney inclination angle on space flow pattern and ventilation rate

    Energy Technology Data Exchange (ETDEWEB)

    Bassiouny, Ramadan; Korah, Nader S.A. [Department of Mechanical Power Engineering and Energy, Minia University, Minia 61111 (Egypt)

    2009-02-15

    The solar chimney is a simple and practical idea that is applied to enhance space natural ventilation. The chimney could be vertical or inclined. The chimney inclination angle is an important parameter that greatly affects space flow pattern and ventilation rate. In the present study, the effect of chimney inclination angle on air change per hour and indoor flow pattern was numerically and analytically investigated. A numerical simulation using Ansys, a FEM-based code, was used to predict flow pattern. Then the results were compared with published experimental measurements. A FORTRAN program was developed to iteratively solve the mathematical model that was obtained through an overall energy balance on the solar chimney. The analytical results showed that an optimum air flow rate value was achieved when the chimney inclination is between 45 and 70 for latitude of 28.4 . The numerically predicted flow pattern inside the space supports this finding. Moreover, in the present study a correlation to predict the air change per hour was developed. The correlation was tested within a solar intensity greater than or equal to 500 W/m{sup 2}, and chimney width from 0.1 m to 0.35 m for different inclination angles with acceptable values. (author)

  7. Evaluation of the indoor air quality minimum ventilation rate procedure for use in California retail buildings.

    Science.gov (United States)

    Dutton, S M; Mendell, M J; Chan, W R; Barrios, M; Sidheswaran, M A; Sullivan, D P; Eliseeva, E A; Fisk, W J

    2015-02-01

    This research assesses benefits of adding to California Title-24 ventilation rate (VR) standards a performance-based option, similar to the American Society of Heating, Refrigerating, and Air Conditioning Engineers 'Indoor Air Quality Procedure' (IAQP) for retail spaces. Ventilation rates and concentrations of contaminants of concern (CoC) were measured in 13 stores. Mass balance models were used to estimate 'IAQP-based' VRs that would maintain concentrations of all CoCs below health- or odor-based reference concentration limits. An intervention study in a 'big box' store assessed how the current VR, the Title 24-prescribed VR, and the IAQP-based VR (0.24, 0.69, and 1.51 air changes per hour) influenced measured IAQ and perceived of IAQ. Neither current VRs nor Title 24-prescribed VRs would maintain all CoCs below reference limits in 12 of 13 stores. In the big box store, the IAQP-based VR kept all CoCs below limits. More than 80% of subjects reported acceptable air quality at all three VRs. In 11 of 13 buildings, saving energy through lower VRs while maintaining acceptable IAQ would require source reduction or gas-phase air cleaning for CoCs. In only one of the 13 retail stores surveyed, application of the IAQP would have allowed reduced VRs without additional contaminant-reduction strategies. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

  8. Modeling ventilation rates in bedrooms based on building characteristics and occupant behavior

    DEFF Research Database (Denmark)

    Bekö, Gabriel; Toftum, Jørn; Clausen, Geo

    2011-01-01

    Air change rate (ACR) data obtained from the bedrooms of 500 Danish children and presented in an earlier paper were analyzed in more detail. Questionnaires distributed to the families, home inspections and interviews with the parents provided information about a broad range of residential charact...

  9. Use of ventilator associated pneumonia bundle and statistical process control chart to decrease VAP rate in Syria.

    Science.gov (United States)

    Alsadat, Reem; Al-Bardan, Hussam; Mazloum, Mona N; Shamah, Asem A; Eltayeb, Mohamed F E; Marie, Ali; Dakkak, Abdulrahman; Naes, Ola; Esber, Faten; Betelmal, Ibrahim; Kherallah, Mazen

    2012-10-01

    Implementation of ventilator associated pneumonia (VAP) bundle as a performance improvement project in the critical care units for all mechanically ventilated patients aiming to decrease the VAP rates. VAP bundle was implemented in 4 teaching hospitals after educational sessions and compliance rates along with VAP rates were monitored using statistical process control charts. VAP bundle compliance rates were steadily increasing from 33 to 80% in hospital 1, from 33 to 86% in hospital 2 and from 83 to 100% in hospital 3 during the study period. The VAP bundle was not applied in hospital 4 therefore no data was available. A target level of 95% was reached only in hospital 3. This correlated with a decrease in VAP rates from 30 to 6.4 per 1000 ventilator days in hospital 1, from 12 to 4.9 per 1000 ventilator days in hospital 3, whereas VAP rate failed to decrease in hospital 2 (despite better compliance) and it remained high around 33 per 1000 ventilator days in hospital 4 where VAP bundle was not implemented. VAP bundle has performed differently in different hospitals in our study. Prevention of VAP requires a multidimensional strategy that includes strict infection control interventions, VAP bundle implementation, process and outcome surveillance and education.

  10. On-the-job training makes the difference: healthcare assistants' perceived competence and responsibility in the care of patients with home mechanical ventilation.

    Science.gov (United States)

    Swedberg, Lena; Michélsen, Hans; Chiriac, Eva Hammar; Hylander, Ingrid

    2015-06-01

    To describe and analyse perceived competence and perceived responsibility among healthcare assistants (HC assistants), caring for patients with home mechanical ventilation (HMV) and other advanced caring needs, adjusted for socio-demographic and workplace background factors. A cross-sectional study was conducted including 128 HC assistants employed in Stockholm County, Sweden. The HC assistants responded to a study-specific questionnaire on perceived competence and perceived responsibility, provided socio-demographic and workplace background data, as well as information on the patient characteristics for the understanding of their work situations. Descriptive statistics and logistic regression analyses were performed. Eighty per cent of the HC assistants rated their perceived competence as high, and fifty-nine per cent rated their perceived responsibility as high. Fifty-five per cent lacked formal healthcare training, and only one in five of the HC assistants had a formal training equivalent with a licensed practical nurse (LPN) examination. Males lacked formal training to a greater extent than females and rated their competence accordingly. On-the-job training was significantly associated with high ratings on both perceived competence and perceived responsibility, and clinical supervision was associated with high rating on perceived responsibility. HC assistants with limited formal training self-reported their competence as high, and on-the-job training was found to be important. Also, clinical supervision was found important for their perception of high responsibility. In Sweden, HC assistants have a 24-hour responsibility for the care and safety of their patient with HMV and other advanced caring needs. The study results point out important issues for further research regarding formal training requirements as well as the needs for standardised workplace training and supervision of HC assistants. The consequences of transfer of responsibility by delegation from

  11. Ventilation Effectiveness

    DEFF Research Database (Denmark)

    Mundt, M.; Mathisen, H. M.; Moser, M.

    Improving the ventilation effectiveness allows the indoor air quality to be significantly enhanced without the need for higher air changes in the building, thereby avoiding the higher costs and energy consumption associated with increasing the ventilation rates. This Guidebook provides easy-to-un...

  12. Energy and IAQ Implications of Alternative Minimum Ventilation Rates in California Retail and School Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Dutton, Spencer M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Fisk, William J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2015-01-01

    For a stand-alone retail building, a primary school, and a secondary school in each of the 16 California climate zones, the EnergyPlus building energy simulation model was used to estimate how minimum mechanical ventilation rates (VRs) affect energy use and indoor air concentrations of an indoor-generated contaminant. The modeling indicates large changes in heating energy use, but only moderate changes in total building energy use, as minimum VRs in the retail building are changed. For example, predicted state-wide heating energy consumption in the retail building decreases by more than 50% and total building energy consumption decreases by approximately 10% as the minimum VR decreases from the Title 24 requirement to no mechanical ventilation. The primary and secondary schools have notably higher internal heat gains than in the retail building models, resulting in significantly reduced demand for heating. The school heating energy use was correspondingly less sensitive to changes in the minimum VR. The modeling indicates that minimum VRs influence HVAC energy and total energy use in schools by only a few percent. For both the retail building and the school buildings, minimum VRs substantially affected the predicted annual-average indoor concentrations of an indoor generated contaminant, with larger effects in schools. The shape of the curves relating contaminant concentrations with VRs illustrate the importance of avoiding particularly low VRs.

  13. Model-based setting of inspiratory pressure and respiratory rate in pressure-controlled ventilation

    International Nuclear Information System (INIS)

    Schranz, C; Möller, K; Becher, T; Schädler, D; Weiler, N

    2014-01-01

    Mechanical ventilation carries the risk of ventilator-induced-lung-injury (VILI). To minimize the risk of VILI, ventilator settings should be adapted to the individual patient properties. Mathematical models of respiratory mechanics are able to capture the individual physiological condition and can be used to derive personalized ventilator settings. This paper presents model-based calculations of inspiration pressure (p I ), inspiration and expiration time (t I , t E ) in pressure-controlled ventilation (PCV) and a retrospective evaluation of its results in a group of mechanically ventilated patients. Incorporating the identified first order model of respiratory mechanics in the basic equation of alveolar ventilation yielded a nonlinear relation between ventilation parameters during PCV. Given this patient-specific relation, optimized settings in terms of minimal p I and adequate t E can be obtained. We then retrospectively analyzed data from 16 ICU patients with mixed pathologies, whose ventilation had been previously optimized by ICU physicians with the goal of minimization of inspiration pressure, and compared the algorithm's ‘optimized’ settings to the settings that had been chosen by the physicians. The presented algorithm visualizes the patient-specific relations between inspiration pressure and inspiration time. The algorithm's calculated results highly correlate to the physician's ventilation settings with r = 0.975 for the inspiration pressure, and r = 0.902 for the inspiration time. The nonlinear patient-specific relations of ventilation parameters become transparent and support the determination of individualized ventilator settings according to therapeutic goals. Thus, the algorithm is feasible for a variety of ventilated ICU patients and has the potential of improving lung-protective ventilation by minimizing inspiratory pressures and by helping to avoid the build-up of clinically significant intrinsic positive end

  14. Model-based setting of inspiratory pressure and respiratory rate in pressure-controlled ventilation.

    Science.gov (United States)

    Schranz, C; Becher, T; Schädler, D; Weiler, N; Möller, K

    2014-03-01

    Mechanical ventilation carries the risk of ventilator-induced-lung-injury (VILI). To minimize the risk of VILI, ventilator settings should be adapted to the individual patient properties. Mathematical models of respiratory mechanics are able to capture the individual physiological condition and can be used to derive personalized ventilator settings. This paper presents model-based calculations of inspiration pressure (pI), inspiration and expiration time (tI, tE) in pressure-controlled ventilation (PCV) and a retrospective evaluation of its results in a group of mechanically ventilated patients. Incorporating the identified first order model of respiratory mechanics in the basic equation of alveolar ventilation yielded a nonlinear relation between ventilation parameters during PCV. Given this patient-specific relation, optimized settings in terms of minimal pI and adequate tE can be obtained. We then retrospectively analyzed data from 16 ICU patients with mixed pathologies, whose ventilation had been previously optimized by ICU physicians with the goal of minimization of inspiration pressure, and compared the algorithm's 'optimized' settings to the settings that had been chosen by the physicians. The presented algorithm visualizes the patient-specific relations between inspiration pressure and inspiration time. The algorithm's calculated results highly correlate to the physician's ventilation settings with r = 0.975 for the inspiration pressure, and r = 0.902 for the inspiration time. The nonlinear patient-specific relations of ventilation parameters become transparent and support the determination of individualized ventilator settings according to therapeutic goals. Thus, the algorithm is feasible for a variety of ventilated ICU patients and has the potential of improving lung-protective ventilation by minimizing inspiratory pressures and by helping to avoid the build-up of clinically significant intrinsic positive end-expiratory pressure.

  15. The effect of time-dependent ventilation and radon (thoron) gas emanation rates in underground uranium mines

    International Nuclear Information System (INIS)

    Bigu, J.

    1987-01-01

    A theoretical radiation mine model, suitable for underground uranium mines, has been investigated. In this model, the rate of ventilation and/or the radon (thoron) gas emanation from mine walls are time-dependent. Several cases of practical interest have been investigated including sinusoidal, linear, exponential, stepwise, or a combination of two or more of the above. Analytical solutions were obtained for the time-dependent radon (thoron) gas emanation rate. However, because of the extreme analytical complexity of the solutions corresponding to the time-dependent ventilation rate case, numerical solutions were found using a special Runge-Kutta procedure and the Hamming's modified predictor-corrector method for the solution of linear initial-value problems. The mine model makes provisions for losses of radioactivity, other than by ventilation and radioactive decay, by, say, plate-out on mine walls, and by other mechanisms. Radioactivity data, i.e., radon, thoron, and their progeny, obtained with the above mine model for a number of ventilation and emanation conditions, are presented. Experimental data obtained in an inactive stope of an underground uranium mine for a time-dependent air flow case are shown. Air flow conditions (ventilation rate) were determined by tracer gas techniques using SF 6

  16. Estimation of the variations of ventilation rate and indoor radon concentration using the observed wind velocity and indoor-outdoor temperature difference

    International Nuclear Information System (INIS)

    Nagano, Katsuhiro; Inose, Yuichi; Kojima, Hiroshi

    2006-01-01

    The indoor radon concentration in the building depends on the ventilation rate. Measurement results of indoor-outdoor pressure difference showed the ventilation rate correlated closely with the indoor-outdoor pressure difference. The observation results showed that one of factor of indoor-outdoor pressure difference was the wind velocity. When the wind velocity is small, the ventilation rate is affected by the indoor-outdoor temperature difference and the effect depends on the wind velocity. The temporal variation of indoor radon concentration was predicted by the time depending indoor radon balance model and the ventilation rate estimated from the wind velocity and the indoor-outdoor temperature difference. The temporal variations of predicted radon concentration gave good agreement with the experimental values. The measurement method, indoor radon concentration and ventilation rate, factors of temporal variation of ventilation rate, and prediction of indoor radon concentration are reported. (S.Y.)

  17. Home visits: why do rates vary so much?

    LENUS (Irish Health Repository)

    Stewart, P

    2012-03-01

    Data including information on patient age, gender, who initiated the visit and call classification was collected during office hours from 12 G.P. rural teaching practices with a combined GMS patient population of 24,720, over a 2 month period. There were a total of 603 home visits, giving an annual visiting rate of 143\\/1000. Visiting rates varied between practices from 45 to 305\\/1000 per year. When high visiting practices (>210\\/1000\\/year) were compared to low visiting rate practices (>90\\/1000\\/year), patients tended to be older (79.7 v. 74.5 years) and calls were 12 times more likely to be doctor initiated (16.6% v. 1.4%) or classified as routine( 50.7% v. 44.9%). The variation between practices was related in part to patient age but appears largely due to differences in doctor home visiting behaviour. There are no recent figures on home visiting in Ireland.

  18. 46 CFR 108.437 - Pipe sizes and discharge rates for enclosed ventilation systems for rotating electrical equipment.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Pipe sizes and discharge rates for enclosed ventilation systems for rotating electrical equipment. 108.437 Section 108.437 Shipping COAST GUARD, DEPARTMENT OF... Systems Fixed Carbon Dioxide Fire Extinguishing Systems § 108.437 Pipe sizes and discharge rates for...

  19. How Long Does it Take to Initiate a Child on Long-Term Invasive Ventilation? Results From A Canadian Pediatric Home Ventilation Program

    Directory of Open Access Journals (Sweden)

    Reshma Amin

    2015-01-01

    Full Text Available OBJECTIVE: To assess the length of stay required to initiate long-term invasive ventilation at the authors’ institution, which would inform future interventional strategies to streamline the in-hospital stay for these families.

  20. Test plan for measuring ventilation rates and combustible gas levels in TWRS active catch tanks

    Energy Technology Data Exchange (ETDEWEB)

    NGUYEN, D.M.

    1999-05-20

    The purpose of this test is to provide an initial screening of combustible gas concentrations in catch tanks that currently are operated by Tank Waste Remediation System (TWRS). The data will be used to determine whether or not additional data will be needed for closure of the flammable gas unreviewed safety question for these facilities. This test will involve field measurements of ammonia, organic vapor, and total combustible gas levels in the headspace of the catch tanks. If combustible gas level in a tank exceeds an established threshold, gas samples will be collected in SUMMA canisters for more extensive laboratory analysis. In addition, ventilation rates of some catch tanks will be measured to evaluate removal of flammable gas by air flow through the tanks.

  1. Test plan for measuring ventilation rates and combustible gas levels in RPP active catch tanks

    Energy Technology Data Exchange (ETDEWEB)

    NGUYEN, D.M.

    1999-06-03

    The purpose of this test is to provide an initial screening of combustible gas concentrations in catch tanks that currently are operated by River Protection Project (RPP). The data will be used to determine whether or not additional data will be needed for closure of the flammable gas unreviewed safety question for these facilities. This test will involve field measurements of ammonia, organic vapor, and total combustible gas levels in the headspace of the catch tanks. If combustible gas level in a tank exceeds an established threshold, gas samples will be collected in SUMMA canisters for more extensive laboratory analysis. In addition, ventilation rates of some catch tanks will be measured to evaluate removal of flammable gas by air flow through the tanks.

  2. Novel approach for evaluation of air change rate in naturally ventilated occupied spaces based on metabolic CO2 time variation

    DEFF Research Database (Denmark)

    Melikov, Arsen Krikor; Markov, Detelin G.

    2014-01-01

    IAQ in many residential buildings relies on non-organized natural ventilation. Accurate evaluation of air change rate (ACR) in this situation is difficult due to the nature of the phenomenon - intermittent infiltration-exfiltration periods of mass exchange between the room air and the outdoor air...... at low rate. This paper describes a new approach for ACR evaluation in naturally ventilated occupied spaces. Actual metabolic CO2 time variation record in an interval of time is compared with the computed variation of metabolic CO2 for the same time interval under reference conditions: sleeping occupants...

  3. [Outcome of patients with chronic respiratory insufficiency treated at home with tracheotomy and assisted ventilation].

    Science.gov (United States)

    Dudeffant, P; Manier, G; Gbikpi-Benissan, G; Cardinaud, J P

    1985-01-01

    60 patients were studied with severe chronic respiratory failure (IRC) and a permanent tracheostomy treated with domiciliary ventilation (VADT). The study commenced from the time of the tracheostomy and included length of survival (by the actuarial method) quality of life, subjectively and objectively (progress of blood gases in a stable clinical state and cumulative length of periods in hospital). Factors influencing the decision for tracheostomy and VADT were examined. Restrictive cases benefitted from the technique as much from the improved quality of life as from the duration of survival (77% at 5 years). Patients with an obstructive or mixed pattern had a 5 years survival of 73% after the first episode of acute or chronic respiratory failure which was 73% better than comparable patients given neither a tracheostomy nor oxygen therapy. The five years survival of 42% on VADT in our series compares favourably with the main series published. In our opinion the improved survival in these patients (which tends to rejoin that of the general population) and the improved quality of life justifies the use of this treatment in severe obstructive IRC, despite a greater demand and cost of this treatment than those with a restrictive defect.

  4. Tracheostomy and invasive mechanical ventilation in amyotrophic lateral sclerosis: decision-making factors and survival analysis.

    Science.gov (United States)

    Kimura, Fumiharu

    2016-04-28

    Invasive and/or non-invasive mechanical ventilation are most important options of respiratory management in amyotrophic lateral sclerosis. We evaluated the frequency, clinical characteristics, decision-making factors about ventilation and survival analysis of 190 people with amyotrophic lateral sclerosis patients from 1990 until 2013. Thirty-one percentage of patients underwent tracheostomy invasive ventilation with the rate increasing more than the past 20 years. The ratio of tracheostomy invasive ventilation in patients >65 years old was significantly increased after 2000 (25%) as compared to before (10%). After 2010, the standard use of non-invasive ventilation showed a tendency to reduce the frequency of tracheostomy invasive ventilation. Mechanical ventilation prolonged median survival (75 months in tracheostomy invasive ventilation, 43 months in non-invasive ventilation vs natural course, 32 months). The life-extending effects by tracheostomy invasive ventilation were longer in younger patients ≤65 years old at the time of ventilation support than in older patients. Presence of partners and care at home were associated with better survival. Following factors related to the decision to perform tracheostomy invasive ventilation: patients ≤65 years old: greater use of non-invasive ventilation: presence of a spouse: faster tracheostomy: higher progression rate; and preserved motor functions. No patients who underwent tracheostomy invasive ventilation died from a decision to withdraw mechanical ventilation. The present study provides factors related to decision-making process and survival after tracheostomy and help clinicians and family members to expand the knowledge about ventilation.

  5. Numerical Studies on Heat Release Rate in Room Fire on Liquid Fuel under Different Ventilation Factors

    Directory of Open Access Journals (Sweden)

    N. Cai

    2012-01-01

    Full Text Available Heat release rate (HRR of the design fire is the most important parameter in assessing building fire hazards. However, HRR in room fire was only studied by computational fluid dynamics (CFD in most of the projects determining fire safety provisions by performance-based design. In contrast to ten years ago, officers in the Far East are now having better knowledge of CFD. Two common questions are raised on CFD-predicted results on describing free boundaries; and on computing grid size. In this work, predicting HRR by the CFD model was justified with experimental room pool fire data reported earlier. The software fire dynamics simulator (FDS version 5 was selected as the CFD simulation tool. Prescribed input heating rate based on the experimental results was used with the liquid fuel model in FDS. Five different free boundary conditions were investigated to predict HRR. Grid sensitivity study was carried out using one stretched mesh and multiple uniform meshes with different grid sizes. As it is difficult to have the entire set of CFD predicted results agreed with experiments, macroscopic flow parameters on the mass flow rate through door opening predicted by CFD were also justified by another four conditions with different ventilation factors.

  6. Parental Perceptions of Quality of Life in Children on Long-Term Ventilation at Home as Compared to Enterostomy Tubes.

    Directory of Open Access Journals (Sweden)

    Brahim Redouane

    Full Text Available Health related quality of life (HRQL of children using medical technology at home is largely unknown. Our aim was to examine the HRQL in children on long-term ventilation at home (LTHV in comparison to a cohort using an enterostomy tube.Participants were divided into three groups: 1 LTHV without an enterostomy tube (LTHV cohort; 2 Enterostomy tube (GT cohort; 3 LTHV with an enterostomy tube (LTHV+GT cohort. Caregivers of children ≥ 5 years and followed at SickKids, Toronto, Canada, completed three questionnaires: Health Utilities Index 2/3 (HUI2/3, Caregiver Priorities Caregiver Health Index (CPCHILD, and the Paediatric Quality of Life Inventory (PedsQL. The primary outcome was the difference in utility (HUI2/3 scores between the cohorts.One hundred and nineteen children were enrolled; 47 in the LTHV cohort, 44 in the GT cohort, and 28 in the LTHV+GT cohort. In univariate analysis, HUI2 mean (SE scores were lowest for the GT cohort, 0.4 (0.04 followed by the LTHV+GT, 0.42 (0.05 and then the LTHV cohort, 0.7 (0.04, p = 0.001. A similar trend was seen for the HUI3 mean (SE scores: GT cohort, 0.1 (0.06, followed by the LTHV +GT cohort, 0.2 (0.08 and then the LTHV cohort, 0.5 (0.06, p = 0.0001. Technology cohort, nursing hours and the severity of health care needs predicted HRQL as measured by the HUI2/3.The HRQL of these children is low. Children on LTHV had higher HRQL than children using enterostomy tubes. Further work is needed to identify modifiable factors that can improve HRQL.

  7. Ventilation effectiveness : health benefits of heat recovery ventilators

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    2010-08-15

    Studies have shown that the installation of a heat recovery ventilator (HRV) in homes in northern Canada could improve indoor air quality and the respiratory health of inhabitants. Low ventilation rates are common in many homes in the North because the climate is severe, homes are smaller and lack basements, and occupancies are higher, leading to unhealthy indoor air quality. Northern communities also have a high rate of respiratory infections. HRVs recover much of the energy used to ventilate, which is desirable in cold regions with high heating costs. For the study, the test sample was divided into two types of houses, notably houses with active HRVs and those with control HRVs that were installed and operated but that did not function. The study results showed that HRVs provided increased ventilation. Complaints by residents about HRV noise, discomfort, or low humidity were common but equally spread between those with active and placebo HRVs. The study showed that the system design needs to be improved to better suit the needs of Inuit families. The nature of northern housing presents installation and maintenance challenges. It is hard to retrofit HRV ducting inside small, existing houses, and building supplies arrive infrequently, so detailed planning and careful take-offs of all supplies and materials must be done well in advance of construction. In addition, contractors are hard to locate and have variable expertise, and there is little technical follow-up. Robust technical support by local contractors and housing authorities is therefore important. 2 refs.

  8. Ventilator-Associated Pneumonia in Trauma Patients: Different Criteria, Different Rates.

    Science.gov (United States)

    Leonard, Kenji L; Borst, Gregory M; Davies, Stephen W; Coogan, Michael; Waibel, Brett H; Poulin, Nathaniel R; Bard, Michael R; Goettler, Claudia E; Rinehart, Shane M; Toschlog, Eric A

    2016-06-01

    No consensus exists regarding the definition of ventilator-associated pneumonia (VAP). Even within a single institution, inconsistent diagnostic criteria result in conflicting rates of VAP. As a Level 1 trauma center participating in the Trauma Quality Improvement Project (TQIP) and the National Healthcare Safety Network (NHSN), our institution showed inconsistencies in VAP rates depending on which criteria was applied. The purpose of this study was to compare VAP definitions, defined by culture-based criteria, National Trauma Data Bank (NTDB) and NHSN, using incidence in trauma patients. A retrospective chart review of consecutive trauma patients who were diagnosed with VAP and met pre-determined inclusion and exclusion criteria admitted to our rural, 861-bed, Level 1 trauma and tertiary care center between January 2008 and December 2011 was performed. These patients were identified from the National Trauma Registry of the American College of Surgeons (NTRACS) database and an in-house infection control database. Ventilator-associated pneumonia diagnosis criteria defined by the U.S. Center for Disease Control and Prevention (used by the NHSN), the NTDB, and our institutional, culture-based criteria gold standard were compared among patients. Two hundred seventy-nine patients were diagnosed with VAP (25.4% met NHSN criteria, 88.2% met NTDB, and 76.3% met culture-based criteria). Only 58 (20.1%) patients met all three criteria. When NHSN criteria were compared with culture-based criteria, NHSN showed a high specificity (92.5%) and low sensitivity (28.2%). The positive predictive value (PPV) was 84.5%, but the negative predictive value (NPV) was 47.1%. The agreement between the NHSN and the culture-based criteria was poor (κ = 0.18). Conversely, the NTDB showed a lower specificity (57.8%), but greater sensitivity (86.4%) compared with culture-based criteria. The PPV and NPV were both 74% and the two criteria showed fair agreement (κ = 0.41). The lack of

  9. 75 FR 81138 - Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011...

    Science.gov (United States)

    2010-12-27

    ... [CMS-1510-CN2] RIN 0938-AP88 Medicare Program; Home Health Prospective Payment System Rate Update for... ``Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011; Changes in... Prospective Payment System Rate Update for Calendar Year 2011; Changes in Certification Requirements for Home...

  10. Developing evidence-based prescriptive ventilation rate standards for commercial buildings in California: a proposed framework

    Energy Technology Data Exchange (ETDEWEB)

    Mendell, Mark J.; Fisk, William J.

    2014-02-01

    Background - The goal of this project, with a focus on commercial buildings in California, was to develop a new framework for evidence-based minimum ventilation rate (MVR) standards that protect occupants in buildings while also considering energy use and cost. This was motivated by research findings suggesting that current prescriptive MVRs in commercial buildings do not provide occupants with fully safe and satisfactory indoor environments. Methods - The project began with a broad review in several areas ? the diverse strategies now used for standards or guidelines for MVRs or for environmental contaminant exposures, current knowledge about adverse human effects associated with VRs, and current knowledge about contaminants in commercial buildings, including their their presence, their adverse human effects, and their relationships with VRs. Based on a synthesis of the reviewed information, new principles and approaches are proposed for setting evidence-based VRs standards for commercial buildings, considering a range of human effects including health, performance, and acceptability of air. Results ? A review and evaluation is first presented of current approaches to setting prescriptive building ventilation standards and setting acceptable limits for human contaminant exposures in outdoor air and occupational settings. Recent research on approaches to setting acceptable levels of environmental exposures in evidence-based MVR standards is also described. From a synthesis and critique of these materials, a set of principles for setting MVRs is presented, along with an example approach based on these principles. The approach combines two sequential strategies. In a first step, an acceptable threshold is set for each adverse outcome that has a demonstrated relationship to VRs, as an increase from a (low) outcome level at a high reference ventilation rate (RVR, the VR needed to attain the best achievable levels of the adverse outcome); MVRs required to meet each

  11. Ventilation and Heart Rate Monitoring in Drivers using a Contactless Electrical Bioimpedance System

    Science.gov (United States)

    Macías, R.; García, M. A.; Ramos, J.; Bragós, R.; Fernández, M.

    2013-04-01

    Nowadays, the road safety is one of the most important priorities in the automotive industry. Many times, this safety is jeopardized because of driving under inappropriate states, e.g. drowsiness, drugs and/or alcohol. Therefore several systems for monitoring the behavior of subjects during driving are researched. In this paper, a device based on a contactless electrical bioimpedance system is shown. Using the four-wire technique, this system is capable of obtaining the heart rate and the ventilation of the driver through multiple textile electrodes. These textile electrodes are placed on the car seat and the steering wheel. Moreover, it is also reported several measurements done in a controlled environment, i.e. a test room where there are no artifacts due to the car vibrations or the road state. In the mentioned measurements, the system response can be observed depending on several parameters such as the placement of the electrodes or the number of clothing layers worn by the driver.

  12. Ventilation and Heart Rate Monitoring in Drivers using a Contactless Electrical Bioimpedance System

    International Nuclear Information System (INIS)

    Macías, R; García, M A; Ramos, J; Bragós, R; Fernández, M

    2013-01-01

    Nowadays, the road safety is one of the most important priorities in the automotive industry. Many times, this safety is jeopardized because of driving under inappropriate states, e.g. drowsiness, drugs and/or alcohol. Therefore several systems for monitoring the behavior of subjects during driving are researched. In this paper, a device based on a contactless electrical bioimpedance system is shown. Using the four-wire technique, this system is capable of obtaining the heart rate and the ventilation of the driver through multiple textile electrodes. These textile electrodes are placed on the car seat and the steering wheel. Moreover, it is also reported several measurements done in a controlled environment, i.e. a test room where there are no artifacts due to the car vibrations or the road state. In the mentioned measurements, the system response can be observed depending on several parameters such as the placement of the electrodes or the number of clothing layers worn by the driver.

  13. Review and Extension of CO2-Based Methods to Determine Ventilation Rates with Application to School Classrooms

    Directory of Open Access Journals (Sweden)

    Stuart Batterman

    2017-02-01

    Full Text Available The ventilation rate (VR is a key parameter affecting indoor environmental quality (IEQ and the energy consumption of buildings. This paper reviews the use of CO2 as a “natural” tracer gas for estimating VRs, focusing on applications in school classrooms. It provides details and guidance for the steady-state, build-up, decay and transient mass balance methods. An extension to the build-up method and an analysis of the post-exercise recovery period that can increase CO2 generation rates are presented. Measurements in four mechanically-ventilated school buildings demonstrate the methods and highlight issues affecting their applicability. VRs during the school day fell below recommended minimum levels, and VRs during evening and early morning were on the order of 0.1 h−1, reflecting shutdown of the ventilation systems. The transient mass balance method was the most flexible and advantageous method given the low air change rates and dynamic occupancy patterns observed in the classrooms. While the extension to the build-up method improved stability and consistency, the accuracy of this and the steady-state method may be limited. Decay-based methods did not reflect the VR during the school day due to heating, ventilation and air conditioning (HVAC system shutdown. Since the number of occupants in classrooms changes over the day, the VR expressed on a per person basis (e.g., L·s−1·person−1 depends on the occupancy metric. If occupancy measurements can be obtained, then the transient mass balance method likely will provide the most consistent and accurate results among the CO2-based methods. Improved VR measurements can benefit many applications, including research examining the linkage between ventilation and health.

  14. Being the parent of a ventilator-assisted child: perceptions of the family-health care provider relationship when care is offered in the family home.

    Science.gov (United States)

    Lindahl, Berit; Lindblad, Britt-Marie

    2013-11-01

    The number of medically fragile children cared for at home is increasing; however, there are few studies about the professional support these families receive in their homes. The aim of the study was to understand the meanings that parents had about the support they received from health care professionals who offered care for their ventilator-assisted child in the family home. A phenomenological-hermeneutic method was used. Data included the narratives of five mother-father couples living in Sweden who were receiving professional support for their ventilator-assisted child. The findings indicate that receiving professional support meant being at risk of and/or exposed to the exercise of control over family privacy. The professional support system in the families' homes worked more by chance than by competent and sensible planning. In good cases, caring encounters were characterized by a mutual relationship where various occupational groups were embraced as a part of family life. The findings are discussed in light of compassionate care, exercise of power, and the importance of holistic educational programs.

  15. Ventilator-driven xenon ventilation studies

    International Nuclear Information System (INIS)

    Chilcoat, R.T.; Thomas, F.D.; Gerson, J.I.

    1984-01-01

    A modification of a common commercial Xe-133 ventilation device is described for mechanically assisted ventilation imaging. The patient's standard ventilator serves as the power source controlling the ventilatory rate and volume during the xenon study, but the gases in the two systems are not intermixed. This avoids contamination of the ventilator with radioactive xenon. Supplemental oxygen and positive end-expiratory pressure (PEEP) are provided if needed. The system can be converted quickly for conventional studies with spontaneous respiration

  16. Advanced Controls for Residential Whole-House Ventilation Systems

    Energy Technology Data Exchange (ETDEWEB)

    Turner, William [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Walker, Iain [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sherman, Max [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2014-08-01

    Whole-house ventilation systems are becoming commonplace in new construction, remodeling/renovation, and weatherization projects, driven by combinations of specific requirements for indoor air quality (IAQ), health and compliance with standards, such as ASHRAE 62.2. Ventilation systems incur an energy penalty on the home via fan power used to drive the airflow, and the additional space-conditioning load associated with heating or cooling the ventilation air. Finding a balance between IAQ and energy use is important if homes are to be adequately ventilated while not increasing the energy burden. This study used computer simulations to examine RIVEC the Residential Integrated Ventilation Controller - a prototype ventilation controller that aims to deliver whole-house ventilation rates that comply with ventilation standards, for the minimum use of energy. Four different whole-house ventilation systems were simulated, both with and without RIVEC, so that the energy and IAQ results could be compared. Simulations were conducted for 13 US climate zones, three house designs, and three envelope leakage values. The results showed that the RIVEC controller could typically return ventilation energy savings greater than 40percent without compromising long-term chronic or short-term acute exposures to relevant indoor contaminants. Critical and average peak power loads were also reduced as a consequence of using RIVEC.

  17. Hypercapnia Response in Patients with Obesity-Hypoventilation Syndrome Treated with Non-Invasive Ventilation at Home.

    Science.gov (United States)

    Fernández Álvarez, Ramón; Rubinos Cuadrado, Gemma; Ruiz Alvarez, Ines; Hermida Valverde, Tamara; Iscar Urrutia, Marta; Vázquez Lopez, María José; Casan Clara, Pere

    2018-06-02

    Respiratory center (RC) dysfunction has been implicated in the pathogenesis of obesity-hypoventilation syndrome (OHS), and often requires treatment with home non-invasive ventilation (NIV). Our objective was to measure the effect of NIV on RC function in patients with OHS, and the factors that determine such an effect. We performed a prospective, repeated measures study to evaluate hypercapnia response (HR) by determining the p01/pEtCO 2 ratio slope at baseline and after 6months of treatment with NIV in a group of OHS patients. A threshold of 0.22cmH 2 O/mmHg had previously been established in a control group, in order to differentiate optimal RC response from suboptimal RC response. A total of 36 cases were included, 19 men (52%) aged 65 (SD 9) years, 63% of whom had p01/pEtCO 2 below the reference value. Baseline p01/pEtCO 2 was 0.17 (SD: 0.14) cmH 2 O/mmHg and, after 6 months of NIV, 0.30 (SD: 0.22) cmH 2 O/mmHg (p=0.011). After 6months of treatment with NIV, depressed RC function persisted in 12 cases (33%). In total, 63% of OHS patients had RC dysfunction. The application of NIV improves RC function but not in all cases. Copyright © 2018 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Indoor air pollutants, ventilation rate determinants and potential control strategies in Chinese dwellings: A literature review.

    Science.gov (United States)

    Ye, Wei; Zhang, Xu; Gao, Jun; Cao, Guangyu; Zhou, Xiang; Su, Xing

    2017-05-15

    After nearly twenty years of rapid modernization and urbanization in China, huge achievements have transformed the daily lives of the Chinese people. However, unprecedented environmental consequences in both indoor and outdoor environments have accompanied this progress and have triggered public awareness and demands for improved living standards, especially in residential environments. Indoor pollution data measured for >7000 dwellings (approximately 1/3 were newly decorated and were tested for volatile organic compound (VOC) measurements, while the rest were tested for particles, phthalates and other semi-volatile organic compounds (SVOCs), moisture/mold, inorganic gases and radon) in China within the last ten years were reviewed, summarized and compared with indoor concentration recommendations based on sensory or health end-points. Ubiquitous pollutants that exceed the concentration recommendations, including particulate matter, formaldehyde, benzene and other VOCs, moisture/mold, inorganic gases and radon, were found, indicating a common indoor air quality (IAQ) issue in Chinese dwellings. With very little prevention, oral, inhalation and dermal exposure to those pollutants at unhealthy concentration levels is almost inevitable. CO 2 , VOCs, humidity and radon can serve as ventilation determinants, each with different ventilation demands and strategies, at typical occupant densities in China; and particle reduction should be a prerequisite for determining ventilation requirements. Two directional ventilation modes would have profound impacts on improving IAQ for Chinese residences are: 1) natural (or window) ventilation with an air cleaner and 2) mechanical ventilation with an air filtration unit, these two modes were reviewed and compared for their applicability and advantages and disadvantages for reducing human exposure to indoor air pollutants. In general, mode 2 can more reliably ensure good IAQ for occupants; while mode 1 is more applicable due to its

  19. [Responding to patients with home mechanical ventilation after the Great East Japan Earthquake and during the planned power outages. How should we be prepared for a future disaster ?].

    Science.gov (United States)

    Takechi, Yukako

    2011-12-01

    The unprecedented earthquake(magnitude-9 in the Japanese seismic intensity scale)hit off the east coast of Japan on March 11, 2011. Consequently, there were planned power outages in the area nearby Tokyo to avoid massive blackouts caused by a stoppage of Fukushima nuclear plants.Our clinic located in Kawasaki city was also hit by the earthquake(magnitude- 5).During the period of two months(March and April 2011), we had a total of 52 patients with home respiratory care (5-TPPV, 11-NPPV and 36-HOT)at that time.Two out of three 24 hour-TPPV users had no external battery.After the earthquake, there was a 7-hour electricity failure in some areas, and a patient with ASV(adaptive servo ventilator)was living there.Moreover, 3-hour/day power outages were carried out from March 14 to March 28, affecting people's everyday lives. However, the patient had no harmful influences from the power failure because a ventilation company lent us an external battery(4-9 hour life capacity)for the patients, and we were able to avoid an emergency situation caused by the power failure.In conclusion, we ought to be prepared for patients with home mechanical ventilation in the future toward unforeseen large scale power outages.

  20. Evaluating Moisture Control of Variable-Capacity Heat Pumps in Mechanically Ventilated, Low-Load Homes in Climate Zone 2A

    Energy Technology Data Exchange (ETDEWEB)

    Martin, Eric [Univ. of Central Florida, Orlando, FL (United States). Florida Solar Energy Center; Withers, Chuck [Univ. of Central Florida, Orlando, FL (United States). Florida Solar Energy Center; McIlvaine, Janet [Univ. of Central Florida, Orlando, FL (United States). Florida Solar Energy Center; Chasar, Dave [Univ. of Central Florida, Orlando, FL (United States). Florida Solar Energy Center; Beal, David [Univ. of Central Florida, Orlando, FL (United States). Florida Solar Energy Center

    2018-02-07

    The well-sealed, highly insulated building enclosures constructed by today's home building industry coupled with efficient lighting and appliances are achieving significantly reduced heating and cooling loads. These low-load homes can present a challenge when selecting appropriate space-conditioning equipment. Conventional, fixed-capacity heating and cooling equipment is often oversized for small homes, causing increased first costs and operating costs. Even if fixed-capacity equipment can be properly specified for peak loads, it remains oversized for use during much of the year. During these part-load cooling hours, oversized equipment meets the target dry-bulb temperatures very quickly, often without sufficient opportunity for moisture control. The problem becomes more acute for high-performance houses in humid climates when meeting ASHRAE Standard 62.2 recommendations for wholehouse mechanical ventilation.

  1. Assessment of heart rate, acidosis, consciousness, oxygenation, and respiratory rate to predict noninvasive ventilation failure in hypoxemic patients.

    Science.gov (United States)

    Duan, Jun; Han, Xiaoli; Bai, Linfu; Zhou, Lintong; Huang, Shicong

    2017-02-01

    To develop and validate a scale using variables easily obtained at the bedside for prediction of failure of noninvasive ventilation (NIV) in hypoxemic patients. The test cohort comprised 449 patients with hypoxemia who were receiving NIV. This cohort was used to develop a scale that considers heart rate, acidosis, consciousness, oxygenation, and respiratory rate (referred to as the HACOR scale) to predict NIV failure, defined as need for intubation after NIV intervention. The highest possible score was 25 points. To validate the scale, a separate group of 358 hypoxemic patients were enrolled in the validation cohort. The failure rate of NIV was 47.8 and 39.4% in the test and validation cohorts, respectively. In the test cohort, patients with NIV failure had higher HACOR scores at initiation and after 1, 12, 24, and 48 h of NIV than those with successful NIV. At 1 h of NIV the area under the receiver operating characteristic curve was 0.88, showing good predictive power for NIV failure. Using 5 points as the cutoff value, the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for NIV failure were 72.6, 90.2, 87.2, 78.1, and 81.8%, respectively. These results were confirmed in the validation cohort. Moreover, the diagnostic accuracy for NIV failure exceeded 80% in subgroups classified by diagnosis, age, or disease severity and also at 1, 12, 24, and 48 h of NIV. Among patients with NIV failure with a HACOR score of >5 at 1 h of NIV, hospital mortality was lower in those who received intubation at ≤12 h of NIV than in those intubated later [58/88 (66%) vs. 138/175 (79%); p = 0.03). The HACOR scale variables are easily obtained at the bedside. The scale appears to be an effective way of predicting NIV failure in hypoxemic patients. Early intubation in high-risk patients may reduce hospital mortality.

  2. Pollutant Concentrations and Emission Rates from Scripted Natural Gas Cooking Burner Use in Nine Northern California Homes

    Energy Technology Data Exchange (ETDEWEB)

    Singer, Brett C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Delp, William W. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Lorenzetti, David M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Maddalena, Randy L. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2016-10-01

    in the kitchen and bedroom of several homes. A hood with large capture volume and a measured flow of 108 L/s reduced concentrations 80-95%. IMPLICATIONS: These measurements demonstrate that operation of natural gas cooking burners without venting can cause short-term kitchen concentrations of NO2 to exceed the US outdoor health standard, and can elevate concentrations of NO, NO2, and ultrafine particles throughout the home. Results are generally consistent with a recent simulation study that estimated widespread 1h NO2 exposures exceeding 100 ppb in homes that use gas burners without venting. While operating a venting range hood can greatly reduce pollutant levels from burner use (and presumably from cooking as well), performance varies widely across hoods. Increased awareness of the need to ventilate when cooking would substantially reduce in-home exposure to NO2 and ultrafine particles in California homes. Helping consumers select effective hoods, for example by publishing capture efficiency performance ratings, also would help reduce exposure.

  3. Alterations in the rate of limb movement using a lower body positive pressure treadmill do not influence respiratory rate or phase III ventilation.

    Science.gov (United States)

    Buono, Michael J; Burnsed-Torres, Marissa; Hess, Bethany; Lopez, Kristine; Ortiz, Catherine; Girodo, Ariel; Lolli, Karen; Bloom, Brett; Bailey, David; Kolkhorst, Fred W

    2015-01-01

    The purpose of this study was to determine the effect of alterations in rate of limb movement on Phase III ventilation during exercise, independent of metabolic rate, gait style, and treadmill incline. Subjects completed five submaximal exercise bouts on a lower body positive pressure treadmill (AlterG P 200). The percent body weight for the five exercise bouts was 100, 87, 75, 63, and 50% and each was matched for carbon dioxide production (V CO2 ). Naturally, to match the V CO2 while reducing the body weight up to 50% of normal required a significant increase in the treadmill speed from 3.0 ± 0.1 to 4.1 ± 0.2 mph, which resulted in a significant (P body weight) to 133 ± 6 at 4.1 mph (i.e., 50% of body weight). The most important finding was that significant increases in step frequency did not significantly alter minute ventilation or respiratory rate. Such results do not support an important role for the rate of limb movement in Phase III ventilation during submaximal exercise, when metabolic rate, gait style, and treadmill incline are controlled.

  4. Alterations in the Rate of Limb Movement Using a Lower Body Positive Pressure Treadmill Do Not Influence Respiratory Rate or Phase III Ventilation

    Directory of Open Access Journals (Sweden)

    Michael J. Buono

    2015-01-01

    Full Text Available The purpose of this study was to determine the effect of alterations in rate of limb movement on Phase III ventilation during exercise, independent of metabolic rate, gait style, and treadmill incline. Subjects completed five submaximal exercise bouts on a lower body positive pressure treadmill (AlterG P 200. The percent body weight for the five exercise bouts was 100, 87, 75, 63, and 50% and each was matched for carbon dioxide production (VCO2. Naturally, to match the VCO2 while reducing the body weight up to 50% of normal required a significant increase in the treadmill speed from 3.0±0.1 to 4.1±0.2 mph, which resulted in a significant (P<0.05 increase in the mean step frequency (steps per minute from 118±10 at 3 mph (i.e., 100% of body weight to 133±6 at 4.1 mph (i.e., 50% of body weight. The most important finding was that significant increases in step frequency did not significantly alter minute ventilation or respiratory rate. Such results do not support an important role for the rate of limb movement in Phase III ventilation during submaximal exercise, when metabolic rate, gait style, and treadmill incline are controlled.

  5. Final Report Balancing energy conservation and occupant needs in ventilation rate standards for Big Box stores in California. Predicted indoor air quality and energy consumption using a matrix of ventilation scenarios

    Energy Technology Data Exchange (ETDEWEB)

    Apte, Michael G. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Mendell, Mark J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sohn, Michael D. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Dutton, Spencer M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Berkeley, Pam M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Spears, Michael [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2011-02-01

    Through mass-balance modeling of various ventilation scenarios that might satisfy the ASHRAE 62.1 Indoor Air Quality (IAQ) Procedure, we estimate indoor concentrations of contaminants of concern (COCs) in California “big box” stores, compare estimates to available thresholds, and for selected scenarios estimate differences in energy consumption. Findings are intended to inform decisions on adding performance-based approaches to ventilation rate (VR) standards for commercial buildings. Using multi-zone mass-balance models and available contaminant source rates, we estimated concentrations of 34 COCs for multiple ventilation scenarios: VRmin (0.04 cfm/ft2 ), VRmax (0.24 cfm/ft2 ), and VRmid (0.14 cfm/ft2 ). We compared COC concentrations with available health, olfactory, and irritant thresholds. We estimated building energy consumption at different VRs using a previously developed EnergyPlus model. VRmax did control all contaminants adequately, but VRmin did not, and VRmid did so only marginally. Air cleaning and local ventilation near strong sources both showed promise. Higher VRs increased indoor concentrations of outdoor air pollutants. Lowering VRs in big box stores in California from VRmax to VRmid would reduce total energy use by an estimated 6.6% and energy costs by 2.5%. Reducing the required VRs in California’s big box stores could reduce energy use and costs, but poses challenges for health and comfort of occupants. Source removal, air cleaning, and local ventilation may be needed at reduced VRs, and even at current recommended VRs. Also, alternative ventilation strategies taking climate and season into account in ventilation schedules may provide greater energy cost savings than constant ventilation rates, while improving IAQ.

  6. Demand specifying variables and current ventilation rate requirements with respect to the future use of voc sensing for dcv control

    DEFF Research Database (Denmark)

    Kolarik, Jakub

    be also taken into account in the ventilation control. Recent development in gas sensing technology resulted in a new generation of relatively cheap and practically applicable sensors that can offer measurements of some of the pollutants mentioned above – mainly Volatile Organic Compounds (VOC......Demand Controlled Ventilation (DCV) is a well established principle to provide a certain indoor environmental quality, defined both in the terms of air quality and thermal comfort. This is accomplished by adjusting the supplied airflow rate according to a certain demand indicator, which......). This seems to bring a new dimension into the control of DCV systems. This paper is a contribution to the workshop on utilization of VOC sensing technology used for DCV control. The aim of the paper is to provide a short review of different types of demand variables used to control DCV systems and summarize...

  7. Maternity care in the Netherlands: the changing home birth rate.

    NARCIS (Netherlands)

    Wiegers, T.A.; Zee, J. van der; Keirse, M.J.N.C.

    1998-01-01

    In 1965 two-thirds of all births in The Netherlands occurred at home. In the next 25 years, that situation became reversed with more than two-thirds of births occurring in hospital and fewer than one-third at home. Several factors have influenced that change, including the introduction of short-stay

  8. Home noninvasive positive pressure ventilation with built-in software in stable hypercapnic COPD: a short-term prospective, multicenter, randomized, controlled trial.

    Science.gov (United States)

    Zhou, Luqian; Li, Xiaoying; Guan, Lili; Chen, Jianhua; Guo, Bingpeng; Wu, Weiliang; Huo, Yating; Zhou, Ziqing; Liang, Zhenyu; Zhou, Yuqi; Tan, Jie; Chen, Xin; Song, Yuanlin; Chen, Rongchang

    2017-01-01

    The benefits of noninvasive positive pressure ventilation (NPPV) in patients with hypercapnic COPD are controversial. It is presumed that methodology and appropriate use of NIV ventilator might be crucial for the outcomes. With the new built-in software, the performance of NIV can be monitored at home, which can guarantee the compliance and appropriate use. This study investigated effects of home use of NIV in hypercapnia in COPD patients using the NIV ventilator with built-in software for monitoring. The current multicenter prospective, randomized, controlled trial enrolled patients with stable GOLD stages III and IV hypercapnic COPD. Patients were randomly assigned via a computer-generated randomization sequence, with a block size of four patients, to continue optimized treatment (control group) or to receive additional NPPV (intervention group) for 3 months. The primary outcome was arterial carbon dioxide pressure (PaCO 2 ). Data were derived from built-in software and analyzed every 4 weeks. Analysis was carried out with the intention to treat. This study is registered with ClinicalTrials.gov, number NCT02499718. Patients were recruited from 20 respiratory units in China from October 1, 2015, and recruitment was terminated with a record of the vital statistics on May 31, 2016. A total of 115 patients were randomly assigned to the NPPV group (n=57) or the control group (n=58). Patients complied well with NPPV therapy (mean [± standard deviation] day use 5.6±1.4 h). The mean estimation of leaks was 37.99±13.71 L/min. The changes in PaCO 2 (-10.41±0.97 vs -4.32±0.68 mmHg, P =0.03) and 6-min walk distance (6MWD) (38.2% vs 18.2%, P =0.02) were statistically significant in the NPPV group versus the control group. COPD assessment test (CAT) showed a positive trend ( P =0.06) in favor of the NPPV group. Pulmonary function and dyspnea were not different between groups. Ventilators equipped with built-in software provided methodology for monitoring NIV use at home

  9. 13 CFR 123.104 - What interest rate will I pay on my home disaster loan?

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false What interest rate will I pay on... ADMINISTRATION DISASTER LOAN PROGRAM Home Disaster Loans § 123.104 What interest rate will I pay on my home disaster loan? If you can obtain credit elsewhere, your interest rate is set by a statutory formula, but...

  10. 76 FR 68525 - Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2012

    Science.gov (United States)

    2011-11-04

    ... Prospective Payment System Rate Update for Calendar Year 2012; Final Rule #0;#0;Federal Register / Vol. 76, No... 0938-AQ30 Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2012... sets forth updates to the home health prospective payment system (HH PPS) rates, including: the...

  11. 75 FR 76293 - Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011...

    Science.gov (United States)

    2010-12-08

    ... [CMS-1510-CN] RIN 0938-AP88 Medicare Program; Home Health Prospective Payment System Rate Update for... Health Prospective Payment System Rate Update for Calendar Year 2011; Changes in Certification... effective as if they had been included in the Medicare Program; Home Health Prospective Payment System Rate...

  12. Test plan for headspace gas concentration measurement and headspace ventilation rate measurement for DCRTs 241-A-244, 241-BX-244, 241-S-244, 241-TX-244

    International Nuclear Information System (INIS)

    Bauer, R.E.

    1998-01-01

    This test plan provides the directions to characterize the headspace gas concentrations and the headspace ventilation rate for double contained receiver tanks 241-A-244, 241-BX-244, 241-S-244, and 241-TX-244

  13. Ventilation systems

    International Nuclear Information System (INIS)

    Gossler

    1980-01-01

    The present paper deals with - controlled area ventilation systems - ventilation systems for switchgear-building and control-room - other ventilation systems for safety equipments - service systems for ventilation systems. (orig./RW)

  14. Mechanical Ventilation

    Science.gov (United States)

    ... ventilation is a life support treatment. A mechanical ventilator is a machine that helps people breathe when ... to breathe enough on their own. The mechanical ventilator is also called a ventilator , respirator, or breathing ...

  15. Evaluation of an Incremental Ventilation Energy Model for Estimating Impacts of Air Sealing and Mechanical Ventilation

    Energy Technology Data Exchange (ETDEWEB)

    Logue, Jennifer M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Turner, Willliam JN [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Walker, Iain S. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Singer, Brett C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2012-07-01

    Changing the rate of airflow through a home affects the annual thermal conditioning energy. Large-scale changes to airflow rates of the housing stock can significantly alter the energy consumption of the residential energy sector. However, the complexity of existing residential energy models hampers the ability to estimate the impact of policy changes on a state or nationwide level. The Incremental Ventilation Energy (IVE) model developed in this study was designed to combine the output of simple airflow models and a limited set of home characteristics to estimate the associated change in energy demand of homes. The IVE model was designed specifically to enable modelers to use existing databases of home characteristics to determine the impact of policy on ventilation at a population scale. In this report, we describe the IVE model and demonstrate that its estimates of energy change are comparable to the estimates of a wellvalidated, complex residential energy model when applied to homes with limited parameterization. Homes with extensive parameterization would be more accurately characterized by complex residential energy models. The demonstration included a range of home types, climates, and ventilation systems that cover a large fraction of the residential housing sector.

  16. CFD Simulations to Improve Ventilation in Low-Income Housing

    Science.gov (United States)

    Ho, Rosemond; Gorle, Catherine

    2017-11-01

    Quality of housing plays an important role in public health. In Dhaka, Bangladesh, the leading causes of death include tuberculosis, lower respiratory infections, and chronic obstructive pulmonary disease, so improving home ventilation could potentially mitigate these negative health effects. The goal of this project is to use computational fluid dynamics (CFD) to predict the relative effectiveness of different ventilation strategies for Dhaka homes. A Reynolds-averaged Navier-Stokes CFD model of a standard Dhaka home with apertures of different sizes and locations was developed to predict air exchange rates. Our initial focus is on simulating ventilation driven by buoyancy-alone conditions, which is often considered the limiting case in natural ventilation design. We explore the relationship between ventilation rate and aperture area to determine the most promising configurations for optimal ventilation solutions. Future research will include the modeling of wind-driven conditions, and extensive uncertainty quantification studies to investigate the effect of variability in the layout of homes and neighborhoods, and in local wind and temperature conditions. The ultimate objective is to formulate robust design recommendations that can reduce risks of respiratory illness in low-income housing.

  17. Alterations in the Rate of Limb Movement Using a Lower Body Positive Pressure Treadmill Do Not Influence Respiratory Rate or Phase III Ventilation

    OpenAIRE

    Michael J. Buono; Marissa Burnsed-Torres; Bethany Hess; Kristine Lopez; Catherine Ortiz; Ariel Girodo; Karen Lolli; Brett Bloom; David Bailey; Fred W. Kolkhorst

    2015-01-01

    The purpose of this study was to determine the effect of alterations in rate of limb movement on Phase III ventilation during exercise, independent of metabolic rate, gait style, and treadmill incline. Subjects completed five submaximal exercise bouts on a lower body positive pressure treadmill (AlterG P 200). The percent body weight for the five exercise bouts was 100, 87, 75, 63, and 50% and each was matched for carbon dioxide production (V CO2 ). Naturally, to match the V CO2 while reducin...

  18. The influence of broiler activity, growth rate, and litter on carbon dioxide balances for the determination of ventilation flow rates in broiler production.

    Science.gov (United States)

    Calvet, S; Estellés, F; Cambra-López, M; Torres, A G; Van den Weghe, H F A

    2011-11-01

    Carbon dioxide balances are useful in determining ventilation rates in livestock buildings. These balances need an accurate estimation of the CO(2) produced by animals and their litter to determine the ventilation flows. To estimate the daily variation in ventilation flow, it is necessary to precisely know the daily variation pattern of CO(2) production, which mainly depends on animal activity. The objective of this study was to explore the applicability of CO(2) balances for determining ventilation flows in broiler buildings. More specifically, this work aimed to quantify the amount of CO(2) produced by the litter, as well as the amount of CO(2) produced by the broilers, as a function of productive parameters, and to analyze the influence of broiler activity on CO(2) emissions. Gas concentrations and ventilation flows were simultaneously measured in 3 trials, with 1 under experimental conditions and the other 2 in a commercial broiler farm. In the experimental assay, broiler activity was also determined. At the end of the experimental trial, on the day after the removal of the broilers, the litter accounted for 20% of the total CO(2) produced, and the broilers produced 3.71 L/h of CO(2) per kg of metabolic weight. On the commercial farm, CO(2) production was the same for the 2 cycles (2.60 L/h per kg of metabolic weight, P > 0.05). However, substantial differences were found between CO(2) and broiler activity patterns after changes in light status. A regression model was used to explain these differences (R(2) = 0.52). Carbon dioxide increased with bird activity, being on average 3.02 L/h per kg of metabolic weight for inactive birds and 4.73 L/h per kg of metabolic weight when bird activity was highest. Overall, CO(2) balances are robust tools for determining the daily average ventilation flows in broiler farms. These balances could also be applied at more frequent intervals, but in this case, particular care is necessary after light status changes because of

  19. Medicare and Medicaid Programs; CY 2017 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.

    Science.gov (United States)

    2016-11-03

    This final rule updates the Home Health Prospective Payment System (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor; effective for home health episodes of care ending on or after January 1, 2017. This rule also: Implements the last year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates; updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the 2nd-year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between CY 2012 and CY 2014; finalizes changes to the methodology used to calculate payments made under the HH PPS for high-cost "outlier" episodes of care; implements changes in payment for furnishing Negative Pressure Wound Therapy (NPWT) using a disposable device for patients under a home health plan of care; discusses our efforts to monitor the potential impacts of the rebasing adjustments; includes an update on subsequent research and analysis as a result of the findings from the home health study; and finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model, which was implemented on January 1, 2016; and updates to the Home Health Quality Reporting Program (HH QRP).

  20. 76 FR 9502 - Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011...

    Science.gov (United States)

    2011-02-18

    ... [CMS-1510-F2] RIN 0938-AP88 Medicare Program; Home Health Prospective Payment System Rate Update for... set forth an update to the Home Health Prospective Payment System (HH PPS) rates, including: The... the Medicare prospective payment system for HHAs. This correcting amendment corrects a technical error...

  1. Impact of ventilation rates on SBS symptoms and productivity in offices

    DEFF Research Database (Denmark)

    Wargocki, Pawel; Fanger, Povl Ole

    1999-01-01

    Perceived air quality, Sick Building Syndrome (SBS) symptoms and productivity were studied in a normally furnished office space ventilated with an outdoor air flow of 3, 10 and 30 L/s per person (corresponding to aiur changes of 0.6, 2.0 and 6 h-1, respectively), while all other environmental...... subjects occupied the office for 4.6 hours in the afternoon, six subjects at a time; they remained thermally neutral by adjusting their clothing. Subjects assessed perceived air quality and SBS symptoms, and performed simulated office work so that their productivity could be assessed. Increasing the supply...

  2. Effect of metronome rates on the quality of bag-mask ventilation during metronome-guided 30:2 cardiopulmonary resuscitation: A randomized simulation study.

    Science.gov (United States)

    Na, Ji Ung; Han, Sang Kuk; Choi, Pil Cho; Shin, Dong Hyuk

    2017-01-01

    Metronome guidance is a feasible and effective feedback technique to improve the quality of cardiopulmonary resuscitation (CPR). The rate of the metronome should be set between 100 to 120 ticks/minute and the speed of ventilation may have crucial effect on the quality of ventilation. We compared three different metronome rates (100, 110, 120 ticks/minute) to investigate its effect on the quality of ventilation during metronome-guided 30:2 CPR. This is a prospective, randomized, crossover observational study using a RespiTrainer○ r . To simulate 30 chest compressions, one investigator counted from 1 to 30 in cadence with the metronome rate (1 count for every 1 tick), and the participant performed 2 consecutive ventilations immediately following the counting of 30. Thirty physicians performed 5 sets of 2 consecutive (total 10) bag-mask ventilations for each metronome rate. Participants were instructed to squeeze the bag over 2 ticks (1.0 to 1.2 seconds depending on the rate of metronome) and deflate the bag over 2 ticks. The sequence of three different metronome rates was randomized. Mean tidal volume significantly decreased as the metronome rate was increased from 110 ticks/minute to 120 ticks/minute (343±84 mL vs. 294±90 mL, P =0.004). Peak airway pressure significantly increased as metronome rate increased from 100 ticks/minute to 110 ticks/minute (18.7 vs. 21.6 mmHg, P =0.006). In metronome-guided 30:2 CPR, a higher metronome rate may adversely affect the quality of bag-mask ventilations. In cases of cardiac arrest where adequate ventilation support is necessary, 100 ticks/minute may be better than 110 or 120 ticks/minute to deliver adequate tidal volume during audio tone guided 30:2 CPR.

  3. Nursing home 5-star rating system exacerbates disparities in quality, by payer source.

    Science.gov (United States)

    Konetzka, R Tamara; Grabowski, David C; Perraillon, Marcelo Coca; Werner, Rachel M

    2015-05-01

    Market-based reforms in health care, such as public reporting of quality, may inadvertently exacerbate disparities. We examined how the Centers for Medicare and Medicare Services' five-star rating system for nursing homes has affected residents who are dually enrolled in Medicare and Medicaid ("dual eligibles"), a particularly vulnerable and disadvantaged population. Specifically, we assessed the extent to which dual eligibles and non-dual eligibles avoided the lowest-rated nursing homes and chose the highest-rated homes once the five-star rating system began, in late 2008. We found that both populations resided in better-quality homes over time but that by 2010 the increased likelihood of choosing the highest-rated homes was substantially smaller for dual eligibles than for non-dual eligibles. Thus, the gap in quality, as measured by a nursing home's star rating, grew over time. Furthermore, we found that the benefit of the five-star system to dual eligibles was largely due to providers' improving their ratings, not to consumers' choosing different providers. We present evidence suggesting that supply constraints play a role in limiting dual eligibles' responses to quality ratings, since high-quality providers tend to be located close to relatively affluent areas. Increases in Medicaid payment rates for nursing home services may be the only long-term solution. Project HOPE—The People-to-People Health Foundation, Inc.

  4. Healthy Zero Energy Buildings (HZEB) Program - Cross-Sectional Study of Contaminant Levels, Source, Strengths, and Ventilation Rates in Retail Stores

    Energy Technology Data Exchange (ETDEWEB)

    Chan, Wanyu R.; Sidheswaran, Meera; Cohn, Sebastian; Sullivan, Douglas P.; Fisk, William

    2014-02-01

    This field study measured ventilation rates and indoor air quality parameters in 21 visits to retail stores in California. The data was collected to guide the development of new, science-based commercial building ventilation rate standards that balance the dual objectives of increasing energy efficiency and maintaining acceptable indoor air quality. Data collection occurred between September 2011 and March 2013. Three types of stores participated in this study: grocery stores, furniture/hardware stores, and apparel stores. Ventilation rates and indoor air contaminant concentrations were measured on a weekday, typically between 9 am and 6 pm. Ventilation rates measured using a tracer gas decay method exceeded the minimum requirement of California’s Title 24 Standard in all but one store. Even though there was adequate ventilation according to Title 24, concentrations of formaldehyde, acetaldehyde, and acrolein exceeded the most stringent chronic health guidelines. Other indoor air contaminants measured included carbon dioxide (CO{sub 2}), carbon monoxide (CO), ozone (O{sub 3}), and particulate matter (PM). Concentrations of CO{sub 2} were kept low by adequate ventilation, and were assumed low also because the sampling occurred on a weekday when retail stores were less busy. CO concentrations were also low. The indoor-outdoor ratios of O{sub 3} showed that the first-order loss rate may vary by store trade types and also by ventilation mode (mechanical versus natural). Analysis of fine and ultrafine PM measurements showed that a substantial portion of the particle mass in grocery stores with cooking-related emissions was in particles less than 0.3 μm. Stores without cooking as an indoor source had PM size distributions that were more similar indoors and outdoors. The whole-building emission rates of volatile organic compounds (VOCs) and PM were estimated from the measured ventilation rates and indoor and outdoor contaminant concentrations. Mass balance models were

  5. In China, students in crowded dormitories with a low ventilation rate have more common colds: evidence for airborne transmission.

    Directory of Open Access Journals (Sweden)

    Yuexia Sun

    Full Text Available OBJECTIVE: To test whether the incidence of common colds among college students in China is associated with ventilation rates and crowdedness in dormitories. METHODS: In Phase I of the study, a cross-sectional study, 3712 students living in 1569 dorm rooms in 13 buildings responded to a questionnaire about incidence and duration of common colds in the previous 12 months. In Phase II, air temperature, relative humidity and CO(2 concentration were measured for 24 hours in 238 dorm rooms in 13 buildings, during both summer and winter. Out-to indoor air flow rates at night were calculated based on measured CO(2 concentrations. RESULTS: In Phase I, 10% of college students reported an incidence of more than 6 common colds in the previous 12 months, and 15% reported that each infection usually lasted for more than 2 weeks. Students in 6-person dorm rooms were about 2 times as likely to have an incidence of common colds ≥6 times per year and a duration ≥2 weeks, compared to students in 3-person rooms. In Phase II, 90% of the measured dorm rooms had an out-to indoor air flow rate less than the Chinese standard of 8.3 L/s per person during the heating season. There was a dose-response relationship between out-to indoor air flow rate per person in dorm rooms and the proportion of occupants with annual common cold infections ≥6 times. A mean ventilation rate of 5 L/(s•person in dorm buildings was associated with 5% of self reported common cold ≥6 times, compared to 35% at 1 L/(s•person. CONCLUSION: Crowded dormitories with low out-to indoor airflow rates are associated with more respiratory infections among college students.

  6. Nunavut housing ventilation research 2003-2005

    Energy Technology Data Exchange (ETDEWEB)

    Fugler, D.

    2005-11-15

    Inuit children in Alaska and Nunavut have high rates of severe lower respiratory tract infections, with hospitalization rates of 300 per year for each 1000 infants. The aim of this research report was to summarize the findings of a pilot project measuring the indoor air quality (IAQ) in 20 Cape Dorset houses as well as a study measuring the ventilation rates of 100 house from 4 communities in Nunavut. The 20 house pilot study included a respiratory questionnaire; a detailed home inspection and data collection; a blower door airtightness test; 7 day measurements of nitrogen dioxide (NO{sub 2}), nicotine, carbon dioxide (CO{sub 2}), relative humidity and temperature; a natural air change rate testing using Brookhaven tracer gas technology; and settled floor dust and bed dust collection followed by biological analysis. The 100 house study recorded 3 to 5 days of house temperatures, relative humidity and CO{sub 2}. The Brookhaven tracer gas technique was used to establish house air change rate. A questionnaire was used to assess ventilation devices. A medical questionnaire was administered and an evaluation of hospitalization data was carried out. Results indicated that a large number of Nunavut houses were not adequately ventilated. In the 20 house study, a third of the houses showed air change rates that would be considered low by any ventilation standards, and that were very low when considering the high occupancy of the houses. In the hundred house study, almost all houses indicated a mean CO{sub 2} level over 1000 ppm, and peaks exceeded 2000 ppm in approximately half the houses. The concentrations were far higher than those seen in southern Canadian homes. It was concluded that the development and promotion of energy-efficient ventilation devices could help to resolve ventilation deficiencies in Nunavut. 2 figs.

  7. Heart rate and leukocytes after air and ground transportation in artificially ventilated neonates: a prospective observational study.

    Science.gov (United States)

    Grosek, Stefan; Mlakar, Gorazd; Vidmar, Ivan; Ihan, Alojz; Primozic, Janez

    2009-01-01

    To evaluate the effect of interhospital air and ground transportation of artificially ventilated neonates on heart rate and peripheral blood leukocyte counts. Prospective, observational study. Level III multidisciplinary Neonatal and Pediatric Intensive Care Unit. Fifty-eight near-term artificially ventilated transported neonates between May 2006 and April 2007. Day-helicopter, day- and night-ground transportation. Heart rate at retrieval, on admission to the ICU and 1 h later, and peripheral blood leukocyte counts on admission and 1 d later were compared. Fifteen neonates were transported by helicopter during the daytime (D-HEL), 20 by daytime ground and 23 by nighttime ground transportation (D-GROUND, N-GROUND). No differences in delivery mode, birth weight, gestational age, gender, primary diagnoses for transportation, response time and duration of transportation were found between the groups. Similarly, no differences in pH, pCO(2), blood pressure and skin temperature at retrieval and on admission to the ICU were found between the three groups. The mean heart rate at retrieval did not differ significantly, while on arrival in the ICU and 1 h later the D-GROUND group of patients showed a significantly higher mean heart rate compared to the D-HEL and N-GROUND groups. Moreover, leukocyte counts on arrival in the ICU showed significantly higher leukocyte counts in the D-GROUND group of patients compared to the D-HEL group of patients. These results demonstrate that there is an association between daytime ground transportation and higher heart rate and peripheral blood leukocytes.

  8. Characteristics of highly rated leadership in nursing homes using item response theory.

    Science.gov (United States)

    Backman, Annica; Sjögren, Karin; Lindkvist, Marie; Lövheim, Hugo; Edvardsson, David

    2017-12-01

    To identify characteristics of highly rated leadership in nursing homes. An ageing population entails fundamental social, economic and organizational challenges for future aged care. Knowledge is limited of both specific leadership behaviours and organizational and managerial characteristics which have an impact on the leadership of contemporary nursing home care. Cross-sectional. From 290 municipalities, 60 were randomly selected and 35 agreed to participate, providing a sample of 3605 direct-care staff employed in 169 Swedish nursing homes. The staff assessed their managers' (n = 191) leadership behaviours using the Leadership Behaviour Questionnaire. Data were collected from November 2013 - September 2014, and the study was completed in November 2016. A two-parameter item response theory approach and regression analyses were used to identify specific characteristics of highly rated leadership. Five specific behaviours of highly rated nursing home leadership were identified; that the manager: experiments with new ideas; controls work closely; relies on subordinates; coaches and gives direct feedback; and handles conflicts constructively. The regression analyses revealed that managers with social work backgrounds and privately run homes were significantly associated with higher leadership ratings. This study highlights the five most important leadership behaviours that characterize those nursing home managers rated highest in terms of leadership. Managers in privately run nursing homes and managers with social work backgrounds were associated with higher leadership ratings. Further work is needed to explore these behaviours and factors predictive of higher leadership ratings. © 2017 John Wiley & Sons Ltd.

  9. Variation in home-birth rates between midwifery practices in the Netherlands.

    NARCIS (Netherlands)

    Wiegers, T.A.; Zee, J. van der; Kerssens, J.J.; Keirse, M.J.N.C.

    2000-01-01

    Objective: to examine the reasons for the variation in home-birth rates between midwifery practices. method: multi-level analysis of client and midwife associated, case-specific and structural factors in relation to 4420 planned and actual home or hospital births in 42 midwifery practices. Findings:

  10. Looking Maori predicts decreased rates of home ownership : Institutional racism in housing based on perceived appearance

    NARCIS (Netherlands)

    Houkamau, C.A.; Sibley, C.G.

    2015-01-01

    This study examined differences in rates of home ownership among Māori (the indigenous peoples of New Zealand). We identified systematic factors that predicted why some Māori were more likely to own their own home (partially or fully) relative to other Māori. Data were drawn from a large national

  11. Changes in Consumer Demand Following Public Reporting of Summary Quality Ratings: An Evaluation in Nursing Homes.

    Science.gov (United States)

    Werner, Rachel M; Konetzka, R Tamara; Polsky, Daniel

    2016-06-01

    Limited consumer use of health care report cards may be due to the large amount of information presented in report cards, which can be difficult to understand. These limitations may be overcome with summary measures. Our objective was to evaluate consumer response to summary measures in the setting of nursing homes. 2005-2010 nursing home Minimum Data Set and Online Survey, Certification and Reporting (OSCAR) datasets. In December 2008, Medicare converted its nursing home report card to summary or star ratings. We test whether there was a change in consumer demand for nursing homes related to the nursing home's star rating after the information was released. The star rating system was associated with a significant change in consumer demand for low- and high-scoring facilities. After the star-based rating system was released, 1-star facilities typically lost 8 percent of their market share and 5-star facilities gained over 6 percent of their market share. The nursing home star rating system significantly affected consumer demand for high- and low-rated nursing homes. These results support the use of summary measures in report cards. © Health Research and Educational Trust.

  12. Anaesthesia ventilators

    Directory of Open Access Journals (Sweden)

    Rajnish K Jain

    2013-01-01

    Full Text Available Anaesthesia ventilators are an integral part of all modern anaesthesia workstations. Automatic ventilators in the operating rooms, which were very simple with few modes of ventilation when introduced, have become very sophisticated with many advanced ventilation modes. Several systems of classification of anaesthesia ventilators exist based upon various parameters. Modern anaesthesia ventilators have either a double circuit, bellow design or a single circuit piston configuration. In the bellows ventilators, ascending bellows design is safer than descending bellows. Piston ventilators have the advantage of delivering accurate tidal volume. They work with electricity as their driving force and do not require a driving gas. To enable improved patient safety, several modifications were done in circle system with the different types of anaesthesia ventilators. Fresh gas decoupling is a modification done in piston ventilators and in descending bellows ventilator to reduce th incidence of ventilator induced volutrauma. In addition to the conventional volume control mode, modern anaesthesia ventilators also provide newer modes of ventilation such as synchronised intermittent mandatory ventilation, pressure-control ventilation and pressure-support ventilation (PSV. PSV mode is particularly useful for patients maintained on spontaneous respiration with laryngeal mask airway. Along with the innumerable benefits provided by these machines, there are various inherent hazards associated with the use of the ventilators in the operating room. To use these workstations safely, it is important for every Anaesthesiologist to have a basic understanding of the mechanics of these ventilators and breathing circuits.

  13. Anaesthesia ventilators.

    Science.gov (United States)

    Jain, Rajnish K; Swaminathan, Srinivasan

    2013-09-01

    Anaesthesia ventilators are an integral part of all modern anaesthesia workstations. Automatic ventilators in the operating rooms, which were very simple with few modes of ventilation when introduced, have become very sophisticated with many advanced ventilation modes. Several systems of classification of anaesthesia ventilators exist based upon various parameters. Modern anaesthesia ventilators have either a double circuit, bellow design or a single circuit piston configuration. In the bellows ventilators, ascending bellows design is safer than descending bellows. Piston ventilators have the advantage of delivering accurate tidal volume. They work with electricity as their driving force and do not require a driving gas. To enable improved patient safety, several modifications were done in circle system with the different types of anaesthesia ventilators. Fresh gas decoupling is a modification done in piston ventilators and in descending bellows ventilator to reduce th incidence of ventilator induced volutrauma. In addition to the conventional volume control mode, modern anaesthesia ventilators also provide newer modes of ventilation such as synchronised intermittent mandatory ventilation, pressure-control ventilation and pressure-support ventilation (PSV). PSV mode is particularly useful for patients maintained on spontaneous respiration with laryngeal mask airway. Along with the innumerable benefits provided by these machines, there are various inherent hazards associated with the use of the ventilators in the operating room. To use these workstations safely, it is important for every Anaesthesiologist to have a basic understanding of the mechanics of these ventilators and breathing circuits.

  14. Anaesthesia ventilators

    Science.gov (United States)

    Jain, Rajnish K; Swaminathan, Srinivasan

    2013-01-01

    Anaesthesia ventilators are an integral part of all modern anaesthesia workstations. Automatic ventilators in the operating rooms, which were very simple with few modes of ventilation when introduced, have become very sophisticated with many advanced ventilation modes. Several systems of classification of anaesthesia ventilators exist based upon various parameters. Modern anaesthesia ventilators have either a double circuit, bellow design or a single circuit piston configuration. In the bellows ventilators, ascending bellows design is safer than descending bellows. Piston ventilators have the advantage of delivering accurate tidal volume. They work with electricity as their driving force and do not require a driving gas. To enable improved patient safety, several modifications were done in circle system with the different types of anaesthesia ventilators. Fresh gas decoupling is a modification done in piston ventilators and in descending bellows ventilator to reduce th incidence of ventilator induced volutrauma. In addition to the conventional volume control mode, modern anaesthesia ventilators also provide newer modes of ventilation such as synchronised intermittent mandatory ventilation, pressure-control ventilation and pressure-support ventilation (PSV). PSV mode is particularly useful for patients maintained on spontaneous respiration with laryngeal mask airway. Along with the innumerable benefits provided by these machines, there are various inherent hazards associated with the use of the ventilators in the operating room. To use these workstations safely, it is important for every Anaesthesiologist to have a basic understanding of the mechanics of these ventilators and breathing circuits. PMID:24249886

  15. Why We Ventilate

    Energy Technology Data Exchange (ETDEWEB)

    Logue, Jennifer M.; Sherman, Max H.; Price, Phil N.; Singer, Brett C.

    2011-09-01

    It is widely accepted that ventilation is critical for providing good indoor air quality (IAQ) in homes. However, the definition of"good" IAQ, and the most effective, energy efficient methods for delivering it are still matters of research and debate. This paper presents the results of work done at the Lawrence Berkeley National Lab to identify the air pollutants that drive the need for ventilation as part of a larger effort to develop a health-based ventilation standard. First, we present results of a hazard analysis that identified the pollutants that most commonly reach concentrations in homes that exceed health-based standards or guidelines for chronic or acute exposures. Second, we present results of an impact assessment that identified the air pollutants that cause the most harm to the U.S. population from chronic inhalation in residences. Lastly, we describe the implications of our findings for developing effective ventilation standards.

  16. A High Rated Solar Water Distillation Unit for Solar Homes

    Directory of Open Access Journals (Sweden)

    Abhishek Saxena

    2016-01-01

    Full Text Available India is presently focusing on complete utilization of solar energy and saving fossil fuels, which are limited. Various solar energy systems like solar cookers, solar water heaters, solar lanterns, solar PV lights, and solar lamps are continuously availing by the people of India at a low cost and on good subsidies. Apart from this, India is a solar energy promising country with a good number of solar homes (carrying solar energy systems in its various locations. The present paper focuses on a unique combination of solar dish cooker (SDC and solar water heater (SWH to produce distilled water with a high distillate and a high daily productivity. The procedure has been discussed on the basis of experimental testing to produce distilled water by combining an evacuated type SWH and a SDC. Experimentation has been carried out in MIT, Moradabad (longitude, 28.83°N, and latitude, 78.78°E by developing the same experimental setup on behalf of solar homes. The daily productivity of distilled water was found around 3.66 litres per day in full sunshine hours for an approximated pH value of 7.7 and a ppm value of 21. The payback period (PBP has been estimated around 1.16 years of the present system.

  17. Optimal Chest Compression Rate and Compression to Ventilation Ratio in Delivery Room Resuscitation: Evidence from Newborn Piglets and Neonatal Manikins

    Science.gov (United States)

    Solevåg, Anne Lee; Schmölzer, Georg M.

    2017-01-01

    Cardiopulmonary resuscitation (CPR) duration until return of spontaneous circulation (ROSC) influences survival and neurologic outcomes after delivery room (DR) CPR. High quality chest compressions (CC) improve cerebral and myocardial perfusion. Improved myocardial perfusion increases the likelihood of a faster ROSC. Thus, optimizing CC quality may improve outcomes both by preserving cerebral blood flow during CPR and by reducing the recovery time. CC quality is determined by rate, CC to ventilation (C:V) ratio, and applied force, which are influenced by the CC provider. Thus, provider performance should be taken into account. Neonatal resuscitation guidelines recommend a 3:1 C:V ratio. CCs should be delivered at a rate of 90/min synchronized with ventilations at a rate of 30/min to achieve a total of 120 events/min. Despite a lack of scientific evidence supporting this, the investigation of alternative CC interventions in human neonates is ethically challenging. Also, the infrequent occurrence of extensive CPR measures in the DR make randomized controlled trials difficult to perform. Thus, many biomechanical aspects of CC have been investigated in animal and manikin models. Despite mathematical and physiological rationales that higher rates and uninterrupted CC improve CPR hemodynamics, studies indicate that provider fatigue is more pronounced when CC are performed continuously compared to when a pause is inserted after every third CC as currently recommended. A higher rate (e.g., 120/min) is also more fatiguing, which affects CC quality. In post-transitional piglets with asphyxia-induced cardiac arrest, there was no benefit of performing continuous CC at a rate of 90/min. Not only rate but duty cycle, i.e., the duration of CC/total cycle time, is a known determinant of CC effectiveness. However, duty cycle cannot be controlled with manual CC. Mechanical/automated CC in neonatal CPR has not been explored, and feedback systems are under-investigated in this

  18. Anaesthesia ventilators

    OpenAIRE

    Jain, Rajnish K; Swaminathan, Srinivasan

    2013-01-01

    Anaesthesia ventilators are an integral part of all modern anaesthesia workstations. Automatic ventilators in the operating rooms, which were very simple with few modes of ventilation when introduced, have become very sophisticated with many advanced ventilation modes. Several systems of classification of anaesthesia ventilators exist based upon various parameters. Modern anaesthesia ventilators have either a double circuit, bellow design or a single circuit piston configuration. In the bello...

  19. Modelling radiation exposure in homes from siporex blocks by using exhalation rates of radon

    Directory of Open Access Journals (Sweden)

    Nikolić Mladen D.

    2015-01-01

    Full Text Available Building materials are the second major source of indoor radon, after soil. The contribution of building materials to indoor radon amount depends upon the radium content and exhalation rates, which can be used as a primary index for radon levels in the dwellings. This paper presents the results of using the experimentally determined exhalation rates of siporex blocks and concrete plates, to assess the radiation exposure in dwellings built of siporex blocks. The annual doses in rooms have been estimated depending on the established modes of ventilation. Realistic scenario was created to predict an annual effective dose for an old person, a housewife, a student, and an employed tenant, who live in the same apartment, spending different periods of time in it. The results indicate the crucial importance of good ventilation of the living space.

  20. Ventilating Air-Conditioner

    Science.gov (United States)

    Dinh, Khanh

    1994-01-01

    Air-conditioner provides ventilation designed to be used alone or incorporated into cooling or heating system operates efficiently only by recirculating stale air within building. Energy needed to operate overall ventilating cooling or heating system slightly greater than operating nonventilating cooling or heating system. Helps to preserve energy efficiency while satisfying need for increased forced ventilation to prevent accumulation of undesired gases like radon and formaldehyde. Provides fresh treated air to variety of confined spaces: hospital surgeries, laboratories, clean rooms, and printing shops and other places where solvents used. In mobile homes and portable classrooms, eliminates irritant chemicals exuded by carpets, panels, and other materials, ensuring healthy indoor environment for occupants.

  1. Mitigation of indoor radon using balanced mechanical ventilation

    International Nuclear Information System (INIS)

    Wellford, B.W.

    1986-01-01

    Previous research has shown that, for a given source strength, the concentration of Rn 222 in the home is inversely proportional to the ventilation rate. Further reductions in the concentration of the decay products of radon can be achieved due to the decrease in residence time of the parent gas as well as increased plate-out of the progeny. Natural and mechanical ventilation can affect the distribution of pressure across the building envelope potentially increasing the flow of radon bearing soil gas into the home gas into the home and/or promoting mixing of areas of higher and lower concentration. Balanced heat recovery ventilation systems were installed in ten homes in the Boyertown, Pennsylvania area. Ventilation was restricted initially to the basement area. Five installations were later modified to introduce supply air to upstairs living spaces while continuing to exhaust from the basement. An independent contractor measured Rn 222 concentrations and decay product activity in the basement and first floor living area before and after installation or modification of the heat recovery ventilation system. Additional experiments to evaluate the effect of house tightening techniques and positive pressurization of the basement were conducted. With balanced ventilation of the basement only, the mean reduction in Working Level was 92.8% with a high of 98% and a low of 76%. Mean reduction of radon gas concentration was 79.1%. When modified to supply air upstairs, mean reduction in Working Level in the living area was 90%. House tightening measures to reduce stack effect were observed to reduce radon concentration. Results indicate that balanced ventilation is an effective strategy for radon mitigation and can be expected to achieve recommended levels in a majority of homes. 9 references, 2 figures, 2 tables

  2. Home

    Science.gov (United States)

    Military Commission Seal VWAP Login Home Go ABOUT US Organization Overview Organizational Chart Families VWAP Login CCTV Sites Travel Media MC News CCTV Sites Travel Today at OMC Home Today at OMC Daily

  3. Medicare and Medicaid Programs; CY 2016 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.

    Science.gov (United States)

    2015-11-05

    This final rule will update Home Health Prospective Payment System (HH PPS) rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor under the Medicare prospective payment system for home health agencies (HHAs), effective for episodes ending on or after January 1, 2016. As required by the Affordable Care Act, this rule implements the 3rd year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates. This rule updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking and provides a clarification regarding the use of the "initial encounter'' seventh character applicable to certain ICD-10-CM code categories. This final rule will also finalize reductions to the national, standardized 60-day episode payment rate in CY 2016, CY 2017, and CY 2018 of 0.97 percent in each year to account for estimated case-mix growth unrelated to increases in patient acuity (nominal case-mix growth) between CY 2012 and CY 2014. In addition, this rule implements a HH value-based purchasing (HHVBP) model, beginning January 1, 2016, in which all Medicare-certified HHAs in selected states will be required to participate. Finally, this rule finalizes minor changes to the home health quality reporting program and minor technical regulations text changes.

  4. Indoor Air Quality and Ventilation in Residential Deep Energy Retrofits

    Energy Technology Data Exchange (ETDEWEB)

    Less, Brennan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Walker, Iain [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2014-06-01

    Because airtightening is a significant part of Deep Energy Retrofits (DERs), concerns about ventilation and Indoor Air Quality (IAQ) have emerged. To investigate this, ventilation and IAQ were assessed in 17 non-smoking California Deep Energy Retrofit homes. Inspections and surveys were used to assess household activities and ventilation systems. Pollutant sampling performed in 12 homes included six-day passive samples of nitrogen dioxide (NO2), formaldehyde and air exchange rate (AER); time-resolved data loggers were used to measure particle counts. Half of the homes provided continuous mechanical ventilation. Despite these homes being twice as airtight (3.0 and 7.6 ACH50, respectively), their median AER was indistinguishable from naturally vented homes (0.36 versus 0.37 hr-1). Numerous problems were found with ventilation systems; however, pollutant levels did not reach levels of concern in most homes. Ambient NO2 standards were exceeded in some gas cooking homes that used legacy ranges with standing pilots, and in Passive House-style homes without range hoods exhausted to outside. Cooking exhaust systems were installed and used inconsistently. The majority of homes reported using low-emitting materials, and formaldehyde levels were approximately half those in conventional new CA homes (19.7 versus 36 μg/m3), with emissions rates nearly 40percent less (12.3 versus 20.6 μg/m2/hr.). Presence of air filtration systems led to lower indoor particle number concentrations (PN>0.5: 8.80E+06 PN/m3 versus 2.99E+06; PN>2.5: 5.46E+0.5 PN/m3 versus 2.59E+05). The results indicate that DERs can provide adequate ventilation and IAQ, and that DERs should prioritize source control, particle filtration and well-designed local exhaust systems, while still providing adequate continuous ventilation.

  5. Thermal Plumes in Ventilated Rooms

    DEFF Research Database (Denmark)

    Kofoed, P.; Nielsen, Peter Vilhelm

    The main objective of ventilation is to provide good air quality for the occupants. For this purpose the necessary ventilating air change rate must be determined. Within displacement ventilation the estimation is closely related to the air flow rate in the thermal plumes when an air quality based...

  6. Linking mortgage finance incentives to a voluntary home energy rating system: Insight into consensus building

    International Nuclear Information System (INIS)

    Jenior, M.-M.

    1994-01-01

    A collaborative consensus process was created to implement a program linking voluntary home energy rating systems (HERS) to mortgage incentives. The participants involved many of the stakeholders or interest groups who have a role in implementing and who will be affected by energy efficiency mortgate incentive programs linked to HERS. The participants included representatives from the primary and secondary mortgage market; real estate, home building, and remodeling industries; utilities; state, local, consumer, and environmental organizations; and home energy rating providers. The participants defined the actions required to implement as well as the technical requirements of a program linking home energy ratings and mortgage finance. Building on the recommendations of the collaborative process, members of the collaborative continue to take initiatives to put a Home Energy Rating Systems Council into place, in planning pilot programs for developing and testing ways to link HERS and mortgage programs, and in making home buyers and owners aware of existing mortgage incentives. At the same time, mortgage providers are working to develop uniformity among mortgage incentive programs and with the US Department of Energy to develop procedures to verify the relative accuracy of HERS calculation tools and their application, and with the emerging HERS Council to develop the guidelines for voluntary HERS required under the Energy Policy Act of 1992

  7. When Patients Customize Nursing Home Ratings, Choices And Rankings Differ From The Government's Version.

    Science.gov (United States)

    Mukamel, Dana B; Amin, Alpesh; Weimer, David L; Sharit, Joseph; Ladd, Heather; Sorkin, Dara H

    2016-04-01

    Report cards currently published by the Centers for Medicare and Medicaid Services (CMS) offer composite (summary) quality measures based on a five-star ratings system, such as the one featured on the Nursing Home Compare website. These ratings are "one size fits all patients" measures. Nursing Home Compare Plus is an alternative that allows patients and their families to create their own composite scores based on their own preferences and medical needs. We present data from 146 patients who were discharged from the hospital to nursing homes who used Nursing Home Compare Plus. We found that the individual patient-constructed composites differed from CMS's five-star ratings composite. Patients differed from each other and from CMS in the number of performance measures they chose to include in their composite and in their weighting of each performance measure. When comparing Nursing Home Compare Plus to Medicare's five-star ratings, we found only minimal agreement on ranking of nursing homes. We conclude that patients might benefit if current report cards are modified to include an option for personalized ranking. Project HOPE—The People-to-People Health Foundation, Inc.

  8. The effect of low ventilation rate with elevated bioeffluent concentration on work performance, perceived indoor air quality, and health symptoms.

    Science.gov (United States)

    Maula, H; Hongisto, V; Naatula, V; Haapakangas, A; Koskela, H

    2017-11-01

    The aim of this laboratory experiment was to study the effects of ventilation rate, and related changes in air quality, predominantly bioeffluents, on work performance, perceived indoor air quality, and health symptoms in a typical conditions of modern open-plan office with low material and equipment emissions. In Condition A, outdoor air flow rate of 28.2 l/s person (CO 2 level 540 ppm) was applied and in Condition B, outdoor air flow rate was 2.3 l/s person (CO 2 level 2260 ppm). CO 2 concentration level was used as an indicator of bioeffluents. Performance was measured with seven different tasks which measure different cognitive processes. Thirty-six subjects participated in the experiment. The exposure time was 4 hours. Condition B had a weak negative effect on performance only in the information retrieval tasks. Condition B increased slightly subjective workload and perceived fatigue. No effects on health symptoms were found. The intensity of symptoms was low in both conditions. The experimental condition had an effect on perceived air quality and observed odor intensity only in the beginning of the session. Although the room temperature was controlled in both conditions, the heat was perceived to impair the performance more in Condition B. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Displacement ventilation

    DEFF Research Database (Denmark)

    Kosonen, Risto; Melikov, Arsen Krikor; Mundt, Elisabeth

    The aim of this Guidebook is to give the state-of-the art knowledge of the displacement ventilation technology, and to simplify and improve the practical design procedure. The Guidebook discusses methods of total volume ventilation by mixing ventilation and displacement ventilation and it gives...... insights of the performance of the displacement ventilation. It also shows practical case studies in some typical applications and the latest research findings to create good local micro-climatic conditions....

  10. Decrease in delivery room intubation rates after use of nasal intermittent positive pressure ventilation in the delivery room for resuscitation of very low birth weight infants.

    Science.gov (United States)

    Biniwale, Manoj; Wertheimer, Fiona

    2017-07-01

    The literature supports minimizing duration of invasive ventilation to decrease lung injury in premature infants. Neonatal Resuscitation Program recommended use of non-invasive ventilation (NIV) in delivery room for infants requiring prolonged respiratory support. To evaluate the impact of implementation of non-invasive ventilation (NIV) using nasal intermittent positive pressure ventilation (NIPPV) for resuscitation in very low birth infants. Retrospective study was performed after NIPPV was introduced in the delivery room and compared with infants receiving face mask to provide positive pressure ventilation for resuscitation of very low birth weight infants prior to its use. Data collected from 119 infants resuscitated using NIPPV and 102 infants resuscitated with a face mask in a single institution. The primary outcome was the need for endotracheal intubation in the delivery room. Data was analyzed using IBM SPSS Statistics software version 24. A total of 31% of infants were intubated in the delivery room in the NIPPV group compared to 85% in the Face mask group (p=rates were 11% in the NIPPV group and 31% in the Face mask group (p<0.001). Epinephrine administration was also lower in NIPPV group (2% vs. 8%; P=0.03). Only 38% infants remained intubated at 24hours of age in the NIPPV group compared to 66% in the Face mask group (p<0.001). Median duration of invasive ventilation in the NIPPV group was shorter (2days) compared to the Face mask group (11days) (p=0.01). The incidence of air-leaks was not significant between the two groups. NIPPV was safely and effectively used in the delivery room settings to provide respiratory support for VLBW infants with less need for intubation, chest compressions, epinephrine administration and subsequent invasive ventilation. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Determination by a CFD code of the heat release rate in a confined and mechanically-ventilated compartment fire

    International Nuclear Information System (INIS)

    Nasr, Ayoub

    2011-01-01

    For several years, many experimental/numerical research programs have been carried out at IRSN in order to provide sufficient data on the burning process and understand the behavior of a pool fire in a confined and mechanically ventilated compartment. Several experimental tests have shown that in some cases, the oxygen concentration in the local decreases then stabilizes until fire extinction. The fuel mass loss rate is instantaneously adjusted according to the ventilation in the local, which may leads to a lower fuel consumption rate as compared to that in free atmosphere. The fire duration is then 2 to 3 times greater than that obtained in free atmosphere, which may damages some specific safety equipment used to reduce the spread of fire between compartments such as fire doors. The objective of this work is to propose a theoretical approach that allows the determination of the burning rate of fuels for pool fires in a closed compartment. Fuel response to vitiated air as well as burning enhancement due to hot gases and confinement should be taken into account. Thus, a theoretical formulation, based on an energy balance equation at the pool fire surface, was developed and compared with the empirical correlation of Peatross and Beyler before being implemented in a CFD code 'ISIS', developed at IRSN and validated against PRISME fire test results. The main advantage of this global approach is that no assumptions were made on the relative importance of each mode of heat transfer from the flame. In fact, the convective and the radiant components of the heat flux from the flame to the fuel surface were determined taking into account the air vitiation effect. In addition to this theoretical approach, an experimental work was conducted at the Institut PPRIME to study heptane pool fires in a reduced-scale fire compartment, in the aim to investigate the effects of vitiated air on fire parameters. These results were used to validate the theoretical formulation developed

  12. Demand Controlled Ventilation in a Combined Ventilation and Radiator System

    OpenAIRE

    Hesaraki, Arefeh; Holmberg, Sture

    2013-01-01

    With growing concerns for efficient and sustainable energy treatment in buildings there is a need for balanced and intelligent ventilation solutions. This paper presents a strategy for demand controlled ventilation with ventilation radiators, a combined heating and ventilation system. The ventilation rate was decreased from normal requirements (per floor area) of 0.375 l·s-1·m-2 to 0.100 l·s-1·m-2 when the residence building was un-occupied. The energy saving potential due to decreased ventil...

  13. The influence of opening windows and doors on the natural ventilation rate of a residential building

    Science.gov (United States)

    Increased building energy efficiency is important in reducing national energy use and greenhouse gas emissions. An analysis of air change rates due to door and window openings in a research test house located in a residential environment are presented. These data inform developme...

  14. Decreased re-conviction rates of DUI offenders with intensive supervision and home confinement.

    Science.gov (United States)

    Barta, William D; Fisher, Virginia; Hynes, Patrick

    2017-11-01

    In some jurisdictions, persons who are convicted of driving under the influence of alcohol (DUI) are allowed to serve some portion of their prison sentence under home confinement as part of Intensive Supervision Programs (ISPs) which include pre-release psycho-education and close post-release supervision. Test the hypothesis that persons convicted of DUI offenses who have spent some portion of their sentence under home confinement, as compared to a historical comparison group, will exhibit a relatively low re-conviction rate. Using administrative data for 1,410 repeat DUI offenders (302 members of the historical comparison group, 948 ISP members, and 160 persons who appear in both groups at different points in time), with a follow-up period of up to 3 years and 10 months, a marginal Cox model was employed to compare conviction rates of persons who experienced intensive supervision and home confinement with historical comparison group members. Persons with ISP + home confinement experience a re-conviction rate that is less than half that observed in the comparison group. Age, ethnicity (white vs. non-white), and gender are also significant predictors of re-conviction. Home confinement, in conjunction with psycho-education and other program elements, is one means of reducing the costs of incarceration. The results of this study suggest that, in addition to cost savings, states may realize a public safety benefit in the form of a reduction in DUI offense rates.

  15. Ventilation System Effectiveness and Tested Indoor Air Quality Impacts

    Energy Technology Data Exchange (ETDEWEB)

    Rudd, Armin [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bergey, Daniel [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2014-02-01

    Ventilation system effectiveness testing was conducted at two unoccupied, single-family, detached lab homes at the University of Texas - Tyler. Five ventilation system tests were conducted with various whole-building ventilation systems. Multizone fan pressurization testing characterized building and zone enclosure leakage. PFT testing showed multizone air change rates and interzonal airflow. Cumulative particle counts for six particle sizes, and formaldehyde and other Top 20 VOC concentrations were measured in multiple zones. The testing showed that single-point exhaust ventilation was inferior as a whole-house ventilation strategy. It was inferior because the source of outside air was not direct from outside, the ventilation air was not distributed, and no provision existed for air filtration. Indoor air recirculation by a central air distribution system can help improve the exhaust ventilation system by way of air mixing and filtration. In contrast, the supply and balanced ventilation systems showed that there is a significant benefit to drawing outside air from a known outside location, and filtering and distributing that air. Compared to the Exhaust systems, the CFIS and ERV systems showed better ventilation air distribution and lower concentrations of particulates, formaldehyde and other VOCs. System improvement percentages were estimated based on four System Factor Categories: Balance, Distribution, Outside Air Source, and Recirculation Filtration. Recommended System Factors could be applied to reduce ventilation fan airflow rates relative to ASHRAE Standard 62.2 to save energy and reduce moisture control risk in humid climates. HVAC energy savings were predicted to be 8-10%, or $50-$75/year.

  16. Ventilation System Effectiveness and Tested Indoor Air Quality Impacts

    Energy Technology Data Exchange (ETDEWEB)

    Rudd, Armin [Building Science Corporation, Somerville, MA (United States); Bergey, Daniel [Building Science Corporation, Somerville, MA (United States)

    2014-02-01

    In this project, Building America research team Building Science Corporation tested the effectiveness of ventilation systems at two unoccupied, single-family, detached lab homes at the University of Texas - Tyler. Five ventilation system tests were conducted with various whole-building ventilation systems. Multizone fan pressurization testing characterized building and zone enclosure leakage. PFT testing showed multizone air change rates and interzonal airflow. Cumulative particle counts for six particle sizes, and formaldehyde and other Top 20 VOC concentrations were measured in multiple zones. The testing showed that single-point exhaust ventilation was inferior as a whole-house ventilation strategy. This was because the source of outside air was not direct from outside, the ventilation air was not distributed, and no provision existed for air filtration. Indoor air recirculation by a central air distribution system can help improve the exhaust ventilation system by way of air mixing and filtration. In contrast, the supply and balanced ventilation systems showed that there is a significant benefit to drawing outside air from a known outside location, and filtering and distributing that air. Compared to the exhaust systems, the CFIS and ERV systems showed better ventilation air distribution and lower concentrations of particulates, formaldehyde and other VOCs. System improvement percentages were estimated based on four system factor categories: balance, distribution, outside air source, and recirculation filtration. Recommended system factors could be applied to reduce ventilation fan airflow rates relative to ASHRAE Standard 62.2 to save energy and reduce moisture control risk in humid climates. HVAC energy savings were predicted to be 8-10%, or $50-$75/year.

  17. Performance characteristics of seven bilevel mechanical ventilators in pressure-support mode with different cycling criteria: a comparative bench study.

    Science.gov (United States)

    Chen, Yuqing; Cheng, Kewen; Zhou, Xin

    2015-01-26

    Pressure support ventilation from a bilevel device is a standard technique for non-invasive home ventilation. A bench study was designed to compare the performance and patient-ventilator synchronization of 7 bilevel ventilators, in the presence of system leaks. Ventilators were connected to a Hans Rudolph Series 1101 lung simulator (compliance, 50 mL/cmH2O; expiratory resistance, 20 cmH2O/L/s; respiratory rate, 15 breaths/min; inspiratory time, 1.0 s). All ventilators were set at 15 cmH2O pressure support and 5 cmH2O positive end-expiratory pressure. Tests were conducted at 2 system leaks (12-15 and 25-28 L/min). The performance characteristics and patient-ventilator asynchrony were assessed, including flow, airway pressure, time, and workload. The Breas Vivo30 could not synchronize with the simulator (frequent auto-triggering) at a leak of 25-28 L/min, but provided stable assisted ventilation when the leak was 12-15 L/min. Missed efforts and back-up ventilation occurred for the Weinmann VENTImotion and Airox Smartair Plus, requiring adjustment of trigger effort. All ventilators had a short trigger delay time (ventilators, possibly due to software algorithm differences. Adjusting the cycling criteria settings can alter the shape of the inspiratory phase and peak expiratory flow, and improve patient-ventilator synchrony.

  18. A COMPARISON BETWEEN VENTILATION AND HEART RATE AS INDICATOR OF OXYGEN UPTAKE DURING DIFFERENT INTENSITIES OF EXERCISE

    Directory of Open Access Journals (Sweden)

    Jacques Prioux

    2010-03-01

    Full Text Available The aim of this study is to compare the relation between ventilation (VE and oxygen uptake (VO2 [VO2=ƒ(VE] and between heart rate (HR and VO2 [VO2=ƒ(HR]. Each one of the subjects performed three types of activities of different intensities (walking without load, walking with load and intermittent work. VO2, VE, and HR were measured continuously by using indirect calorimetry and an electrocardiogram. Linear regressions and coefficients of determination (r² were calculated to compare the relation VO2 =ƒ(VE and VO2 =ƒ(HR for two different regroupings: by session duration (r²session and by subject (r²subject. Results showed that r²session of the relation VO2 =ƒ(VE were significantly higher than those of the relation VO2 =ƒ(HR for steady state activities (walking with or without load during 3 or 6 min, p < 0.01 and for activities without oxygen consumption steady state (walking with or without load during 1 min, p < 0.01 and intermittent work, p < 0.05. VE is more strongly correlated with VO2 than with HR. This is a very promising approach to develop a new method to estimate energy expenditure

  19. Rate of driving a ventilation tunnel by means of the GPK heading machine using roof bolting and steel supports. [USSR

    Energy Technology Data Exchange (ETDEWEB)

    Cheremnov, V.I.; Kruglyak, A.S.; Miroshnikova, L.A.; Sharov, V.N.

    1983-05-01

    The paper discusses a method for strata control during mine drivage tested in the im. Voroshilov coal mine in 1982. A ventilation tunnel with a crosscut of 16.4 m/sup 2/ was driven in coal with compression strength coefficient from 0.8 to 1.0, argillites and aleurites in the floor and the roof with compression strength coefficient from 4 to 6. Mining depth was 150 m, water influx was low. The tunnel was driven by means of the GPK heading machine with a 1PNB-2 loader. The AMK support system which consisted of arched steel supports, steel beams for joining steel arches and of roof bolts was used. Arched supports were installed each 0.8 m. The roof between the arches was supported by a system of roof bolts and junction beams. Support design is shown in a scheme. Increasing support spacing to 0.8 m (instead of 0.5 m) and roof bolting permitted drivage rate to be increased and steel consumption to be significantly reduced (by 244 kg/m). (3 refs.)

  20. Ventilation rates in classrooms and performances of students. Preliminary study on their association; Ventilatiedebieten in klaslokalen en prestaties van scholieren

    Energy Technology Data Exchange (ETDEWEB)

    Shaughnessy, R.J. [The University of Tulsa, Tulsa, OK (United States); Haverinen-Shaughnessy, U.; Nevalainen, A. [Department of Environmental Health, National Public Health Institute, Kuopio (Finland); Moschandreas, D. [Department of Chemical and Environmental Engineering, Illinois Institute of Technology, Chicago, IL (United States)

    2007-10-15

    Poor conditions leading to sub-standard indoor air quality (IAQ) in classrooms have been frequently cited in the literature over the past two decades. However, there is limited data linking poor IAQ in the classrooms to student performance. Whereas, it is assumed that poor IAQ results in reduced attendance and learning potential, and subsequent poor student performance, validating this hypothesis presents a challenge in today's school environment. This study explores the association between student performance on standardized aptitude tests that are administered to students on a yearly basis, to classroom carbon dioxide (CO2) concentrations, which provide a surrogate of ventilation being provided to each room. Data on classroom CO2 concentrations (over a 4-5h time span within a typical school day) were recorded in fifth grade classrooms in 54 elementary schools within a school district in the USA. Results from this preliminary study yield a significant (P<0.10) association between classroom-level ventilation rate and test results in math. They also indicate that non-linear effects may need to be considered for better representation of the association. A larger sample size is required in order to draw more definitive conclusions. [Dutch] Slechte omstandigheden die leiden tot een benedenmaatse binnenluchtkwaliteit (Indoor Air Quality - IAQ) in klaslokalen, zijn in de afgelopen twee decennia regelmatig aangehaald in de literatuur. Toch zijn er weinig onderzoeksresultaten waarin een verband wordt gelegd tussen een slechte IAQ in klaslokalen en de prestatie van scholieren. Er wordt verondersteld dat een slechte IAQ resulteert in een verminderde aanwezigheid en in een verminderd vermogen om te studeren, en daarop volgend in een slechte schoolprestatie. Om die reden zal het valideren van deze hypothese een uitdaging vormen in de schoolomgeving van dit moment. Dit onderzoek bestudeert het verband tussen de prestaties van scholieren en de concentraties koolstofdioxide

  1. VENTILATION MODEL

    International Nuclear Information System (INIS)

    V. Chipman

    2002-01-01

    The purpose of the Ventilation Model is to simulate the heat transfer processes in and around waste emplacement drifts during periods of forced ventilation. The model evaluates the effects of emplacement drift ventilation on the thermal conditions in the emplacement drifts and surrounding rock mass, and calculates the heat removal by ventilation as a measure of the viability of ventilation to delay the onset of peak repository temperature and reduce its magnitude. The heat removal by ventilation is temporally and spatially dependent, and is expressed as the fraction of heat carried away by the ventilation air compared to the fraction of heat produced by radionuclide decay. One minus the heat removal is called the wall heat fraction, or the remaining amount of heat that is transferred via conduction to the surrounding rock mass. Downstream models, such as the ''Multiscale Thermohydrologic Model'' (BSC 2001), use the wall heat fractions as outputted from the Ventilation Model to initialize their postclosure analyses

  2. [Anesthesia ventilators].

    Science.gov (United States)

    Otteni, J C; Beydon, L; Cazalaà, J B; Feiss, P; Nivoche, Y

    1997-01-01

    To review anaesthesia ventilators in current use in France by categories of ventilators. References were obtained from computerized bibliographic search. (Medline), recent review articles, the library of the service and personal files. Anaesthesia ventilators can be allocated into three groups, depending on whether they readminister expired gases or not or allow both modalities. Contemporary ventilators provide either constant volume ventilation, or constant pressure ventilation, with or without a pressure plateau. Ventilators readministering expired gases after CO2 absorption, or closed circuit ventilators, are either of a double- or a single-circuit design. Double-circuit ventilators, or pneumatical bag or bellows squeezers, or bag-in-bottle or bellows-in-bottle (or box) ventilators, consist of a primary, or driving circuit (bottle or box) and a secondary or patient circuit (including a bag or a bellows or membrane chambers). Bellows-in-bottle ventilators have either standing bellows ascending at expiration, or hanging bellows, descending at expiration. Ascending bellows require a positive pressure of about 2 cmH2O throughout exhalation to allow the bellows to refill. The expired gas volume is a valuable indicator for leak and disconnection. Descending bellows generate a slight negative pressure during exhalation. In case of leak or disconnection they aspirate ambient air and cannot act therefore as an indicator for integrity of the circuit and the patient connection. Closed circuit ventilators with a single-circuit (patient circuit) include a insufflating device consisting either in a bellows or a cylinder with a piston, operated by a electric or pneumatic motor. As the hanging bellows of the double circuit ventilators, they generate a slight negative pressure during exhalation and aspirate ambient air in case of leak or disconnection. Ventilators not designed for the readministration of expired gases, or open circuit ventilators, are generally stand

  3. Ventilation models

    Science.gov (United States)

    Skaaret, Eimund

    Calculation procedures, used in the design of ventilating systems, which are especially suited for displacement ventilation in addition to linking it to mixing ventilation, are addressed. The two zone flow model is considered and the steady state and transient solutions are addressed. Different methods of supplying air are discussed, and different types of air flow are considered: piston flow, plane flow and radial flow. An evaluation model for ventilation systems is presented.

  4. Home Country National Intelligence and Self-Employment Rates among Immigrants in Norway

    Science.gov (United States)

    Vinogradov, Evgueni; Kolvereid, Lars

    2010-01-01

    The level of self-employment varies significantly among immigrants from different countries of origin. The objective of this research is to examine the relationship between home-country national intelligence and self-employment rates among first generation immigrants in Norway. Empirical secondary data on self-employment among immigrants from 117…

  5. Nijmegen Observer-Rated Depression scale for detection of depression in nursing home residents.

    NARCIS (Netherlands)

    Leontjevas, R.; Gerritsen, D.L.; Vernooij-Dassen, M.J.F.J.; Teerenstra, S.; Smalbrugge, M.; Koopmans, R.T.C.M.

    2012-01-01

    OBJECTIVE: This study aims to test the accuracy of the Nijmegen Observer-Rated Depression (NORD) scale, a new short scale for screening of depression in nursing home (NH) residents with and without dementia. METHODS: This cross-sectional study with 103 residents with dementia (N = 19 depressed) and

  6. Nijmegen Observer-Rated Depression scale for detection of depression in nursing home residents

    NARCIS (Netherlands)

    Leontjevas, R.; Gerritsen, D.L.; Vernooij-Dassen, M.J.; Teerenstra, S.; Smalbrugge, M.; Koopmans, R.T.

    2012-01-01

    Objective This study aims to test the accuracy of the Nijmegen Observer-Rated Depression (NORD) scale, a new short scale for screening of depression in nursing home (NH) residents with and without dementia. Methods This cross-sectional study with 103 residents with dementia (N = 19 depressed) and 72

  7. Industrial ventilation

    Science.gov (United States)

    Goodfellow, H. D.

    Industrial ventilation design methodology, using computers and using fluid dynamic models, is considered. It is noted that the design of a ventilation system must be incorporated into the plant design and layout at the earliest conceptual stage of the project. A checklist of activities concerning the methodology for the design of a ventilation system for a new facility is given. A flow diagram of the computer ventilation model shows a typical input, the initialization and iteration loop, and the output. The application of the fluid dynamic modeling techniques include external and internal flow fields, and individual sources of heat and contaminants. Major activities for a ventilation field test program are also addressed.

  8. 76 FR 44573 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2011-07-26

    ... DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations of Day Care Homes for the Period July 1, 2011 Through June 30, 2012 Correction In notice document 2011-18257 appearin...

  9. 76 FR 43254 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2011-07-20

    ... adjustments to the national average payment rates for meals and snacks served in child care centers, outside... payment rates for meals and snacks served in day care homes; and the administrative reimbursement rates for sponsoring organizations of day care homes, to reflect changes in the Consumer Price Index...

  10. Indoor particle dynamics in a school office: determination of particle concentrations, deposition rates and penetration factors under naturally ventilated conditions.

    Science.gov (United States)

    Cong, X C; Zhao, J J; Jing, Z; Wang, Q G; Ni, P F

    2018-05-09

    Recently, the problem of indoor particulate matter pollution has received much attention. An increasing number of epidemiological studies show that the concentration of atmospheric particulate matter has a significant effect on human health, even at very low concentrations. Most of these investigations have relied upon outdoor particle concentrations as surrogates of human exposures. However, considering that the concentration distribution of the indoor particulate matter is largely dependent on the extent to which these particles penetrate the building and on the degree of suspension in the indoor air, human exposures to particles of outdoor origin may not be equal to outdoor particle concentration levels. Therefore, it is critical to understand the relationship between the particle concentrations found outdoors and those found in indoor micro-environments. In this study, experiments were conducted using a naturally ventilated office located in Qingdao, China. The indoor and outdoor particle concentrations were measured at the same time using an optical counter with four size ranges. The particle size distribution ranged from 0.3 to 2.5 μm, and the experimental period was from April to September, 2016. Based on the experimental data, the dynamic and mass balance model based on time was used to estimate the penetration rate and deposition rate at air exchange rates of 0.03-0.25 h -1 . The values of the penetration rate and deposition velocity of indoor particles were determined to range from 0.45 to 0.82 h -1 and 1.71 to 2.82 m/h, respectively. In addition, the particulate pollution exposure in the indoor environment was analyzed to estimate the exposure hazard from indoor particulate matter pollution, which is important for human exposure to particles and associated health effects. The conclusions from this study can serve to provide a better understanding the dynamics and behaviors of airborne particle entering into buildings. And they will also highlight

  11. Trends in family ratings of experience with care and racial disparities among Maryland nursing homes.

    Science.gov (United States)

    Li, Yue; Ye, Zhiqiu; Glance, Laurent G; Temkin-Greener, Helena

    2014-07-01

    Providing equitable and patient-centered care is critical to ensuring high quality of care. Although racial/ethnic disparities in quality are widely reported for nursing facilities, it is unknown whether disparities exist in consumer experiences with care and how public reporting of consumer experiences affects facility performance and potential racial disparities. We analyzed trends of consumer ratings publicly reported for Maryland nursing homes during 2007-2010, and determined whether racial/ethnic disparities in experiences with care changed during this period. Multivariate longitudinal regression models controlled for important facility and county characteristics and tested changes overall and by facility groups (defined based on concentrations of black residents). Consumer ratings were reported for: overall care; recommendation of the facility; staff performance; care provided; food and meals; physical environment; and autonomy and personal rights. Overall ratings on care experience remained relatively high (mean=8.3 on a 1-10 scale) during 2007-2010. Ninety percent of survey respondents each year would recommend the facility to someone who needs nursing home care. Ratings on individual domains of care improved among all nursing homes in Maryland (Pfood and meals (P=0.827 for trend). However, site-of-care disparities existed in each year for overall ratings, recommendation rate, and ratings on all domains of care (P0.2 for trends in disparities). Although Maryland nursing homes showed maintained or improved consumer ratings during the first 4 years of public reporting, gaps persisted between facilities with high versus low concentrations of minority residents.

  12. Uranium mine ventilation

    International Nuclear Information System (INIS)

    Katam, K.; Sudarsono

    1982-01-01

    Uranium mine ventilation system aimed basically to control and decreasing the air radioactivity in mine caused by the radon emanating from uranium ore. The control and decreasing the air ''age'' in mine, with adding the air consumption volume, increasing the air rate consumption, closing the mine-out area; using closed drainage system. Air consumption should be 60m 3 /minute for each 9m 2 uranium ore surfaces with ventilation rate of 15m/minute. (author)

  13. The association of Nursing Home Compare quality measures with market competition and occupancy rates.

    Science.gov (United States)

    Castle, Nicholas G; Liu, Darren; Engberg, John

    2008-01-01

    Since 2002, the Centers for Medicare and Medicaid Services have reported quality measures on the Nursing Home Compare Web site. It has been assumed that nursing homes are able to make improvements on these measures. In this study researchers examined nursing homes to see whether they have improved their quality scores, after accounting for regression to the mean. Researchers also examined whether gains varied according to market competition or market occupancy rates. They identified some regression to the mean for the quality measure scores over time; nevertheless, they also determined that some nursing homes had indeed made small improvements in their quality measure scores. As would be predicted based on the market-driven mechanism underlying quality improvements using report cards, the greatest improvements occurred in the most competitive markets and in those with the Lowest average occupancy rates. As policies to promote more competition in Long-term care proceed, further reducing occupancy rates, further, albeit small, quality gains will likely be made in the future.

  14. Bench performance of ventilators during simulated paediatric ventilation.

    Science.gov (United States)

    Park, M A J; Freebairn, R C; Gomersall, C D

    2013-05-01

    This study compares the accuracy and capabilities of various ventilators using a paediatric acute respiratory distress syndrome lung model. Various compliance settings and respiratory rate settings were used. The study was done in three parts: tidal volume and FiO2 accuracy; pressure control accuracy and positive end-expiratory pressure (PEEP) accuracy. The parameters set on the ventilator were compared with either or both of the measured parameters by the test lung and the ventilator. The results revealed that none of the ventilators could consistently deliver tidal volumes within 1 ml/kg of the set tidal volume, and the discrepancy between the delivered volume and the volume measured by the ventilator varied greatly. The target tidal volume was 8 ml/kg, but delivered tidal volumes ranged from 3.6-11.4 ml/kg and the volumes measured by the ventilator ranged from 4.1-20.6 ml/kg. All the ventilators maintained pressure within 20% of the set pressure, except one ventilator which delivered pressures of up to 27% higher than the set pressure. Two ventilators maintained PEEP within 10% of the prescribed PEEP. The majority of the readings were also within 10%. However, three ventilators delivered, at times, PEEPs over 20% higher. In conclusion, as lung compliance decreases, especially in paediatric patients, some ventilators perform better than others. This study highlights situations where ventilators may not be able to deliver, nor adequately measure, set tidal volumes, pressure, PEEP or FiO2.

  15. Two-year home-based nocturnal noninvasive ventilation added to rehabilitation in chronic obstructive pulmonary disease patients: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Zijlstra Jan G

    2011-08-01

    Full Text Available Abstract Background The use of noninvasive intermittent positive pressure ventilation (NIPPV in chronic obstructive pulmonary disease (COPD patients with chronic hypercapnic respiratory failure remains controversial as long-term data are almost lacking. The aim was to compare the outcome of 2-year home-based nocturnal NIPPV in addition to rehabilitation (NIPPV + PR with rehabilitation alone (PR in COPD patients with chronic hypercapnic respiratory failure. Methods Sixty-six patients could be analyzed for the two-year home-based follow-up period. Differences in change between the NIPPV + PR and PR group were assessed by a linear mixed effects model with a random effect on the intercept, and adjustment for baseline values. The primary outcome was health-related quality of life (HRQoL; secondary outcomes were mood state, dyspnea, gas exchange, functional status, pulmonary function, and exacerbation frequency. Results Although the addition of NIPPV did not significantly improve the Chronic Respiratory Questionnaire compared to rehabilitation alone (mean difference in change between groups -1.3 points (95% CI: -9.7 to 7.4, the addition of NIPPV did improve HRQoL assessed with the Maugeri Respiratory Failure questionnaire (-13.4% (-22.7 to -4.2; p = 0.005, mood state (Hospital Anxiety and Depression scale -4.0 points (-7.8 to 0.0; p = 0.05, dyspnea (Medical Research Council -0.4 points (-0.8 to -0.0; p = 0.05, daytime arterial blood gases (PaCO2 -0.4 kPa (-0.8 to -0.2; p = 0.01; PaO2 0.8 kPa (0.0 to 1.5; p = 0.03, 6-minute walking distance (77.3 m (46.4 to 108.0; p Conclusions The addition of NIPPV to pulmonary rehabilitation for 2 years in severe COPD patients with chronic hypercapnic respiratory failure improves HRQoL, mood, dyspnea, gas exchange, exercise tolerance and lung function decline. The benefits increase further with time. Trial registration ClinicalTrials.Gov (ID NCT00135538.

  16. Interfaces and ventilator settings for long-term noninvasive ventilation in COPD patients

    Directory of Open Access Journals (Sweden)

    Callegari J

    2017-06-01

    Full Text Available Jens Callegari,1 Friederike Sophie Magnet,1 Steven Taubner,1 Melanie Berger,2 Sarah Bettina Schwarz,1 Wolfram Windisch,1 Jan Hendrik Storre3,4 1Department of Pneumology, Cologne-Merheim Hospital, Kliniken der Stadt Koeln, Witten/Herdecke University Hospital, 2Department of Pneumology, Malteser Hospital St Hildegardis, Cologne, 3Department of Pneumology, University Medical Hospital, Freiburg, 4Department of Intensive Care, Sleep Medicine and Mechanical Ventilation, Asklepios Fachkliniken Munich-Gauting, Gauting, Germany Introduction: The establishment of high-intensity (HI noninvasive ventilation (NIV that targets elevated PaCO2 has led to an increase in the use of long-term NIV to treat patients with chronic hypercapnic COPD. However, the role of the ventilation interface, especially in more aggressive ventilation strategies, has not been systematically assessed.Methods: Ventilator settings and NIV compliance were assessed in this prospective cross-sectional monocentric cohort study of COPD patients with pre-existing NIV. Daytime ­arterialized blood gas analyses and lung function testing were also performed. The primary end point was the distribution among study patients of interfaces (full-face masks [FFMs] vs nasal masks [NMs] in a real-life setting.Results: The majority of the 123 patients studied used an FFM (77%, while 23% used an NM. Ventilation settings were as follows: mean ± standard deviation (SD inspiratory positive airway pressure (IPAP was 23.2±4.6 mbar and mean ± SD breathing rate was 16.7±2.4/minute. Pressure support ventilation (PSV mode was used in 52.8% of patients, while assisted pressure-controlled ventilation (aPCV was used in 47.2% of patients. Higher IPAP levels were associated with an increased use of FFMs (IPAP <21 mbar: 73% vs IPAP >25 mbar: 84%. Mean compliance was 6.5 hours/day, with no differences between FFM (6.4 hours/day and NM (6.7 hours/day users. PaCO2 assessment of ventilation quality revealed

  17. Mine ventilation engineering

    Energy Technology Data Exchange (ETDEWEB)

    Hall, C.J.

    1981-01-01

    This book on mine ventilation covers psychometrics, airflow through roadways and ducts, natural ventilation, fans, instruments, ventilation surveys, auxiliary ventilation, air quality, and planning and economics.

  18. Home

    Science.gov (United States)

    AF Branding & Trademark Licensing Join the Air Force Home About Us The Air Force Symbol Display Resources Document Library TM Connect Search AF Branding and Trademark Licensing Program: important links Legal Documents 10 U.S.C. § 2260 15 U.S.C. § 167;167; 1114-1125 DODI 5535.12, DoD Branding and

  19. Home

    Science.gov (United States)

    intersect as Attack Wing leaders change roles The 112th COS postured as cyber shield for Pa. infrastructure 111th Attack Wing 111th Attack Wing 21st Century Guard Airmen Home News Photos Art Video Resources - The Balance Search 111th Attack Wing: COMMUNITY/ENVIRO May 16, 2018; Pa. Department of Health update

  20. Noninvasive ventilation.

    Science.gov (United States)

    Rabatin, J T; Gay, P C

    1999-08-01

    Noninvasive ventilation refers to the delivery of assisted ventilatory support without the use of an endotracheal tube. Noninvasive positive pressure ventilation (NPPV) can be delivered by using a volume-controlled ventilator, a pressure-controlled ventilator, a bilevel positive airway pressure ventilator, or a continuous positive airway pressure device. During the past decade, there has been a resurgence in the use of noninvasive ventilation, fueled by advances in technology and clinical trials evaluating its use. Several manufacturers produce portable devices that are simple to operate. This review describes the equipment, techniques, and complications associated with NPPV and also the indications for both short-term and long-term applications. NPPV clearly represents an important addition to the techniques available to manage patients with respiratory failure. Future clinical trials evaluating its many clinical applications will help to define populations of patients most apt to benefit from this type of treatment.

  1. Diurnal and seasonal variation in air exchange rates and interzonal flows measured by active tracer gas in five Danish homes

    DEFF Research Database (Denmark)

    Clausen, Geo; Bekö, Gabriel; Toftum, Jørn

    2016-01-01

    We measured the air exchange rates (AER) in up to six rooms in five naturally ventilated dwellings across four seasons using active tracer gas. Night time AER was also estimated in all bedrooms based on occupant-generated CO2. Additionally, we studied the pollutant distribution across the dwellin...

  2. 78 FR 41013 - Medicare and Medicaid Programs; Home Health Prospective Payment System Rate Update for CY 2014...

    Science.gov (United States)

    2013-07-09

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 431 [CMS-1450-CN] RIN 0938-AR52 Medicare and Medicaid Programs; Home Health Prospective Payment System Rate... period titled ``Medicare and Medicaid Programs; Home Health Prospective Payment System Rate Update for CY...

  3. Induced radioactivity in air-estimation of ventilation rates at the vault and experimental areas of the proposed K-500 superconducting cyclotron, Calcutta

    International Nuclear Information System (INIS)

    Ravishankar, R.

    1999-01-01

    Guidelines are given for the necessary ventilation rates in vault and experimental areas from radiological safety point of view, for the proposed K-500 super-conducting cyclotron at Calcutta. A method is presented for estimating the amount of short lived radioisotopes like 13 N and 15 O taking the (n,2n) mode of productions. Considering the operating conditions of K-500 machine for the production of maximum neutron flux (300 MeV, 50pnA Li beam on Ta target) the energy differential neutron flux and the energy differential production cross section of 13 N and 15 O have been generated using ALICE-91 computer code. The differential cross sections have been folded with radial neutron flux distribution and then integrated over the entire volume of the cyclotron vault, to obtain the total production of the two radioactive gases. The DAC values have been obtained by considering the immersion dose in a semi-infinite hemispherical cloud. Natural decay and removal due to ventilation have been considered to get the recommended ventilation rates. (author)

  4. A comparison between tracer gas and aerosol particles distribution indoors: The impact of ventilation rate, interaction of airflows, and presence of objects

    DEFF Research Database (Denmark)

    Bivolarova, Mariya Petrova; Ondráček, Jakub; Melikov, Arsen Krikor

    2017-01-01

    for the exposure to all different-sized test particles. A change in the ventilation rate did not affect the difference in concentration distribution between tracer gas and larger particle sizes. Increasing the room surface area did not influence the similarity in the dispersion of the aerosol particles...... room with mixing ventilation. Three layouts were arranged: an empty room, an office room with an occupant sitting in front of a table, and a single-bed hospital room. The room occupant was simulated by a thermal manikin. Monodisperse particles of three sizes (0.07, 0.7, and 3.5 μm) and nitrous oxide...... tracer gas were generated simultaneously at the same location in the room. The particles and gas concentrations were measured in the bulk room air, in the breathing zone of the manikin, and in the exhaust air. Within the breathing zone of the sitting occupant, the tracer gas emerged as reliable predictor...

  5. Displacement Ventilation

    DEFF Research Database (Denmark)

    Nielsen, Peter Vilhelm

    Displacement ventilation is an interesting new type of air distribution principle which should be considered in connection with design of comfort ventilation in both smal1 and large spaces. Research activities on displacement ventilation are large all over the world and new knowledge of design...... methods appears continuously. This book gives an easy introduction to the basis of displacement ventilation and the chapters are written in the order which is used in a design procedure. The main text is extended by five appendices which show some of the new research activities taking place at Aalborg...

  6. Demand Controlled Ventilation and Classroom Ventilation

    Energy Technology Data Exchange (ETDEWEB)

    Fisk, William J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Mendell, Mark J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Davies, Molly [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Eliseeva, Ekaterina [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Faulkner, David [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hong, Tienzen [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sullivan, Douglas P. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2012-05-01

    This document summarizes a research effort on demand controlled ventilation and classroom ventilation. The research on demand controlled ventilation included field studies and building energy modeling.

  7. Demand controlled ventilation and classroom ventilation

    Energy Technology Data Exchange (ETDEWEB)

    Fisk, William J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Mendell, Mark J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Davies, Molly [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Eliseeva, Ekaterina [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Faulkner, David [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hong, Tienzen [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sullivan, Douglas P. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2014-01-06

    This document summarizes a research effort on demand controlled ventilation and classroom ventilation. The research on demand controlled ventilation included field studies and building energy modeling.

  8. Equivalence in Ventilation and Indoor Air Quality

    Energy Technology Data Exchange (ETDEWEB)

    Sherman, Max; Walker, Iain; Logue, Jennifer

    2011-08-01

    We ventilate buildings to provide acceptable indoor air quality (IAQ). Ventilation standards (such as American Society of Heating, Refrigerating, and Air-Conditioning Enginners [ASHRAE] Standard 62) specify minimum ventilation rates without taking into account the impact of those rates on IAQ. Innovative ventilation management is often a desirable element of reducing energy consumption or improving IAQ or comfort. Variable ventilation is one innovative strategy. To use variable ventilation in a way that meets standards, it is necessary to have a method for determining equivalence in terms of either ventilation or indoor air quality. This study develops methods to calculate either equivalent ventilation or equivalent IAQ. We demonstrate that equivalent ventilation can be used as the basis for dynamic ventilation control, reducing peak load and infiltration of outdoor contaminants. We also show that equivalent IAQ could allow some contaminants to exceed current standards if other contaminants are more stringently controlled.

  9. Medicaid payment rates, case-mix reimbursement, and nursing home staffing--1996-2004.

    Science.gov (United States)

    Feng, Zhanlian; Grabowski, David C; Intrator, Orna; Zinn, Jacqueline; Mor, Vincent

    2008-01-01

    We examined the impact of state Medicaid payment rates and case-mix reimbursement on direct care staffing levels in US nursing homes. We used a recent time series of national nursing home data from the Online Survey Certification and Reporting system for 1996-2004, merged with annual state Medicaid payment rates and case-mix reimbursement information. A 5-category response measure of total staffing levels was defined according to expert recommended thresholds, and examined in a multinomial logistic regression model. Facility fixed-effects models were estimated separately for Registered Nurse (RN), Licensed Practical Nurse (LPN), and Certified Nurse Aide (CNA) staffing levels measured as average hours per resident day. Higher Medicaid payment rates were associated with increases in total staffing levels to meet a higher recommended threshold. However, these gains in overall staffing were accompanied by a reduction of RN staffing and an increase in both LPN and CNA staffing levels. Under case-mix reimbursement, the likelihood of nursing homes achieving higher recommended staffing thresholds decreased, as did levels of professional staffing. Independent of the effects of state, market, and facility characteristics, there was a significant downward trend in RN staffing and an upward trend in both LPN and CNA staffing. Although overall staffing may increase in response to more generous Medicaid reimbursement, it may not translate into improvements in the skill mix of staff. Adjusting for reimbursement levels and resident acuity, total staffing has not increased after the implementation of case-mix reimbursement.

  10. Behovstyret ventilation

    DEFF Research Database (Denmark)

    Afshari, Alireza; Heiselberg, Per; Reinhold, Claus

    2010-01-01

    I en nylig afsluttet undersøgelse er der udført en række målinger på otte udvalgte børneinstitutioner. Fire af disse med mekanisk ventilation og fire med naturlig ventilation. Formålet er at udvide den erfaringsbaserede viden om funktionen af naturlige og mekaniske ventilationsløsninger i...

  11. Ventilation Model

    International Nuclear Information System (INIS)

    Yang, H.

    1999-01-01

    The purpose of this analysis and model report (AMR) for the Ventilation Model is to analyze the effects of pre-closure continuous ventilation in the Engineered Barrier System (EBS) emplacement drifts and provide heat removal data to support EBS design. It will also provide input data (initial conditions, and time varying boundary conditions) for the EBS post-closure performance assessment and the EBS Water Distribution and Removal Process Model. The objective of the analysis is to develop, describe, and apply calculation methods and models that can be used to predict thermal conditions within emplacement drifts under forced ventilation during the pre-closure period. The scope of this analysis includes: (1) Provide a general description of effects and heat transfer process of emplacement drift ventilation. (2) Develop a modeling approach to simulate the impacts of pre-closure ventilation on the thermal conditions in emplacement drifts. (3) Identify and document inputs to be used for modeling emplacement ventilation. (4) Perform calculations of temperatures and heat removal in the emplacement drift. (5) Address general considerations of the effect of water/moisture removal by ventilation on the repository thermal conditions. The numerical modeling in this document will be limited to heat-only modeling and calculations. Only a preliminary assessment of the heat/moisture ventilation effects and modeling method will be performed in this revision. Modeling of moisture effects on heat removal and emplacement drift temperature may be performed in the future

  12. Demand controlled ventilation in a bathroom

    DEFF Research Database (Denmark)

    Mortensen, Dorthe Kragsig; Nielsen, Toke Rammer; Topp, Claus

    2008-01-01

    consumption during periods where the demand for ventilation is low and poor indoor climate during periods where the demand for ventilation is high. Controlling the ventilation rate by demand can improve the energy performance of the ventilation system and the indoor climate. This paper compares the indoor...... climate and energy consumption of a Constant Air Volume (CAV) system and a Demand Controlled Ventilation (DCV) system for two different bathroom designs. The air change rate of the CAV system corresponded to 0.5h-1. The ventilation rate of the DCV system was controlled by occupancy and by the relative...

  13. Liquid Ventilation

    Directory of Open Access Journals (Sweden)

    Qutaiba A. Tawfic

    2011-01-01

    Full Text Available Mammals have lungs to breathe air and they have no gills to breath liquids. When the surface tension at the air-liquid interface of the lung increases, as in acute lung injury, scientists started to think about filling the lung with fluid instead of air to reduce the surface tension and facilitate ventilation. Liquid ventilation (LV is a technique of mechanical ventilation in which the lungs are insufflated with an oxygenated perfluorochemical liquid rather than an oxygen-containing gas mixture. The use of perfluorochemicals, rather than nitrogen, as the inert carrier of oxygen and carbon dioxide offers a number of theoretical advantages for the treatment of acute lung injury. In addition, there are non-respiratory applications with expanding potential including pulmonary drug delivery and radiographic imaging. The potential for multiple clinical applications for liquid-assisted ventilation will be clarified and optimized in future. Keywords: Liquid ventilation; perfluorochemicals; perfluorocarbon; respiratory distress; surfactant.

  14. Ventilative Cooling

    DEFF Research Database (Denmark)

    Heiselberg, Per Kvols; Kolokotroni, Maria

    This report, by venticool, summarises the outcome of the work of the initial working phase of IEA ECB Annex 62 Ventilative Cooling and is based on the findings in the participating countries. It presents a summary of the first official Annex 62 report that describes the state-of-the-art of ventil......This report, by venticool, summarises the outcome of the work of the initial working phase of IEA ECB Annex 62 Ventilative Cooling and is based on the findings in the participating countries. It presents a summary of the first official Annex 62 report that describes the state......-of-the-art of ventilative cooling potentials and limitations, its consideration in current energy performance regulations, available building components and control strategies and analysis methods and tools. In addition, the report provides twenty six examples of operational buildings using ventilative cooling ranging from...

  15. Pilot States Program report: Home energy ratings systems and energy-efficient mortgages

    Energy Technology Data Exchange (ETDEWEB)

    Farhar, B.

    2000-04-04

    This report covers the accomplishments of the home energy ratings systems/energy-efficient mortgages (HERS/EEMs) pilot states from 1993 through 1998, including such indicators as funding, ratings and EEMs achieved, active raters, and training and marketing activities. A brief description of each HERS program's evolution is included, as well as their directors' views of the programs' future prospects. Finally, an analysis is provided of successful HERS program characteristics and factors that appear to contribute to HERS program success.

  16. National status report: Home energy rating systems and energy-efficient mortgages

    Energy Technology Data Exchange (ETDEWEB)

    Plympton, P.

    2000-04-27

    The Energy Policy Act of 1992 included several provisions promoting the use of HERS and EEMs, which strengthened efforts to develop a national infrastructure for HERS and to promote the use of EEMs. This report documents HERS and EEMs activities since 1992 by the U.S. Department of Energy, the U.S. Environmental Protection Agency, the U.S. Department of Housing and Urban Development, mortgage lenders, and other organizations. Though the process of establishing HERS has faced some barriers, this report shows that, as of November 1999, home energy ratings were available in 47 states and the District of Columbia, which represents a significant increase from 1993 when home energy ratings were available in 17 states. Both national and state organizations have developed HERS and related residential energy-efficiency programs. The availability and use of EEMs has also increased significantly. The number of EEMs supported by the Federal Housing Administration has increased more than eight times in the last three years. More than $2.5 billion in federally supported EEMs have been issued to date. Several national lenders offer EEMs, and six states have state-specific EEM or loan programs. EEMs have been used to finance energy-efficient homes in every state.

  17. ASHRAE and residential ventilation

    Energy Technology Data Exchange (ETDEWEB)

    Sherman, Max H.

    2003-10-01

    In the last quarter of a century, the western world has become increasingly aware of environmental threats to health and safety. During this period, people psychologically retreated away from outdoors hazards such as pesticides, smog, lead, oil spills, and dioxin to the seeming security of their homes. However, the indoor environment may not be healthier than the outdoor environment, as has become more apparent over the past few years with issues such as mold, formaldehyde, and sick-building syndrome. While the built human environment has changed substantially over the past 10,000 years, human biology has not; poor indoor air quality creates health risks and can be uncomfortable. The human race has found, over time, that it is essential to manage the indoor environments of their homes. ASHRAE has long been in the business of ventilation, but most of the focus of that effort has been in the area of commercial and institutional buildings. Residential ventilation was traditionally not a major concern because it was felt that, between operable windows and envelope leakage, people were getting enough outside air in their homes. In the quarter of a century since the first oil shock, houses have gotten much more energy efficient. At the same time, the kinds of materials and functions in houses changed in character in response to people's needs. People became more environmentally conscious and aware not only about the resources they were consuming but about the environment in which they lived. All of these factors contributed to an increasing level of public concern about residential indoor air quality and ventilation. Where once there was an easy feeling about the residential indoor environment, there is now a desire to define levels of acceptability and performance. Many institutions--both public and private--have interests in Indoor Air Quality (IAQ), but ASHRAE, as the professional society that has had ventilation as part of its mission for over 100 years, is the

  18. Estimation of time-varying pollutant emission rates in a ventilated enclosure: inversion of a reduced model obtained by experimental application of the modal identification method

    International Nuclear Information System (INIS)

    Girault, M; Maillet, D; Bonthoux, F; Galland, B; Martin, P; Braconnier, R; Fontaine, J R

    2008-01-01

    A method is proposed for the estimation of time-varying emission rates of pollutant sources in a ventilated enclosure, through the resolution of an inverse forced convection problem. Unsteady transport–diffusion of the pollutant is considered, with the assumption of a stationary velocity field remaining unchanged during emission (passive contaminant). The pollutant transport equation is therefore linear with respect to concentration. The source's location is also supposed to be known. As the first step, a reduced model (RM) linking concentrations at a set of control points to emission rates of sources is identified from experimental data by using the modal identification method (MIM). This parameter estimation problem uses transient contaminant concentration measurements made at control points inside the ventilated enclosure, corresponding to increasing and decreasing steps of emission rates. Such experimental modelling allows us to avoid dealing with a CFD code involving turbulence modelling and to get rid of uncertainties about sensors position. In a second step, the identified RM is used to solve an inverse forced convection problem: from contaminant concentration measured at the same control points, rates of sources emitting simultaneously are estimated with a sequential in time algorithm using future time steps

  19. Parental Perceptions of Child Care Quality in Centre-Based and Home-Based Settings: Associations with External Quality Ratings

    Science.gov (United States)

    Lehrer, Joanne S.; Lemay, Lise; Bigras, Nathalie

    2015-01-01

    The current study examined how parental perceptions of child care quality were related to external quality ratings and considered how parental perceptions of quality varied according to child care context (home-based or centre-based settings). Parents of 179 4-year-old children who attended child care centres (n = 141) and home-based settings…

  20. Performance evaluation of ventilation radiators

    International Nuclear Information System (INIS)

    Myhren, Jonn Are; Holmberg, Sture

    2013-01-01

    A ventilation radiator is a combined ventilation and heat emission unit currently of interest due to its potential for increasing energy efficiency in exhaust-ventilated buildings with warm water heating. This paper presents results of performance tests of several ventilation radiator models conducted under controlled laboratory conditions. The purpose of the study was to validate results achieved by Computational Fluid Dynamics (CFD) in an earlier study and identify possible improvements in the performance of such systems. The main focus was on heat transfer from internal convection fins, but comfort and health aspects related to ventilation rates and air temperatures were also considered. The general results from the CFD simulations were confirmed; the heat output of ventilation radiators may be improved by at least 20% without sacrificing ventilation efficiency or thermal comfort. Improved thermal efficiency of ventilation radiators allows a lower supply water temperature and energy savings both for heating up and distribution of warm water in heat pumps or district heating systems. A secondary benefit is that a high ventilation rate can be maintained all year around without risk for cold draught. -- Highlights: ► Low temperature heat emitters are currently of interest due to their potential for increasing energy efficiency. ► A ventilation radiator is a combined ventilation and heat emission unit which can be adapted to low temperature heating systems. ► We examine how ventilation radiators can be made to be more efficient in terms of energy consumption and thermal comfort. ► Current work focuses on heat transfer mechanisms and convection fin configuration of ventilation radiators

  1. Characteristics of visiting nurse agencies with high home death rates: A prefecture-wide study in Japan.

    Science.gov (United States)

    Kashiwagi, Masayo; Tamiya, Nanako; Murata, Masako

    2015-08-01

    The purpose of the present study was to identify characteristics of visiting nurse agencies (VNA) in Japan with high home death rates by a prefecture-wide survey. A cross-sectional study of visiting nurse agencies (n = 101) in Ibaraki Prefecture, Japan, was completed. Data included the basic characteristics of each VNA, the type of services provided, level of coordination with other service providers, total number of VNA patients who died per year and place of death and contractual relationship with home-care supporting clinics providing end-of-life care services in the home 24 h a day. The VNA characteristics were analyzed by logistic regression, using the home death rate per VNA as a dependent variable. A total 69 agencies, excluding those that did not report number of deaths (n = 14) and those without deaths during the year (n = 6), were analyzed. The median home death rate of the 69 VNA was 29.8%. The results of logistic regression analysis showed that higher home death rate was significantly associated with lack of attachment to a hospital, existence of a contractual relationship with home-care supporting clinics and existence of an interactive information exchange through telephone/face-to-face communication with attending physicians. In order to increase the home death rate of people using VNA, policymakers must consider establishing home-based service systems within the community that can provide home end-of-life care services 24 h a day, and support the interactive exchange of information between the visiting nurse and the attending physician. © 2014 The Authors. Geriatrics & Gerontology International published by Wiley Publishing Asia Pty Ltd on behalf of Japanese Geriatrics Society.

  2. Water requirements and drinking rates of homing pigeons: A consideration for exposure risk of migratory birds.

    Science.gov (United States)

    Perez, Cristina R; Moye, John K; Pritsos, Chris A

    2017-09-01

    Access to water along a bird's migratory flyway is essential during the vital process of migration. Because of the scarcity of water in some environments, there is potential for migratory birds to encounter and drink from contaminated bodies of water. Ingestion of contaminated water may cause injury and compromise flying ability, leading to a disruption of migration. To determine injury to birds from potential exposure, it is essential to know not only the concentration of a given contaminant in the water but also the quantity and rate of water consumption by the birds. Homing pigeons (Columba livia) were used in a series of experiments to determine differences in drinking behavior after various flights and after periods of resting. Results from the present study demonstrate that homing pigeons' water consumption is dramatically different when assessed according to activity, flight distance, and time elapsed after flight. This suggests that the drinking rates of birds during migration are extremely important and much greater than estimated using traditional exposure assessment procedures. Thus, exposure to contaminants via drinking water may be greatly underestimated, and the rate of water consumption should be considered when estimating potential exposure risk to avian species. Integr Environ Assess Manag 2017;13:870-876. © 2017 SETAC. © 2017 SETAC.

  3. Variations in hospitalization rates among nursing home residents: the role of discretionary hospitalizations.

    Science.gov (United States)

    Carter, Mary W

    2003-08-01

    To examine variations in hospitalization rates among nursing home residents associated with discretionary hospitalization practices. Quarterly Medicaid case-mix reimbursement data from the state of Massachusetts served as the core data source for this study, which was linked with data from the Medicare Provider Analysis and Review file (MEDPAR) to specify hospitalization status, nursing facility attribute data from the state of Massachusetts to specify facility-level organizational and structural attributes, and data from the Area Resource File (ARF) to specify area market-level attributes. Data spans three years (1991-1993) to produce a longitudinal analytical file containing 72,319 person-quarter-level observations. Two-step, multivariate logistic regression models were estimated for highly discretionary hospitalizations versus those containing less discretion, and low discretionary hospitalizations versus those containing greater amounts of physician discretion. Findings indicate that facility case-mix levels and area hospital bed supply levels contribute to variations in hospitalization rates among nursing home residents. Highly discretionary hospitalizations appear to be most sensitive to patient diagnoses best described as chronic, ambulatory care sensitive conditions. Findings suggest that defining hospitalizations simply in terms of whether an event occurs versus otherwise may obscure valuable information regarding the contribution of various risk factors to highly discretionary versus low discretionary hospitalization rates.

  4. Temperature of gas delivered from ventilators.

    Science.gov (United States)

    Chikata, Yusuke; Onodera, Mutsuo; Imanaka, Hideaki; Nishimura, Masaji

    2013-01-01

    Although heated humidifiers (HHs) are the most efficient humidifying device for mechanical ventilation, some HHs do not provide sufficient humidification when the inlet temperature to the water chamber is high. Because portable and home-care ventilators use turbines, blowers, pistons, or compressors to inhale in ambient air, they may have higher gas temperature than ventilators with piping systems. We carried out a bench study to investigate the temperature of gas delivered from portable and home-care ventilators, including the effects of distance from ventilator outlet, fraction of inspiratory oxygen (FIO2), and minute volume (MV). We evaluated five ventilators equipped with turbine, blower, piston, or compressor system. Ambient air temperature was adjusted to 24°C ± 0.5°C, and ventilation was set at FIO2 0.21, 0.6, and 1.0, at MV 5 and 10 L/min. We analyzed gas temperature at 0, 40, 80, and 120 cm from ventilator outlet and altered ventilator settings. While temperature varied according to ventilators, the outlet gas temperature of ventilators became stable after, at the most, 5 h. Gas temperature was 34.3°C ± 3.9°C at the ventilator outlet, 29.5°C ± 2.2°C after 40 cm, 25.4°C ± 1.2°C after 80 cm and 25.1°C ± 1.2°C after 120 cm (P < 0.01). FIO2 and MV did not affect gas temperature. Gas delivered from portable and home-care ventilator was not too hot to induce heated humidifier malfunctioning. Gas soon declined when passing through the limb.

  5. Pretest Predictions for Ventilation Tests

    International Nuclear Information System (INIS)

    Y. Sun; H. Yang; H.N. Kalia

    2007-01-01

    The objective of this calculation is to predict the temperatures of the ventilating air, waste package surface, concrete pipe walls, and insulation that will be developed during the ventilation tests involving various test conditions. The results will be used as input to the following three areas: (1) Decisions regarding testing set-up and performance. (2) Assessing how best to scale the test phenomena measured. (3) Validating numerical approach for modeling continuous ventilation. The scope of the calculation is to identify the physical mechanisms and parameters related to thermal response in the ventilation tests, and develop and describe numerical methods that can be used to calculate the effects of continuous ventilation. Sensitivity studies to assess the impact of variation of linear power densities (linear heat loads) and ventilation air flow rates are included. The calculation is limited to thermal effect only

  6. Ventilator-associated pneumonia: the influence of bacterial resistance, prescription errors, and de-escalation of antimicrobial therapy on mortality rates

    Directory of Open Access Journals (Sweden)

    Ana Carolina Souza-Oliveira

    2016-09-01

    Conclusion: Prescription errors influenced mortality of patients with Ventilator-associated pneumonia, underscoring the challenge of proper Ventilator-associated pneumonia treatment, which requires continuous reevaluation to ensure that clinical response to therapy meets expectations.

  7. Energy-efficient mortgages and home energy rating systems: A report on the nation`s progress

    Energy Technology Data Exchange (ETDEWEB)

    Farhar, B.C.; Eckert, J.

    1993-09-01

    This report summarizes progress throughout the nation in establishing voluntary programs linking home energy rating systems (HERS) and energy-efficient mortgages (EEMs). These programs use methods for rating the energy efficiency of new and existing homes and predicting energy cost savings so lenders can factor in energy cost savings when underwriting mortgages. The programs also encourage lenders to finance cost-effective energy-efficiency improvements to existing homes with low-interest mortgages or other instruments. The money saved on utility bills over the long term can more than offset the cost of such energy-efficiency improvements. The National Collaborative on HERS and EEMs recommended that this report be prepared.

  8. Captive Reptile Mortality Rates in the Home and Implications for the Wildlife Trade.

    Science.gov (United States)

    Robinson, Janine E; St John, Freya A V; Griffiths, Richard A; Roberts, David L

    2015-01-01

    The trade in wildlife and keeping of exotic pets is subject to varying levels of national and international regulation and is a topic often attracting controversy. Reptiles are popular exotic pets and comprise a substantial component of the live animal trade. High mortality of traded animals raises welfare concerns, and also has implications for conservation if collection from the wild is required to meet demand. Mortality of reptiles can occur at any stage of the trade chain from collector to consumer. However, there is limited information on mortality rates of reptiles across trade chains, particularly amongst final consumers in the home. We investigated mortality rates of reptiles amongst consumers using a specialised technique for asking sensitive questions, additive Randomised Response Technique (aRRT), as well as direct questioning (DQ). Overall, 3.6% of snakes, chelonians and lizards died within one year of acquisition. Boas and pythons had the lowest reported mortality rates of 1.9% and chameleons had the highest at 28.2%. More than 97% of snakes, 87% of lizards and 69% of chelonians acquired by respondents over five years were reported to be captive bred and results suggest that mortality rates may be lowest for captive bred individuals. Estimates of mortality from aRRT and DQ did not differ significantly which is in line with our findings that respondents did not find questions about reptile mortality to be sensitive. This research suggests that captive reptile mortality in the home is rather low, and identifies those taxa where further effort could be made to reduce mortality rates.

  9. Captive Reptile Mortality Rates in the Home and Implications for the Wildlife Trade

    Science.gov (United States)

    Robinson, Janine E.; St. John, Freya A. V.; Griffiths, Richard A.; Roberts, David L.

    2015-01-01

    The trade in wildlife and keeping of exotic pets is subject to varying levels of national and international regulation and is a topic often attracting controversy. Reptiles are popular exotic pets and comprise a substantial component of the live animal trade. High mortality of traded animals raises welfare concerns, and also has implications for conservation if collection from the wild is required to meet demand. Mortality of reptiles can occur at any stage of the trade chain from collector to consumer. However, there is limited information on mortality rates of reptiles across trade chains, particularly amongst final consumers in the home. We investigated mortality rates of reptiles amongst consumers using a specialised technique for asking sensitive questions, additive Randomised Response Technique (aRRT), as well as direct questioning (DQ). Overall, 3.6% of snakes, chelonians and lizards died within one year of acquisition. Boas and pythons had the lowest reported mortality rates of 1.9% and chameleons had the highest at 28.2%. More than 97% of snakes, 87% of lizards and 69% of chelonians acquired by respondents over five years were reported to be captive bred and results suggest that mortality rates may be lowest for captive bred individuals. Estimates of mortality from aRRT and DQ did not differ significantly which is in line with our findings that respondents did not find questions about reptile mortality to be sensitive. This research suggests that captive reptile mortality in the home is rather low, and identifies those taxa where further effort could be made to reduce mortality rates. PMID:26556237

  10. Captive Reptile Mortality Rates in the Home and Implications for the Wildlife Trade.

    Directory of Open Access Journals (Sweden)

    Janine E Robinson

    Full Text Available The trade in wildlife and keeping of exotic pets is subject to varying levels of national and international regulation and is a topic often attracting controversy. Reptiles are popular exotic pets and comprise a substantial component of the live animal trade. High mortality of traded animals raises welfare concerns, and also has implications for conservation if collection from the wild is required to meet demand. Mortality of reptiles can occur at any stage of the trade chain from collector to consumer. However, there is limited information on mortality rates of reptiles across trade chains, particularly amongst final consumers in the home. We investigated mortality rates of reptiles amongst consumers using a specialised technique for asking sensitive questions, additive Randomised Response Technique (aRRT, as well as direct questioning (DQ. Overall, 3.6% of snakes, chelonians and lizards died within one year of acquisition. Boas and pythons had the lowest reported mortality rates of 1.9% and chameleons had the highest at 28.2%. More than 97% of snakes, 87% of lizards and 69% of chelonians acquired by respondents over five years were reported to be captive bred and results suggest that mortality rates may be lowest for captive bred individuals. Estimates of mortality from aRRT and DQ did not differ significantly which is in line with our findings that respondents did not find questions about reptile mortality to be sensitive. This research suggests that captive reptile mortality in the home is rather low, and identifies those taxa where further effort could be made to reduce mortality rates.

  11. Minimum ventilation rates as a function of the use and the frequency of use of rooms. Final report. Mindestluftwechsel in Abhaengigkeit von der Nutzungsart und -intensitaet. Schlussbericht

    Energy Technology Data Exchange (ETDEWEB)

    Wegner, J; Schlueter, G; Angerer, C; Meyer, H D

    1986-12-01

    From a hygienic view-point optimum indoor air quality can be characterized as the complete absence of pollutants. The most important sources of such pollutants are reviewed, amongst them those entering a room from outside, those generated by man and his activities and those emanating from different materials such as building materials, furnishing, cleansing and polishing agents. In view of achieving acceptable indoor conditions all emissions have to be kept as low as possible. Carbon dioxide and body odors as well as pollutants, the concentrations of which cannot be reduced to non-relevant levels by product control, should be eliminated by ventilation measures. However, such measures should not exceed a given limit, since in order to minimize energy consumption, air exchange rates have to be kept at a minimum. As a result of the investigations, it is concluded that the minimum ventilation rate should be derived from the acceptable CO/sub 2/ concentration. The concentrations of all other pollutants (e.g., formaldehyde) should be limited by product control or source removal. With 75 refs., 10 tabs., 19 figs.

  12. Air Distribution Effectiveness for Residential Mechanical Ventilation: Simulation and Comparison of Normalized Exposures

    Energy Technology Data Exchange (ETDEWEB)

    Petithuguenin, T.D.P.; Sherman, M.H.

    2009-05-01

    The purpose of ventilation is to dilute indoor contaminants that an occupant is exposed to. Even when providing the same nominal rate of outdoor air, different ventilation systems may distribute air in different ways, affecting occupants' exposure to household contaminants. Exposure ultimately depends on the home being considered, on source disposition and strength, on occupants' behavior, on the ventilation strategy, and on operation of forced air heating and cooling systems. In any multi-zone environment dilution rates and source strengths may be different in every zone and change in time, resulting in exposure being tied to occupancy patterns.This paper will report on simulations that compare ventilation systems by assessing their impact on exposure by examining common house geometries, contaminant generation profiles, and occupancy scenarios. These simulations take into account the unsteady, occupancy-tied aspect of ventilation such as bathroom and kitchen exhaust fans. As most US homes have central HVAC systems, the simulation results will be used to make appropriate recommendations and adjustments for distribution and mixing to residential ventilation standards such as ASHRAE Standard 62.2.This paper will report on work being done to model multizone airflow systems that are unsteady and elaborate the concept of distribution matrix. It will examine several metrics for evaluating the effect of air distribution on exposure to pollutants, based on previous work by Sherman et al. (2006).

  13. Home energy rating system business plan feasibility study in Washington state

    Energy Technology Data Exchange (ETDEWEB)

    Lineham, T.

    1995-03-01

    In the Fall of 1993, the Washington State Energy Office funded the Washington Home Energy Rating System project to investigate the benefits of a Washington state HERS. WSEO established a HERS and EEM Advisory Group. Composed of mortgage lenders/brokers, realtors, builders, utility staff, remodelers, and other state agency representatives, the Advisory Group met for the first time on November 17, 1993. The Advisory Group established several subcommittees to identify issues and options. During its March 1994 meeting, the Advisory Group formed a consensus directing WSEO to develop a HERS business plan for consideration. The Advisory Group also established a business plan subcommittee to help draft the plan. Under the guidance of the business plan subcommittee, WSEO conducted research on how customers value energy efficiency in the housing market. This plan represents WSEO`s effort to comply with the Advisory Group`s request. Why is a HERS Business Plan necessary? Strictly speaking this plan is more of a feasibility plan than a business plan since it is designed to help determine the feasibility of a new business venture: a statewide home energy rating system. To make this determination decision makers or possible investors require strategic information about the proposed enterprise. Ideally, the plan should anticipate the significant questions parties may want to know. Among other things, this document should establish decision points for action.

  14. Ventilation system design for educational facilities

    Energy Technology Data Exchange (ETDEWEB)

    Elsafty, A.F.; Abo Elazm, M.M. [Arab Academy for Science, Alexandria (Egypt). Technology and Maritime Transport; Safwan, M. [Arab Academy for Science, Cairo (Egypt). Technology and Maritime Transport

    2010-07-01

    In order to maintain acceptable indoor air quality levels in classrooms, high ventilation rates are needed to dilute the concentration of indoor contaminants, resulting in higher energy consumption for the operation of mechanical ventilation systems. Three factors are usually considered when determining the adequate ventilation rate for classrooms in educational facilities. These include the maximum population served in the classroom; carbon dioxide (CO{sub 2}) production rate by occupants; and outdoor air conditions. CO{sub 2} concentrations usually indicate the rate of ventilation required. This paper presented a newly developed computer software program for determining the ventilation rates needed to enhance indoor air quality and to maintain CO{sub 2} concentration within the recommended levels by ANSI/ASHRAE standards for best student performance. This paper also presented design curves for determining the ventilation rates and air changes per hour required for the ventilated educational zone. 15 refs., 2 tabs., 5 figs.

  15. Two-year home-based nocturnal noninvasive ventilation added to rehabilitation in chronic obstructive pulmonary disease patients : A randomized controlled trial

    NARCIS (Netherlands)

    Duiverman, Marieke L.; Wempe, Johan B.; Bladder, Gerrie; Vonk, Judith M.; Zijlstra, Jan G.; Kerstjens, Huib A. M.; Wijkstra, Peter J.

    2011-01-01

    Background: The use of noninvasive intermittent positive pressure ventilation (NIPPV) in chronic obstructive pulmonary disease (COPD) patients with chronic hypercapnic respiratory failure remains controversial as long-term data are almost lacking. The aim was to compare the outcome of 2-year

  16. 75 FR 41793 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2010-07-19

    ...] Lunch and Centers Breakfast supper \\1\\ Snack Contingous States: Paid 0.26 0.26 0.06 Reduced Price 1.18 2... adjustments to the national average payment rates for meals and snacks served in child care centers, outside... payment rates for meals and snacks served in day care homes; and the administrative reimbursement rates...

  17. Ventilation, indoor air quality, and human health and comfort in dwellings and day-care centers

    Energy Technology Data Exchange (ETDEWEB)

    Ruotsalainen, R.

    1995-12-31

    The objective of the study was to assess the actual ventilation and indoor air quality in the Finnish building stock (dwellings and day-care centers) with special reference to the existing guideline values. Furthermore, the objective was to evaluate the occurrence of symptoms and perceptions among occupants (adult residents, children, workers) in relation to ventilation system, ventilation rate and dampness. The measurements of ventilation and indoor air quality in the dwellings and day-care centers included ventilation rate, CO{sub 2} concentration, and temperature and humidity. Self- and parent-administered questionnaires were distributed to the occupants inquiring their personal characteristics, occurrence of symptoms of interest, perceived indoor air quality and details of their home and work environments. Airflows and air change rates varied remarkably both in the dwellings and day-care centers. In the majority of the dwellings and day-care centers, the Finnish guideline values of ventilation rates were not achieved. No consistent associations were observed between the magnitude of mechanical ventilation rates and the occurrence of eye, respiratory, skin and general symptoms, that is, symptoms of sick building syndrome (SBS) among the day-care workers. The results indicate that there is much room for improvement in the ventilation and indoor air quality of Finnish dwellings and day-care centers. The control of ventilation, temperature and humidity and the prevention of water damage are important issues on which to concentrate in the future. There is need to improve the quality in all phases of construction: design, installation, adjustment, operation, and maintenance

  18. Ventilation, indoor air quality, and human health and comfort in dwellings and day-care centers

    Energy Technology Data Exchange (ETDEWEB)

    Ruotsalainen, R

    1996-12-31

    The objective of the study was to assess the actual ventilation and indoor air quality in the Finnish building stock (dwellings and day-care centers) with special reference to the existing guideline values. Furthermore, the objective was to evaluate the occurrence of symptoms and perceptions among occupants (adult residents, children, workers) in relation to ventilation system, ventilation rate and dampness. The measurements of ventilation and indoor air quality in the dwellings and day-care centers included ventilation rate, CO{sub 2} concentration, and temperature and humidity. Self- and parent-administered questionnaires were distributed to the occupants inquiring their personal characteristics, occurrence of symptoms of interest, perceived indoor air quality and details of their home and work environments. Airflows and air change rates varied remarkably both in the dwellings and day-care centers. In the majority of the dwellings and day-care centers, the Finnish guideline values of ventilation rates were not achieved. No consistent associations were observed between the magnitude of mechanical ventilation rates and the occurrence of eye, respiratory, skin and general symptoms, that is, symptoms of sick building syndrome (SBS) among the day-care workers. The results indicate that there is much room for improvement in the ventilation and indoor air quality of Finnish dwellings and day-care centers. The control of ventilation, temperature and humidity and the prevention of water damage are important issues on which to concentrate in the future. There is need to improve the quality in all phases of construction: design, installation, adjustment, operation, and maintenance

  19. Liquid ventilation.

    Science.gov (United States)

    Sarkar, Suman; Paswan, Anil; Prakas, S

    2014-01-01

    Human have lungs to breathe air and they have no gills to breath liquids like fish. When the surface tension at the air-liquid interface of the lung increases as in acute lung injury, scientists started to think about filling the lung with fluid instead of air to reduce the surface tension and facilitate ventilation. Liquid ventilation (LV) is a technique of mechanical ventilation in which the lungs are insufflated with an oxygenated perfluorochemical liquid rather than an oxygen-containing gas mixture. The use of perfluorochemicals, rather than nitrogen as the inert carrier of oxygen and carbon dioxide offers a number of advantages for the treatment of acute lung injury. In addition, there are non-respiratory applications with expanding potential including pulmonary drug delivery and radiographic imaging. It is well-known that respiratory diseases are one of the most common causes of morbidity and mortality in intensive care unit. During the past few years several new modalities of treatment have been introduced. One of them and probably the most fascinating, is of LV. Partial LV, on which much of the existing research has concentrated, requires partial filling of lungs with perfluorocarbons (PFC's) and ventilation with gas tidal volumes using conventional mechanical ventilators. Various physico-chemical properties of PFC's make them the ideal media. It results in a dramatic improvement in lung compliance and oxygenation and decline in mean airway pressure and oxygen requirements. No long-term side-effect reported.

  20. Ventilator-associated pneumonia rates at major trauma centers compared with a national benchmark: a multi-institutional study of the AAST.

    Science.gov (United States)

    Michetti, Christopher P; Fakhry, Samir M; Ferguson, Pamela L; Cook, Alan; Moore, Forrest O; Gross, Ronald

    2012-05-01

    Ventilator-associated pneumonia (VAP) rates reported by the National Healthcare Safety Network (NHSN) are used as a benchmark and quality measure, yet different rates are reported from many trauma centers. This multi-institutional study was undertaken to elucidate VAP rates at major trauma centers. VAP rate/1,000 ventilator days, diagnostic methods, institutional, and aggregate patient data were collected retrospectively from a convenience sample of trauma centers for 2008 and 2009 and analyzed with descriptive statistics. At 47 participating Level I and II centers, the pooled mean VAP rate was 17.2 versus 8.1 for NHSN (2006-2008). Hospitals' rates were highly variable (range, 1.8-57.6), with 72.3% being above NHSN's mean. Rates differed based on who determined the rate (trauma service, 27.5; infection control or quality or epidemiology, 11.9; or collaborative effort, 19.9) and the frequency with which VAP was excluded based on aspiration or diagnosis before hospital day 5. In 2008 and 2009, blunt trauma patients had higher VAP rates (17.3 and 17.6, respectively) than penetrating patients (11.0 and 10.9, respectively). More centers used a clinical diagnostic strategy (57%) than a bacteriologic strategy (43%). Patients with VAP had a mean Injury Severity Score of 28.7, mean Intensive Care Unit length of stay of 20.8 days, and a 12.2% mortality rate. 50.5% of VAP patients had a traumatic brain injury. VAP rates at major trauma centers are markedly higher than those reported by NHSN and vary significantly among centers. Available data are insufficient to set benchmarks, because it is questionable whether any one data set is truly representative of most trauma centers. Application of a single benchmark to all centers may be inappropriate, and reliable diagnostic and reporting standards are needed. Prospective analysis of a larger data set is warranted, with attention to injury severity, risk factors specific to trauma patients, diagnostic method used, VAP definitions

  1. Personalized ventilation

    DEFF Research Database (Denmark)

    Melikov, Arsen Krikor

    2004-01-01

    microenvironment. Furthermore, HVAC systems should be designed to protect occupants from airborne transmission of infectious agents that may be present in exhaled air. Personalized ventilation is a new development in the field of HVAC and has the potential to fulfill the above requirements. This paper reviews...... existing knowledge on performance of personalized ventilation (PV) and on human response to it. The airflow interaction in the vicinity of the human body is analyzed and its impact on thermal comfort and inhaled air quality is discussed together with control strategies and the application of PV in practice...

  2. Planned home compared with planned hospital births: mode of delivery and Perinatal mortality rates, an observational study.

    Science.gov (United States)

    van der Kooy, Jacoba; Birnie, Erwin; Denktas, Semiha; Steegers, Eric A P; Bonsel, Gouke J

    2017-06-08

    To compare the mode of delivery between planned home versus planned hospital births and to determine if differences in intervention rates could be interpreted as over- or undertreatment. Intervention and perinatal mortality rates were obtained for 679,952 low-risk women from the Dutch Perinatal Registry (2000-2007). Intervention was defined as operative vaginal delivery and/or caesarean section. Perinatal mortality was defined as the intrapartum and early neonatal mortality rate up to 7 days postpartum. Besides adjustment for maternal and care factors, we included for additional casemix adjustment: presence of congenital abnormality, small for gestational age, preterm birth, or low Apgar score. The techniques used were nested multiple stepwise logistic regression, and stratified analysis for separate risk groups. An intention-to-treat like analysis was performed. The intervention rate was lower in planned home compared to planned hospital births (10.9% 95% CI 10.8-11.0 vs. 13.8% 95% CI 13.6-13.9). Intended place of birth had significant impact on the likelihood to intervene after adjustment (planned homebirth (OR 0.77 95% CI. 0.75-0.78)). The mortality rate was lower in planned home births (0.15% vs. 0.18%). After adjustment, the interaction term home- intervention was significant (OR1.51 95% CI 1.25-1.84). In risk groups, a higher perinatal mortality rate was observed in planned home births. The potential presence of over- or under treatment as expressed by adjusted perinatal mortality differs per risk group. In planned home births especially multiparous women showed universally lower intervention rates. However, the benefit of substantially fewer interventions in the planned home group seems to be counterbalanced by substantially increased mortality if intervention occurs.

  3. Evaluating Moisture Control of Variable-Capacity Heat Pumps in Mechanically Ventilated, Low-Load Homes in Climate Zone 2A

    Energy Technology Data Exchange (ETDEWEB)

    Eric Martin, Chuck Withers, Janet McIlvaine, Dave Chasar, and David Beal

    2018-03-29

    Low-load homes can present a challenge when selecting appropriate space-conditioning equipment. Conventional, fixed-capacity heating and cooling equipment is often oversized for small homes, causing increased first costs and operating costs. This report evaluates the performance of variable-capacity comfort systems, with a focus on inverter-driven, variable-capacity systems, as well as proposed system enhancements.

  4. The amazing Minivent ventilator

    African Journals Online (AJOL)

    Southern African Journal of Anaesthesia and Analgesia is co-published by Medpharm Publications, NISC (Pty) Ltd and Cogent, ... Respiratory rate was obtained by counting the clicking noise ... was appointed as a part-time lecturer to the University of the ... The Minivent became the first of three miniature ventilators that.

  5. Improved inhaled air quality at reduced ventilation rate by control of airflow interaction at the breathing zone with lobed jets

    DEFF Research Database (Denmark)

    Bolashikov, Zhecho Dimitrov; Melikov, Arsen Krikor; Spilak, Michal

    2014-01-01

    Inhaled air quality at a reduced supply of clean air was studied by controlling the airflow interaction at the breathing zone of a person using lobed jets as part of personalized ventilation (PV). Experiments were performed in a full-scale test room at 23°C (73.4°F) with a breathing thermal manikin...... seated at a workstation, with realistic free-convection flow around the body and a normal breathing cycle. The air in the room was mixed with tracer gas R134a. Clean air was supplied isothermally from three nozzles with circular, four-leafed clover, and six-edged star openings of 0.025 m (0.08 ft...... over the interaction between the inserted jets and the free convection flow was efficient. Over 80% clean PV air was measured in inhalation. The worst performing nozzle was the four-leafed clover: its best performance yielded 23% clean air inhalation, at the shortest distance and the highest velocity...

  6. Home telemonitoring of non-invasive ventilation decreases healthcare utilisation in a prospective controlled trial of patients with amyotrophic lateral sclerosis.

    Science.gov (United States)

    Pinto, Anabela; Almeida, José Pedro; Pinto, Susana; Pereira, João; Oliveira, António Gouveia; de Carvalho, Mamede

    2010-11-01

    Non-invasive ventilation (NIV) is an efficient method for treating respiratory failure in patients with amyotrophic lateral sclerosis (ALS). However, it requires a process of adaptation not always achieved due to poor compliance. The role of telemonitoring of NIV is not yet established. To test the advantage of using modem communication in NIV of ALS patients. Prospective, single blinded controlled trial. Population and methods According to their residence, 40 consecutive ventilated ALS patients were assigned to one of two groups: a control group (G1, n=20) in which compliance and ventilator parameter settings were assessed during office visits; or an intervention group (G2, n=20) in which patients received a modem device connected to the ventilator. The number of office and emergency room visits and hospital admissions during the entire span of NIV use and the number of parameter setting changes to achieve full compliance were the primary outcome measurements. Demographic and clinical features were similar between the two groups at admission. No difference in compliance was found between the groups. The incidence of changes in parameter settings throughout the survival period with NIV was lower in G2 (p<0.0001) but it was increased during the initial period needed to achieve full compliance. The number of office or emergency room visits and inhospital admissions was significantly lower in G2 (p<0.0001). Survival showed a trend favouring G2 (p=0.13). This study shows that telemonitoring reduces health care utilisation with probable favourable implications on costs, survival and functional status.

  7. Incidence Rates of and Mortality after Hip Fracture among German Nursing Home Residents

    Directory of Open Access Journals (Sweden)

    Hannes Jacobs

    2018-02-01

    Full Text Available Little is known about hip fracture rates and post-fracture mortality among nursing home residents. This retrospective cohort study examined incidence rates (IR of and mortality after hip fracture in this population focusing on sex differences. A cohort of >127,000 residents ≥65 years, newly admitted to German nursing homes between 2010 and 2014 were used to calculate age-, sex-, care-need- and time after admission-specific IR. To determine mortality, the Kaplan-Meier-method was applied. Using Cox regression, we studied mortality and estimated time-dependent hazard ratios (HRs. For this purpose, to each person with a hip fracture, one resident without a hip fracture was matched by sex, age and care-need using risk-set sampling. 75% were women (mean age: 84.0 years. During 168,588 person-years (PY, 8537 residents with at least one hip fracture were observed. The IR for women and men were 52.9 and 42.5/1000 PY. For both sexes, IR increased with rising age and decreased with increasing care-level. IR were highest in the first months after admission and subsequently declined afterwards. The impact of hip fractures on mortality was time-dependent. Mortality of residents with hip fracture was highest in the first two months after fracture compared to those without (HR: 2.82; 95% CI 2.57–3.11 and after six months, no differences were found (HR: 1.10; 95% CI 0.98–1.22 Further research should always include analyses stratified by sex, age and time period after admission.

  8. Solute kinetics with short-daily home hemodialysis using slow dialysate flow rate.

    Science.gov (United States)

    Kohn, Orly F; Coe, Fredric L; Ing, Todd S

    2010-01-01

    "NxStage System One()" is increasingly used for daily home hemodialysis. The ultrapure dialysate volumes are typically between 15 L and 30 L per dialysis, substantially smaller than the volumes used in conventional dialysis. In this study, the impact of the use of low dialysate volumes on the removal rates of solutes of different molecular weights and volumes of distribution was evaluated. Serum measurements before and after dialysis and total dialysate collection were performed over 30 times in 5 functionally anephric patients undergoing short-daily home hemodialysis (6 d/wk) over the course of 8 to 16 months. Measured solutes included beta(2) microglobulin (beta(2)M), phosphorus, urea nitrogen, and potassium. The average spent dialysate volume (dialysate plus ultrafiltrate) was 25.4+/-4.7 L and the dialysis duration was 175+/-15 min. beta(2) microglobulin clearance of the polyethersulfone dialyzer averaged 53+/-14 mL/min. Total beta(2)M recovered in the dialysate was 106+/-42 mg per treatment (n=38). Predialysis serum beta(2)M levels remained stable over the observation period. Phosphorus removal averaged 694+/-343 mg per treatment with a mean predialysis serum phosphorus of 5.2+/-1.8 mg/dL (n=34). Standard Kt/V averaged 2.5+/-0.3 per week and correlated with the dialysate-based weekly Kt/V. Weekly beta(2)M, phosphorus, and urea nitrogen removal in patients dialyzing 6 d/wk with these relatively low dialysate volumes compared favorably with values published for thrice weekly conventional and with short-daily hemodialysis performed with machines using much higher dialysate flow rates. Results of the present study were achieved, however, with an average of 17.5 hours of dialysis per week.

  9. Displacement Ventilation

    DEFF Research Database (Denmark)

    Bjørn, Erik; Mattsson, Magnus; Sandberg, Mats

    Full-scale experiments were made in a displacement ventilated room with two breathing thermal manikins to study the effect of movements and breathing on the vertical contaminant distribution, and on the personal exposure of occupants. Concentrations were measured with tracer gas equipment...

  10. Mixing Ventilation

    DEFF Research Database (Denmark)

    Kandzia, Claudia; Kosonen, Risto; Melikov, Arsen Krikor

    In this guidebook most of the known and used in practice methods for achieving mixing air distribution are discussed. Mixing ventilation has been applied to many different spaces providing fresh air and thermal comfort to the occupants. Today, a design engineer can choose from large selection...

  11. Intelligent ventilation in the intensive care unit

    Directory of Open Access Journals (Sweden)

    Sigal Sviri

    2012-08-01

    Full Text Available Objectives. Automated, microprocessor-controlled, closed-loop mechanical ventilation has been used in our Medical Intensive Care Unit (MICU at the Hadassah Hebrew-University Medical Center for the past 15 years; for 10 years it has been the primary (preferred ventilator modality. Design and setting. We describe our clinical experience with adaptive support ventilation (ASV over a 6-year period, during which time ASV-enabled ventilators became more readily available and were used as the primary (preferred ventilators for all patients admitted to the MICU. Results. During the study period, 1 220 patients were ventilated in the MICU. Most patients (84% were ventilated with ASV on admission. The median duration of ventilation with ASV was 6 days. The weaning success rate was 81%, and tracheostomy was required in 13%. Sixty-eight patients (6% with severe hypoxia and high inspiratory pressures were placed on pressure-controlled ventilation, in most cases to satisfy a technical requirement for precise and conservative administration of inhaled nitric oxide. The overall pneumothorax rate was less than 3%, and less than 1% of patients who were ventilated only using ASV developed pneumothorax. Conclusions. ASV is a safe and acceptable mode of ventilation for complicated medical patients, with a lower than usual ventilation complication rate.

  12. Planned home compared with planned hospital births: Mode of delivery and Perinatal mortality rates, an observational study

    NARCIS (Netherlands)

    Kooy, J. (Jacoba); E. Birnie (Erwin); S. Denktaş (Semiha); E.A.P. Steegers (Eric); G.J. Bonsel (Gouke)

    2017-01-01

    textabstractBackground: To compare the mode of delivery between planned home versus planned hospital births and to determine if differences in intervention rates could be interpreted as over- or undertreatment. Methods: Intervention and perinatal mortality rates were obtained for 679,952 low-risk

  13. Medicare and Medicaid Programs; CY 2018 Home Health Prospective Payment System Rate Update and CY 2019 Case-Mix Adjustment Methodology Refinements; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.

    Science.gov (United States)

    2017-11-07

    This final rule updates the home health prospective payment system (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor, effective for home health episodes of care ending on or after January 1, 2018. This rule also: Updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the third year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between calendar year (CY) 2012 and CY 2014; and discusses our efforts to monitor the potential impacts of the rebasing adjustments that were implemented in CY 2014 through CY 2017. In addition, this rule finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model and to the Home Health Quality Reporting Program (HH QRP). We are not finalizing the implementation of the Home Health Groupings Model (HHGM) in this final rule.

  14. Relationship between staff-reported culture change and occupancy rate and organizational commitment among nursing homes in South Korea.

    Science.gov (United States)

    Lee, Minhong; Choi, Jae-Sung; Lim, Jinseop; Kim, Young Sun

    2013-04-01

    This study aims to examine culture change in nursing homes in South Korea and to identify the outcomes of culture change implementation. Data were taken from survey responses from 223 top- or mid-level staff among nursing homes in South Korea that were selected through a proportionate random-stratified sampling method from four regions nationwide. Culture change in nursing homes was operationalized by five person-directed care (PDC) constructs and three organizational environment constructs, and outcome quality was indicated by changes to occupancy rate and organizational commitment. After controlling for facility characteristics, the effect of staff-reported culture change on occupancy rate and organizational commitment was analyzed through the multiple-regression method. Consistent with previous research, this study revealed positive effects of culture change for nursing homes in South Korea. The study found that staff-reported culture change correlated with occupancy rate and organizational commitment. Given that culture change variables were significantly related to occupancy rate and organizational commitment, the findings of the study provide a persuasive argument that policies and/or programs to support culture change in nursing homes should be enhanced. Management-level workers in these facilities should have the skills and knowledge to foster more PDC and a more person-directed environment.

  15. My eyes, your eyes--the relationship between CMS five-star rating of nursing homes and family rating of experience of care in Maryland.

    Science.gov (United States)

    Çalıkoğlu, Şule; Christmyer, Carol S; Kozlowski, Bruce U

    2012-01-01

    In 2008, the Centers for Medicaid and Medicare Services (CMS) launched the Five-Star Quality Rating System to help consumers compare nursing homes. The quality rating system consists of three domains: nursing home inspection results, staffing, and quality measures (QMs) and an overall rating calculated from the three domains. The Five-Star System has both advocates and detractors. One source of criticism about the rating system is its lack of input from consumer surveys. Although different dimensions of quality have been recognized as important by the experts and studied in the literature, how these dimensions are linked with each other is largely unknown. This article describes an analysis of the relationship between overall experience of care ratings from a family survey and ratings obtained on the CMS Five-Star Quality Rating for Maryland nursing homes. The results indicated a strong positive correlation between family experience of care score and two five-star domains, namely health inspections and nurse staffing, and no relationship with the quality domain. The lack of relationship between the quality domain and the family score may be due to inadequate risk adjustment or that each rating system measures different aspects of quality. © 2011 National Association for Healthcare Quality.

  16. Intrinsic positive end-expiratory pressure during one-lung ventilation of patients with pulmonary hyperinflation. Influence of low respiratory rate with unchanged minute volume.

    Science.gov (United States)

    Szegedi, L L; Barvais, L; Sokolow, Y; Yernault, J C; d'Hollander, A A

    2002-01-01

    We measured lung mechanics and gas exchange during one-lung ventilation (OLV) of patients with chronic obstructive pulmonary disease, using three respiratory rates (RR) and unchanged minute volume. We studied 15 patients about to undergo lung surgery, during anaesthesia, and placed in the lateral position. Ventilation was with constant minute volume, inspiratory flow and FIO2. For periods of 15 min, RR of 5, 10, and 15 bpm were applied in a random sequence and recordings were made of lung mechanics and an arterial blood gas sample was taken. Data were analysed with the repeated measures ANOVA and paired t-test with Bonferroni correction. PaO2 changes were not significant. At the lowest RR, PaCO2 decreased (from 42 (SD 4) mm Hg at RR 15-41 (4) mm Hg at RR 10 and 39 (4) mm Hg at RR 5, P<0.01), and end-tidal carbon dioxide increased (from 33 (5) mm Hg at RR 15 to 35 (5) mm Hg at RR 10 and 36 (6) mm Hg at RR 5, P<0.01). Intrinsic positive end-expiratory pressure (PEEPi) was reduced even with larger tidal volumes (from 6 (4) cm H2O at RR 15-5 (4) cm H2O at RR 10, and 3 (3) cm H2O at RR 5, P<0.01), most probably caused by increased expiratory time at the lowest RR. A reduction in RR reduces PEEPi and hypercapnia during OLV in anaesthetized patients with chronic obstructive lung disease.

  17. Modeling and Control of Livestock Ventilation Systems and Indoor Environments

    DEFF Research Database (Denmark)

    Wu, Zhuang; Heiselberg, Per; Stoustrup, Jakob

    2005-01-01

    The hybrid ventilation systems have been widely used for livestock barns to provide optimum indoor climate by controlling the ventilation rate and air flow distribution within the ventilated building structure. The purpose of this paper is to develop models for livestock ventilation systems and i...

  18. Thermal optimum for pikeperch (Sander lucioperca) and the use of ventilation frequency as a predictor of metabolic rate

    DEFF Research Database (Denmark)

    Frisk, Michael; Skov, Peter Vilhelm; Steffensen, John Fleng

    2012-01-01

    at six temperatures, ranging from 13 to 28 °C, in order to identify the temperature where pikeperch has the largest metabolic scope (MS). Between 13 and 25 °C, standard metabolic rates (SMR) increased as expected with a Q10=1.8 in response to increasing temperatures, while maximum metabolic rate (MMR...... consumption rate (M_ O2), during normoxia and progressive hypoxia. A strong correlation was found between fV and M_ O2 across all temperatures, and fV could predict M_ O2 with a high degree of accuracy in normoxia...

  19. Exposure to Exhaled Air from a Sick Occupant in a Two-Bed Hospital Room with Mixing Ventilation: Effect of Posture of Doctor and Air Change Rate

    DEFF Research Database (Denmark)

    Bolashikov, Zhecho Dimitrov; Melikov, Arsen Krikor; Barova, Mariya

    2013-01-01

    Full-scale measurements were performed in a climate chamber set as a two-bed hospital room, ventilated at 3, 6 and 12 ACH with overhead mixing ventilation. Air temperature was kept constant at 22 °C. Two breathing thermal manikins were used to mimic a sick patient lying on one side in one of the ...

  20. Computer program for sizing residential energy recovery ventilator

    International Nuclear Information System (INIS)

    Koontz, M.D.; Lee, S.M.; Spears, J.W.; Kesselring, J.P.

    1991-01-01

    Energy recovery ventilators offer the prospect of tighter control over residential ventilation rates than manual methods, such as opening windows, with a lesser energy penalty. However, the appropriate size of such a ventilator is not readily apparent in most situations. Sizing of energy recovery ventilation software was developed to calculate the size of ventilator necessary to satisfy ASHRAE Standard 62-1989, Ventilation for Acceptable Air Quality, or a user-specified air exchange rate. Inputs to the software include house location, structural characteristics, house operations and energy costs, ventilation characteristics, and HVAC system COP/efficiency. Based on these inputs, the program estimates the existing air exchange rate for the house, the ventilation rate required to meet the ASHRAE standard or user-specified air exchange rate, the size of the ventilator needed to meet the requirement, and the expected changes in indoor air quality and energy consumption. In this paper an illustrative application of the software is provided

  1. Balancing energy conservation and occupant needs in ventilation rate standards for Big Box stores and other commercial buildings in California. Issues related to the ASHRAE 62.1 Indoor Air Quality Procedure

    Energy Technology Data Exchange (ETDEWEB)

    Mendell, Mark J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Apte, Mike G. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2010-10-31

    This report considers the question of whether the California Energy Commission should incorporate the ASHRAE 62.1 ventilation standard into the Title 24 ventilation rate (VR) standards, thus allowing buildings to follow the Indoor Air Quality Procedure. This, in contrast to the current prescriptive standard, allows the option of using ventilation rate as one of several strategies, which might include source reduction and air cleaning, to meet specified targets of indoor air concentrations and occupant acceptability. The research findings reviewed in this report suggest that a revised approach to a ventilation standard for commercial buildings is necessary, because the current prescriptive ASHRAE 62.1 Ventilation Rate Procedure (VRP) apparently does not provide occupants with either sufficiently acceptable or sufficiently healthprotective air quality. One possible solution would be a dramatic increase in the minimum ventilation rates (VRs) prescribed by a VRP. This solution, however, is not feasible for at least three reasons: the current need to reduce energy use rather than increase it further, the problem of polluted outdoor air in many cities, and the apparent limited ability of increasing VRs to reduce all indoor airborne contaminants of concern (per Hodgson (2003)). Any feasible solution is thus likely to include methods of pollutant reduction other than increased outdoor air ventilation; e.g., source reduction or air cleaning. The alternative 62.1 Indoor Air Quality Procedure (IAQP) offers multiple possible benefits in this direction over the VRP, but seems too limited by insufficient specifications and inadequate available data to provide adequate protection for occupants. Ventilation system designers rarely choose to use it, finding it too arbitrary and requiring use of much non-engineering judgment and information that is not readily available. This report suggests strategies to revise the current ASHRAE IAQP to reduce its current limitations. These

  2. The effects of moderately raised classroom temperatures and classroom ventilation rate on the performance of schoolwork by children (RP-1257)

    DEFF Research Database (Denmark)

    Wargocki, Pawel; Wyon, David Peter

    2007-01-01

    Two independent field intervention experiments were carried out in school classrooms in late summer (in 2004 and 2005). The air temperature was manipulated by either operating or idling split cooling units installed for the purpose. In one of these experiments, the outdoor air supply rate was also...... series. The above improvements were mainly in terms of the speed at which tasks were performed, with negligible effects on error rate. Most school classrooms worldwide experience raised air temperatures during increased thermal loads, e.g., in warm weather; these results show that providing some means...

  3. The effect of somatic symptom attribution on the prevalence rate of depression and anxiety among nursing home patients

    NARCIS (Netherlands)

    Smalbrugge, M.; Pot, A.M.; Jongenelis, L.; Beekman, A.T.F.; Eefsting, J.A.

    2005-01-01

    The validity of diagnostic psychiatric instruments for depression and anxiety disorders may be compromised among patients with complex physical illness and disability. The objective of this study was to determine the effect on the prevalence rate of depression and anxiety in a nursing home

  4. Antipsychotic drug prescription rates among Dutch nursing homes : the influence of patient characteristics and the dementia special care unit

    NARCIS (Netherlands)

    van der Putten, M. J. G.; Wetzels, R. B.; Bor, H.; Zuidema, S. U.; Koopmans, R. T. C. M.

    2014-01-01

    Objectives: To assess the differences in antipsychotic drug prescription rates in residents with dementia in dementia special care units (SCUs) of Dutch nursing homes, considering the differences in patient characteristics. Method: As part of the Waalbed-II study, the data on antipsychotic drug use

  5. Healthy Efficient New Gas Homes (HENGH) Pilot Test Results

    Energy Technology Data Exchange (ETDEWEB)

    Chan, Wanyu R. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Maddalena, Randy L [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Stratton, Chris [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hotchi, Toshifumi [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Singer, Brett C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Walker, Iain S. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sherman, Max H. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2016-05-01

    The Healthy Efficient New Gas Homes (HENGH) is a field study that will collect data on ventilation systems and indoor air quality (IAQ) in new California homes that were built to 2008 Title 24 standards. A pilot test was performed to help inform the most time and cost effective approaches to measuring IAQ in the 100 test homes that will be recruited for this study. Two occupied, single-family detached homes built to 2008 Title 24 participated in the pilot test. One of the test homes uses exhaust-only ventilation provided by a continuous exhaust fan in the laundry room. The other home uses supply air for ventilation. Measurements of IAQ were collected for two weeks. Time-resolved concentrations of particulate matter (PM), nitrogen dioxide (NO2), carbon dioxide (CO2), carbon monoxide (CO), and formaldehyde were measured. Measurements of IAQ also included time-integrated concentrations of volatile organic compounds (VOCs), volatile aldehydes, and NO2. Three perfluorocarbon tracers (PFTs) were used to estimate the dilution rate of an indoor emitted air contaminant in the two pilot test homes. Diagnostic tests were performed to measure envelope air leakage, duct leakage, and airflow of range hood, exhaust fans, and clothes dryer vent when accessible. Occupant activities, such as cooking, use of range hood and exhaust fans, were monitored using various data loggers. This document describes results of the pilot test.

  6. 78 FR 45176 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2013-07-26

    ...This notice announces the annual adjustments to the national average payment rates for meals and snacks served in child care centers, outside-school-hours care centers, at-risk afterschool care centers, and adult day care centers; the food service payment rates for meals and snacks served in day care homes; and the administrative reimbursement rates for sponsoring organizations of day care homes, to reflect changes in the Consumer Price Index. Further adjustments are made to these rates to reflect the higher costs of providing meals in the States of Alaska and Hawaii. The adjustments contained in this notice are made on an annual basis each July, as required by the laws and regulations governing the Child and Adult Care Food Program.

  7. Optimal Chest Compression Rate and Compression to Ventilation Ratio in Delivery Room Resuscitation: Evidence from Newborn Piglets and Neonatal Manikins

    OpenAIRE

    Solev?g, Anne Lee; Schm?lzer, Georg M.

    2017-01-01

    Cardiopulmonary resuscitation (CPR) duration until return of spontaneous circulation (ROSC) influences survival and neurologic outcomes after delivery room (DR) CPR. High quality chest compressions (CC) improve cerebral and myocardial perfusion. Improved myocardial perfusion increases the likelihood of a faster ROSC. Thus, optimizing CC quality may improve outcomes both by preserving cerebral blood flow during CPR and by reducing the recovery time. CC quality is determined by rate, CC to vent...

  8. Medicare and Medicaid programs; CY 2015 Home Health Prospective Payment System rate update; Home Health Quality Reporting Requirements; and survey and enforcement requirements for home health agencies. Final rule.

    Science.gov (United States)

    2014-11-06

    This final rule updates Home Health Prospective Payment System (HH PPS) rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor under the Medicare prospective payment system for home health agencies (HHAs), effective for episodes ending on or after January 1, 2015. As required by the Affordable Care Act, this rule implements the second year of the four-year phase-in of the rebasing adjustments to the HH PPS payment rates. This rule provides information on our efforts to monitor the potential impacts of the rebasing adjustments and the Affordable Care Act mandated face-to-face encounter requirement. This rule also implements: Changes to simplify the face-to-face encounter regulatory requirements; changes to the HH PPS case-mix weights; changes to the home health quality reporting program requirements; changes to simplify the therapy reassessment timeframes; a revision to the Speech-Language Pathology (SLP) personnel qualifications; minor technical regulations text changes; and limitations on the reviewability of the civil monetary penalty provisions. Finally, this rule also discusses Medicare coverage of insulin injections under the HH PPS, the delay in the implementation of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), and a HH value-based purchasing (HH VBP) model.

  9. Summary of human responses to ventilation

    Energy Technology Data Exchange (ETDEWEB)

    Seppanen, Olli A.; Fisk, William J.

    2004-06-01

    The effects of ventilation on indoor air quality and health is a complex issue. It is known that ventilation is necessary to remove indoor generated pollutants from indoor air or dilute their concentration to acceptable levels. But, as the limit values of all pollutants are not known, the exact determination of required ventilation rates based on pollutant concentrations and associated risks is seldom possible. The selection of ventilation rates has to be based also on epidemiological research (e.g. Seppanen et al., 1999), laboratory and field experiments (e.g. CEN 1996, Wargocki et al., 2002a) and experience (e.g. ECA 2003). Ventilation may also have harmful effects on indoor air quality and climate if not properly designed, installed, maintained and operated as summarized by Seppdnen (2003). Ventilation may bring indoors harmful substances that deteriorate the indoor environment. Ventilation also affects air and moisture flow through the building envelope and may lead to moisture problems that deteriorate the structures of the building. Ventilation changes the pressure differences over the structures of building and may cause or prevent the infiltration of pollutants from structures or adjacent spaces. Ventilation is also in many cases used to control the thermal environment or humidity in buildings. Ventilation can be implemented with various methods which may also affect health (e.g. Seppdnen and Fisk, 2002, Wargocki et al., 2002a). In non residential buildings and hot climates, ventilation is often integrated with air-conditioning which makes the operation of ventilation system more complex. As ventilation is used for many purposes its health effects are also various and complex. This paper summarizes the current knowledge on positive and negative effects of ventilation on health and other human responses. The focus of the paper is on office-type working environment and residential buildings. In the industrial premises the problems of air quality are usually

  10. Paradoxical Acinetobacter-associated ventilator-associated pneumonia incidence rates within prevention studies using respiratory tract applications of topical polymyxin: benchmarking the evidence base.

    Science.gov (United States)

    Hurley, J C

    2018-04-10

    Regimens containing topical polymyxin appear to be more effective in preventing ventilator-associated pneumonia (VAP) than other methods. To benchmark the incidence rates of Acinetobacter-associated VAP (AAVAP) within component (control and intervention) groups from concurrent controlled studies of polymyxin compared with studies of various VAP prevention methods other than polymyxin (non-polymyxin studies). An AAVAP benchmark was derived using data from 77 observational groups without any VAP prevention method under study. Data from 41 non-polymyxin studies provided additional points of reference. The benchmarking was undertaken by meta-regression using generalized estimating equation methods. Within 20 studies of topical polymyxin, the mean AAVAP was 4.6% [95% confidence interval (CI) 3.0-6.9] and 3.7% (95% CI 2.0-5.3) for control and intervention groups, respectively. In contrast, the AAVAP benchmark was 1.5% (95% CI 1.2-2.0). In the AAVAP meta-regression model, group origin from a trauma intensive care unit (+0.55; +0.16 to +0.94, P = 0.006) or membership of a polymyxin control group (+0.64; +0.21 to +1.31, P = 0.023), but not membership of a polymyxin intervention group (+0.24; -0.37 to +0.84, P = 0.45), were significant positive correlates. The mean incidence of AAVAP within the control groups of studies of topical polymyxin is more than double the benchmark, whereas the incidence rates within the groups of non-polymyxin studies and, paradoxically, polymyxin intervention groups are more similar to the benchmark. These incidence rates, which are paradoxical in the context of an apparent effect against VAP within controlled trials of topical polymyxin-based interventions, force a re-appraisal. Copyright © 2018 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  11. Evaluation of an ultraviolet room disinfection protocol to decrease nursing home microbial burden, infection and hospitalization rates.

    Science.gov (United States)

    Kovach, Christine R; Taneli, Yavuz; Neiman, Tammy; Dyer, Elaine M; Arzaga, Alvin Jason A; Kelber, Sheryl T

    2017-03-03

    The focus of nursing home infection control procedures has been on decreasing transmission between healthcare workers and residents. Less evidence is available regarding whether decontamination of high-touch environmental surfaces impacts infection rates or resident outcomes. The purpose of this study was to examine if ultraviolet disinfection is associated with changes in: 1) microbial counts and adenosine triphosphate counts on high-touch surfaces; and 2) facility wide nursing home acquired infection rates, and infection-related hospitalization. The study was conducted in one 160-bed long-term care facility. Following discharge of each resident, their room was cleaned and then disinfected using a newly acquired ultraviolet light disinfection device. Shared living spaces received weekly ultraviolet light disinfection. Thirty-six months of pretest infection and hospitalization data were compared with 12 months of posttest data. Pre and posttest cultures were taken from high-touch surfaces, and luminometer readings of adenosine triphosphate were done. Nursing home acquired infection rates were analyzed relative to hospital acquired infection rates using analysis of variance procedures. Wilcoxon signed rank tests, The Cochran's Q, and Chi Square were also used. There were statistically significant decreases in adenosine triphosphate readings on all high-touch surfaces after cleaning and disinfection. Culture results were positive for gram-positive cocci or rods on 33% (n = 30) of the 90 surfaces swabbed at baseline. After disinfectant cleaning, 6 of 90 samples (7.1%) tested positive for a gram-positive bacilli, and after ultraviolet disinfection 4 of the 90 samples (4.4%) were positive. There were significant decreases in nursing home acquired relative to hospital-acquired infection rates for the total infections (p = .004), urinary tract infection rates (p = .014), respiratory system infection rates (p = .017) and for rates of infection of the skin

  12. The influence of the cigarette smoke pollution and ventilation rate on alpha-activities per unit volume due to radon and its progeny

    International Nuclear Information System (INIS)

    Misdaq, M.A.; Flata, K.

    2003-01-01

    Alpha and beta activities per unit volume air due to radon, thoron and their decay products were evaluated in the air of various cafe rooms polluted by cigarette smoke. Both CR-39 and LR-115 type II solid state nuclear track detectors (SSNTD) were used. Equilibrium factors between radon and its progeny and thoron and its daughters have been evaluated in the air of the studied cafe rooms. The committed equivalent doses due to short-lived radon decay products were determined in different regions of the respiratory tract of non-smoker members of the public. The influence of cigarette smoke pollution, ventilation rate and exposure time on committed equivalent dose in the respiratory systems of non-smokers was investigated. Committed equivalent doses ranged from 1.15x10 -11 -2.7x10 -7 Sv.y -1 /h of exposure in the extrathoracic region and from 0.8x10 -12 -1.7x10 -8 Sv.y -1 /h of exposure in the thoracic region of the respiratory tract of non-smokers

  13. Effects of ventilation rate per person and per floor area on perceived air quality, sick building syndrome symptoms, and decision-making.

    Science.gov (United States)

    Maddalena, R; Mendell, M J; Eliseeva, K; Chan, W R; Sullivan, D P; Russell, M; Satish, U; Fisk, W J

    2015-08-01

    Ventilation rates (VRs) in buildings must adequately control indoor levels of pollutants; however, VRs are constrained by the energy costs. Experiments in a simulated office assessed the effects of VR per occupant on perceived air quality (PAQ), Sick Building Syndrome (SBS) symptoms, and decision-making performance. A parallel set of experiments assessed the effects of VR per unit floor area on the same outcomes. Sixteen blinded healthy young adult subjects participated in each study. Each exposure lasted four hours and each subject experienced two conditions in a within-subject study design. The order of presentation of test conditions, day of testing, and gender were balanced. Temperature, relative humidity, VRs, and concentrations of pollutants were monitored. Online surveys assessed PAQ and SBS symptoms and a validated computer-based tool measured decision-making performance. Neither changing the VR per person nor changing the VR per floor area, had consistent statistically significant effects on PAQ or SBS symptoms. However, reductions in either occupant-based VR or floor-area-based VR had a significant and independent negative impact on most decision-making measures. These results indicate that the changes in VR employed in the study influence performance of healthy young adults even when PAQ and SBS symptoms are unaffected. The study results indicate the importance of avoiding low VRs per person and low VRs per floor area to minimize decrements in cognitive performance. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. An estimation of intrapartum-related perinatal mortality rates for booked home births in England and Wales between 1994 and 2003.

    Science.gov (United States)

    Mori, R; Dougherty, M; Whittle, M

    2008-04-01

    The objective of this study was to obtain the best estimate of intrapartum-related perinatal mortality (IPPM) rates for booked home births. A population-based cross-sectional study. England and Wales. All births in England and Wales, including home births (intended or unintended) occurring between 1994 and 2003. All IPPM data were derived from the Confidential Enquiry into Maternal and Child Health. Denominators were derived by using unintended home births and transfer rates from home to hospital, from previous studies, with sensitivity analyses. IPPM rates were calculated for the three following subgroups: (a) the completed home birth group, (b) the transferred group and (c) the unintended home birth group. IPPM rate. The overall IPPM rate for England and Wales improved between 1994 and 2003. However, data to obtain a precise estimate of IPPM rate for booked home birth were not available. The average IPPM rate for all births in the study period was 0.79 per 1000 births (95% CI 0.77-0.81), and the estimated IPPM rate for booked home births was 1.28 or 0.74 per 1000 births, depending on the method of calculation (range 0.49-1.47). The IPPM rates for the completed home birth group appeared to be lower throughout the study period compared with the unintended home birth groups. Those women who had booked for a home birth, but later needed to transfer their care for a hospital birth, appeared to have the highest risk of IPPM in the study period. The results of this study need to be interpreted with caution due to inconsistencies occurring in the recorded data. However, the data do highlight two important features. First, they suggest that IPPM rates for home births do not appear to have improved over the study period examined, even though rates did so overall. Second, although the women who booked for home births and had their babies at home seemed to have a generally low IPPM rate, those who required their care to be transferred to hospital did not. Women who book for

  15. Factors Associated With the Increasing Rates of Discharges Directly Home From Intensive Care Units-A Direct From ICU Sent Home Study.

    Science.gov (United States)

    Lau, Vincent I; Priestap, Fran A; Lam, Joyce N H; Ball, Ian M

    2018-02-01

    To evaluate the relationship between rates of discharge directly to home (DDH) from the intensive care unit (ICU) and bed availability (ward and ICU). Also to identify patient characteristics that make them candidates for safe DDH and describe transfer delay impact on length of stay (LOS). Retrospective cohort study of all adult patients who survived their stay in our medical-surgical-trauma ICU between April 2003 and March 2015. Median age was 49 years (interquartile range [IQR]: 33.5-60.4), and the majority of the patients were males (54.8%). Median number of preexisting comorbidities was 5 (IQR: 2-7) diagnoses. Discharge directly to home increased from 28 (3.1% of all survivors) patients in 2003 to 120 (12.5%) patients in 2014. The mean annual rate of DDH was between 11% and 12% over the last 6 years. Approximately 62% (n = 397) of patients waited longer than 4 hours for a ward bed, with a median delay of 2.0 days (IQR: 0.5-4.7) before being DDH. There was an inverse correlation between ICU occupancy and DDH rates ( r P = -.55, P < .0001, 95% confidence interval [CI] = -0.36 to -0.69, R 2 = .29). There was no correlation with ward occupancy and DDH rates ( r s = -.055, P = .64, 95% CI = -0.25 to 0.21). The DDH rates have been increasing over time at our institution and were inversely correlated with ICU bed occupancy but were not associated with ward occupancy. The DDH patients are young, have few comorbidities on admission, and few discharge diagnoses, which are usually reversible single system problems with low disease burden. Transfers to the ward are delayed in a majority of cases, leading to increased ICU LOS and likely increased overall hospital LOS as well.

  16. Severe bronchopulmonary dysplasia improved by noninvasive positive pressure ventilation: a case report

    Directory of Open Access Journals (Sweden)

    Mann Christian

    2011-09-01

    Full Text Available Abstract Introduction This is the first report to describe the feasibility and effectiveness of noninvasive positive pressure ventilation in the secondary treatment of bronchopulmonary dysplasia. Case presentation A former male preterm of Caucasian ethnicity delivered at 29 weeks gestation developed severe bronchopulmonary dysplasia. At the age of six months he was in permanent tachypnea and dyspnea and in need of 100% oxygen with a flow of 2.0 L/minute via a nasal cannula. Intermittent nocturnal noninvasive positive pressure ventilation was then administered for seven hours daily. The ventilator was set at a positive end-expiratory pressure of 6 cmH2O, with pressure support of 4 cmH2O, trigger at 1.4 mL/second, and a maximum inspiratory time of 0.7 seconds. Over the course of seven weeks, the patient's maximum daytime fraction of inspired oxygen via nasal cannula decreased from 1.0 to 0.75, his respiratory rate from 64 breaths/minute to 50 breaths/minute and carbon dioxide from 58 mmHg to 44 mmHg. Conclusion Noninvasive positive pressure ventilation may be a novel therapeutic option for established severe bronchopulmonary dysplasia. In the case presented, noninvasive positive pressure ventilation achieved sustained improvement in ventilation and thus prepared our patient for safe home oxygen therapy.

  17. Looking Māori predicts decreased rates of home ownership: institutional racism in housing based on perceived appearance.

    Science.gov (United States)

    Houkamau, Carla A; Sibley, Chris G

    2015-01-01

    This study examined differences in rates of home ownership among Māori (the indigenous peoples of New Zealand). We identified systematic factors that predicted why some Māori were more likely to own their own home (partially or fully) relative to other Māori. Data were drawn from a large national postal sample of 561 self-identified Māori collected as part of the New Zealand Attitudes and Values Study. As predicted, our analyses indicated that self-reported appearance as Māori, or the extent to which people thought they personally displayed features which visibly identified them as Māori to others, significantly predicted decreased rates of home ownership. This association held when adjusting for numerous demographic covariates, such as education, level of deprivation of the immediate area, household income, age, relationship status, region of residence, and so forth. Our analyses suggest there is, or at least has been in the recent past, institutional racism against Māori in New Zealand's home lending industry based on merely appearing more Māori.

  18. Comparative Performance of Two Ventilation Strategies in a Hot-Humid Climate

    Energy Technology Data Exchange (ETDEWEB)

    Widder, Sarah [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Martin, Eric [Building America Partnership for Improved Residential Construction, FL (United States); Chasar, Dave [Building America Partnership for Improved Residential Construction, FL (United States); McIIvaine, Janet [Building America Partnership for Improved Residential Construction, FL (United States); Fonorow, Bryan [Building America Partnership for Improved Residential Construction, FL (United States); Fonorow, Ken [Florida HERO, Newberry, FL (United States)

    2017-02-01

    In fiscal year 2013, Pacific Northwest National Laboratory (PNNL), Florida Solar Energy Center (FSEC), and Florida Home Energy and Resources Organization (Florida HERO) began a collaborative effort to evaluate the impact of ventilation rate on interior comfort conditions, space-conditioning energy use, and indoor air contaminant concentrations. Relevant parameters were measured in 10 homes in Gainesville, Florida, along with corresponding outdoor conditions, to characterize the impact of differing ventilation rates. This report provides information about the data collection method and results from more than 1 year of data collection during a period from summer 2013 through summer 2014. Indoor air quality was sampled in three discrete periods with the first occurring in August/September 2013, the second occurring in March/April 2014, and the third occurring in August 2014.

  19. Occupants’ Utilization of Natural Ventilation: A Study of Selected Terrace House Designs in Hot-humid Climate

    Directory of Open Access Journals (Sweden)

    Ibiyeye AI

    2015-05-01

    Full Text Available With increased time spent indoors and demand for enhanced comfort levels, energy consumption in homes is rising mostly for cooling, particularly in hot-humid regions. Natural ventilation is seen as an alternative to mechanical cooling as it is totally independent on energy and has been reported to be of high potential. However, little information is available on the utilization of natural ventilation in individual living spaces in different house designs. Therefore, this paper aims to investigate occupants’ utilization of natural ventilation in living spaces under different terrace house designs in hot-humid climate and also the relationship between the openings and occupants’ satisfaction with natural ventilation. Five (5 different terrace house types in Putrajaya, Malaysia with different opening design characteristics were selected for the study. A total of 298 households from these house types were surveyed and results show that occupants mostly open their windows during the daytime to capture breeze from outside despite the fact that they owned air-conditioners. In terms of occupants’ level of satisfaction with indoor ventilation when utilizing natural ventilation, majority rated neither satisfied nor unsatisfied. Further regression analysis reveals that this level of satisfaction is significantly related to opening sizes that are in accordance with the law, duration of opening windows and AC ownership. Findings from this study will shed more light on behavioural pattern of occupants of residential buildings towards natural ventilation provisions and highlight the importance of conforming to the law governing them.

  20. Evaluation of an ultraviolet room disinfection protocol to decrease nursing home microbial burden, infection and hospitalization rates

    OpenAIRE

    Kovach, Christine R.; Taneli, Yavuz; Neiman, Tammy; Dyer, Elaine M.; Arzaga, Alvin Jason A.; Kelber, Sheryl T

    2017-01-01

    Background The focus of nursing home infection control procedures has been on decreasing transmission between healthcare workers and residents. Less evidence is available regarding whether decontamination of high-touch environmental surfaces impacts infection rates or resident outcomes. The purpose of this study was to examine if ultraviolet disinfection is associated with changes in: 1) microbial counts and adenosine triphosphate counts on high-touch surfaces; and 2) facility wide nursing ho...

  1. 77 FR 67067 - Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2013...

    Science.gov (United States)

    2012-11-08

    ... Home Assessment Validation and Entry System HCC Hierarchical Condition Categories HCIS Health Care... cost basis and that such amounts be initially based on the most recent audited cost report data... case-mix growth are robust. We have not commissioned work analyzing case-mix change based on...

  2. 75 FR 70371 - Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011...

    Science.gov (United States)

    2010-11-17

    ... patient acuity. Finally, this rule incorporates new legislative requirements regarding face-to-face... Provisions for HHAs 1. HHA Capitalization 2. HHA Changes of Ownership F. Home Health Face-to-Face Encounter G... changes one at a time and phasing them in to allow time to determine the impact of those individual...

  3. Diffuse Ceiling Ventilation

    DEFF Research Database (Denmark)

    Zhang, Chen; Yu, Tao; Heiselberg, Per Kvols

    with conventional ventilation systems (mixing or displacement ventilation), diffuse ceiling ventilation can significantly reduce or even eliminate draught risk in the occupied zone. Moreover, this ventilation system presents a promising opportunity for energy saving, because of the low pressure loss, extended free...

  4. Diffuse ceiling ventilation

    DEFF Research Database (Denmark)

    Zhang, Chen

    Diffuse ceiling ventilation is an innovative ventilation concept where the suspended ceiling serves as air diffuser to supply fresh air into the room. Compared with conventional ventilation systems, diffuse ceiling ventilation can significantly reduce or even eliminate draught risk due to the low...

  5. Variable mechanical ventilation.

    Science.gov (United States)

    Fontela, Paula Caitano; Prestes, Renata Bernardy; Forgiarini, Luiz Alberto; Friedman, Gilberto

    2017-01-01

    To review the literature on the use of variable mechanical ventilation and the main outcomes of this technique. Search, selection, and analysis of all original articles on variable ventilation, without restriction on the period of publication and language, available in the electronic databases LILACS, MEDLINE®, and PubMed, by searching the terms "variable ventilation" OR "noisy ventilation" OR "biologically variable ventilation". A total of 36 studies were selected. Of these, 24 were original studies, including 21 experimental studies and three clinical studies. Several experimental studies reported the beneficial effects of distinct variable ventilation strategies on lung function using different models of lung injury and healthy lungs. Variable ventilation seems to be a viable strategy for improving gas exchange and respiratory mechanics and preventing lung injury associated with mechanical ventilation. However, further clinical studies are necessary to assess the potential of variable ventilation strategies for the clinical improvement of patients undergoing mechanical ventilation.

  6. VENTILATION NEEDS DURING CONSTRUCTION

    International Nuclear Information System (INIS)

    C.R. Gorrell

    1998-01-01

    The purpose of this analysis is to determine ventilation needs during construction and development of the subsurface repository and develop systems to satisfy those needs. For this analysis, construction is defined as pre-emplacement excavation and development is excavation that takes place simultaneously with emplacement. The three options presented in the ''Overall Development and Emplacement Ventilation Systems'' analysis (Reference 5.5) for development ventilation will be applied to construction ventilation in this analysis as well as adding new and updated ventilation factors to each option for both construction and development. The objective of this analysis is to develop a preferred ventilation system to support License Application Design. The scope of this analysis includes: (1) Description of ventilation conditions; (2) Ventilation factors (fire hazards, dust control, construction logistics, and monitoring and control systems); (3) Local ventilation alternatives; (4) Global ventilation options; and (5) Evaluation of options

  7. Potential risk for bacterial contamination in conventional reused ventilator systems and disposable closed ventilator-suction systems.

    Science.gov (United States)

    Li, Ya-Chi; Lin, Hui-Ling; Liao, Fang-Chun; Wang, Sing-Siang; Chang, Hsiu-Chu; Hsu, Hung-Fu; Chen, Sue-Hsien; Wan, Gwo-Hwa

    2018-01-01

    Few studies have investigated the difference in bacterial contamination between conventional reused ventilator systems and disposable closed ventilator-suction systems. The aim of this study was to investigate the bacterial contamination rates of the reused and disposable ventilator systems, and the association between system disconnection and bacterial contamination of ventilator systems. The enrolled intubated and mechanically ventilated patients used a conventional reused ventilator system and a disposable closed ventilator-suction system, respectively, for a week; specimens were then collected from the ventilator circuit systems to evaluate human and environmental bacterial contamination. The sputum specimens from patients were also analyzed in this study. The detection rate of bacteria in the conventional reused ventilator system was substantially higher than that in the disposable ventilator system. The inspiratory and expiratory limbs of the disposable closed ventilator-suction system had higher bacterial concentrations than the conventional reused ventilator system. The bacterial concentration in the heated humidifier of the reused ventilator system was significantly higher than that in the disposable ventilator system. Positive associations existed among the bacterial concentrations at different locations in the reused and disposable ventilator systems, respectively. The predominant bacteria identified in the reused and disposable ventilator systems included Acinetobacter spp., Bacillus cereus, Elizabethkingia spp., Pseudomonas spp., and Stenotrophomonas (Xan) maltophilia. Both the reused and disposable ventilator systems had high bacterial contamination rates after one week of use. Disconnection of the ventilator systems should be avoided during system operation to decrease the risks of environmental pollution and human exposure, especially for the disposable ventilator system. ClinicalTrials.gov PRS / NCT03359148.

  8. Thermal Plumes in Ventilated Rooms

    DEFF Research Database (Denmark)

    Kofoed, Peter; Nielsen, Peter V.

    The design of a displacement ventilation system involves determination of the flow rate in the thermal plumes. The flow rate in the plumes and the vertical temperature gradient influence each other, and they are influenced by many factors. This paper shows some descriptions of these effects....

  9. IMPACT OF HEATING AND AIR CONDITIONING SYSTEM OPERATION AND LEAKAGE ON VENTILATION AND INTERCOMPARTMENT TRANSPORT: STUDIES IN UNOCCUPIED AND OCCUPIED TENNESSEE VALLEY HOMES

    Science.gov (United States)

    Forced-air heating and air conditioning (HAC) systems caused an average and maximum increase in air infiltration rates of 1.8- and 4.3-fold, respectively, during brief whole-house studies of tracer gas decay In 39 occupied houses. An average Increase in air infiltration rate of 0...

  10. Maternal and newborn outcomes in planned home birth vs planned hospital births: a metaanalysis.

    Science.gov (United States)

    Wax, Joseph R; Lucas, F Lee; Lamont, Maryanne; Pinette, Michael G; Cartin, Angelina; Blackstone, Jacquelyn

    2010-09-01

    We sought to systematically review the medical literature on the maternal and newborn safety of planned home vs planned hospital birth. We included English-language peer-reviewed publications from developed Western nations reporting maternal and newborn outcomes by planned delivery location. Outcomes' summary odds ratios with 95% confidence intervals were calculated. Planned home births were associated with fewer maternal interventions including epidural analgesia, electronic fetal heart rate monitoring, episiotomy, and operative delivery. These women were less likely to experience lacerations, hemorrhage, and infections. Neonatal outcomes of planned home births revealed less frequent prematurity, low birthweight, and assisted newborn ventilation. Although planned home and hospital births exhibited similar perinatal mortality rates, planned home births were associated with significantly elevated neonatal mortality rates. Less medical intervention during planned home birth is associated with a tripling of the neonatal mortality rate. Copyright 2010 Mosby, Inc. All rights reserved.

  11. Using preventive home monitoring to reduce hospital admission rates and reduce costs

    DEFF Research Database (Denmark)

    Dinesen, Birthe Irene; Haesum, Lisa K E; Soerensen, Natascha

    2012-01-01

    We studied whether preventive home monitoring of patients with chronic obstructive pulmonary disease (COPD) could reduce the frequency of hospital admissions and lower the cost of hospitalization. Patients were recruited from a health centre, general practitioner (GP) or the pulmonary hospital ward....... They were randomized to usual care or tele-rehabilitation with a telehealth monitoring device installed in their home for four months. A total of 111 patients were suitable for inclusion and consented to be randomized: 60 patients were allocated to intervention and three were lost to follow...... of admissions was €3461 per patient in the intervention group and €4576 in the control group; this difference was not significant. The Kaplan-Meier estimates for time to hospital admission were longer for the intervention group than the controls, but the difference was not significant. Future work requires...

  12. Using a Ventilation Controller to Optimize Residential Passive Ventilation For Energy and Indoor Air Quality

    Energy Technology Data Exchange (ETDEWEB)

    Turner, William [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Walker, Iain [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2014-08-01

    One way to reduce the energy impact of providing residential ventilation is to use passive and hybrid systems. However, these passive and hybrid (sometimes called mixed-mode) systems must still meet chronic and acute health standards for ventilation. This study uses a computer simulation approach to examine the energy and indoor air quality (IAQ) implications of passive and hybrid ventilation systems, in 16 California climate zones. Both uncontrolled and flow controlled passive stacks are assessed. A new hybrid ventilation system is outlined that uses an intelligent ventilation controller to minimise energy use, while ensuring chronic and acute IAQ standards are met. ASHRAE Standard 62.2-2010 – the United States standard for residential ventilation - is used as the chronic standard, and exposure limits for PM2.5, formaldehyde and NO2 are used as the acute standards.The results show that controlled passive ventilation and hybrid ventilation can be used in homes to provide equivalent IAQ to continuous mechanical ventilation, for less use of energy.

  13. Impact of Residential Mechanical Ventilation on Energy Cost and Humidity Control

    Energy Technology Data Exchange (ETDEWEB)

    Martin, Eric [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2014-01-01

    The DOE Building America program has been conducting research leading to cost effective high performance homes since the early 1990's. Optimizing whole house mechanical ventilation as part of the program's systems engineered approach to constructing housing has been an important subject of the program's research. Ventilation in residential buildings is one component of an effective, comprehensive strategy for creation and maintenance of a comfortable and healthy indoor air environment. The study described in this white paper is based on building energy modeling with an important focus on the indoor humidity impacts of ventilation. The modeling tools used were EnergyPlus version 7.1 (E+) and EnergyGauge USA (EGUSA). Twelve U.S. cities and five climate zones were represented. A total of 864 simulations (2*2*3*3*12= 864) were run using two building archetypes, two building leakage rates, two building orientations, three ventilation systems, three ventilation rates, and twelve climates.

  14. The effect of somatic symptom attribution on the prevalence rate of depression and anxiety among nursing home patients.

    Science.gov (United States)

    Smalbrugge, Martin; Pot, Anne Margriet; Jongenelis, Lineke; Beekman, Aartjan T F; Eefsting, Jan A

    2005-01-01

    The validity of diagnostic psychiatric instruments for depression and anxiety disorders may be compromised among patients with complex physical illness and disability. The objective of this study was to determine the effect on the prevalence rate of depression and anxiety in a nursing home population of attributing somatic symptoms of depression and anxiety to either somatic or psychiatric disorder. Symptoms of major depression (MD), generalized anxiety disorder (GAD) and panic disorder (PD) were measured using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Somatic symptoms of MD, GAD and PD were attributed to somatic causes when the interviewer was not sure about a psychiatric cause. To analyse the effect of this attribution on the prevalence rate of MD, GAD and PD, a sensitivity analysis was undertaken in which symptoms that were attributed to somatic causes were recoded as symptoms attributed to psychiatric disorder. Prevalence rates of MD, GAD and PD were calculated before and after recoding. The prevalence of MD after recoding rose from 7.5% to 8.1%. The prevalence of GAD did not change. The prevalence of PD rose from 1.5% to 1.8%. Attribution of somatic symptoms to either somatic or psychiatric disorder when the interviewer was not sure about a psychiatric cause of the somatic symptoms had only a very modest effect on the prevalence rate of major depression, generalized anxiety disorder and panic disorder in a nursing home population.

  15. Cellular phone interference with the operation of mechanical ventilators.

    Science.gov (United States)

    Shaw, Cheryl I; Kacmarek, Robert M; Hampton, Rickey L; Riggi, Vincent; El Masry, Ashraf; Cooper, Jeffrey B; Hurford, William E

    2004-04-01

    To determine whether a cellular phone would interfere with the operation of mechanical ventilators. Laboratory study. University medical center. Fourteen mechanical ventilators. We evaluated change in operation and malfunction of the mechanical ventilators. The cellular phone (Nokia 6120i) was computer controlled, operating at 828.750 MHz analog modulation. It was operated at 16, 40, 100, 250, and 600 mW, 30 cm from the floor and 30, 15, and ventilator. Six of the 14 ventilators tested malfunctioned when a cellular phone at maximum power output was placed ventilating when the cellular phone at maximum power output was placed ventilator. One ventilator doubled the ventilatory rate and another increased the displayed tidal volume from 350 to 1033 mL. In one of the infant ventilators, displayed tidal volume increased from 21 to 100 mL. In another ventilator, the high respiratory rate alarm sounded but the rate had not changed. In a controlled laboratory setting, cellular phones placed in close proximity to some commercially available intensive care ventilators can cause malfunctions, including irrecoverable cessation of ventilation. This is most likely to occur if the cellular phone is or =3 feet from all medical devices. The current electromagnetic compatibility standards for mechanical ventilators are inadequate to prevent malfunction. Manufacturers should ensure that their products are not affected by wireless technology even when placed immediately next to the device.

  16. Impacts of Mixing on Acceptable Indoor Air Quality in Homes

    Energy Technology Data Exchange (ETDEWEB)

    Sherman, Max H.; Walker, Iain I.

    2010-01-01

    Ventilation reduces occupant exposure to indoor contaminants by diluting or removing them. In a multi-zone environment such as a house, every zone will have different dilution rates and contaminant source strengths. The total ventilation rate is the most important factor in determining occupant exposure to given contaminant sources, but the zone-specific distribution of exhaust and supply air and the mixing of ventilation air can play significant roles. Different types of ventilation systems will provide different amounts of mixing depending on several factors such as air leakage, air distribution system, and contaminant source and occupant locations. Most U.S. and Canadian homes have central heating, ventilation, and air conditioning systems, which tend to mix the air; thus, the indoor air in different zones tends to be well mixed for significant fractions of the year. This article reports recent results of investigations to determine the impact of air mixing on exposures of residential occupants to prototypical contaminants of concern. We summarize existing literature and extend past analyses to determine the parameters than affect air mixing as well as the impacts of mixing on occupant exposure, and to draw conclusions that are relevant for standards development and for practitioners designing and installing home ventilation systems. The primary conclusion is that mixing will not substantially affect the mean indoor air quality across a broad population of occupants, homes, and ventilation systems, but it can reduce the number of occupants who are exposed to extreme pollutant levels. If the policy objective is to minimize the number of people exposed above a given pollutant threshold, some amount of mixing will be of net benefit even though it does not benefit average exposure. If the policy is to minimize exposure on average, then mixing air in homes is detrimental and should not be encouraged. We also conclude that most homes in the US have adequate mixing

  17. Natural ventilation for reducing airborne infection in hospitals

    Energy Technology Data Exchange (ETDEWEB)

    Qian, Hua [School of Energy and Environment, Southeast University, Nanjing (China); Department of Mechanical Engineering, The University of Hong Kong, Pokfulam, Hong Kong (China); Li, Yuguo; Ching, W.H.; Sun, H.Q. [Department of Mechanical Engineering, The University of Hong Kong, Pokfulam, Hong Kong (China); Seto, W.H.; Ching, Patricia [Department of Microbiology, Queen Mary Hospital, Hong Kong (China)

    2010-03-15

    High ventilation rate is shown to be effective for reducing cross-infection risk of airborne diseases in hospitals and isolation rooms. Natural ventilation can deliver much higher ventilation rate than mechanical ventilation in an energy-efficient manner. This paper reports a field measurement of naturally ventilated hospital wards in Hong Kong and presents a possibility of using natural ventilation for infection control in hospital wards. Our measurements showed that natural ventilation could achieve high ventilation rates especially when both the windows and the doors were open in a ward. The highest ventilation rate recorded in our study was 69.0 ACH. The airflow pattern and the airflow direction were found to be unstable in some measurements with large openings. Mechanical fans were installed in a ward window to create a negative pressure difference. Measurements showed that the negative pressure difference was negligible with large openings but the overall airflow was controlled in the expected direction. When all the openings were closed and the exhaust fans were turned on, a reasonable negative pressure was created although the air temperature was uncontrolled. The high ventilation rate provided by natural ventilation can reduce cross-infection of airborne diseases, and thus it is recommended for consideration of use in appropriate hospital wards for infection control. Our results also demonstrated a possibility of converting an existing ward using natural ventilation to a temporary isolation room through installing mechanical exhaust fans. (author)

  18. Indoor air quality in 24 California residences designed as high-performance homes

    Energy Technology Data Exchange (ETDEWEB)

    Less, Brennan [Lawrence Berkeley National Laboratory (LBNL), Berkeley, CA (United States); Mullen, Nasim [Gap, Inc., San Francisco, CA (United States); Singer, Brett [Lawrence Berkeley National Laboratory (LBNL), Berkeley, CA (United States); Walker, Iain [Lawrence Berkeley National Laboratory (LBNL), Berkeley, CA (United States)

    2015-01-01

    Today’s high performance green homes are reaching previously unheard of levels of airtightness and are using new materials, technologies and strategies, whose impacts on Indoor Air Quality (IAQ) cannot be fully anticipated from prior studies. This research study used pollutant measurements, home inspections, diagnostic testing and occupant surveys to assess IAQ in 24 new or deeply retrofitted homes designed to be high performance green buildings in California. Although the mechanically vented homes were six times as airtight as non-mechanically ventilated homes (medians of 1.1 and 6.1 ACH50, n=11 and n=8, respectively), their use of mechanical ventilation systems and possibly window operation meant their median air exchange rates were almost the same (0.30 versus 0.32 hr-1, n=8 and n=8, respectively). Pollutant levels were also similar in vented and unvented homes. In addition, these similarities were achieved despite numerous observed faults in complex mechanical ventilation systems. More rigorous commissioning is still recommended. Cooking exhaust systems were used inconsistently and several suffered from design flaws. Failure to follow best practices led to IAQ problems in some cases. Ambient nitrogen dioxide standards were exceeded or nearly so in four homes that either used gas ranges with standing pilots, or in Passive House-style homes that used gas cooking burners without venting range hoods. Homes without active particle filtration had particle count concentrations approximately double those in homes with enhanced filtration. The majority of homes reported using low-emitting materials; consistent with this, formaldehyde levels were approximately half those in conventional, new CA homes built before 2008. Emissions of ultrafine particles (with diameters <100 nm) were dramatically lower on induction electric cooktops, compared with either gas or resistance electric models. These results indicate that high performance homes can achieve

  19. Home-based family intervention increases knowledge, communication and living donation rates: a randomized controlled trial.

    Science.gov (United States)

    Ismail, S Y; Luchtenburg, A E; Timman, R; Zuidema, W C; Boonstra, C; Weimar, W; Busschbach, J J V; Massey, E K

    2014-08-01

    Our aim was to develop and test an educational program to support well-informed decision making among patients and their social network regarding living donor kidney transplantation (LDKT). One hundred sixty-three patients who were unable to find a living donor were randomized to standard care or standard care plus home-based education. In the education condition, patients and members of their social network participated in home-based educational meetings and discussed renal replacement therapy options. Patients and invitees completed pre-post self-report questionnaires measuring knowledge, risk perception, communication, self-efficacy and subjective norm. LDKT activities were observed for 6 months postintervention. Patients in the experimental group showed significantly more improvements in knowledge (p communication (p = 0.012) compared with the control group. The invitees showed pre-post increases in knowledge (p decision making and promotes access to LDKT. © Copyright 2014 The American Society of Transplantation and the American Society of Transplant Surgeons.

  20. A pilot study using scripted ventilation conditions to identify key factors affecting indoor pollutant concentration and air exchange rate in a residence.

    Science.gov (United States)

    Johnson, Ted; Myers, Jeffrey; Kelly, Thomas; Wisbith, Anthony; Ollison, Will

    2004-01-01

    A pilot study was conducted using an occupied, single-family test house in Columbus, OH, to determine whether a script-based protocol could be used to obtain data useful in identifying the key factors affecting air-exchange rate (AER) and the relationship between indoor and outdoor concentrations of selected traffic-related air pollutants. The test script called for hourly changes to elements of the test house considered likely to influence air flow and AER, including the position (open or closed) of each window and door and the operation (on/off) of the furnace, air conditioner, and ceiling fans. The script was implemented over a 3-day period (January 30-February 1, 2002) during which technicians collected hourly-average data for AER, indoor, and outdoor air concentrations for six pollutants (benzene, formaldehyde (HCHO), polycyclic aromatic hydrocarbons (PAH), carbon monoxide (CO), nitric oxide (NO), and nitrogen oxides (NO(x))), and selected meteorological variables. Consistent with expectations, AER tended to increase with the number of open exterior windows and doors. The 39 AER values measured during the study when all exterior doors and windows were closed varied from 0.36 to 2.29 h(-1) with a geometric mean (GM) of 0.77 h(-1) and a geometric standard deviation (GSD) of 1.435. The 27 AER values measured when at least one exterior door or window was opened varied from 0.50 to 15.8 h(-1) with a GM of 1.98 h(-1) and a GSD of 1.902. AER was also affected by temperature and wind speed, most noticeably when exterior windows and doors were closed. Results of a series of stepwise linear regression analyses suggest that (1) outdoor pollutant concentration and (2) indoor pollutant concentration during the preceding hour were the "variables of choice" for predicting indoor pollutant concentration in the test house under the conditions of this study. Depending on the pollutant and ventilation conditions, one or more of the following variables produced a small, but

  1. Quality of life and psychosocial issues in ventilated patients with amyotrophic lateral sclerosis and their caregivers.

    Science.gov (United States)

    Kaub-Wittemer, Dagmar; Steinbüchel, Nicole von; Wasner, Maria; Laier-Groeneveld, Gerhard; Borasio, Gian Domenico

    2003-10-01

    Non-invasive ventilation (NIV) is an efficient palliative measure for symptoms of chronic hypoventilation in patients with amyotrophic lateral sclerosis (ALS), and can also lengthen survival. A subset of ALS patients undergoes tracheostomy ventilation (TV) for life prolongation. We investigated the quality of life (QOL) and psychosocial situation of 52 home ventilated ALS patients and their caregivers. The battery included sociodemographic, generic, and disease-specific variables, as well as the Profile of Mood States and the Munich Quality of Life Dimensions List. Data were compared between the NIV (n=32) and the TV (n=21) groups. Mean ventilation time was 14 months for NIV and 35 months for TV. Eighty-one percent of TV patients had been tracheotomized without informed consent. The data show a good overall QOL for both NIV and TV patients, but a very high burden of care for TV caregivers, 30% of whom rated their own QOL lower than their patient's QOL. Sexuality was an important issue. Thus, any assessment of QOL in a home palliative care situation should include the primary caregivers.

  2. Patient-Ventilator Dyssynchrony

    Directory of Open Access Journals (Sweden)

    Elvira-Markela Antonogiannaki

    2017-11-01

    Full Text Available In mechanically ventilated patients, assisted mechanical ventilation (MV is employed early, following the acute phase of critical illness, in order to eliminate the detrimental effects of controlled MV, most notably the development of ventilator-induced diaphragmatic dysfunction. Nevertheless, the benefits of assisted MV are often counteracted by the development of patient-ventilator dyssynchrony. Patient-ventilator dyssynchrony occurs when either the initiation and/or termination of mechanical breath is not in time agreement with the initiation and termination of neural inspiration, respectively, or if the magnitude of mechanical assist does not respond to the patient’s respiratory demand. As patient-ventilator dyssynchrony has been associated with several adverse effects and can adversely influence patient outcome, every effort should be made to recognize and correct this occurrence at bedside. To detect patient-ventilator dyssynchronies, the physician should assess patient comfort and carefully inspect the pressure- and flow-time waveforms, available on the ventilator screen of all modern ventilators. Modern ventilators offer several modifiable settings to improve patient-ventilator interaction. New proportional modes of ventilation are also very helpful in improving patient-ventilator interaction.

  3. Short-term airing by natural ventilation

    DEFF Research Database (Denmark)

    Perino, Marco; Heiselberg, Per

    2009-01-01

    The need to improve the energy efficiency of buildings requires new and more efficient ventilation systems. It has been demonstrated that innovative operating concepts that make use of natural ventilation seem to be more appreciated by occupants. This kind of system frequently integrates traditio......The need to improve the energy efficiency of buildings requires new and more efficient ventilation systems. It has been demonstrated that innovative operating concepts that make use of natural ventilation seem to be more appreciated by occupants. This kind of system frequently integrates...... traditional mechanical ventilation components with natural ventilation devices, such as motorized windows and louvers. Among the various ventilation strategies that are currently available, buoyancy driven single-sided natural ventilation has proved to be very effective and can provide high air change rates...... that was aimed at developing and validating numerical models for the analysis of buoyancy driven single-sided natural ventilation systems. Once validated, these models can be used to optimize control strategies in order to achieve satisfactory indoor comfort conditions and IAQ....

  4. Bilevel vs ICU ventilators providing noninvasive ventilation: effect of system leaks: a COPD lung model comparison.

    Science.gov (United States)

    Ferreira, Juliana C; Chipman, Daniel W; Hill, Nicholas S; Kacmarek, Robert M

    2009-08-01

    Noninvasive positive-pressure ventilation (NPPV) modes are currently available on bilevel and ICU ventilators. However, little data comparing the performance of the NPPV modes on these ventilators are available. In an experimental bench study, the ability of nine ICU ventilators to function in the presence of leaks was compared with a bilevel ventilator using the IngMar ASL5000 lung simulator (IngMar Medical; Pittsburgh, PA) set at a compliance of 60 mL/cm H(2)O, an inspiratory resistance of 10 cm H(2)O/L/s, an expiratory resistance of 20 cm H(2)O/ L/s, and a respiratory rate of 15 breaths/min. All of the ventilators were set at 12 cm H(2)O pressure support and 5 cm H(2)O positive end-expiratory pressure. The data were collected at baseline and at three customized leaks. At baseline, all of the ventilators were able to deliver adequate tidal volumes, to maintain airway pressure, and to synchronize with the simulator, without missed efforts or auto-triggering. As the leak was increased, all of the ventilators (except the Vision [Respironics; Murrysville, PA] and Servo I [Maquet; Solna, Sweden]) needed adjustment of sensitivity or cycling criteria to maintain adequate ventilation, and some transitioned to backup ventilation. Significant differences in triggering and cycling were observed between the Servo I and the Vision ventilators. The Vision and Servo I were the only ventilators that required no adjustments as they adapted to increasing leaks. There were differences in performance between these two ventilators, although the clinical significance of these differences is unclear. Clinicians should be aware that in the presence of leaks, most ICU ventilators require adjustments to maintain an adequate tidal volume.

  5. Short Term Airing by Natural Ventilation

    DEFF Research Database (Denmark)

    Heiselberg, Per; Perino, M.

    2010-01-01

    The need to improve the energy efficiency of buildings requires new and more efficient ventilation systems. It has been demonstrated that innovative operating concepts that make use of natural ventilation seem to be more appreciated by occupants. Among the available ventilation strategies...... that are currently available, buoyancy driven, single-sided natural ventilation has proved to be very effective and can provide high air change rates for temperature and Indoor Air Quality (IAQ) control. However, to promote a wider distribution of these systems an improvement in the knowledge of their working...... airflow rate, ventilation efficiency, thermal comfort and dynamic temperature conditions. A suitable laboratory test rig was developed to perform extensive experimental analyses of the phenomenon under controlled and repeatable conditions. The results showed that short-term window airing is very effective...

  6. Procedures and Standards for Residential Ventilation System Commissioning: An Annotated Bibliography

    Energy Technology Data Exchange (ETDEWEB)

    Stratton, J. Chris [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Wray, Craig P. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2013-04-01

    Beginning with the 2008 version of Title 24, new homes in California must comply with ANSI/ASHRAE Standard 62.2-2007 requirements for residential ventilation. Where installed, the limited data available indicate that mechanical ventilation systems do not always perform optimally or even as many codes and forecasts predict. Commissioning such systems when they are installed or during subsequent building retrofits is a step towards eliminating deficiencies and optimizing the tradeoff between energy use and acceptable IAQ. Work funded by the California Energy Commission about a decade ago at Berkeley Lab documented procedures for residential commissioning, but did not focus on ventilation systems. Since then, standards and approaches for commissioning ventilation systems have been an active area of work in Europe. This report describes our efforts to collect new literature on commissioning procedures and to identify information that can be used to support the future development of residential-ventilation-specific procedures and standards. We recommend that a standardized commissioning process and a commissioning guide for practitioners be developed, along with a combined energy and IAQ benefit assessment standard and tool, and a diagnostic guide for estimating continuous pollutant emission rates of concern in residences (including a database that lists emission test data for commercially-available labeled products).

  7. Mechanical ventilator - infants

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007240.htm Mechanical ventilator - infants To use the sharing features on this page, please enable JavaScript. A mechanical ventilator is a machine that assists with breathing. ...

  8. Learning about ventilators

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000458.htm Learning about ventilators To use the sharing features on this page, ... fixed or changed. How Does Being on a Ventilator Feel? A person receives medicine to remain comfortable ...

  9. VENTILATION TECHNOLOGY SYSTEMS ANALYSIS

    Science.gov (United States)

    The report gives results of a project to develop a systems analysis of ventilation technology and provide a state-of-the-art assessment of ventilation and indoor air quality (IAQ) research needs. (NOTE: Ventilation technology is defined as the hardware necessary to bring outdoor ...

  10. Ventilation of nuclear facilities

    International Nuclear Information System (INIS)

    1982-01-01

    In this work an examination is made of ventilation problems in nuclear installations, of the fuel cycle or the handling of radioactive compounds. The study covers the detection of radioactive aerosols, purification, iodine trapping, ventilation equipment and its maintenance, engineering, safety of ventilation, fire efficiency, operation, regulations and normalization [fr

  11. 77 FR 41547 - Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2013...

    Science.gov (United States)

    2012-07-13

    ... national standardized 60- day episode rates, the national per-visit rates, the low-utilization payment... Care Hospital LUPA Low Utilization Payment Amount MEPS Medical Expenditures Panel Survey MMA Medicare... units of services, adjustments for geographic differences in wage levels, outlier payments, the...

  12. Quantum-to-the-Home: Achieving Gbits/s Secure Key Rates via Commercial Off-the-Shelf Telecommunication Equipment

    Directory of Open Access Journals (Sweden)

    Rameez Asif

    2017-01-01

    Full Text Available There is current significant interest in Fiber-to-the-Home (FTTH networks, that is, end-to-end optical connectivity. Currently, it may be limited due to the presence of last-mile copper wire connections. However, in near future, it is envisaged that FTTH connections will exist, and a key offering would be the possibility of optical encryption that can best be implemented using Quantum Key Distribution (QKD. However, it is very important that the QKD infrastructure is compatible with the already existing networks for a smooth transition and integration with the classical data traffic. In this paper, we report the feasibility of using off-the-shelf telecommunication components to enable high performance Continuous Variable-Quantum Key Distribution (CV-QKD systems that can yield secure key rates in the range of 100 Mbits/s under practical operating conditions. Multilevel phase modulated signals (m-PSK are evaluated in terms of secure key rates and transmission distances. The traditional receiver is discussed, aided by the phase noise cancellation based digital signal processing module for detecting the complex quantum signals. Furthermore, we have discussed the compatibility of multiplexers and demultiplexers for wavelength division multiplexed Quantum-to-the-Home (QTTH network and the impact of splitting ratio is analyzed. The results are thoroughly compared with the commercially available high-cost encryption modules.

  13. The CEE housing markets before, during and after the transition: an overview of property prices and home ownership rates

    Directory of Open Access Journals (Sweden)

    Elena IONASCU

    2017-10-01

    Full Text Available The purpose of this research is to investigate relevant economic aspects, which characterized housing markets from Central and Eastern European (CEE countries, to identify the factors which determine the house prices and to find the economic implications of property investments, under an international micro and macroeconomic environment. Methodological, the article uses the deduction and comparative analysis of collected statistical data, and strategic reforms in post-communist countries are qualitatively explored through content analysis. In the case of CEE region, fundamentals determinants, such as real income, real interest rate, demographic factors, play an extremely important role in explaining house price distortions. The principles of communist ideology added a special note in the evolution of prices, so the home ownership rate, the housing quality, the financial housing system, European integration represent a number of traditional factors with significant impact.

  14. Accuracy of an indirect calorimeter for mechanically ventilated infants and children: the influence of low rates of gas exchange and varying FIO2.

    Science.gov (United States)

    Joosten, K F; Jacobs, F I; van Klaarwater, E; Baartmans, M G; Hop, W C; Meriläinen, P T; Hazelzet, J A

    2000-08-01

    To test the accuracy and validity of the Deltatrac II MBM-200 metabolic monitor for use in mechanically ventilated infants and children in the pediatric intensive care unit. Laboratory validation of an indirect calorimeter with a ventilated lung model. The influence of low tidal volumes and low levels of oxygen consumption (V(O2)) and carbon dioxide production (V(CO2)) in combination with different levels of inspired oxygen concentrations (F(IO2)) was investigated. University research laboratory. Low tidal volumes were provided with two intermittent flow types of ventilators, a Servo 300 and a Servo 900C. A butane flame with a V(O2) approximating 20 mL/min and 40 mL/min was ventilated. To investigate the effect of different levels of F(IO2) on the accuracy of V(O2), V(CO2), and respiratory quotient (RQ), measurements were performed at F(IO2) target values of 0.25, 0.40, and 0.60. No significant differences were found between the ventilators regarding V(O2), V(CO2), and RQ measurements. The mean deviation of V(O2) increased significantly with increasing F(IO2) to -7.98% with a V(O2) of 21.0 mL/min and to -8.46% with a V(O2) of 38.9 mL/min (F(IO2), 0.558) with a variability (2 SD) of +/- 4.86% and +/- 6.82%, respectively. The mean deviation and variability of V(CO2) in all tests remained within 8%. The mean deviation of RQ increased significantly with increasing F(IO2) to 5.5% with a V(O2) of 21.0 mL/min and to 5.69% with a V(O2) of 38.9 mL/min (F(IO2), 0.558) with a variability (2 SD) of +/- 5.62% and +/- 5.76%, respectively. The minute to minute delivered F(IO2) fluctuated significantly when increasing the level of F(IO2). The Deltatrac II MBM-200 metabolic monitor appears accurate for low levels of V(O2) and V(CO2) during mechanical ventilation with F(IO2) levels up to 0.390. With increasing F(IO2) to 0.558, the increase in deviation of V(O2) for single measurements can be of clinical relevance for mechanically ventilated infants and children. The increased

  15. Conservative fluid management prevents age-associated ventilator induced mortality.

    Science.gov (United States)

    Herbert, Joseph A; Valentine, Michael S; Saravanan, Nivi; Schneck, Matthew B; Pidaparti, Ramana; Fowler, Alpha A; Reynolds, Angela M; Heise, Rebecca L

    2016-08-01

    Approximately 800 thousand patients require mechanical ventilation in the United States annually with an in-hospital mortality rate of over 30%. The majority of patients requiring mechanical ventilation are over the age of 65 and advanced age is known to increase the severity of ventilator-induced lung injury (VILI) and in-hospital mortality rates. However, the mechanisms which predispose aging ventilator patients to increased mortality rates are not fully understood. Ventilation with conservative fluid management decreases mortality rates in acute respiratory distress patients, but to date there has been no investigation of the effect of conservative fluid management on VILI and ventilator associated mortality rates. We hypothesized that age-associated increases in susceptibility and incidence of pulmonary edema strongly promote age-related increases in ventilator associated mortality. 2month old and 20month old male C57BL6 mice were mechanically ventilated with either high tidal volume (HVT) or low tidal volume (LVT) for up to 4h with either liberal or conservative fluid support. During ventilation, lung compliance, total lung capacity, and hysteresis curves were quantified. Following ventilation, bronchoalveolar lavage fluid was analyzed for total protein content and inflammatory cell infiltration. Wet to dry ratios were used to directly measure edema in excised lungs. Lung histology was performed to quantify alveolar barrier damage/destruction. Age matched non-ventilated mice were used as controls. At 4h, both advanced age and HVT ventilation significantly increased markers of inflammation and injury, degraded pulmonary mechanics, and decreased survival rates. Conservative fluid support significantly diminished pulmonary edema and improved pulmonary mechanics by 1h in advanced age HVT subjects. In 4h ventilations, conservative fluid support significantly diminished pulmonary edema, improved lung mechanics, and resulted in significantly lower mortality rates in

  16. Ventilation and ventilation/perfusion ratios

    International Nuclear Information System (INIS)

    Valind, S.O.

    1989-01-01

    The thesis is based on five different papers. The labelling of specific tracer compounds with positron emitting radionuclides enables a range of structural, physiological and biochemical parameters in the lung to be measured non-invasively, using positron emission tomography. This concept affords a unique opportunity for in vivo studies of different expressions of pulmonary pathophysiology at the regional level. The present thesis describes the application of positron emission tomography to the measurements of ventilation and ventilation/perfusion ratios using inert gas tracers, neon-19 and nitrogen-13 respectively. The validity of the methods applied was investigated with respect to the transport of inert gas tracers in the human lung. Both ventilation and the ventilation/perfusion ratio may be obtained with errors less than 10 % in the normal lung. In disease, however, errors may increase in those instances where the regional ventilation is very low or the intra-regional gas flow distribution is markedly nonuniform. A 2-3 fold increase in ventilation was demonstrated in normal nonsmoking subjects going from ventral to dorsal regions in the supine posture. These large regional differences could be well explained by the intrinsic elastic properties of lung tissue, considering the gravitational gradient in transpulmonary pressure. In asymptomatic smokers substantial regional ventilatroy abnormalities were found whilst the regional gas volume was similar in smokers and nonsmokers. The uncoupling between ventilation and gas volume probably reflects inflammatory changes in the airways. The regional differences in dV/dt/dQ/dt were relatively small and blood flow was largely matched to ventilation in the supine posture. However, small regions of lung with very low ventilation, unmatched by blood flow commonly exists in the most dependent parts of the lung in both smokers and nonsmokers. (29 illustrations, 7 tables, 113 references)

  17. Limiting volume with modern ventilators.

    Science.gov (United States)

    Wing, Thomas J; Haan, Lutana; Ashworth, Lonny J; Anderson, Jeff

    2015-06-01

    The acute respiratory distress syndrome (ARDS) network low tidal-volume study comparing tidal volumes of 12 ml/kg versus 6 ml/kg was published in 2000. The study was stopped early as data revealed a 22% relative reduction in mortality rate when using 6 ml/kg tidal volume. The current generation of critical care ventilators allows the tidal volume to be set during volume-targeted, assist/control (volume A/C); however, some ventilators include options that may prevent the tidal volume from being controlled. The purpose of this bench study was to evaluate the delivered tidal volume, when these options are active, in a spontaneously breathing lung model using an electronic breathing simulator. Four ventilators were evaluated: CareFusion AVEA (AVEA), Dräger Evita® XL (Evita XL), Covidien Puritan Bennett® 840(TM) (PB 840), and Maquet SERVO-i (SERVO-i). Each ventilator was connected to the Hans Rudolph Electronic Breathing Simulator at an amplitude of 0 cm H2O and then 10 cm H2O. All four ventilators were set to deliver volume A/C, tidal volume 400 ml, respiratory rate 20 bpm, positive end-expiratory pressure 5 cm H2O, peak flowrate 60 L/min. The displayed tidal volume was recorded for each ventilator at the above settings with additional options OFF and then ON. The AVEA has two options in volume A/C: demand breaths and V-sync. When activated, these options allow the patient to exceed the set tidal volume. When using the Evita XL, the option AutoFlow can be turned ON or OFF, and when this option is ON, the tidal volume may vary. The PB 840 does not have any additional options that affect volume delivery, and it maintains the set tidal volume regardless of patient effort. The SERVO-i's demand valve allows additional flow if the patient's inspiratory flowrate exceeds the set flowrate, increasing the delivered tidal volume; this option can be turned OFF with the latest software upgrade. Modern ventilators have an increasing number of optional settings. These settings may

  18. Sensor-based demand controlled ventilation

    Energy Technology Data Exchange (ETDEWEB)

    De Almeida, A.T. [Universidade de Coimbra (Portugal). Dep. Eng. Electrotecnica; Fisk, W.J. [Lawrence Berkeley National Lab., CA (United States)

    1997-07-01

    In most buildings, occupancy and indoor pollutant emission rates vary with time. With sensor-based demand-controlled ventilation (SBDCV), the rate of ventilation (i.e., rate of outside air supply) also varies with time to compensate for the changes in pollutant generation. In other words, SBDCV involves the application of sensing, feedback and control to modulate ventilation. Compared to ventilation without feedback, SBDCV offers two potential advantages: (1) better control of indoor pollutant concentrations; and (2) lower energy use and peak energy demand. SBDCV has the potential to improve indoor air quality by increasing the rate of ventilation when indoor pollutant generation rates are high and occupants are present. SBDCV can also save energy by decreasing the rate of ventilation when indoor pollutant generation rates are low or occupants are absent. After providing background information on indoor air quality and ventilation, this report provides a relatively comprehensive discussion of SBDCV. Topics covered in the report include basic principles of SBDCV, sensor technologies, technologies for controlling air flow rates, case studies of SBDCV, application of SBDCV to laboratory buildings, and research needs. SBDCV appears to be an increasingly attractive technology option. Based on the review of literature and theoretical considerations, the application of SBDCV has the potential to be cost-effective in applications with the following characteristics: (a) a single or small number of dominant pollutants, so that ventilation sufficient to control the concentration of the dominant pollutants provides effective control of all other pollutants; (b) large buildings or rooms with unpredictable temporally variable occupancy or pollutant emission; and (c) climates with high heating or cooling loads or locations with expensive energy.

  19. Air Distribution and Ventilation Effectiveness in a room with Floor/Ceiling Heating and Mixing/Displacement Ventilation

    DEFF Research Database (Denmark)

    Wu, Xiaozhou; Fang, Lei; Olesen, Bjarne W.

    2014-01-01

    vertical air temperature differences and air velocities for different hybrid systems are less than 3 C and 0.2 m/s when supply air temperature is 19 C, air change rate is 4.2 h-1, and heated surface temperature of floor/ceiling heating system is 25 C. Ventilation effectiveness of mixing ventilation system...... combined with floor/ceiling heating systems is approximately equal to 1.0, and ventilation effectiveness of displacement ventilation system combined with floor/ceiling heating systems ranges from 1.0 to 1.2. The floor/ceiling heating systems combined with mixing ventilation system have more uniform indoor...... air distribution but smaller ventilation effectiveness compared with the floor/ceiling heating systems combined with displacement ventilation system. With regard to the building heat loss increased by non-uniform indoor air distribution and small ventilation effectiveness, there should be an optimal...

  20. A simplified model for estimating population-scale energy impacts of building envelope air-tightening and mechanical ventilation retrofits

    Energy Technology Data Exchange (ETDEWEB)

    Logue, Jennifer M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Turner, William J. N. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Trinity College Dublin, Dublin (Ireland); Walker, Iain S. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Singer, Brett C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2015-01-19

    Changing the air exchange rate of a home (the sum of the infiltration and mechanical ventilation airflow rates) affects the annual thermal conditioning energy. Large-scale changes to air exchange rates of the housing stock can significantly alter the residential sector's energy consumption. However, the complexity of existing residential energy models is a barrier to the accurate quantification of the impact of policy changes on a state or national level. The Incremental Ventilation Energy (IVE) model developed in this study combines the output of simple air exchange models with a limited set of housing characteristics to estimate the associated change in energy demand of homes. The IVE model was designed specifically to enable modellers to use existing databases of housing characteristics to determine the impact of ventilation policy change on a population scale. The IVE model estimates of energy change when applied to US homes with limited parameterisation are shown to be comparable to the estimates of a well-validated, complex residential energy model.

  1. Effectiveness of radon control techniques in fifteen homes

    International Nuclear Information System (INIS)

    Turk, B.H.; Prill, R.J.; Fisk, W.J.; Grimsrud, D.T.; Sextro, R.G.

    1991-01-01

    Radon control systems were installed and evaluated in fourteen homes in the Spokane River Valley/Rathdrum Prairie and in one home in Vancouver, Washington. Because of local soil conditions, subsurface ventilation (SSV) by pressurization was always more effective in these houses than SSV by depressurization in reducing indoor radon levels to below guidelines. Basement overpressurization was successfully applied in five houses with airtight basements where practical-sized fans could develop an overpressure of 1 to 3 Pascals. Crawlspace ventilation was more effective than crawlspace isolation in reducing radon entry from the crawlspace, but had to be used in conjunction with other mitigation techniques, from the crawlspace, but had to be used in conjunction with other mitigation techniques, since the houses also had basements. Indoor radon concentrations in two houses with air-to-air heat exchangers (AAHX) were reduced to levels inversely dependent on the new total ventilation rates and were lowered even further in one house where the air distribution system was modified. Sealing penetrations in the below-grade surfaces of substructures was relatively ineffective in controlling radon. Operation of the radon control systems (except for the AAHX's) made no measurable change in ventilation rates or indoor concentrations of other measured pollutants. Installation costs ranged from approximately $4/m 2 for sealing to $28/m 2 for the AAHXs. Annual operating costs for the active systems were estimated to be approximately $60 to $170

  2. Complications of mechanical ventilation

    Directory of Open Access Journals (Sweden)

    Drašković Biljana

    2011-01-01

    Full Text Available Mechanical ventilation of the lungs, as an important therapeutic measure, cannot be avoided in critically ill patients. However, when machines take over some of vital functions there is always a risk of complications and accidents. Complications associated with mechanical ventilation can be divided into: 1 airway-associated complications; 2 complications in the response of patients to mechanical ventilation; and 3 complications related to the patient’s response to the device for mechanical ventilation. Complications of artificial airway may be related to intubation and extubation or the endotracheal tube. Complications of mechanical ventilation, which arise because of the patient’s response to mechanical ventilation, may primarily cause significant side effects to the lungs. During the last two decades it was concluded that mechanical ventilation can worsen or cause acute lung injury. Mechanical ventilation may increase the alveolar/capillary permeability by overdistension of the lungs (volutrauma, it can exacerbate lung damage due to the recruitment/derecruitment of collapsed alveoli (atelectrauma and may cause subtle damages due to the activation of inflammatory processes (biotrauma. Complications caused by mechanical ventilation, beside those involving the lungs, can also have significant effects on other organs and organic systems, and can be a significant factor contributing to the increase of morbidity and mortality in critically ill of mechanically ventilated patients. Complications are fortunately rare and do not occur in every patient, but due to their seriousness and severity they require extensive knowledge, experience and responsibility by health-care workers.

  3. Admission rates in a general practitioner-based versus a hospital specialist based, hospital-at-home model

    DEFF Research Database (Denmark)

    Mogensen, Christian Backer; Ankersen, Ejnar Skytte; Lindberg, Mats J

    2018-01-01

    . CONCLUSIONS: The GP based HaH model was more effective than the hospital specialist model in avoiding hospital admissions within 7 days among elderly patients with an acute medical condition with no differences in mental or physical recovery rates or deaths between the two models. REGISTRATION: No. NCT......BACKGROUND: Hospital at home (HaH) is an alternative to acute admission for elderly patients. It is unclear if should be cared for a primarily by a hospital intern specialist or by the patient's own general practitioner (GP). The study assessed whether a GP based model was more effective than...... Denmark, including + 65 years old patients with an acute medical condition that required acute hospital in-patient care. The patients were randomly assigned to hospital specialist based model or GP model of HaH care. Five physical and cognitive performance tests were performed at inclusion and after 7...

  4. Variations over time in the effects of age and sex on hospitalization rates before and after admission to a nursing home: A German cohort study.

    Science.gov (United States)

    Hoffmann, Falk; Allers, Katharina

    2017-08-01

    We examined hospitalization rates for nursing home residents before and after their entry to the home, stratified by sex and age. A cohort study was conducted using data from a large health insurance fund on 127,227 residents aged 65 years and over newly admitted to a nursing home between January 1, 2010, and December 31, 2014. We assessed hospitalization rates and proportions being hospitalized in 6-month intervals one year before nursing home placement and up to 5 years thereafter. Multiple Poisson regression models were fitted to calculate relative risks (RR). Mean age was 84.0 years and 74.6% of the cohort were females. Hospitalization rates were 194.4 per 100 person-years (PY) in the 12 months before entry to the nursing home and 120.0 per 100 PY thereafter. Rates were highest immediately before entry in both sexes. The influence of age was most pronounced in the 12-7 months before entry (RR: 2.37 for 65-74 vs. 95+ years) and declined thereafter (1.29-1.38 up to month 24 after entry). In contrast, the influence of sex was greater after entry (RR: 1.13 for males vs. females in the 12-7 months before and 1.23-1.31 up to month 24 after entry). Hospitalization rates of nursing home residents are much higher in Germany than in other Western countries. We have provided some insight into the influence of age and sex on hospitalization rates, which varied over the period (time before and after entry to the nursing home) analyzed. We urgently recommend that future studies on the hospitalization of residents stratify their analyses by sex, age and period. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Protective garment ventilation system

    Science.gov (United States)

    Lang, R. (Inventor)

    1970-01-01

    A method and apparatus for ventilating a protective garment, space suit system, and/or pressure suits to maintain a comfortable and nontoxic atmosphere within is described. The direction of flow of a ventilating and purging gas in portions of the garment may be reversed in order to compensate for changes in environment and activity of the wearer. The entire flow of the ventilating gas can also be directed first to the helmet associated with the garment.

  6. Ventilation of uranium mines

    International Nuclear Information System (INIS)

    Francois, Y.; Pradel, J.; Zettwoog, P.; Dumas, M.

    1975-01-01

    In the first part of the paper the authors describe the ventilation of French mines in terms of the primary ventilation system, which brings the outside air close to the working places using the overall structure of the mine to form the airways, and the secondary ventilation system, which is for the distribution of the primary air or for the ventilation of the development drifts and blind tunnels. Brief mention is made of the French regulations on the ventilation of mines in general and uranium mines in particular. The authors describe the equipment used and discuss the installed capacities and air flow per man and per working place. The difficulties encountered in properly ventilating various types of working places are mentioned, such as sub-level development drifts, reinforced stopes, and storage chambers with an artificial crown. The second part of the paper is devoted to computer calculations of the primary ventilation system. It is explained why the Commissariat a l'energie atomique has found it necessary to make these calculations. Without restating the mathematical theories underlying the methods employed, the authors demonstrate how simple measuring instruments and a small-size computer can be used to solve the ventilation problems arising in French mines. Emphasis is given to the layout of the ventilation system and to air flow and negative pressure measurements at the base of the mine. The authors show how calculations can be applied to new heading operations, a change in resistance, the replacement or addition of a ventilator, and a new air inlet or outlet. The authors come to the conclusion that since ventilation is at present the most reliable way of avoiding the pollution of mines, a thorough knowledge of the capabilities in this respect can often help improve working conditions. Despite the progress made, however, constant surveillance of the ventilation systems in uranium mines by a separate team with no responsibility for production problems is

  7. Ventilation of uranium mines

    International Nuclear Information System (INIS)

    Francois, Y.; Pradel, J.; Zettwoog, P.; Dumas, M.

    1975-01-01

    In the first part of the paper the authors describe the ventilation of French mines in terms of the primary ventilation system, which brings the outside air close to the working places using the overall structure of the mine to form the airways, and the secondary ventilation system, which is for the distribution of the primary air or for the ventilation of the development drifts and blind tunnels. Brief mention is made of the French regulations on the ventilation of mines in general and uranium mines in particular. The authors describe the equipment used and discuss the installed capacities and air flow per man and per working place. The difficulties encountered in properly ventilating various types of working places are mentioned, such as sublevel development drifts, reinforced stopes, and storage chambers with an artificial crown. The second part of the paper is devoted to computer calculations of the primary ventilation system. It is explained why the Commissariat a l'energie atomique has found it necessary to make these calculations. Without restating the mathematical theories underlying the methods employed, the authors demonstrate how simple measuring instruments and a small-size computer can be used to solve the ventilation problems arising in French mines. Emphasis is given to the layout of the ventilation system and to air flow and negative pressure measurements at the base of the mine. The authors show how calculations can be applied to new heading operations, a change in resistance, the replacement or addition of a ventilator, and a new air inlet or outlet. The authors come to the conclusion that since ventilation is at present the most reliable way of avoiding the pollution of mines, a thorough knowledge of the capabilities in this respect can often help improve working conditions. Despite the progress made, however, constant surveillance of the ventilation systems in uranium mines by a separate team with no responsibility for production problems is

  8. Design Principles for Hybrid Ventilation

    DEFF Research Database (Denmark)

    Heiselberg, Per

    For many years mechanical and natural ventilation systems have developed separately. Naturally, the next step in this development is the development of ventilation concepts that utilize and combine the best features from each system to create a new type of ventilation system -Hybrid Ventilation. ....... The hybrid ventilation concepts, design challenges and - principles are discussed and illustrated by four building examples....

  9. Phrenic pacing compared with mechanical ventilation

    DEFF Research Database (Denmark)

    Andersen, Morten Packert; Laub, Michael; Biering-Sørensen, Fin

    2017-01-01

    mechanical ventilator dependent tetraplegics met the inclusion criteria. Data were retrieved from medical records and a structured follow-up interview with seven individuals from each group. RESULTS: No significant differences were found when comparing age at injury, time since injury, length...... of hospitalization, incidence of pneumonia, number of pneumonia hospitalizations, number of tracheal suctions, speech quality and activities of daily living or quality of life. On the Short Form Health Survey (SF36) mental health summary the median for both users of phrenic nerve pacing and users of mechanical...... ventilation was one s.d. above the mean of a standard population. CONCLUSIONS: Nine people have had a phrenic nerve pacer implanted. They do not significantly differ from a group of home mechanical ventilator dependent tetraplegics on a number of performance measures, but both groups seem to have better...

  10. Natural Ventilation in Atria

    DEFF Research Database (Denmark)

    Svidt, Kjeld; Heiselberg, Per; Hendriksen, Ole Juhl

    This case study comprises a monitoring programme as well as a Computational Fluid Dynamics (CFD) analysis of a natural ventilated atrium. The purpose has been to analyse the performance of a typical natural ventilation system in Denmark under both summer and winter conditions.......This case study comprises a monitoring programme as well as a Computational Fluid Dynamics (CFD) analysis of a natural ventilated atrium. The purpose has been to analyse the performance of a typical natural ventilation system in Denmark under both summer and winter conditions....

  11. Experimental Investigation of Heat Transfer during Night-Time Ventilation

    DEFF Research Database (Denmark)

    Artmann, Nikolai; Jensen, Rasmus Lund; Manz, H.

    2010-01-01

    is the heat transfer at the internal room surfaces. Increased convection is expected due to high air flow rates and the possibility of a cold air jet flowing along the ceiling, but the magnitude of these effects is hard to predict. In order to improve the predictability, heat transfer during night......-time ventilation in case of mixing and displacement ventilation has been investigated in a full scale test room. The results show that for low air flow rates displacement ventilation is more efficient than mixing ventilation. For higher air flow rates the air jet flowing along the ceiling has a significant effect...

  12. Effect of openings location on the ventilation efficiency in dwellings; Influencia de la ubicacion de las aberturas en la eficiencia de la ventilacion en viviendas

    Energy Technology Data Exchange (ETDEWEB)

    Meiss, A.; Feijo, J.

    2011-07-01

    Building ventilation implies managing the clean air and extracting the contaminated air through the walls, distributing and circulating the incoming air and preventing the contamination of the indoor air. The Spanish Technical Building Code, in his section HS3 -IAQ, usually set up minimum ventilation flow rates according to its typology, surface, possible contamination sources or the number of occupants, without thinking over the path of the air from the inlet to the exhaust point. For that reason, even if such standards are met within the spaces of the home, there may still be areas in the interior that suffer an excess or deficit of ventilation. The present study aims to overcome the purely quantitative performance of DBHS3, to control qualitatively the air renewal throughout the living space; this allows even to reduce the volumetric flow rate with the consequent energetic saving. (Author) 7 refs.

  13. Canadian House Dust Study: Population-based concentrations, loads and loading rates of arsenic, cadmium, chromium, copper, nickel, lead, and zinc inside urban homes

    Energy Technology Data Exchange (ETDEWEB)

    Rasmussen, Pat E. [Exposure and Biomonitoring Division, Healthy Environments and Consumer Safety Branch, Health Canada, 50 Colombine Driveway, Ottawa, ON, Canada K1A 0K9 (Canada); Department of Earth Sciences, University of Ottawa, 140 Louis Pasteur, Ottawa, ON, Canada K1N 6N5 (Canada); Levesque, Christine [Exposure and Biomonitoring Division, Healthy Environments and Consumer Safety Branch, Health Canada, 50 Colombine Driveway, Ottawa, ON, Canada K1A 0K9 (Canada); Chénier, Marc; Gardner, H. David [Exposure and Biomonitoring Division, Healthy Environments and Consumer Safety Branch, Health Canada, 50 Colombine Driveway, Ottawa, ON, Canada K1A 0K9 (Canada); Department of Earth Sciences, University of Ottawa, 140 Louis Pasteur, Ottawa, ON, Canada K1N 6N5 (Canada); Jones-Otazo, Heather [Regions and Programs Branch, Health Canada, 180 Queen Street West, Toronto, ON, Canada M5V 3L7 (Canada); Petrovic, Sanya [Contaminated Sites Division, Healthy Environments and Consumer Safety Branch, Health Canada, 269 Laurier Ave West, Ottawa, ON, Canada K1A 0K9 (Canada)

    2013-01-15

    The Canadian House Dust Study was designed to obtain nationally representative urban house dust metal concentrations (μg g{sup −1}) and metal loadings (μg m{sup −2}) for arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), nickel (Ni), lead (Pb), and zinc (Zn). Consistent sampling of active dust of known age and provenance (area sampled) also permitted the calculation of indoor loading rates (mg m{sup −2} day{sup −1} for dust and μg m{sup −2} day{sup −1} for metals) for the winter season (from 2007 to 2010) when houses are most tightly sealed. Geomean/median indoor dust loading rates in homes located more than 2 km away from industry of any kind (9.6/9.1 mg m{sup −2} day{sup −1}; n = 580) were significantly lower (p < .001) than geomean (median) dust loading rates in homes located within 2 km of industry (13.5/13.4 mg m{sup −2} day{sup −1}; n = 421). Proximity to industry was characterized by higher indoor metal loading rates (p < .003), but no difference in dust metal concentrations (.29 ≥ p ≤ .97). Comparisons of non-smokers' and smokers' homes in non-industrial zones showed higher metal loading rates (.005 ≥ p ≤ .038) in smokers' homes, but no difference in dust metal concentrations (.15 ≥ p ≤ .97). Relationships between house age and dust metal concentrations were significant for Pb, Cd and Zn (p < .001) but not for the other four metals (.14 ≥ p ≤ .87). All seven metals, however, displayed a significant increase in metal loading rates with house age (p < .001) due to the influence of higher dust loading rates in older homes (p < .001). Relationships between three measures of metals in house dust – concentration, load, and loading rate – in the context of house age, smoking behavior and urban setting consistently show that concentration data is a useful indicator of the presence of metal sources in the home, whereas dust mass is the overriding influence on metal loadings and loading rates

  14. Experimental analysis of energy performance of a ventilated window for heat recovery under controlled conditions

    DEFF Research Database (Denmark)

    Appelfeld, David; Svendsen, Svend

    2011-01-01

    balance of the ventilated window and clarified the methodology for thermal performance evaluation. Comparison between windows with and without ventilation using the window-room-ventilation heat balance revealed that a ventilated window can potentially contribute to energy savings. In addition...... transmittance introduced by the ventilation was higher than the effect of heat recovery. Accordingly, the use of the ventilated windows might be most suitable for window unit with low ventilation rates. The results correlated with theoretical calculations in standards and software. However, the concept...

  15. Styret naturlig ventilation

    DEFF Research Database (Denmark)

    Morsing, S.; Strøm, J.S.

    Publikationen præsenterer et generelt dimensioneringsgrundlag for naturlig ventilation i husdyrstalde. Det er kontrolleret ved forsøg i slagtesvinestalde, hvor det ligeledes er undersøgt hvilken temperaturstabilitet, der kan opnås ved naturlig ventilation, samt produktions- og adfærdsmæssige...

  16. Multifamily Ventilation Retrofit Strategies

    Energy Technology Data Exchange (ETDEWEB)

    Ueno, K. [Building Science Corporation (BSC), Somerville, MA (United States); Lstiburek, J. [Building Science Corporation (BSC), Somerville, MA (United States); Bergey, D. [Building Science Corporation (BSC), Somerville, MA (United States)

    2012-12-01

    In multifamily buildings, central ventilation systems often have poor performance, overventilating some portions of the building (causing excess energy use), while simultaneously underventilating other portions (causing diminished indoor air quality). BSC and Innova Services Corporation performed a series of field tests at a mid-rise test building undergoing a major energy audit and retrofit, which included ventilation system upgrades.

  17. Diffuse Ceiling Ventilation

    DEFF Research Database (Denmark)

    Zhang, Chen; Heiselberg, Per; Nielsen, Peter V.

    2014-01-01

    As a novel air distribution system, diffuse ceiling ventilation combines the suspended acoustic ceiling with ventilation supply. Due to the low-impulse supply from the large ceiling area, the system does not generate draught when supplying cold air. However, heat sources play an important role...

  18. Enhancing Safety of Artificially Ventilated Patients Using Ambient Process Analysis.

    Science.gov (United States)

    Lins, Christian; Gerka, Alexander; Lüpkes, Christian; Röhrig, Rainer; Hein, Andreas

    2018-01-01

    In this paper, we present an approach for enhancing the safety of artificially ventilated patients using ambient process analysis. We propose to use an analysis system consisting of low-cost ambient sensors such as power sensor, RGB-D sensor, passage detector, and matrix infrared temperature sensor to reduce risks for artificially ventilated patients in both home and clinical environments. We describe the system concept and our implementation and show how the system can contribute to patient safety.

  19. Particle deposition in ventilation ducts

    Energy Technology Data Exchange (ETDEWEB)

    Sippola, Mark Raymond [Univ. of California, Berkeley, CA (United States)

    2002-09-01

    Exposure to airborne particles is detrimental to human health and indoor exposures dominate total exposures for most people. The accidental or intentional release of aerosolized chemical and biological agents within or near a building can lead to exposures of building occupants to hazardous agents and costly building remediation. Particle deposition in heating, ventilation and air-conditioning (HVAC) systems may significantly influence exposures to particles indoors, diminish HVAC performance and lead to secondary pollutant release within buildings. This dissertation advances the understanding of particle behavior in HVAC systems and the fates of indoor particles by means of experiments and modeling. Laboratory experiments were conducted to quantify particle deposition rates in horizontal ventilation ducts using real HVAC materials. Particle deposition experiments were conducted in steel and internally insulated ducts at air speeds typically found in ventilation ducts, 2-9 m/s. Behaviors of monodisperse particles with diameters in the size range 1-16 μm were investigated. Deposition rates were measured in straight ducts with a fully developed turbulent flow profile, straight ducts with a developing turbulent flow profile, in duct bends and at S-connector pieces located at duct junctions. In straight ducts with fully developed turbulence, experiments showed deposition rates to be highest at duct floors, intermediate at duct walls, and lowest at duct ceilings. Deposition rates to a given surface increased with an increase in particle size or air speed. Deposition was much higher in internally insulated ducts than in uninsulated steel ducts. In most cases, deposition in straight ducts with developing turbulence, in duct bends and at S-connectors at duct junctions was higher than in straight ducts with fully developed turbulence. Measured deposition rates were generally higher than predicted by published models. A model incorporating empirical equations based on the

  20. Pulmonary perfusion ''without ventilation''

    International Nuclear Information System (INIS)

    Chapman, C.N.; Sziklas, J.J.; Spencer, R.P.; Rosenberg, R.J.

    1983-01-01

    An 88-yr-old man, with prior left upper lobectomy and phrenic nerve injury, had a ventilation/perfusion lung image. Both wash-in and equilibrium ventilation images showed no radioactive gas in the left lung. Nevertheless, the left lung was perfused. A similar result was obtained on a repeat study 8 days later. Delayed images, during washout, showed some radioactive gas in the left lung. Nearly absent ventilation (but continued perfusion) of that lung might have been related to altered gas dynamics brought about by the prior lobectomy, a submucosal bronchial lesion, phrenic nerve damage, and limited motion of the left part of the diaphragm. This case raises the issue of the degree of ventilation (and the phase relationship between the lungs) required for the entry of radioactive gas into a diseased lung, and the production of a ''reversed ventilation/perfusion mismatch.''

  1. Realtime mine ventilation simulation

    International Nuclear Information System (INIS)

    McDaniel, K.H.

    1997-01-01

    This paper describes the development of a Windows based, interactive mine ventilation simulation software program at the Waste Isolation Pilot Plant (WIPP). To enhance the operation of the underground ventilation system, Westinghouse Electric Corporation developed the program called WIPPVENT. While WIPPVENT includes most of the functions of the commercially available simulation program VNETPC and uses the same subroutine to calculate airflow distributions, the user interface has been completely rewritten as a Windows application with screen graphics. WIPPVENT is designed to interact with WIPP ventilation monitoring systems through the sitewise Central monitoring System. Data can be continuously collected from the Underground Ventilation Remote Monitoring and Control System (e.g., air quantity and differential pressure) and the Mine Weather Stations (psychrometric data). Furthermore, WIPPVENT incorporates regulator characteristic curves specific to the site. The program utilizes this data to create and continuously update a REAL-TIME ventilation model. This paper discusses the design, key features, and interactive capabilities of WIPPVENT

  2. Comparison of airway pressure release ventilation to conventional mechanical ventilation in the early management of smoke inhalation injury in swine.

    Science.gov (United States)

    Batchinsky, Andriy I; Burkett, Samuel E; Zanders, Thomas B; Chung, Kevin K; Regn, Dara D; Jordan, Bryan S; Necsoiu, Corina; Nguyen, Ruth; Hanson, Margaret A; Morris, Michael J; Cancio, Leopoldo C

    2011-10-01

    The role of airway pressure release ventilation in the management of early smoke inhalation injury has not been studied. We compared the effects of airway pressure release ventilation and conventional mechanical ventilation on oxygenation in a porcine model of acute respiratory distress syndrome induced by wood smoke inhalation. Prospective animal study. Government laboratory animal intensive care unit. Thirty-three Yorkshire pigs. Smoke inhalation injury. Anesthetized female Yorkshire pigs (n = 33) inhaled room-temperature pine-bark smoke. Before injury, the pigs were randomized to receive conventional mechanical ventilation (n = 15) or airway pressure release ventilation (n = 12) for 48 hrs after smoke inhalation. As acute respiratory distress syndrome developed (PaO2/Fio2 ratio conventional mechanical ventilation for 48 hrs and served as time controls. Changes in PaO2/Fio2 ratio, tidal volume, respiratory rate, mean airway pressure, plateau pressure, and hemodynamic variables were recorded. Survival was assessed using Kaplan-Meier analysis. PaO2/Fio2 ratio was lower in airway pressure release ventilation vs. conventional mechanical ventilation pigs at 12, 18, and 24 hrs (p conventional mechanical ventilation animals between 30 and 48 hrs post injury (p animals between 6 and 48 hrs (p conventional mechanical ventilation and airway pressure release ventilation pigs. In this model of acute respiratory distress syndrome caused by severe smoke inhalation in swine, airway pressure release ventilation-treated animals developed acute respiratory distress syndrome faster than conventional mechanical ventilation-treated animals, showing a lower PaO2/Fio2 ratio at 12, 18, and 24 hrs after injury. At other time points, PaO2/Fio2 ratio was not different between conventional mechanical ventilation and airway pressure release ventilation.

  3. The impacts of balanced and exhaust mechanical ventilation on indoor radon

    International Nuclear Information System (INIS)

    Fisk, W.J.; Mowris, R.J.

    1987-02-01

    Models for estimating radon entry rates, indoor radon concentrations, and ventilation rates in houses with a basement or a vented crawl-space and ventilated by natural infiltration, mechanical exhaust ventilation, or balanced mechanical ventilation are described. Simulations are performed for a range of soil and housing characteristics using hourly weather data for the heating season in Spokane, WA. For a house with a basement, we show that any ventilation technique should be acceptable when the soil permeability is less than approximately 10 -12 m 2 . However, exhaust ventilation leads to substantially higher indoor radon concentrations than infiltration or balanced ventilation with the same average air exchange rate when the soil permeability is 10 -10 m 2 or greater. For houses with a crawl-space, indoor radon concentrations are lowest with balanced ventilation, intermediate with exhaust ventilation, and highest with infiltration

  4. Characteristics of rain penetration through a gravity ventilator used for natural ventilation.

    Science.gov (United States)

    Kim, Taehyeung; Lee, Dong Ho; Ahn, Kwangseog; Ha, Hyunchul; Park, Heechang; Piao, Cheng Xu; Li, Xiaoyu; Seo, Jeoungyoon

    2008-01-01

    Gravity ventilators rely simply on air buoyancy to extract air and are widely used to exhaust air contaminants and heat from workplaces using minimal energy. They are designed to maximize the exhaust flow rate, but the rain penetration sometimes causes malfunctioning. In this study, the characteristics of rain penetration through a ventilator were examined as a preliminary study to develop a ventilator with the maximum exhaust capacity while minimizing rain penetration. A model ventilator was built and exposed to artificial rain and wind. The paths, intensities and amounts of penetration through the ventilator were observed and measured in qualitative and quantitative fashions. In the first phase, the pathways and intensities of rain penetration were visually observed. In the second phase, the amounts of rain penetration were quantitatively measured under the different configurations of ventilator components that were installed based on the information obtained in the first-phase experiment. The effects of wind speed, grill direction, rain drainage width, outer wall height, neck height and leaning angle of the outer wall from the vertical position were analyzed. Wind speed significantly affected rain penetration. Under the low crosswind conditions, the rain penetration intensities were under the limit of detection. Under the high crosswind conditions, grill direction and neck height were the most significant factors in reducing rain penetration. The installation of rain drainage was also important in reducing rain penetration. The experimental results suggest that, with proper configurations of its components, a gravity ventilator can be used for natural ventilation without significant rain penetration problems.

  5. Analysis on ventilation pressure of fire area in longitudinal ventilation of underground tunnel

    Science.gov (United States)

    Li, Jiaxin; Li, Yanfeng; Feng, Xiao; Li, Junmei

    2018-03-01

    In order to solve the problem of ventilation pressure loss in the fire area under the fire condition, the wind pressure loss model of the fire area is established based on the thermodynamic equilibrium relation. The semi-empirical calculation formula is obtained by using the model experiment and CFD simulation. The validity of the formula is verified. The results show that the ventilation pressure loss in the fire zone is proportional to the convective heat release rate at the critical velocity, which is inversely proportional to the upstream ventilation velocity and the tunnel cross-sectional area. The proposed formula is consistent with the law of the tunnel fire test fitting formula that results are close, in contrast, the advantage lies in a clear theoretical basis and ventilation velocity values. The resistance of road tunnel ventilation system is calculated accurately and reliably, and then an effective emergency ventilation operation program is developed. It is necessary to consider the fire zone ventilation pressure loss. The proposed ventilation pressure loss formula can be used for design calculation after thorough verification.

  6. Factors Predicting Ventilator Dependence in Patients with Ventilator-Associated Pneumonia

    Directory of Open Access Journals (Sweden)

    Chia-Cheng Tseng

    2012-01-01

    Full Text Available Objectives. To determine risk factors associated with ventilator dependence in patients with ventilator-associated pneumonia (VAP. Study Design. A retrospective study was conducted at Chang Gung Memorial Hospital, Kaohsiung, from January 1, 2007 to January 31, 2008. Methods. This study evaluated 163 adult patients (aged ≥18 years. Eligibility was evaluated according to the criterion for VAP, Sequential Organ Failure Assessment (SOFA score, Acute Physiological Assessment and Chronic Health Evaluation II (APACHE II score. Oxygenation index, underlying comorbidities, septic shock status, previous tracheostomy status, and factors related to pneumonia were collected for analysis. Results. Of the 163 VAP patients in the study, 90 patients survived, yielding a mortality rate of 44.8%. Among the 90 surviving patients, only 36 (40% had been weaned off ventilators at the time of discharge. Multivariate logistic regression analysis was used to identify underlying factors such as congestive cardiac failure (P=0.009, initial high oxygenation index value (P=0.04, increased SOFA scores (P=0.01, and increased APACHE II scores (P=0.02 as independent predictors of ventilator dependence. Results from the Kaplan-Meier method indicate that initial therapy with antibiotics could increase the ventilator weaning rate (log Rank test, P<0.001. Conclusions. Preexisting cardiopulmonary function, high APACHE II and SOFA scores, and high oxygenation index were the strongest predictors of ventilator dependence. Initial empiric antibiotic treatment can improve ventilator weaning rates at the time of discharge.

  7. Relationship between Staff-Reported Culture Change and Occupancy Rate and Organizational Commitment among Nursing Homes in South Korea

    Science.gov (United States)

    Lee, Minhong; Choi, Jae-Sung; Lim, Jinseop; Kim, Young Sun

    2013-01-01

    Purpose: This study aims to examine culture change in nursing homes in South Korea and to identify the outcomes of culture change implementation. Design and Methods: Data were taken from survey responses from 223 top- or mid-level staff among nursing homes in South Korea that were selected through a proportionate random-stratified sampling method…

  8. Challenges and Opportunities to Improve Cervical Cancer Screening Rates in US Health Centers through Patient-Centered Medical Home Transformation

    Directory of Open Access Journals (Sweden)

    Olga Moshkovich

    2015-01-01

    Full Text Available Over the last 50 years, the incidence of cervical cancer has dramatically decreased. However, health disparities in cervical cancer screening (CCS persist for women from racial and ethnic minorities and those residing in rural and poor communities. For more than 45 years, federally funded health centers (HCs have been providing comprehensive, culturally competent, and quality primary health care services to medically underserved communities and vulnerable populations. To enhance the quality of care and to ensure more women served at HCs are screened for cervical cancer, over eight HCs received funding to support patient-centered medical home (PCMH transformation with goals to increase CCS rates. The study conducted a qualitative analysis using Atlas.ti software to describe the barriers and challenges to CCS and PCMH transformation, to identify potential solutions and opportunities, and to examine patterns in barriers and solutions proposed by HCs. Interrater reliability was assessed using Cohen’s Kappa. The findings indicated that HCs more frequently described patient-level barriers to CCS, including demographic, cultural, and health belief/behavior factors. System-level barriers were the next commonly cited, particularly failure to use the full capability of electronic medical records (EMRs and problems coordinating with external labs or providers. Provider-level barriers were least frequently cited.

  9. The Bonneville Power Administration new energy-efficient homes programs: Final environmental impact statement: Volume 1, Assessing indoor air quality options

    International Nuclear Information System (INIS)

    1988-03-01

    BPA has underway marketing and incentive programs to encourage the construction of new energy-efficient homes that comply with Model Conservation Standards (MCS) developed by the Northwest Power Planning Council. These homes are designed to have lower infiltration rates than current building practices provide, which is likely to contribute to increased levels of indoor air pollutants, and may adversely affect the health of occupants. BPA's current and past new homes programs maintained ventilation rates comparable to those found in current practice homes by requiring balanced mechanical ventilation. BPA now proposes to give builders and consumers more flexibility by increasing the options for protecting indoor air quality in its new homes programs. This proposal is the impetus for this Environmental Impact Statement (EIS), which was prepared for BPA by Pacific Northwest Laboratory. BPS is preparing this EIS to assess whether other techniques maintain indoor air quality comparable to that found in homes built using current practices. Although many pollutants are potentially of great concern, our analysis concentrates on radon and formaldehyde. It is based on measured concentrations of these pollutants and measured ventilation rates in current practice. Ventilation was measured using fan pressurization tests, which measure only air leakage, and perfluorocarbon tracer gas (PFT) tests, which account for ventilation from mechanical devices and occupant behavior in addition to air leakage. These tests yielded two different estimates. We used these data to estimate pollutant concentrations and lifetime cancer rates under three alternative actions. Under all of the alternatives, radon had a much greater effect than formaldehyde. 102 refs

  10. Changes in the Self-Rated Well-Being of People Who Move from Congregated Settings to Personalized Arrangements and Group Home Placements

    Science.gov (United States)

    McConkey, Roy; Keogh, Fiona; Bunting, Brendan; Iriarte, Edurne Garcia

    2018-01-01

    A natural experiment contrasted the self-rated well-being of people with intellectual disabilities (n = 75) and those with enduring mental health problems (n = 44) after they moved to new accommodation and support options, while others remained in congregated settings or living in the family home. Most support staff also provided well-being…

  11. Comparative validation of proxy-based montgomery-asberg depression rating scale and cornell scale for depression in dementia in nursing home residents with dementia

    NARCIS (Netherlands)

    Leontjevas, R.; Gerritsen, D.L.; Vernooij-Dassen, M.F.J.; Smalbrugge, M.; Koopmans, R.T.C.M.

    2012-01-01

    Objective: To 1) compare the accuracy of the Montgomery-̊Asberg Depression Rating Scale (MADRS) and the Cornell Scale for Depression in Dementia (CSDD) in nursing home residents with dementia when professional caregivers are the only available source of information and 2) explore different methods

  12. Thermal comfort and ventilation effectiveness in an office room with radiant floor cooling and displacement ventilation

    DEFF Research Database (Denmark)

    Krajcik, Michal; Tomasi, Roberta; Simone, Angela

    2016-01-01

    conditions, varying the nominal air change rate from 4.5h-1 down to 1.5h-1. Contaminant removal and mean-age-of-air measurements were performed to characterize the ventilation effectiveness and air velocity; air and operative temperature profiles were measured, together with thermal manikin equivalent...... temperatures, to evaluate the thermal environment. The combined system was able to achieve good ventilation effectiveness close to a heat source, so that in the occupant's breathing zone the ventilation effectiveness was significantly better than for ideal mixing, even at a nominal air change rate as low as 1......% at the highest nominal air change rate of 4.5h-1, even for an occupant sitting 1 meter in front of the supply diffuser, the local thermal discomfort occasioned by the excessive vertical temperature differences gives chilled ceilings the advantage over chilled floors for use with displacement ventilation....

  13. Weaning newborn infants from mechanical ventilation

    Directory of Open Access Journals (Sweden)

    Paolo Biban

    2013-06-01

    Full Text Available Invasive mechanical ventilation is a life-saving procedure which is largely used in neonatal intensive care units, particularly in very premature newborn infants. However, this essential treatment may increase mortality and cause substantial morbidity, including lung or airway injuries, unplanned extubations, adverse hemodynamic effects, analgosedative dependency and severe infectious complications, such as ventilator-associated pneumonia. Therefore, limiting the duration of airway intubation and mechanical ventilator support is crucial for the neonatologist, who should aim to a shorter process of discontinuing mechanical ventilation as well as an earlier appreciation of readiness for spontaneous breathing trials. Unfortunately, there is scarce information about the best ways to perform an effective weaning process in infants undergoing mechanical ventilation, thus in most cases the weaning course is still based upon the individual judgment of the attending clinician. Nonetheless, some evidence indicate that volume targeted ventilation modes are more effective in reducing the duration of mechanical ventilation than traditional pressure limited ventilation modes, particularly in very preterm babies. Weaning and extubation directly from high frequency ventilation could be another option, even though its effectiveness, when compared to switching and subsequent weaning and extubating from conventional ventilation, is yet to be adequately investigated. Some data suggest the use of weaning protocols could reduce the weaning time and duration of mechanical ventilation, but better designed prospective studies are still needed to confirm these preliminary observations. Finally, the implementation of short spontaneous breathing tests in preterm infants has been shown to be beneficial in some centres, favoring an earlier extubation at higher ventilatory settings compared with historical controls, without worsening the extubation failure rate. Further

  14. Academic Emergency Medicine Physicians’ Knowledge of Mechanical Ventilation

    Directory of Open Access Journals (Sweden)

    Susan R. Wilcox

    2016-05-01

    Full Text Available Introduction: Although emergency physicians frequently intubate patients, management of mechanical ventilation has not been emphasized in emergency medicine (EM education or clinical practice. The objective of this study was to quantify EM attendings’ education, experience, and knowledge regarding mechanical ventilation in the emergency department. Methods: We developed a survey of academic EM attendings’ educational experiences with ventilators and a knowledge assessment tool with nine clinical questions. EM attendings at key teaching hospitals for seven EM residency training programs in the northeastern United States were invited to participate in this survey study. We performed correlation and regression analyses to evaluate the relationship between attendings’ scores on the assessment instrument and their training, education, and comfort with ventilation. Results: Of 394 EM attendings surveyed, 211 responded (53.6%. Of respondents, 74.5% reported receiving three or fewer hours of ventilation-related education from EM sources over the past year and 98 (46% reported receiving between 0-1 hour of education. The overall correct response rate for the assessment tool was 73.4%, with a standard deviation of 19.9. The factors associated with a higher score were completion of an EM residency, prior emphasis on mechanical ventilation during one’s own residency, working in a setting where an emergency physician bears primary responsibility for ventilator management, and level of comfort with managing ventilated patients. Physicians’ comfort was associated with the frequency of ventilator changes and EM management of ventilation, as well as hours of education. Conclusion: EM attendings report caring for mechanically ventilated patients frequently, but most receive fewer than three educational hours a year on mechanical ventilation, and nearly half receive 0-1 hour. Physicians’ performance on an assessment tool for mechanical ventilation is

  15. Evaporation Controlled Emission in Ventilated Rooms

    DEFF Research Database (Denmark)

    Topp, Claus; Nielsen, Peter V.; Heiselberg, Per

    -scale ventilated room when the emission is fully or partly evaporation controlled. The objective of the present research work has been to investigate the change of emission rates from small-scale experiments to full-scale ventilated rooms and to investigate the influence of the local air velocity field near......Emission of volatile organic compounds (VOCs) from materials is traditionally determined from tests carried out in small-scale test chambers. However, a difference in scale may lead to a difference in the measured emission rate in a small-scale test chamber and the actual emission rate in a full...

  16. The impact of a ventilator bundle on preventing ventilator-associated pneumonia: a multicenter study.

    Science.gov (United States)

    Eom, Joong Sik; Lee, Mi-Suk; Chun, Hee-Kyung; Choi, Hee Jung; Jung, Sun-Young; Kim, Yeon-Sook; Yoon, Seon Jin; Kwak, Yee Gyung; Oh, Gang-Bok; Jeon, Min-Hyok; Park, Sun-Young; Koo, Hyun-Sook; Ju, Young-Su; Lee, Jin Seo

    2014-01-01

    For prevention of ventilator-associated pneumonia (VAP), a bundle approach was applied to patients receiving mechanical ventilation in intensive care units. The incidence of VAP and the preventive efficacy of the VAP bundle were investigated. A quasi-experimental study was conducted in adult intensive care units of 6 university hospitals with similar VAP rates. We implemented the VAP bundle between March 2011 and June 2011, then compared the rate of VAP after implementation of the VAP bundle with the rate in the previous 8 months. Our ventilator bundle included head of bed elevation, peptic ulcer disease prophylaxis, deep venous thrombosis prophylaxis, and oral decontamination with chlorhexidine 0.12%. Continuous aspiration of subglottic secretions was an option. Implementation of the VAP bundle reduced the VAP rate from a mean of 4.08 cases per 1,000 ventilator-days to 1.16 cases per 1,000 ventilator-days. The incidence density ratio (rate) was 0.28 (95% confidence interval, 0.275-0.292). Implementing the appropriate VAP bundle significantly decreased the incidence of VAP in patients with mechanical ventilation. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  17. Minute Ventilation Limitations of Two Field Transport Ventilators.

    Science.gov (United States)

    Szpisjak, Dale F; Horn, Gregory; Shalov, Samuel; Abes, Alvin Angelo; Van Decar, Lauren

    2017-01-01

    Knowledge of transport ventilator performance impacts patient safety. This study compared minute ventilation (V E ) of the MOVES and Uni-Vent 731 when ventilating the VentAid Training Test Lung with compliance (C) ranging from 0.02 to 0.10 L/cm H 2 O and three different airway resistances (R) (none, Rp5, or Rp20). Tidal volume (V T ) was 800 ± 25 mL. Respiratory rate was increased to ventilator's maximum or until auto-PEEP > 5 cm H 2 O. Respiratory parameters were recorded with the RSS 100HR Research Pneumotach. Data were reported as median (interquartile range). Peak inspiratory pressure (PIP) of the Uni-Vent and MOVES ranged from 22.3 (22.2-22.5) to 82.6 (82.2-83.2) and 20.8 (20.6-20.9) to 50.6 (50.2-50.9) cm H 2 O, respectively. V E of the Uni-Vent and MOVES ranged from 17.7 (17.7-17.7) to 31.5 (31.5-31.5) and 11.3 (10.5-11.3) to 20.2 (19.7-20.5) L/min, respectively. Linear regression demonstrated strong, negative correlation of V E with PIP for the MOVES (V E [L/min] = 26 - 0.31 × PIP [cm H 2 O], r = -0.97) but weak, positive correlation for the Uni-Vent (r = 0.05). Uni-Vent V E exceeded MOVES V E under each test condition (p = 0.0002). If patient V E requirements exceed those predicted by the MOVES regression equation, then using the Uni-Vent should be considered. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  18. Planning an outing from hospital for ventilator-dependent children.

    Science.gov (United States)

    Gilgoff, I S; Helgren, J

    1992-10-01

    Returning ventilator-dependent children to the home environment has become a well-accepted occurrence. The success of a home program depends on careful pre-discharge planning in order to ensure the child's medical safety, and adequate preparation to ensure the child's and family's adjustment to an active community life after discharge. To achieve this, involvement in community activities must begin while the child is still in hospital. As part of a complete rehabilitation program, nine ventilator-dependent children were taken on an inpatient outing to Disneyland. The planning and goals of the outing are described.

  19. Meeting Residential Ventilation Standards Through Dynamic Control of Ventilation Systems

    OpenAIRE

    Sherman, Max H.

    2011-01-01

    Existing ventilation standards, including American Society of Heating, Refrigerating, and Air-conditioning Engineers (ASHRAE) Standard 62.2, specify continuous operation of a defined mechanical ventilation system to provide minimum ventilation, with time-based intermittent operation as an option. This requirement ignores several factors and concerns including: other equipment such as household exhaust fans that might incidentally provide ventilation, negative impacts of ventilation when outd...

  20. What Is a Ventilator?

    Science.gov (United States)

    ... who are on ventilators for shorter periods. The advantage of this tube is that it can be ... other disease or condition. VAP is treated with antibiotics. You may need special antibiotics if the VAP ...

  1. Survival after Pneumocystis jirovecii pneumonia requiring ventilation ...

    African Journals Online (AJOL)

    Pneumocystis pneumonia (PCP) in patients with the human immunodeficiency virus (HIV) is associated with a high mortality rate, which increases substantially with the need for mechanical ventilation. Local experience of patients with PCP admitted to the intensive care unit has revealed mortality rates close to 100%.

  2. Can We Rely on Predicted Basal Metabolic Rate in Patients With Intestinal Failure on Home Parenteral Nutrition?

    Science.gov (United States)

    Skallerup, Anders; Nygaard, Louis; Olesen, Søren Schou; Vinter-Jensen, Lars; Køhler, Marianne; Rasmussen, Henrik Højgaard

    2017-09-01

    Intestinal failure (IF) is a serious and common complication of short bowel syndrome with patients depending on parenteral nutrition (PN) support. Effective nutrition management requires an accurate estimation of the patient's basal metabolic rate (BMR) to avoid underfeeding or overfeeding. However, indirect calorimetry, considered the gold standard for BMR assessment, is a time- and resource-consuming procedure. Consequently, several equations for prediction of BMR have been developed in different settings, but their accuracy in patients with IF are yet to be investigated. We evaluated the accuracy of predicted BMR in clinically stable patients with IF dependent on home parenteral nutrition (HPN). In total, 103 patients with IF were included. We used indirect calorimetry for assessment of BMR and calculated predicted BMR using different equations based on anthropometric and/or bioelectrical impedance parameters. The accuracy of predicted BMR was evaluated using Bland-Altman analysis with measured BMR as the gold standard. The average measured BMR was 1272 ± 245 kcal/d. The most accurate estimations of BMR were obtained using the Harris-Benedict equation (mean bias, 14 kcal/d [ P = .28]; limits of agreement [LoA], -238 to 266 kcal/d) and the Johnstone equation (mean bias, -16 kcal/d [ P = .24]; LoA, -285 to 253 kcal/d). For both equations, 67% of patients had a predicted BMR from 90%-110% All other equations demonstrated a statistically and clinically significant difference between measured and predicted BMR. The Harris-Benedict and Johnstone equations reliably predict BMR in two-thirds of clinically stable patients with IF on HPN.

  3. Fire, safety and ventilation

    Energy Technology Data Exchange (ETDEWEB)

    Hindle, D.

    1999-02-01

    Correct ventilation in tunnel environments is vital for the comfort and safety of the people passing through. This article gives details of products from several manufacturers of safety rescue and fire fighting equipment, fire and fume detection equipment, special fire resistant materials, fire resistant hydraulic oils and fire dampers, and ventilation systems. Company addresses and fax numbers are supplied. 4 refs., 5 tabs., 10 photos.

  4. Long Term Follow-up of Ventilated Patients with Thoracic Restriction and Neuromuscular Disease

    Directory of Open Access Journals (Sweden)

    Dina Brooks

    2002-01-01

    Full Text Available OBJECTIVE: To evaluate the long term effects of home mechanical ventilation (HMV on pulmonary function, nighttime gas exchange, daytime arterial blood gases, sleep architecture and functional exercise capacity (6 min walk. Patients with respiratory failure attributable to thoracic restrictive disease (TRD (kyphoscoliosis or neuromuscular disease (NMD were assessed, ventilated, trained and followed in a dedicated unit for the care of patients requiring long term ventilation.

  5. Human care system for heart-rate and human-movement trajectory in home and its application to detect mental disease

    Science.gov (United States)

    Hata, Yutaka; Kanazawa, Seigo; Endo, Maki; Tsuchiya, Naoki; Nakajima, Hiroshi

    2012-06-01

    This paper proposes a heart rate monitoring system for detecting autonomic nervous system by the heart rate variability using an air pressure sensor to diagnose mental disease. Moreover, we propose a human behavior monitoring system for detecting the human trajectory in home by an infrared camera. In day and night times, the human behavior monitoring system detects the human movement in home. The heart rate monitoring system detects the heart rate in bed in night time. The air pressure sensor consists of a rubber tube, cushion cover and pressure sensor, and it detects the heart rate by setting it to bed. It unconstraintly detects the RR-intervals; thereby the autonomic nervous system can be assessed. The autonomic nervous system analysis can examine the mental disease. While, the human behavior monitoring system obtains distance distribution image by an infrared camera. It classifies adult, child and the other object from distance distribution obtained by the camera, and records their trajectories. This behavior, i.e., trajectory in home, strongly corresponds to cognitive disorders. Thus, the total system can detect mental disease and cognitive disorders by uncontacted sensors to human body.

  6. Outcome-based ventilation: A framework for assessing performance, health, and energy impacts to inform office building ventilation decisions.

    Science.gov (United States)

    Rackes, A; Ben-David, T; Waring, M S

    2018-04-23

    This article presents an outcome-based ventilation (OBV) framework, which combines competing ventilation impacts into a monetized loss function ($/occ/h) used to inform ventilation rate decisions. The OBV framework, developed for U.S. offices, considers six outcomes of increasing ventilation: profitable outcomes realized from improvements in occupant work performance and sick leave absenteeism; health outcomes from occupant exposure to outdoor fine particles and ozone; and energy outcomes from electricity and natural gas usage. We used the literature to set low, medium, and high reference values for OBV loss function parameters, and evaluated the framework and outcome-based ventilation rates using a simulated U.S. office stock dataset and a case study in New York City. With parameters for all outcomes set at medium values derived from literature-based central estimates, higher ventilation rates' profitable benefits dominated negative health and energy impacts, and the OBV framework suggested ventilation should be ≥45 L/s/occ, much higher than the baseline ~8.5 L/s/occ rate prescribed by ASHRAE 62.1. Only when combining very low parameter estimates for profitable impacts with very high ones for health and energy impacts were all outcomes on the same order. Even then, however, outcome-based ventilation rates were often twice the baseline rate or more. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Effectiveness of air vapor barriers combined with ventilated crawlspaces in decreasing residential exposure to radon daughters to radon daughters: preliminary report

    International Nuclear Information System (INIS)

    Sterling, T.D.; Arundel, A.; McIntyre, D.; Sterling, E.; Sterling, T.D.

    1986-01-01

    Radon gas is present in many homes. Concentrations may be increased in airtight, energy-efficient structures. This is especially true in cold climates where energy conservation is an important factor leading to the widespread application of sealing and tightening techniques both in older renovated homes and new construction. To reduce radon concentrations, it may be effective to ventilate crawlspaces and prevent infiltration of radon gas into the house by means of an air/vapor barrier. The authors report first results of comparing radon levels in homes with and without ventilated crawlspaces and air/vapor barriers. Radon emissions were measured in a tightly sealed home with ventilated crawlspaces and an air/vapor barrier and in two homes without such vapor barriers and ventilated crawlspaces, but differing in ventilation. Preliminary results suggest that use of ventilated crawlspaces and bottomside vapor barriers may reduce indoor radon levels by approximately 60%. 15 references, 1 table

  8. Mobile communication devices causing interference in invasive and noninvasive ventilators.

    Science.gov (United States)

    Dang, Bao P; Nel, Pierre R; Gjevre, John A

    2007-06-01

    The aim of this study was to assess if common mobile communication systems would cause significant interference on mechanical ventilation devices and at what distances would such interference occur. We tested all the invasive and noninvasive ventilatory devices used within our region. This consisted of 2 adult mechanical ventilators, 1 portable ventilator, 2 pediatric ventilators, and 2 noninvasive positive pressure ventilatory devices. We operated the mobile devices from the 2 cellular communication systems (digital) and 1 2-way radio system used in our province at varying distances from the ventilators and looked at any interference they created. We tested the 2-way radio system, which had a fixed operation power output of 3.0 watts, the Global Systems for Mobile Communication cellular system, which had a maximum power output of 2.0 watts and the Time Division Multiple Access cellular system, which had a maximum power output of 0.2 watts on our ventilators. The ventilators were ventilating a plastic lung at fixed settings. The mobile communication devices were tested at varying distances starting at zero meter from the ventilator and in all operation modes. The 2-way radio caused the most interference on some of the ventilators, but the maximum distance of interference was 1.0 m. The Global Systems for Mobile Communication system caused significant interference only at 0 m and minor interference at 0.5 m on only 1 ventilator. The Time Division Multiple Access system caused no interference at all. Significant interference consisted of a dramatic rise and fluctuation of the respiratory rate, pressure, and positive end-expiratory pressure of the ventilators with no normalization when the mobile device was removed. From our experiment on our ventilators with the communication systems used in our province, we conclude that mobile communication devices such as cellular phones and 2-way radios are safe and cause no interference unless operated at very close distances of

  9. EVALUATION TOOL OF CLIMATE POTENTIAL FOR VENTILATIVE COOLING

    DEFF Research Database (Denmark)

    Belleri, Annamaria; Psomas, Theofanis Ch.; Heiselberg, Per Kvols

    2015-01-01

    . Within IEA Annex 62 project, national experts are working on the development of a climate evaluation tool, which aims at assessing the potential of ventilative cooling by taking into account also building envelope thermal properties, internal gains and ventilation needs. The analysis is based on a single......-zone thermal model applied to user-input climatic data on hourly basis. The tool identifies the percentage of hours when natural ventilation can be exploited to assure minimum air change rates required by state of the art research, standards and regulations and the percentage of hours when direct ventilative...

  10. Ventilation and perfusion display in a single image

    International Nuclear Information System (INIS)

    Lima, J.J.P. de; Botelho, M.F.R.; Pereira, A.M.S.; Rafael, J.A.S.; Pinto, A.J.; Marques, M.A.T.; Pereira, M.C.; Baganha, M.F.; Godinho, F.

    1991-01-01

    A new method of ventilation and perfusion display onto a single image is presented. From the data on regions of interest of the lungs, three-dimensional histograms are created, containing as parameters X and Y for the position of the pixels, Z for the perfusion and colour for local ventilation. The perfusion value is supplied by sets of curves having Z proportional to the local perfusion count rate. Ventilation modulates colour. Four perspective views of the histogram are simultaneously displayed to allow visualization of the entire organ. Information about the normal ranges for both ventilation and perfusion is also provided in the histograms. (orig.)

  11. The predictive value of respiratory function tests for non-invasive ventilation in amyotrophic lateral sclerosis

    NARCIS (Netherlands)

    Tilanus, T.B.M.; Groothuis, J.T.; Broek-Pastoor, J.M.C. ten; Feuth, T.; Heijdra, Y.F.; Slenders, J.P.L.; Doorduin, J.; Engelen, B.G.M. van; Kampelmacher, M.J.; Raaphorst, J.

    2017-01-01

    BACKGROUND: Non-invasive ventilation (NIV) improves survival and quality of life in amyotrophic lateral sclerosis (ALS) patients. The timing of referral to a home ventilation service (HVS), which is in part based on respiratory function tests, has shown room for improvement. It is currently unknown

  12. The predictive value of respiratory function tests for non-invasive ventilation in amyotrophic lateral sclerosis

    NARCIS (Netherlands)

    Tilanus, T. B. M.; Groothuis, J. T.; TenBroek-Pastoor, J. M. C.; Feuth, T. B.; Heijdra, Y. F.; Slenders, J. P. L.; Doorduin, J.; van Engelen, B. G.; Kampelmacher, M. J.; Raaphorst, J.

    2017-01-01

    Background: Non-invasive ventilation (NIV) improves survival and quality of life in amyotrophic lateral sclerosis (ALS) patients. The timing of referral to a home ventilation service (HVS), which is in part based on respiratory function tests, has shown room for improvement. It is currently unknown

  13. The predictive value of self-rated health in the presence of subjective memory complaints on permanent nursing home placement in elderly primary care patients over 4-year follow-up

    DEFF Research Database (Denmark)

    Nielsen, Anni Brit Sternhagen; Siersma, Volkert Dirk; Waldemar, Gunhild

    2013-01-01

    self-rated health (SRH) predicts nursing home (NH) placement; subjective memory complaints (SMC) too. However, the predictive value of SRH in the presence of SMC is unclear.......self-rated health (SRH) predicts nursing home (NH) placement; subjective memory complaints (SMC) too. However, the predictive value of SRH in the presence of SMC is unclear....

  14. Optimization of Occupancy Based Demand Controlled Ventilation in Residences

    DEFF Research Database (Denmark)

    Mortensen, Dorthe Kragsig; Walker, Iain; Sherman, Max

    2011-01-01

    Although it has been used for many years in commercial buildings, the application of demand controlled ventilation in residences is limited. In this study we used occupant exposure to pollutants integrated over time (referred to as "dose") as the metric to evaluate the effectiveness and air quality...... implications of demand controlled ventilation in residences. We looked at air quality for two situations. The first is that typically used in ventilation standards: the exposure over a long term. The second is to look at peak exposures that are associated with time variations in ventilation rates and pollutant...... when occupied. We used analytical solutions to the continuity equation to determine the ventilation effectiveness and the long-term chronic dose and peak acute exposure for a representative range of occupancy periods, pollutant generation rates and airflow rates. The results of the study showed that we...

  15. Monitoring of ovarian activity by measurement of urinary excretion rates of estrone glucuronide and pregnanediol glucuronide using the Ovarian Monitor, Part II: reliability of home testing.

    Science.gov (United States)

    Blackwell, Leonard F; Vigil, Pilar; Gross, Barbara; d'Arcangues, Catherine; Cooke, Delwyn G; Brown, James B

    2012-02-01

    The UNDP/WHO/World Bank/Special Programme of Research, Development and Research Training in Human Reproduction (Geneva) set up a study to determine whether it is feasible for women to monitor their ovarian activity reliably by home testing. Daily self-monitoring of urinary hormone metabolites for menstrual cycle assessment was evaluated by comparison of results obtained with the Home Ovarian Monitor by untrained users both at home and in study centres. Women collected daily data for urinary estrone glucuronide (E1G) and pregnanediol glucuronide (PdG) for two cycles, then the procedure was repeated in the women's local centre (in Chile, Australia or New Zealand) giving a total of 113 duplicate cycles. The tests were performed without the benefit of replicates or quality controls. The home and centre cycles were normalized and compared to identify assay errors, and the resulting home and centre menstrual cycle profiles were averaged. Reliable mean cycle profiles were obtained with the home and centre excretion rates agreeing to within 36 ± 21 nmol/24 h for E1G and 0.77 ± 0.28 µmol/24 h for baseline PdG values (1-5 µmol/24 h). The cycles had a mean length of 28.1 ± 3.1 days (n = 112; 5th and 95th percentiles: 24 and 35 days, respectively), a mean follicular phase of 14.8 ± 3.1 days (n = 107; 5th and 95th percentiles: 11 and 21 days) and a mean luteal phase length of 13.3 ± 1.5 days (n = 106; 5th and 95th percentiles: 11 and 17 days), calculated from the day of the LH peak. The study confirmed that the Ovarian Monitor pre-coated assay tubes worked well even in the hands of lay users, without standard curves, quality controls or replicates. Point-of-care monitoring to give reliable fertility data is feasible.

  16. Clinical challenges in mechanical ventilation.

    Science.gov (United States)

    Goligher, Ewan C; Ferguson, Niall D; Brochard, Laurent J

    2016-04-30

    Mechanical ventilation supports gas exchange and alleviates the work of breathing when the respiratory muscles are overwhelmed by an acute pulmonary or systemic insult. Although mechanical ventilation is not generally considered a treatment for acute respiratory failure per se, ventilator management warrants close attention because inappropriate ventilation can result in injury to the lungs or respiratory muscles and worsen morbidity and mortality. Key clinical challenges include averting intubation in patients with respiratory failure with non-invasive techniques for respiratory support; delivering lung-protective ventilation to prevent ventilator-induced lung injury; maintaining adequate gas exchange in severely hypoxaemic patients; avoiding the development of ventilator-induced diaphragm dysfunction; and diagnosing and treating the many pathophysiological mechanisms that impair liberation from mechanical ventilation. Personalisation of mechanical ventilation based on individual physiological characteristics and responses to therapy can further improve outcomes. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Evaluation of Mechanical Ventilator Use with Liquid Oxygen Systems

    Science.gov (United States)

    2017-02-22

    Endotracheal tubes, high-volume, low-pressure, tracheal wall injury 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT SAR 18. NUMBER OF...ventilators to the LOX devices. Ventilator settings were as follows : respiratory rate 35 breaths/min, inspiratory time 0.8 seconds, tidal volume 450 mL

  18. The growing role of noninvasive ventilation in patients requiring prolonged mechanical ventilation.

    Science.gov (United States)

    Hess, Dean R

    2012-06-01

    For many patients with chronic respiratory failure requiring ventilator support, noninvasive ventilation (NIV) is preferable to invasive support by tracheostomy. Currently available evidence does not support the use of nocturnal NIV in unselected patients with stable COPD. Several European studies have reported benefit for high intensity NIV, in which setting of inspiratory pressure and respiratory rate are selected to achieve normocapnia. There have also been studies reporting benefit for the use of NIV as an adjunct to exercise training. NIV may be useful as an adjunct to airway clearance techniques in patients with cystic fibrosis. Accumulating evidence supports the use of NIV in patients with obesity hypoventilation syndrome. There is considerable observational evidence supporting the use of NIV in patients with chronic respiratory failure related to neuromuscular disease, and one randomized controlled trial reported that the use of NIV was life-prolonging in patients with amyotrophic lateral sclerosis. A variety of interfaces can be used to provide NIV in patients with stable chronic respiratory failure. The mouthpiece is an interface that is unique in this patient population, and has been used with success in patients with neuromuscular disease. Bi-level pressure ventilators are commonly used for NIV, although there are now a new generation of intermediate ventilators that are portable, have a long battery life, and can be used for NIV and invasive applications. Pressure support ventilation, pressure controlled ventilation, and volume controlled ventilation have been used successfully for chronic applications of NIV. New modes have recently become available, but their benefits await evidence to support their widespread use. The success of NIV in a given patient population depends on selection of an appropriate patient, selection of an appropriate interface, selection of an appropriate ventilator and ventilator settings, the skills of the clinician, the

  19. Estimating intrapartum-related perinatal mortality rates for booked home births: when the 'best' available data are not good enough.

    Science.gov (United States)

    Gyte, G; Dodwell, M; Newburn, M; Sandall, J; Macfarlane, A; Bewley, S

    2009-06-01

    To critically appraise a recent study on the safety of home birth (Mori R, Dougherty M, Whittle M. BJOG 2008;115:554) and assess its contribution to the debate about risks and benefits of planned home birth for women at low risk of complications. Critical appraisal of a published paper. England and Wales. Home births from 1994-2003 and all women giving birth in the same time period. Six members of a multidisciplinary group appraised the paper independently. Comments were collated and synthesised. Assessment of: overall methodology; assumptions used in estimating figures; methods used for calculations; conclusions drawn from the results and reliability and consistency of data. Although there were some positive aspects to the study, there were weaknesses in design and an inaccurate estimate of risk. Our evidence suggests that the conclusions drawn did not reflect the results and the methodological weaknesses found in the study rendered both the results and conclusions invalid. On the basis of our critical appraisal, the study does not contribute to the existing evidence about the safety of home birth to inform decision-making or provision of care. The limitations could have been identified by the peer review process and the problems were compounded by an inaccurate press release. Great care needs to be taken by journals to ensure the accuracy of information before dissemination to the scientific community, clinicians and the public. These data should not have been used to inform national guidelines.

  20. A hospital-based palliative care service for patients with advanced organ failure in sub-Saharan Africa reduces admissions and increases home death rates.

    Science.gov (United States)

    Desrosiers, Taylor; Cupido, Clint; Pitout, Elizabeth; van Niekerk, Lindi; Badri, Motasim; Gwyther, Liz; Harding, Richard

    2014-04-01

    Despite emerging data of cost savings under palliative care in various regions, no such data have been generated in response to the high burden of terminal illness in Africa. This evaluation of a novel hospital-based palliative care service for patients with advanced organ failure in urban South Africa aimed to determine whether the service reduces admissions and increases home death rates compared with the same fixed time period of standard hospital care. Data on admissions and place of death were extracted from routine hospital activity records for a fixed period before death, using standard patient daily expense rates. Data from the first 56 consecutive deaths under the new service (intervention group) were compared with 48 consecutive deaths among patients immediately before the new service (historical controls). Among the intervention and control patients, 40 of 56 (71.4%) and 47 of 48 (97.9%), respectively, had at least one admission (P home death was achieved by 33 of 56 (58.9%) and nine of 48 (18.8%), respectively (P ≤ 0.001). These data demonstrate that an outpatient hospital-based service reduced admissions and improved the rate of home deaths and offers a feasible and cost-effective model for such settings. Copyright © 2014 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  1. On the calculation of air flow rates to ventilate closed-type stations in subway with the double-track tunnel

    Science.gov (United States)

    Kiyanitsa, LA

    2018-03-01

    Metro is not only the most promising kind of public transport but also an important part of infrastructure in a modern city. As a place where large groups of people gather, subway is to ensure the required air exchange at the passenger platforms of the stations. The air flow rate for airing the stations is also determined based on the required temperature, humidity and MAC of gases. The present study estimates the required air flow rate at the passenger platform of the closed-type subway station with the double-track tunnel given the standard air temperature, humidity and gas concentration, as well as based on the condition of the specified air flow feed and air changes per hour. The article proposes the scheme of air recirculation from the double-track tunnel to the station.

  2. Impact of providing in-home water service on the rates of infectious diseases: results from four communities in Western Alaska.

    Science.gov (United States)

    Thomas, T K; Ritter, T; Bruden, D; Bruce, M; Byrd, K; Goldberger, R; Dobson, J; Hickel, K; Smith, J; Hennessy, T

    2016-02-01

    Approximately 20% of rural Alaskan homes lack in-home piped water; residents haul water to their homes. The limited quantity of water impacts the ability to meet basic hygiene needs. We assessed rates of infections impacted by water quality (waterborne, e.g. gastrointestinal infections) and quantity (water-washed, e.g. skin and respiratory infections) in communities transitioning to in-home piped water. Residents of four communities consented to a review of medical records 3 years before and after their community received piped water. We selected health encounters with ICD-9CM codes for respiratory, skin and gastrointestinal infections. We calculated annual illness episodes for each infection category after adjusting for age. We obtained 5,477 person-years of observation from 1032 individuals. There were 9,840 illness episodes with at least one ICD-9CM code of interest; 8,155 (83%) respiratory, 1,666 (17%) skin, 241 (2%) gastrointestinal. Water use increased from an average 1.5 gallons/capita/day (g/c/d) to 25.7 g/c/d. There were significant (P-value water. This study reinforces the importance of adequate quantities of water for health.

  3. Incidence of the geometric parameters and of flow in the primary ventilation rate and of carbon monoxide emissions in burning atmospherics of medium and high pressure

    International Nuclear Information System (INIS)

    Amell A, Andres; Hernandez V, Jaime; Cortes T, Jaime

    2000-01-01

    In this kind of atmospheric burners, high-pressure gas supply and Venturi geometry guarantee a good primary air entrance for combustion. In this project we analyze the most important burner geometric parameters (outlet diameter, injection diameter and mixer geometry) and gas flux conditions (supply pressure) that have an influence over primary aeration rate. The results of this investigation will contribute with the methodology design improvement, focused to use this kind of burners in our country

  4. Gas cooking, kitchen ventilation, and exposure to combustion products

    NARCIS (Netherlands)

    Willers, SM; Brunekreef, B; Oldenwening, M; Smit, HA; Kerkhof, M; De Vries, H

    We evaluated a questionnaire-based system for classifying homes into groups with distinctly different chances of accumulating combustion products from cooking appliances. The system was based on questions about type of cooking appliance, type and use of ventilation provisions, and kitchen size.

  5. Natural ventilation for the prevention of airborne contagion.

    Science.gov (United States)

    Escombe, A Roderick; Oeser, Clarissa C; Gilman, Robert H; Navincopa, Marcos; Ticona, Eduardo; Pan, William; Martínez, Carlos; Chacaltana, Jesus; Rodríguez, Richard; Moore, David A J; Friedland, Jon S; Evans, Carlton A

    2007-02-01

    Institutional transmission of airborne infections such as tuberculosis (TB) is an important public health problem, especially in resource-limited settings where protective measures such as negative-pressure isolation rooms are difficult to implement. Natural ventilation may offer a low-cost alternative. Our objective was to investigate the rates, determinants, and effects of natural ventilation in health care settings. The study was carried out in eight hospitals in Lima, Peru; five were hospitals of "old-fashioned" design built pre-1950, and three of "modern" design, built 1970-1990. In these hospitals 70 naturally ventilated clinical rooms where infectious patients are likely to be encountered were studied. These included respiratory isolation rooms, TB wards, respiratory wards, general medical wards, outpatient consulting rooms, waiting rooms, and emergency departments. These rooms were compared with 12 mechanically ventilated negative-pressure respiratory isolation rooms built post-2000. Ventilation was measured using a carbon dioxide tracer gas technique in 368 experiments. Architectural and environmental variables were measured. For each experiment, infection risk was estimated for TB exposure using the Wells-Riley model of airborne infection. We found that opening windows and doors provided median ventilation of 28 air changes/hour (ACH), more than double that of mechanically ventilated negative-pressure rooms ventilated at the 12 ACH recommended for high-risk areas, and 18 times that with windows and doors closed (p ventilation than modern naturally ventilated rooms (40 versus 17 ACH; p natural ventilation exceeded mechanical (p ventilated rooms 39% of susceptible individuals would become infected following 24 h of exposure to untreated TB patients of infectiousness characterised in a well-documented outbreak. This infection rate compared with 33% in modern and 11% in pre-1950 naturally ventilated facilities with windows and doors open. Opening windows and

  6. Implementation of a real-time compliance dashboard to help reduce SICU ventilator-associated pneumonia with the ventilator bundle.

    Science.gov (United States)

    Zaydfudim, Victor; Dossett, Lesly A; Starmer, John M; Arbogast, Patrick G; Feurer, Irene D; Ray, Wayne A; May, Addison K; Pinson, C Wright

    2009-07-01

    Ventilator-associated pneumonia (VAP) causes significant morbidity and mortality in critically ill surgical patients. Recent studies suggest that the success of preventive measures is dependent on compliance with ventilator bundle parameters. Implementation of an electronic dashboard will improve compliance with the bundle parameters and reduce rates of VAP in our surgical intensive care unit (SICU). Time series analysis of VAP rates between January 2005 and July 2008, with dashboard implementation in July 2007. Multidisciplinary SICU at a tertiary-care referral center with a stable case mix during the study period. Patients admitted to the SICU between January 2005 and July 2008. Infection control data were used to establish rates of VAP and total ventilator days. For the time series analysis, VAP rates were calculated as quarterly VAP events per 1000 ventilator days. Ventilator bundle compliance was analyzed after dashboard implementation. Differences between expected and observed VAP rates based on time series analysis were used to estimate the effect of intervention. Average compliance with the ventilator bundle improved from 39% in August 2007 to 89% in July 2008 (P dashboard (P = .01). Quarterly VAP rates were significantly reduced in the November 2007 through January 2008 and February through April 2008 periods (P dashboard improved compliance with ventilator bundle measures and is associated with reduced rates of VAP in our SICU.

  7. Ventilation of radioactive enclosures

    International Nuclear Information System (INIS)

    Caminade, F.; Laurent, H.

    1957-01-01

    Mechanical, physical and chemical manipulations on radioactive products must be carried out in properly ventilated enclosed places. The air extracted can only be discharged into the atmosphere after a correct filtration. The power of the ventilation systems is a function of the dimensions and purpose of the enclosure? The choice of types of filter is determined by the physical state and chemical nature of the radioactive materials to be manipulated. This study deals with the individual equipment of small installations: glove boxes, manipulation boxes with outside control and, if necessary, production chambers (maximum useful volume: 5 m 3 ). The performances of three types of 'ventilators', and the modifications provided by the addition of filters, are measured and compared. (author) [fr

  8. Mechanical ventilation strategies.

    Science.gov (United States)

    Keszler, Martin

    2017-08-01

    Although only a small proportion of full term and late preterm infants require invasive respiratory support, they are not immune from ventilator-associated lung injury. The process of lung damage from mechanical ventilation is multifactorial and cannot be linked to any single variable. Atelectrauma and volutrauma have been identified as the most important and potentially preventable elements of lung injury. Respiratory support strategies for full term and late preterm infants have not been as thoroughly studied as those for preterm infants; consequently, a strong evidence base on which to make recommendations is lacking. The choice of modalities of support and ventilation strategies should be guided by the specific underlying pathophysiologic considerations and the ventilatory approach must be individualized for each patient based on the predominant pathophysiology at the time. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. [Ventilator associated pneumonia].

    Science.gov (United States)

    Bellani, S; Nesci, M; Celotto, S; Lampati, L; Lucchini, A

    2003-04-01

    Ventilator associated pneumonia (VAP) is a nosocomial lower respiratory tract infection that ensues in critically ill patients undergoing mechanical ventilation. The reported incidence of VAP varies between 9% and 68% with a mortality ranging between 33% and 71%. Two key factors are implicated in the pathogenesis of VAP: bacterial colonization of the upper digestive-respiratory tract and aspiration of oral secretions into the trachea. Preventive measurements are advocated to reduce the incidence of VAP, such as selective decontamination of the digestive tract (SDD), supraglottic aspiration and positioning. Prompt recognition and treatment of established VAP has also been demostrated to affect outcome. Therefore, the knowledge of risk factors associated with the development of VAP and the implementation of strategies to prevent, diagnose and treat VAP are mainstems in the nursing of mechanically ventilated patients.

  10. CFD and Ventilation Research

    DEFF Research Database (Denmark)

    Li, Y.; Nielsen, Peter V.

    2011-01-01

    There has been a rapid growth of scientific literature on the application of computational fluid dynamics (CFD) in the research of ventilation and indoor air science. With a 1000–10,000 times increase in computer hardware capability in the past 20 years, CFD has become an integral part...... of scientific research and engineering development of complex air distribution and ventilation systems in buildings. This review discusses the major and specific challenges of CFD in terms of turbulence modelling, numerical approximation, and boundary conditions relevant to building ventilation. We emphasize...... the growing need for CFD verification and validation, suggest on-going needs for analytical and experimental methods to support the numerical solutions, and discuss the growing capacity of CFD in opening up new research areas. We suggest that CFD has not become a replacement for experiment and theoretical...

  11. Auxiliary mine ventilation manual

    International Nuclear Information System (INIS)

    Workplace Safety North

    2010-01-01

    An adequate ventilation system is needed for air quality and handling in a mine and is comprised of many different pieces of equipment for removing contaminated air and supplying fresh air and thereby provide a satisfactory working environment. This manual highlights auxiliary ventilation systems made up of small fans, ducts, tubes, air movers, deflectors and additional air flow controls which distribute fresh air delivered by the primary system to all areas. A review of auxiliary ventilation is provided. Design, operation and management issues are discussed and guidelines are furnished. This manual is limited to underground hard rock operations and does not address directly other, specific auxiliary systems, either in underground coal mines or uranium mines.

  12. Auxiliary mine ventilation manual

    Energy Technology Data Exchange (ETDEWEB)

    Workplace Safety North

    2010-07-01

    An adequate ventilation system is needed for air quality and handling in a mine and is comprised of many different pieces of equipment for removing contaminated air and supplying fresh air and thereby provide a satisfactory working environment. This manual highlights auxiliary ventilation systems made up of small fans, ducts, tubes, air movers, deflectors and additional air flow controls which distribute fresh air delivered by the primary system to all areas. A review of auxiliary ventilation is provided. Design, operation and management issues are discussed and guidelines are furnished. This manual is limited to underground hard rock operations and does not address directly other, specific auxiliary systems, either in underground coal mines or uranium mines.

  13. Home automation becomes home entertainment. Emotion replaces function; Hausautomation sucht Naehe zum Home-Entertainment. Emotion verdraengt Funktion

    Energy Technology Data Exchange (ETDEWEB)

    Schmid, W.

    2006-09-15

    Home automation commonly applies to control of lighting, shading, heating, safety etc., i.e. a purely functional concept. Recently, many systems have come to integrate home entertainment as well: Bang and Olufsen and Revox meets heating, light, and ventilation. (orig.)

  14. Heliox Improves Carbon Dioxide Removal during Lung Protective Mechanical Ventilation.

    Science.gov (United States)

    Beurskens, Charlotte J; Brevoord, Daniel; Lagrand, Wim K; van den Bergh, Walter M; Vroom, Margreeth B; Preckel, Benedikt; Horn, Janneke; Juffermans, Nicole P

    2014-01-01

    Introduction. Helium is a noble gas with low density and increased carbon dioxide (CO2) diffusion capacity. This allows lower driving pressures in mechanical ventilation and increased CO2 diffusion. We hypothesized that heliox facilitates ventilation in patients during lung-protective mechanical ventilation using low tidal volumes. Methods. This is an observational cohort substudy of a single arm intervention study. Twenty-four ICU patients were included, who were admitted after a cardiac arrest and mechanically ventilated for 3 hours with heliox (50% helium; 50% oxygen). A fixed protective ventilation protocol (6 mL/kg) was used, with prospective observation for changes in lung mechanics and gas exchange. Statistics was by Bonferroni post-hoc correction with statistical significance set at P ventilation, respiratory rate decreased (25 ± 4 versus 23 ± 5 breaths min(-1), P = 0.010). Minute volume ventilation showed a trend to decrease compared to baseline (11.1 ± 1.9 versus 9.9 ± 2.1 L min(-1), P = 0.026), while reducing PaCO2 levels (5.0 ± 0.6 versus 4.5 ± 0.6 kPa, P = 0.011) and peak pressures (21.1 ± 3.3 versus 19.8 ± 3.2 cm H2O, P = 0.024). Conclusions. Heliox improved CO2 elimination while allowing reduced minute volume ventilation in adult patients during protective mechanical ventilation.

  15. Assessment of Adaptive Rate Response Provided by Accelerometer, Minute Ventilation and Dual Sensor Compared with Normal Sinus Rhythm During Exercise: A Self-controlled Study in Chronotropically Competent Subjects

    Directory of Open Access Journals (Sweden)

    Yuanyuan Cao

    2015-01-01

    Full Text Available Background: Dual sensor (DS for rate adaption was supposed to be more physiological. To evaluate its superiority, the DS (accelerometer [ACC] and minute ventilation [MV] and normal sinus rate response were compared in a self-controlled way during exercise treadmill testing. Methods: This self-controlled study was performed in atrioventricular block patients with normal sinus function who met the indications of pacemaker implant. Twenty-one patients came to the 1-month follow-up visit. Patients performed a treadmill test 1-month post implant while programmed in DDDR and sensor passive mode. For these patients, sensor response factors were left at default settings (ACC = 8, MV = 3 and sensor indicated rates (SIRs for DS, ACC and MV sensor were retrieved from the pacemaker memories, along with measured sinus node (SN rates from the beginning to 1-minute after the end of the treadmill test, and compared among study groups. Repeated measures analysis of variance and profile analysis, as well as variance analysis of randomized block designs, were used for statistical analysis. Results: Fifteen patients (15/21 were determined to be chronotropically competent. The mean differences between DS SIRs and intrinsic sinus rates during treadmill testing were smaller than those for ACC and MV sensor (mean difference between SIR and SN rate: ACC vs. SN, MV vs. SN, DS vs. SN, respectively, 34.84, 17.60, 16.15 beats/min, though no sensors could mimic sinus rates under the default settings for sensor response factor (ACC vs. SN P-adjusted < 0.001; MV vs. SN P-adjusted = 0.002; DS vs. SN P-adjusted = 0.005. However, both in the range of 1 st minute and first 3 minutes of exercise, only the DS SIR profile did not differ from sinus rates (P-adjusted = 0.09, 0.90, respectively. Conclusions: The DS under default settings provides more physiological rate response during physical activity than the corresponding single sensors (ACC or MV sensor. Further study is needed to

  16. Ventilation with heat recovery

    DEFF Research Database (Denmark)

    Tommerup, Henrik M.; Svendsen, Svend

    2005-01-01

    This paper presents the experiences from the use of ventilation with heat recovery in several experimental single-family houses developed and built within the last four years to meet the new Danish energy requirements of 2005. Included are descriptions of the ventilation system components...... and the main functional demands as well as measurements of the thermal efficiency, electricity consumptions and building air tightness. The paper addresses the aspects of minimizing the heat loss from the duct system and the heat recovery unit (when placed in an unheated attic space) in order to obtain...

  17. Behovstyret ventilation til enfamiliehuse

    DEFF Research Database (Denmark)

    Nielsen, Toke Rammer; Drivsholm, Christian; Hansen, Mads Peter Rudolph

    Muligheden for behovsstyret ventilation i enfamiliehuse er undersøgt. To strategier er afprøvet i praksis: En relativ simpel og billig strategi og en relativ avanceret og dyr strategi. Den simple strategi regulerer luftskiftet ensartet for alle rum mellem et lavt eller højt niveau. Den avancerede...... ventilation efter gældende krav. Desuden kræver den simple regulering kun få sensorer og er således væsentlig billigere og enklere at implementere end den avancerede strategi....

  18. Evaluating use of the Siebens Domain Management Model during inpatient rehabilitation to increase functional independence and discharge rate to home in stroke patients.

    Science.gov (United States)

    Kushner, David S; Peters, Kenneth M; Johnson-Greene, Doug

    2015-04-01

    To evaluate use of the Siebens Domain Management Model (SDMM) during stroke inpatient rehabilitation (IR) to increase functional independence and rate of discharge to home. Before and after study. IR facility. Before the intervention: 154 patients with ischemic/hemorrhagic strokes who were admitted to an IR facility in 2010; on average, they were admitted 9.1 days after receiving acute care. After the intervention: 151 patients with ischemic/hemorrhagic strokes who were admitted to an IR facility in 2012; on average they were admitted 7.3 days after receiving acute care. The comorbidity tier severity and prestroke living setting and living support appeared to be similar in both the preintervention and postintervention groups. Use of the SDMM involving weekly adjustments of IR care focused on potential barriers to discharge home including medical/surgical issues, cognitive/emotional coping issues, physical function, and living environment/community re-entry needs. Use of Functional Independence Measure (FIM) score change during IR length of stay (LOS; FIM-LOS efficiency) and rates of discharge to community/home, acute care, and long-term care (LTC) to compare 2010/preintervention data with postintervention data from 2012, along with comparison of facility data to national aggregate data from the Uniform Data System for Medical Rehabilitation (UDSMR) for both years. Preintervention 2010 FIM-LOS efficiency was 1.44 compared with a 2012 postintervention FIM-LOS efficiency of 2.24, which was significant (t = 4.3; P stroke IR may convey improvement in functional independence and is associated with an increased discharge rate to home/community and a reduction in institutionalization and acute-care transfers. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  19. Ventilation Systems Operating Experience Review for Fusion Applications

    International Nuclear Information System (INIS)

    Cadwallader, L.C.

    1999-01-01

    This report is a collection and review of system operation and failure experiences for air ventilation systems in nuclear facilities. These experiences are applicable for magnetic and inertial fusion facilities since air ventilation systems are support systems that can be considered generic to nuclear facilities. The report contains descriptions of ventilation system components, operating experiences with these systems, component failure rates, and component repair times. Since ventilation systems have a role in mitigating accident releases in nuclear facilities, these data are useful in safety analysis and risk assessment of public safety. An effort has also been given to identifying any safety issues with personnel operating or maintaining ventilation systems. Finally, the recommended failure data were compared to an independent data set to determine the accuracy of individual values. This comparison is useful for the International Energy Agency task on fusion component failure rate data collection

  20. [Possibilities of bi-level positive pressure ventilation in chronic hypoventilation].

    Science.gov (United States)

    Saaresranta, Tarja; Anttalainen, Ulla; Polo, Olli

    2011-01-01

    During the last decade, noninvasive bi-level positive pressure ventilation has enabled respiratory support in inpatient wards and at home. In many cases, a bi-level airway pressure ventilator can be used to avoid artificial airway and respirator therapy, and may shorten hospital stay and save costs. The treatment alleviates the patient's dyspnea and fatigue, whereby the quality of life improves, and in certain situations also the life span increases. The implementation of bi-level positive pressure ventilation by the physician requires knowledge of the basics of respiratory physiology and familiarization with the bi-level airway pressure ventilator.

  1. Ventilator associated pneumonia and infection control

    NARCIS (Netherlands)

    Alp, E.; Voss, A.

    2006-01-01

    Ventilator associated pneumonia (VAP) is the leading cause of morbidity and mortality in intensive care units. The incidence of VAP varies from 7% to 70% in different studies and the mortality rates are 20-75% according to the study population. Aspiration of colonized pathogenic microorganisms on

  2. Boundary conditions for natural supply ventilation

    NARCIS (Netherlands)

    Jansen, D.W.L.; Loomans, M.G.L.C.; Wit, de M.H.; Zeiler, W.; Seppänen, O.; Säteri, J.

    2007-01-01

    The development of an air jet from a controlled natural ventilation grill for different outdoor conditions is studied. Extensive laboratory measurements are taken in different situations, while the air flow rate through the grill is kept constant. The grill setting and supply temperature are varied.

  3. Protective ventilation of preterm lambs exposed to acute chorioamnionitis does not reduce ventilation-induced lung or brain injury.

    Science.gov (United States)

    Barton, Samantha K; Moss, Timothy J M; Hooper, Stuart B; Crossley, Kelly J; Gill, Andrew W; Kluckow, Martin; Zahra, Valerie; Wong, Flora Y; Pichler, Gerhard; Galinsky, Robert; Miller, Suzanne L; Tolcos, Mary; Polglase, Graeme R

    2014-01-01

    The onset of mechanical ventilation is a critical time for the initiation of cerebral white matter (WM) injury in preterm neonates, particularly if they are inadvertently exposed to high tidal volumes (VT) in the delivery room. Protective ventilation strategies at birth reduce ventilation-induced lung and brain inflammation and injury, however its efficacy in a compromised newborn is not known. Chorioamnionitis is a common antecedent of preterm birth, and increases the risk and severity of WM injury. We investigated the effects of high VT ventilation, after chorioamnionitis, on preterm lung and WM inflammation and injury, and whether a protective ventilation strategy could mitigate the response. Pregnant ewes (n = 18) received intra-amniotic lipopolysaccharide (LPS) 2 days before delivery, instrumentation and ventilation at 127±1 days gestation. Lambs were either immediately euthanased and used as unventilated controls (LPSUVC; n = 6), or were ventilated using an injurious high VT strategy (LPSINJ; n = 5) or a protective ventilation strategy (LPSPROT; n = 7) for a total of 90 min. Mean arterial pressure, heart rate and cerebral haemodynamics and oxygenation were measured continuously. Lungs and brains underwent molecular and histological assessment of inflammation and injury. LPSINJ lambs had poorer oxygenation than LPSPROT lambs. Ventilation requirements and cardiopulmonary and systemic haemodynamics were not different between ventilation strategies. Compared to unventilated lambs, LPSINJ and LPSPROT lambs had increases in pro-inflammatory cytokine expression within the lungs and brain, and increased astrogliosis (pVentilation after acute chorioamnionitis, irrespective of strategy used, increases haemodynamic instability and lung and cerebral inflammation and injury. Mechanical ventilation is a potential contributor to WM injury in infants exposed to chorioamnionitis.

  4. Ventilation system for 99Mo production apparatus

    International Nuclear Information System (INIS)

    Izumo, Mishiroku; Okane, Shougo; Sorita, Takami; Aoyama, Saburou

    1978-04-01

    In production of 20 Ci 99 Mo from 235 U fission, about 120 Ci of radioiodine ( 131 I, 132 I, and 133 I) is involved. To remove airborne radioiodine from the exhaust air from production apparatus and minimize radioiodine release to the atmosphere, the ventilation system is equipped with 2 units of Model-FD charcoal filter (KI 3 -Impregnated charcoal 2 inch thick of Barnebey-Cheney Co.). From September 1976 to December 1977, 21 runs of 99 Mo production involving airborne radioiodine were carried out. The ventilation system was operated continuously for the whole 15 months period; variation in removal efficiency of airborne radioiodine from the exhaust air stream was observed. In the runs valuable experiences were gained in operation and maintenance of the ventilation system including activated charcoal filter and health-physics management of such facility. Following are the results: (1) Airborne radioiodine from 99 Mo production apparatus is reduced to 10 -3 % of the original quantity. (2) When the ventilation system is operated at a maximum air flow rate through the filter, the average efficiency during 15 months is over 98%. (3) Airborne radioiodine released from 99 Mo production apparatus to the ventilation system is less than 5% particulate iodine and alkyl iodines and more than 95% inorganic iodine. (4) Airborne radioiodine released from the stack is less than 28 μCi/run, which is below the limit in regulations on Radioisotope Production Laboratory. (auth.)

  5. Demand controlled ventilation; Behovsstyrt ventilasjon

    Energy Technology Data Exchange (ETDEWEB)

    Soerensen, Henning Holm

    2006-07-01

    The terms CAV and VAV have been known terms for many years in the ventilation business. The terms are also included in building regulations, but the time is now right to focus on demand controlled ventilation (DCV). The new building regulations and the accompanying energy framework underline the need for a more nuanced thinking when it comes to controlling ventilation systems. Descriptions and further details of the ventilation systems are provided (ml)

  6. Flow measurement in mechanical ventilation: a review.

    Science.gov (United States)

    Schena, Emiliano; Massaroni, Carlo; Saccomandi, Paola; Cecchini, Stefano

    2015-03-01

    Accurate monitoring of flow rate and volume exchanges is essential to minimize ventilator-induced lung injury. Mechanical ventilators employ flowmeters to estimate the amount of gases delivered to patients and use the flow signal as a feedback to adjust the desired amount of gas to be delivered. Since flowmeters play a crucial role in this field, they are required to fulfill strict criteria in terms of dynamic and static characteristics. Therefore, mechanical ventilators are equipped with only the following kinds of flowmeters: linear pneumotachographs, fixed and variable orifice meters, hot wire anemometers, and ultrasonic flowmeters. This paper provides an overview of these sensors. Their working principles are described together with their relevant advantages and disadvantages. Furthermore, the most promising emerging approaches for flowmeters design (i.e., fiber optic technology and three dimensional micro-fabrication) are briefly reviewed showing their potential for this application. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

  7. Hybrid Ventilation Air Flow Process

    DEFF Research Database (Denmark)

    Heiselberg, Per Kvols

    The scope of this annex is therefore to obtain better knowledge of the use of hybrid ventilation technologies. The annex focus on development of control strategies for hybrid ventilation, on development of methods to predict hybrid ventilation performance in office buildings and on implementation...

  8. Ventilator and viral induced inflammation

    NARCIS (Netherlands)

    Hennus, M.P.

    2013-01-01

    This thesis expands current knowledge on ventilator induced lung injury and provides insights on the immunological effects of mechanical ventilation during viral respiratory infections. The experimental studies in the first part of this thesis improve our understanding of how mechanical ventilation

  9. How to Plan Ventilation Systems.

    Science.gov (United States)

    Clarke, John H.

    1963-01-01

    Ventilation systems for factory safety demand careful planning. The increased heat loads and new processes of industry have introduced complex ventilation problems in--(1) ventilation supply, (2) duct work design, (3) space requirements, (4) hood face velocities, (5) discharge stacks, and (6) building eddies. This article describes and diagrams…

  10. Risk factors associated with development of ventilator associated pneumonia.

    Science.gov (United States)

    Noor, Ahmed; Hussain, Syed Fayyaz

    2005-02-01

    To assess the risk factors associated with development of ventilator associated pneumonia (VAP). A case control study. Intensive Care Unit (ICU) at the Aga Khan University Hospital, Karachi, between January 1999 and June 2000. All patients with assisted mechanical ventilation were assessed for the development of VAP. Risk factors associated with development of VAP were determined. Adult patients who developed pneumonia, 48 hours after ventilation, were called cases while those who did not develop pneumonia were called controls. Seventy (28%) out of 250 mechanically ventilated patients developed VAP (rate of VAP was 26 cases per 1000 ventilator days). Shock during first 48 hours of ventilation (odds ratio (OR), 5.95; 95% confidence interval (CI), 2.83-12.52), transport out of ICU during mechanical ventilation (OR, 6.0; 95% CI, 2.92-12.37), re-intubation (OR, 4.23; 95% CI, 2.53-9.85), prior episode of aspiration of gastric content (OR, 3.07; 95% CI, 1.35-7.01), and use of antibiotics prior to intubation (OR,2.55; 95% CI, 1.20-5.41) were found to be independently associated with a higher risk of developing VAP. Gram negative organisms and Staphylococcus aureus were responsible for over 90% of cases. Patients with VAP had higher crude mortality rate (57.1%) compared with controls (32.2%). Ventilator associated pneumonia is associated with a high mortality. This study has identified risk factors associated with VAP.

  11. Omnidirectional ventilated acoustic barrier

    Science.gov (United States)

    Zhang, Hai-long; Zhu, Yi-fan; Liang, Bin; Yang, Jing; Yang, Jun; Cheng, Jian-chun

    2017-11-01

    As an important problem in acoustics, sound insulation finds applications in a great variety of situations. In the existing schemes, however, there has always been a trade-off between the thinness of sound-insulating devices and their ventilating capabilities, limiting their potentials in the control of low-frequency sound in high ventilation environments. Here, we design and experimentally implement an omnidirectional acoustic barrier with a planar profile, subwavelength thickness ( 0.18 λ ), yet high ventilation. The proposed mechanism is based on the interference between the resonant scattering of discrete states and the background scattering of continuous states which induces a Fano-like asymmetric transmission profile. Benefitting from the binary-structured design of the coiled unit and hollow pipe, it maximally simplifies the design and fabrication while ensuring the ventilation for all the non-resonant units with open tubes. The simulated and measured results agree well, showing the effectiveness of our proposed mechanism to block low frequency sound coming from various directions while allowing 63% of the air flow to pass. We anticipate our design to open routes to design sound insulators and to enable applications in traditionally unattainable cases such as those calling for noise reduction and cooling simultaneously.

  12. Mechanical ventilation of mice

    NARCIS (Netherlands)

    Schwarte, L. A.; Zuurbier, C. J.; Ince, C.

    2000-01-01

    Due to growing interest in murine functional genomics research, there is an increasing need for physiological stable in vivo murine models. Of special importance is support and control of ventilation by artificial respiration, which is difficult to execute as a consequence of the small size of the

  13. Lavt elforbrug til ventilation

    DEFF Research Database (Denmark)

    Jagemar, L.; Bergsøe, Niels Christian

    Rapporten giver gode råd om mulige energibesparelser og praktiske projekteringshensyn, som er forbundet med udformning af energieffektiv ventilation i ikke blot kontorbygninger, men i alle bygninger med komfortventilationsanlæg. I forbindelse med projektering af ventilationsanlæg har interessen...

  14. Understanding mechanical ventilators.

    Science.gov (United States)

    Chatburn, Robert L

    2010-12-01

    The respiratory care academic community has not yet adopted a standardized system for classifying and describing modes of ventilation. As a result, there is enough confusion that patient care, clinician education and even ventilator sales are all put at risk. This article summarizes a ventilator mode taxonomy that has been extensively published over the last 15 years. Specifically, the classification system has three components: a description of the control variables within breath; a description of the sequence of mandatory and spontaneous breaths; and a specification for the targeting scheme. This three-level specification provides scalability of detail to make the mode description appropriate for the particular need. At the bedside, we need only refer to a mode briefly using the first or perhaps first and second components. To distinguish between similar modes and brand names, we would need to include all components. This taxonomy uses the equation of motion for the respiratory system as the underlying theoretical framework. All terms relevant to describing modes of mechanical ventilation are defined in an extensive appendix.

  15. Human response to ductless personalized ventilation coupled with displacement ventilation

    DEFF Research Database (Denmark)

    Dalewski, Mariusz; Veselý, Michal; Melikov, Arsen K.

    2012-01-01

    A human subject experiment was carried out to investigate the extent to which ductless personalized ventilation (DPV) in conjunction with displacement ventilation can improve perceived air quality (PAQ) and thermal comfort at elevated room air temperature in comparison with displacement ventilation...... alone. The experimental conditions comprised displacement ventilation alone (room air temperature of 23 °C, 26 °C, 29 °C) and DPV with displacement ventilation (26 °C, 29 °C), both operating at supply air temperatures 3, 5 or 6K lower than room air temperature, as well as mixing ventilation (23 °C, 3 K......). During one hour exposure participants answered questionnaires regarding PAQ and thermal comfort. PAQ was significantly better with DPV than without DPV at the same background conditions. Thermal comfort improved when DPV was used. Combining DPV with displacement ventilation showed the potential...

  16. Ammonia emissions in tunnel-ventilated broiler houses

    Directory of Open Access Journals (Sweden)

    KAO Lima

    2011-12-01

    Full Text Available Gas production in broiler houses and their emissions are closely related to the microclimate established inside the house according to air temperature, humidity, and velocity. Therefore, the internal house environment is influenced by building typology and ventilation system. The objective of the present study was to evaluate ammonia emission rates in broiler houses equipped with different ventilation systems (negative or positive pressure and litter conditions (new or built-up. The environment of six commercial broiler houses was evaluated internal and external NH3 concentrations. Ventilation rates were recorded to estimate ammonia emission rates. The efficiency of circulation and exhaust fans was assessed, and higher ventilation rates were determined in negative-pressure houses due to the higher flow of the fans. Houses with new litter increased ammonia emission rates along the rearing period, indicating the relationship between gas emissions, bird age and ventilation rates, and presented a typical curve of NH3 emission increase. Negative-pressure houses with built-up litter presented higher emission rates during the first rearing week due to the high NH3 concentration during the brooding period, when the ventilation rates required to maintain chick thermal comfort are low. Although the results of the present study indicate an advantage of the positive-pressure systems as to gas emissions, further research is needed reduce gas emissions in broiler houses with negative-pressure systems.

  17. Thermal plumes in ventilated rooms

    DEFF Research Database (Denmark)

    Kofoed, Peter; Nielsen, Peter V.

    1990-01-01

    The design of a displacement ventilation system involves determination of the flow rate in the thermal plumes. The flow rate in the plumes and the vertical temperature gradient influence each other, and they are influenced by many factors. This paper shows some descriptions of these effects. Free...... above a point heat source cannot be used. This is caused either by the way of generating the plume including a long intermediate region or by the environmental conditions where vertical temperature gradients are present. The flow has a larger angle of spread and the entrainment factor is greather than...... turbulent plumes from different heated bodies are investigated. The measurements have taken place in a full-scale test room where the vertical temperature gradient have been changed. The velocity and the temperature distribution in the plume are measured. Large scale plume axis wandering is taken...

  18. Ventilation of nuclear power plants

    International Nuclear Information System (INIS)

    Madoyan, A.A.; Vlasik, V.F.

    1984-01-01

    Foundations and calculation methods of ventilation of rooms with different degree of heat and gas release with the change of operation mode of NPP main equipment, as well as problems of NPP site and adjoining area aerodynamics, have been presented. Systems of air ventilation and conditioning, cooling equipment, are considered. The main points of designing are described and determination of economic efficiency of the ventilation systems are made. Technical characteristics of the ventilators, conditioners, filters and air heaters used, are presented. Organization of adjustment, tests, operation and maintenance of the ventilation systems of NPP with RBMK and WWER-type reactors, is described

  19. Indoor Environmental Quality in Mechanically Ventilated, Energy-Efficient Buildings vs. Conventional Buildings.

    Science.gov (United States)

    Wallner, Peter; Munoz, Ute; Tappler, Peter; Wanka, Anna; Kundi, Michael; Shelton, Janie F; Hutter, Hans-Peter

    2015-11-06

    Energy-efficient buildings need mechanical ventilation. However, there are concerns that inadequate mechanical ventilation may lead to impaired indoor air quality. Using a semi-experimental field study, we investigated if exposure of occupants of two types of buildings (mechanical vs. natural ventilation) differs with regard to indoor air pollutants and climate factors. We investigated living and bedrooms in 123 buildings (62 highly energy-efficient and 61 conventional buildings) built in the years 2010 to 2012 in Austria (mainly Vienna and Lower Austria). Measurements of indoor parameters (climate, chemical pollutants and biological contaminants) were conducted twice. In total, more than 3000 measurements were performed. Almost all indoor air quality and room climate parameters showed significantly better results in mechanically ventilated homes compared to those relying on ventilation from open windows and/or doors. This study does not support the hypothesis that occupants in mechanically ventilated low energy houses are exposed to lower indoor air quality.

  20. Air quality Performance of Ductless Personalized Ventilation in Conjunction with Displacement Ventilation: Impact of Walking Person

    DEFF Research Database (Denmark)

    Bolashikov, Zhecho Dimitrov; Lu, Pengfei; Melikov, Arsen Krikor

    2015-01-01

    The present experiment evaluates the impact of air disturbances from a walking person on inhaled air by ductless personalized ventilation (DPV) with displacement ventilation (DV), when a seated occupant is the source of pollution: bio-effluents and exhaled air. The measurements took place in a full...... and the DV supply. Pollution from feet and exhaled air by one manikin was simulated with tracer gases. Room temperature of 26 °C and 90 L/s DV supply flow rate were kept constant. Measurements under numerous combinations of DPV operation modes and supply flow rates were performed. Tracer gas concentrations...

  1. Design Procedure for Hybrid Ventilation

    DEFF Research Database (Denmark)

    Heiselberg, Per; Tjelflaat, Per Olaf

    Mechanical and natural ventilation systems have developed separately during many years. The natural next step in this development is development of ventilation concepts that utilises and combines the best features from each system into a new type of ventilation system - Hybrid Ventilation....... Buildings with hybrid ventilation often include other sustainable technologies and an energy optimisation requires an integrated approach in the design of the building and its mechanical systems. Therefore, the hybrid ventilation design procedure differs from the design procedure for conventional HVAC....... The first ideas on a design procedure for hybrid ventilation is presented and the different types of design methods, that is needed in different phases of the design process, is discussed....

  2. Cost-benefit of ventilation and averted radon in dwellings

    International Nuclear Information System (INIS)

    Katona, T.; Kanyar, B.

    2003-01-01

    To assess an economically optimal ventilation rate we have introduced a cost-benefit analysis taking into account the cost of heating and benefit of averted dose due to ventilation. The cost of heating due to the elevated ventilation for mitigation of radon content in dwellings can be compensated by the monetary benefit of the averted dose, in case of higher (annually 3-10 mSv) exposure. During the heating season the economically optimal ventilation takes 0.1-0.5 h -1 , meanwhile the radon concentration in the indoor air decreases to 200-800 Bq/m 3 , depending on the exhalation of radon, number of persons living in the dwellings and other local parameters. Our results from the optimal planning correspond to the radon concentrations recommended by the international organizations as action levels. In general, the periodic ventilation in daytime provides a higher averted dose than the constant one in case of the same heating cost. (authors)

  3. Comparison of the New Adult Ventilator-Associated Event Criteria to the Centers for Disease Control and Prevention Pediatric Ventilator-Associated Pneumonia Definition (PNU2) in a Population of Pediatric Traumatic Brain Injury Patients.

    Science.gov (United States)

    Cirulis, Meghan M; Hamele, Mitchell T; Stockmann, Chris R; Bennett, Tellen D; Bratton, Susan L

    2016-02-01

    The new Centers for Disease Control and Prevention paradigm for ventilator-associated events is intended to simplify surveillance of infectious and noninfectious complications of mechanical ventilation in adults. We assessed the ventilator-associated events algorithm in pediatric patients. A retrospective observational cohort study. This single-center study took place in a PICU at an urban academic medical facility. Pediatric (ages 0-18 yr old) trauma patients with moderate-to-severe traumatic brain injury ventilated for greater than or equal to 2 days. We assessed for pediatric ventilator-associated pneumonia (as defined by current Centers for Disease Control and Prevention PNU2 guidelines), adult ventilator-associated events, and an experimental ventilator-associated events definition modified for pediatric patients. We compared ventilator-associated events to ventilator-associated pneumonia to calculate the test characteristics. Thirty-nine of 119 patients (33%) developed ventilator-associated pneumonia. Sensitivity of the adult ventilator-associated condition definition was 23% (95% CI, 11-39%), which increased to 56% (95% CI, 40-72%) using the modified pediatric ventilator-associated pneumonia criterion. Specificity reached 100% for both original and modified pediatric probable ventilator-associated pneumonia using ventilator-associated events criteria. Children who developed ventilator-associated pneumonia or ventilator-associated condition had similar baseline characteristics: age, mechanism of injury, injury severity scores, and use of an intracranial pressure monitor. Diagnosis of ventilator-associated pneumonia and ventilator-associated condition portended similarly unfavorable outcomes: longer median duration of ventilation, ICU and hospital length of stay, and more discharges to rehabilitation, home health, or nursing care compared with patients with no pulmonary complication. Both current and modified ventilator-associated events criteria have poor

  4. Home safe home: Evaluation of a childhood home safety program.

    Science.gov (United States)

    Stewart, Tanya Charyk; Clark, Andrew; Gilliland, Jason; Miller, Michael R; Edwards, Jane; Haidar, Tania; Batey, Brandon; Vogt, Kelly N; Parry, Neil G; Fraser, Douglas D; Merritt, Neil

    2016-09-01

    The London Health Sciences Centre Home Safety Program (HSP) provides safety devices, education, a safety video, and home safety checklist to all first-time parents for the reduction of childhood home injuries. The objective of this study was to evaluate the HSP for the prevention of home injuries in children up to 2 years of age. A program evaluation was performed with follow-up survey, along with an interrupted time series analysis of emergency department (ED) visits for home injuries 5 years before (2007-2013) and 2 years after (2013-2015) implementation. Spatial analysis of ED visits was undertaken to assess differences in home injury rates by dissemination areas controlling differences in socioeconomic status (i.e., income, education, and lone-parent status) at the neighborhood level. A total of 3,458 first-time parents participated in the HSP (a 74% compliance rate). Of these, 20% (n = 696) of parents responded to our questionnaire, with 94% reporting the program to be useful (median, 6; interquartile range, 2 on a 7-point Likert scale) and 81% learning new strategies for preventing home injuries. The median age of the respondent's babies were 12 months (interquartile range, 1). The home safety check list was used by 87% of respondents to identify hazards in their home, with 95% taking action to minimize the risk. The time series analysis demonstrated a significant decline in ED visits for home injuries in toddlers younger than2 years of age after HSP implementation. The declines in ED visits for home injuries remained significant over and above each socioeconomic status covariate. Removing hazards, supervision, and installing safety devices are key facilitators in the reduction of home injuries. Parents found the HSP useful to identify hazards, learn new strategies, build confidence, and provide safety products. Initial finding suggests that the program is effective in reducing home injuries in children up to 2 years of age. Therapeutic/care management study

  5. Football Equipment Removal Improves Chest Compression and Ventilation Efficacy.

    Science.gov (United States)

    Mihalik, Jason P; Lynall, Robert C; Fraser, Melissa A; Decoster, Laura C; De Maio, Valerie J; Patel, Amar P; Swartz, Erik E

    2016-01-01

    Airway access recommendations in potential catastrophic spine injury scenarios advocate for facemask removal, while keeping the helmet and shoulder pads in place for ensuing emergency transport. The anecdotal evidence to support these recommendations assumes that maintaining the helmet and shoulder pads assists inline cervical stabilization and that facial access guarantees adequate airway access. Our objective was to determine the effect of football equipment interference on performing chest compressions and delivering adequate ventilations on patient simulators. We hypothesized that conditions with more football equipment would decrease chest compression and ventilation efficacy. Thirty-two certified athletic trainers were block randomized to participate in six different compression conditions and six different ventilation conditions using human patient simulators. Data for chest compression (mean compression depth, compression rate, percentage of correctly released compressions, and percentage of adequate compressions) and ventilation (total ventilations, mean ventilation volume, and percentage of ventilations delivering adequate volume) conditions were analyzed across all conditions. The fully equipped athlete resulted in the lowest mean compression depth (F5,154 = 22.82; P Emergency medical personnel should remove the helmet and shoulder pads from all football athletes who require cardiopulmonary resuscitation, while maintaining appropriate cervical spine stabilization when injury is suspected. Further research is needed to confirm our findings supporting full equipment removal for chest compression and ventilation delivery.

  6. AsthmaVent – Effect of Ventilation on Asthma Control

    DEFF Research Database (Denmark)

    Hogaard, Nina Viskum; Rubak, Sune Leisgaard Mørck; Halken, Susanne

    sensitive towards. Reducing this exposure may improve the asthma control in these children. Previous studies give conflicting information on the effect of mechanical ventilation on asthma control in children. Objectives We aim at investigating whether mechanical ventilation is capable of improving indoor...... air quality in the home and health outcomes in the outpatient clinic every three months. Fig. 1 and 2. Primary outcome is reduction in minimal effective dose of inhalation steroid. Secondary endpoints….. Perspectives Asthma patients and their families rely on good evidence-based advice on behavior...

  7. High Frequency Oscillatory Ventilation

    Directory of Open Access Journals (Sweden)

    AC Bryan

    1996-01-01

    Full Text Available High frequency oscillatory (HFO ventilation using low tidal volume and peak airway pressures is extremely efficient at eliminating carbon dioxide and raising pH in the newborn infant with acute respiratory failure. Improvement in oxygenation requires a strategy of sustained or repetitive inflations to 25 to 30 cm H2O in order to place the lung on the deflation limb of the pressure-volume curve. This strategy has also been shown to decrease the amount of secondary lung injury in animal models. Experience of the use of HFO ventilation as a rescue therapy as well as several published controlled trials have shown improved outcomes and a decrease in the use of extracorporeal membrane oxygenation when it has been used in newborns.

  8. Diffuse Ceiling Ventilation

    DEFF Research Database (Denmark)

    Zhang, Chen; Yu, Tao; Heiselberg, Per Kvols

    cooling capacity, energy saving, low investment cost and low noise level; while the limitations include condensation risk and the limit on the room geometry. Furthermore, the crucial design parameters are summarized and their effects on the system performance are discussed. In addition to the stand...... is not well structured with this system. These become the motivations in developing the design guide. This design guide aims to establish a systematic understanding of diffuse ceiling ventilation and provide assistance in designing of such a system. The guide is targeted at design engineers, architects...... and manufacturers and the users of diffuse ceiling technology. The design guide introduces the principle and key characteristics of room air distribution with diffuse ceiling ventilation. It provides an overview of potential benefit and limitations of this technology. The benefits include high thermal comfort, high...

  9. Arterial oxygen tension and pulmonary ventilation in horses placed in the Anderson Sling suspension system after a period of lateral recumbency and anaesthetised with constant rate infusions of romifidine and ketamine.

    Science.gov (United States)

    François, I; Lalèyê, F-X; Micat, M; Benredouane, K; Portier, K

    2014-09-01

    Some controversy exists over whether or not horses' recovery and cardiopulmonary function are affected by suspension in slings. To measure arterial oxygen tension and pulmonary ventilation in anaesthetised horses placed in a standing position in an Anderson Sling (AS) after a period of right lateral recumbency (RLR). Randomised crossover experimental study. Six Standardbred horses were anaesthetised twice. Catheters were inserted into the right jugular vein and the left carotid artery. After premedication with romifidine, anaesthesia was induced with diazepam and ketamine. Following 50 min in RLR, horses were maintained in either RLR or AS for an additional 60 min through to recovery. Anaesthesia was maintained i.v. with a constant rate infusion of romifidine and ketamine. Heart rate, respiratory rate, mean arterial pressure, expiratory tidal volume, minute volumes and end tidal CO2 were monitored continuously. Venous and arterial bloods were sampled for lactate concentration, creatine kinase activity and blood gas analysis before premedication, after induction, every 20 min for 100 min, as soon as the horse was standing (TR), and 24 h later. The data were averaged within 2 anaesthetic periods: P1, 0-20 min; and P2, 40-100 min. During P2, horses in the RLR group had lower arterial oxygen tension (P = 0.001), higher alveolar-arterial oxygen tension gradient (P = 0.005), higher respiratory rate (P = 0.04) and higher minute volumes (P = 0.04) than horses in the AS group. Arterial CO2 tension and mean arterial pressure increased in the AS group during P2 (P = 0.01 and 0.02 respectively). The recoveries were judged better in the AS group than in the RLR group (P = 0.01). During TR, lactate were higher in the RLR group than in the AS group (P = 0.007). Creatine kinase activities were higher in the AS group at 24 h vs. TR (P = 0.02). Anderson Sling suspension after a period of recumbency improves cardiopulmonary function and recovery quality in horses and

  10. Harnessing natural ventilation benefits.

    Science.gov (United States)

    O'Leary, John

    2013-04-01

    Making sure that a healthcare establishment has a good supply of clean fresh air is an important factor in keeping patients, staff, and visitors, free from the negative effects of CO2 and other contaminants. John O'Leary of Trend Controls, a major international supplier of building energy management solutions (BEMS), examines the growing use of natural ventilation, and the health, energy-saving, and financial benefits, that it offers.

  11. Purge ventilation operability

    International Nuclear Information System (INIS)

    Marella, J.R.

    1995-01-01

    A determination of minimum requirements for purge exhaust ventilation system operability has been performed. HLWE and HLW Regulatory Program personnel have evaluated the various scenarios of equipment conditions and HLWE has developed the requirements for purge exhaust systems. This report is provided to document operability requirements to assist Tank Farm personnel to determine whether a system is operable/inoperable and to define required compensatory actions

  12. Ventilation i industrien

    DEFF Research Database (Denmark)

    Valbjørn, O.

    I en række afsnit belyses problemer med træk, kulde, varme, og luftforurening på industriens arbejdspladser, og hvordan man ved ventilation og bygningsudformning kan bekæmpe disse gener. Hvert afsnit kan i princippet læses for sig, og anvisningen kan derfor bruges som håndbog, både af de der er...

  13. Use of Ventilator Bundle and Staff Education to Decrease Ventilator-Associated Pneumonia in Intensive Care Patients.

    Science.gov (United States)

    Parisi, Maria; Gerovasili, Vasiliki; Dimopoulos, Stavros; Kampisiouli, Efstathia; Goga, Christina; Perivolioti, Efstathia; Argyropoulou, Athina; Routsi, Christina; Tsiodras, Sotirios; Nanas, Serafeim

    2016-10-01

    Ventilator-associated pneumonia (VAP), one of the most common hospital-acquired infections, has a high mortality rate. To evaluate the incidence of VAP in a multidisciplinary intensive care unit and to examine the effects of the implementation of ventilator bundles and staff education on its incidence. A 24-month-long before/after study was conducted, divided into baseline, intervention, and postintervention periods. VAP incidence and rate, the microbiological profile, duration of mechanical ventilation, and length of stay in the intensive care unit were recorded and compared between the periods. Of 1097 patients evaluated, 362 met the inclusion criteria. The baseline VAP rate was 21.6 per 1000 ventilator days. During the postintervention period, it decreased to 11.6 per 1000 ventilator days (P = .01). Length of stay in the intensive care unit decreased from 36 to 27 days (P = .04), and duration of mechanical ventilation decreased from 26 to 21 days (P = .06). VAP incidence was high in a general intensive care unit in a Greek hospital. However, implementation of a ventilator bundle and staff education has decreased both VAP incidence and length of stay in the unit. ©2016 American Association of Critical-Care Nurses.

  14. Noninvasive Ventilation in Premature Neonates.

    Science.gov (United States)

    Flanagan, Keri Ann

    2016-04-01

    The use of noninvasive ventilation is a constantly evolving treatment option for respiratory disease in the premature infant. The goals of these noninvasive ventilation techniques are to improve gas exchange in the premature infant's lungs and to minimize the need for intubation and invasive mechanical ventilation. The goals of this article are to consider various uses of nasal interfaces, discuss skin care and developmental positioning concerns faced by the bedside nurse, and discuss the medical management aimed to reduce morbidity and mortality. This article explores the nursing role, the advances in medical strategies for noninvasive ventilation, and the team approach to noninvasive ventilation use in this population. Search strategy included a literature review on medical databases, such as EBSCOhost, CINAHL, PubMed, and NeoReviews. Innovative products, nursing research on developmental positioning and skin care, and advanced medical management have led to better and safer outcomes for premature infants requiring noninvasive ventilation. The medical focus of avoiding long-term mechanical ventilation would not be possible without the technology to provide noninvasive ventilation to these premature infants and the watchful eye of the nurse in terms of careful positioning, preventing skin breakdown and facial scarring, and a proper seal to maximize ventilation accuracy. This article encourages nursing-based research to quantify some of the knowledge about skin care and positioning as well as research into most appropriate uses for noninvasive ventilation devices.

  15. Buoyancy Driven Natural Ventilation through Horizontal Openings

    DEFF Research Database (Denmark)

    Heiselberg, Per

    2009-01-01

    An experimental study of the phenomenon of buoyancy driven natural ventilation through single-sided horizontal openings was performed in a full-scale laboratory test rig. The measurements were made for opening ratios L/D ranging from 0.027 to 4.455, where L and D are the length of the opening...... and the diameter of the opening, respectively. The basic nature of airflow through single-sided openings, including airflow rate, air velocity, temperature difference between the rooms and the dimensions of the horizontal openings, were measured. A bi-directional airflow rate was measured using the constant...... quite well with the Epstein's formula ratio are presented. In some cases the measured airflow rates fit quite well with the Epstein's formula but in other cases the measured data show clear deviations from the Epstein's formula. Thus, revised formulas for natural ventilation are proposed....

  16. Active Aging: Exploration into Self-Ratings of "Being Active," Out-of-Home Physical Activity, and Participation among Older Australian Adults Living in Four Different Settings.

    Science.gov (United States)

    Aird, Rosemary L; Buys, Laurie

    2015-01-01

    We examined whether self-ratings of "being active" among older people living in four different settings (major city high and lower density suburbs, a regional city, and a rural area) were associated with out-of-home participation and outdoor physical activity. A mixed-methods approach (survey, travel diary, and GPS tracking over a one-week period) was used to gather data from 48 individuals aged over 55 years. Self-ratings of "being active" were found to be positively correlated with the number of days older people spent time away from home but unrelated to time traveled by active means (walking and biking). No significant differences in active travel were found between the four study locations, despite differences in their respective built environments. The findings suggest that additional strategies to the creation of "age-friendly" environments are needed if older people are to increase their levels of outdoor physical activity. "Active aging" promotion campaigns may need to explicitly identify the benefits of walking outdoors to ambulatory older people as a means of maintaining their overall health, functional ability, and participation within society in the long-term and also encourage the development of community-based programs in order to facilitate regular walking for this group.

  17. Design Principles for Natural and Hybrid Ventilation

    DEFF Research Database (Denmark)

    Heiselberg, Per

    For many years mechanical and natural ventilation systems have developed separately. Naturally, the next step in this development is the development of ventilation concepts that utilize and combine the best features from each system to create a new type of ventilation system- Hybrid Ventilation. ....... The hybrid ventilation concepts, design challenges and principles are discussed and illustrated by four building examples.......For many years mechanical and natural ventilation systems have developed separately. Naturally, the next step in this development is the development of ventilation concepts that utilize and combine the best features from each system to create a new type of ventilation system- Hybrid Ventilation...

  18. Nuclear waste repository ventilation system studies

    International Nuclear Information System (INIS)

    Smith, P.R.; Hensel, E.C.; Leslie, I.H.; Schultheis, T.M.; Walls, J.R.; Gregory, W.S.

    1993-01-01

    Ventilation studies of the Waste Isolation Pilot Plant described in this article were performed by personnel from New Mexico State University in collaboration with Sandia National Laboratories, Los Alamos National Laboratory, and Westinghouse Corporation. The following research tasks were performed: 1) High-efficiency particulate air filters of the type used at the Waste Isolation Pilot Plant were loaded with salt aerosol from the site, 2) Filter resistance as a function of salt mass and flow rate was established for later use in computer simulations, 3) Filter efficiency was measured during the loading tests to establish a relation between efficiency and salt loading, 4) The structural strength of the salt-loaded high-efficiency filters was investigated by subjecting the filters to pressure transients of the types expected from fires, explosions and tornados, 5) Computer codes, obtained from Los Alamos National Laboratory, were used to model the ventilation systems and study their response to accident-induced pressure transients and heat fluxes, 6) Partial verification of the computer simulations was obtained by comparing normal operation of the ventilation systems to predicted normal operation, 7) A feasibility study using model-based control of the ventilation systems was initiated and will be completed during the second year of the project. (author) 12 figs., 16 refs

  19. Aerosol delivery in intubated, mechanically ventilated patients

    International Nuclear Information System (INIS)

    MacIntyre, N.R.; Silver, R.M.; Miller, C.W.; Schuler, F.; Coleman, R.E.

    1985-01-01

    To study the effects of respiratory failure and mechanical ventilation on aerosol delivery to the lungs, nuclear scans were performed after aerosolization of 5 to 9 mCi of Tc-99m diethylenetriamine pentaacetic acid in seven stable, intubated, and mechanically ventilated patients. The radioactivity reaching the lungs was 2.9 +/- .7% (mean +/- SD) of the administered dose, an amount significantly less than that in three healthy nonintubated subjects and also less than what would be expected in nonintubated subjects from other published reports. A subsequent study was performed in 15 additional mechanically ventilated patients who were receiving aerosolized bronchodilators through their endotracheal tube. In these patients, heart rate and lung mechanical function values before and after treatment were not significantly different. It is concluded from these studies that aerosol delivery in mechanically ventilated patients is significantly reduced and that this is probably due to a combination of suboptimal breathing pattern, intrinsic airway disease, and the endotracheal tube functioning as both a site for aerosol deposition through impaction as well as a barrier to gastrointestinal absorption

  20. Ventilators in ICU: A boon or burden

    Directory of Open Access Journals (Sweden)

    Man Mohan Mehndiratta

    2016-01-01

    Full Text Available Background and Aims: Ventilator-associated pneumonia (VAP is a major challenge in intensive care units (ICUs. This challenge is even more discernible in a neurological setting owing to the predispositions of patients. Data on VAP in the neurology and neurosurgery ICUs (NNICUs are scanty in developing countries. This study was conducted to find out the occurrence of VAP, its risk factors, microbiological profile, and antibiotic resistance in patients admitted to the NNICU of a tertiary care institute in India. Materials and Methods: Endotracheal aspirate and blood samples were collected from 100 patients admitted to the NNICU. Complete blood count, microscopic examination, culture and sensitivity testing of aspirate were done. Chest x-ray was also performed to aid in the diagnosis of VAP. Results: Incidence rate of VAP was found to be 24%. Acinetobacter baumannii was the most common pathogen (24.3% isolated from patients with VAP, and all of these isolates were sensitive to meropenem. Duration of mechanical ventilation (P < 0.0001 and associated comorbid illness (P = 0.005 were found to be significantly associated with VAP, and the duration of mechanical ventilation was found to be the only independent risk factor (P < 0.0001. Conclusions: This study highlights the risks and microbiological perspective of ventilator use among neurology patients so that adequate preventive strategies can be adopted on time.

  1. Ventilation in Sewers Quantified by Measurements of CO2

    DEFF Research Database (Denmark)

    Fuglsang, Emil Dietz; Vollertsen, Jes; Nielsen, Asbjørn Haaning

    2012-01-01

    Understanding and quantifying ventilation in sewer systems is a prerequisite to predict transport of odorous and corrosive gasses within the system as well as their interaction with the urban atmosphere. This paper studies ventilation in sewer systems quantified by measurements of the natural...... occurring compound CO2. Most often Danish wastewater is supersaturated with CO2 and hence a potential for stripping is present. A novel model was built based on the kinetics behind the stripping process. It was applied to simulate ventilation rates from field measurements of wastewater temperature, p...

  2. Mechanical ventilation in neurosurgical patients

    Directory of Open Access Journals (Sweden)

    Keshav Goyal

    2013-01-01

    Full Text Available Mechanical ventilation significantly affects cerebral oxygenation and cerebral blood flow through changes in arterial carbon dioxide levels. Neurosurgical patients might require mechanical ventilation for correction and maintenance of changes in the pulmonary system that occur either due to neurosurgical pathology or following surgery during the acute phase. This review discusses the basics of mechanical ventilation relevant to the neurosurgeon in the day-to-day management of neurosurgical patient requiring artificial support of the respiration.

  3. Mechanical Ventilation and Bronchopulmonary Dysplasia.

    Science.gov (United States)

    Keszler, Martin; Sant'Anna, Guilherme

    2015-12-01

    Mechanical ventilation is an important potentially modifiable risk factor for the development of bronchopulmonary dysplasia. Effective use of noninvasive respiratory support reduces the risk of lung injury. Lung volume recruitment and avoidance of excessive tidal volume are key elements of lung-protective ventilation strategies. Avoidance of oxidative stress, less invasive methods of surfactant administration, and high-frequency ventilation are also important factors in lung injury prevention. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Design Principles for Natural and Hybrid Ventilation

    OpenAIRE

    Heiselberg, Per

    2000-01-01

    For many years mechanical and natural ventilation systems have developed separately. Naturally, the next step in this development is the development of ventilation concepts that utilize and combine the best features from each system to create a new type of ventilation system- Hybrid Ventilation. The hybrid ventilation concepts, design challenges and principles are discussed and illustrated by four building examples.

  5. 46 CFR 42.15-45 - Ventilators.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 2 2010-10-01 2010-10-01 false Ventilators. 42.15-45 Section 42.15-45 Shipping COAST... Conditions of Assignment of Freeboard § 42.15-45 Ventilators. (a) Ventilators in position 1 or 2 to spaces... any ventilator exceeds 351/2 inches in height it shall be specially supported. (b) Ventilators passing...

  6. A pilot study of the nocturnal respiration rates in COPD patients in the home environment using a non-contact biomotion sensor

    International Nuclear Information System (INIS)

    Ballal, Tarig; Zaffaroni, Alberto; Heneghan, Conor; Shouldice, Redmond; Boyle, Patricia; McNicholas, Walter T; De Chazal, Philip; Donnelly, Seamas C

    2014-01-01

    Nocturnal respiration rate parameters were collected from 20 COPD subjects over an 8 week period, to determine if changes in respiration rate were associated with exacerbations of COPD. These subjects were primarily GOLD Class 2 to 4, and had been recently discharged from hospital following a recent exacerbation. The respiration rates were collected using a non-contact radio-frequency biomotion sensor which senses respiratory effort and body movement using a short-range radio-frequency sensor. An adaptive notch filter was applied to the measured signal to determine respiratory rate over rolling 15 s segments. The accuracy of the algorithm was initially verified using ten manually-scored 15 min segments of respiration extracted from overnight polysomnograms. The calculated respiration rates were within 1 breath min −1 for >98% of the estimates. For the 20 subjects monitored, 11 experienced one or more subsequent exacerbation of COPD (ECOPD) events during the 8 week monitoring period (19 events total). Analysis of the data revealed a significant increase in nocturnal respiration rate (e.g. >2 breath min −1 ) prior to many ECOPD events. Using a simple classifier of a change of 1 breath min −1 in the mode of the nocturnal respiration rate, a predictive rule showed a sensitivity of 63% and specificity of 85% for predicting an exacerbation within a 5 d window. We conclude that it is possible to collect respiration rates reliably in the home environment, and that the respiration rate may be a potential indicator of change in clinical status. (paper)

  7. Synchronized mechanical ventilation for respiratory support in newborn infants.

    Science.gov (United States)

    Greenough, Anne; Murthy, Vadivelam; Milner, Anthony D; Rossor, Thomas E; Sundaresan, Adesh

    2016-08-19

    During synchronised mechanical ventilation, positive airway pressure and spontaneous inspiration coincide. If synchronous ventilation is provoked, adequate gas exchange should be achieved at lower peak airway pressures, potentially reducing baro/volutrauma, air leak and bronchopulmonary dysplasia. Synchronous ventilation can potentially be achieved by manipulation of rate and inspiratory time during conventional ventilation and employment of patient-triggered ventilation. To compare the efficacy of:(i) synchronised mechanical ventilation, delivered as high-frequency positive pressure ventilation (HFPPV) or patient-triggered ventilation (assist control ventilation (ACV) and synchronous intermittent mandatory ventilation (SIMV)), with conventional ventilation or high-frequency oscillation (HFO);(ii) different types of triggered ventilation (ACV, SIMV, pressure-regulated volume control ventilation (PRVCV), SIMV with pressure support (PS) and pressure support ventilation (PSV)). We used the standard search strategy of the Cochrane Neonatal Review group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 5), MEDLINE via PubMed (1966 to June 5 2016), EMBASE (1980 to June 5 2016), and CINAHL (1982 to June 5 2016). We also searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. Randomised or quasi-randomised clinical trials comparing synchronised ventilation delivered as HFPPV to CMV, or ACV/SIMV to CMV or HFO in neonates. Randomised trials comparing different triggered ventilation modes (ACV, SIMV, SIMV plus PS, PRVCV and PSV) in neonates. Data were collected regarding clinical outcomes including mortality, air leaks (pneumothorax or pulmonary interstitial emphysema (PIE)), severe intraventricular haemorrhage (grades 3 and 4), bronchopulmonary dysplasia (BPD) (oxygen dependency beyond 28 days), moderate/severe BPD (oxygen

  8. Comparison of two modes of ventilation after fast-track cardiac surgery: Adaptive support ventilation versus synchronized intermittent mandatory ventilation

    International Nuclear Information System (INIS)

    Aghadavoudi, O.

    2012-01-01

    Objective: There is substantial debate regarding the appropriate protocol for ventilatory management in fast-track cardiac anesthesia (FTCA). This study was carried out to assess and compare the risks and benefits of respiratory weaning based on adaptive support ventilation (ASV) and synchronized intermittent mandatory ventilation (SIMV) after uncomplicated cardiac surgery. Methodology: In a randomized clinical trial, after receiving approval of the Department Research Committee and informed consent from study subjects, 100 patients undergoing elective coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB) were enrolled during a 4-month period at a university-based hospital. After surgery and admission to the intensive care unit (ICU), patients were randomized to ASV and SIMV groups. Arterial blood gas (ABG) and hemodynamic variables, respiratory and ventilator characteristics including lung compliance, rapid shallow breathing index (RSBI), tidal volume (TV), respiratory rate (RR), peak inspiratory pressure (P peak), mean airway pressure (p mean), Pao2/FIo2, duration of mechanical ventilation and tracheal intubation, and length of ICU stay were recorded and compared between the two groups. The data were analyzed in 82 patients after considering the exclusion criteria. Results: There were no differences between ASV and SIMV groups in demographics and preoperative characteristics. The duration of tracheal intubation and the length of ICU stay were similar in both groups. There were no statistically and clinically relevant differences between the two groups in ABG, hemodynamic changes, and respiratory and ventilator characteristics during ICU stay. Conclusion: Although ASV may facilitate postoperative respiratory management in FTCA, both ASV and SIMV provide similarly safe and practicable respiratory weaning in the cardiac ICU. The evaluation of potential advantages in patient outcomes and resource utilization of respiratory weaning based on ASV

  9. New Air Cleaning Strategies for Reduced Commercial Building Ventilation Energy

    Energy Technology Data Exchange (ETDEWEB)

    Sidheswaran, Meera; Destaillats, Hugo; Sullivan, Douglas P.; Fisk, William J.

    2010-10-27

    Approximately ten percent of the energy consumed in U.S. commercial buildings is used by HVAC systems to condition outdoor ventilation air. Reducing