Clinical assessment of auto-positive end-expiratory pressure by diaphragmatic electrical activity during pressure support and neurally adjusted ventilatory assist.

Science.gov (United States)

Bellani, Giacomo; Coppadoro, Andrea; Patroniti, Nicolò; Turella, Marta; Arrigoni Marocco, Stefano; Grasselli, Giacomo; Mauri, Tommaso; Pesenti, Antonio

2014-09-01

Auto-positive end-expiratory pressure (auto-PEEP) may substantially increase the inspiratory effort during assisted mechanical ventilation. Purpose of this study was to assess whether the electrical activity of the diaphragm (EAdi) signal can be reliably used to estimate auto-PEEP in patients undergoing pressure support ventilation and neurally adjusted ventilatory assist (NAVA) and whether NAVA was beneficial in comparison with pressure support ventilation in patients affected by auto-PEEP. In 10 patients with a clinical suspicion of auto-PEEP, the authors simultaneously recorded EAdi, airway, esophageal pressure, and flow during pressure support and NAVA, whereas external PEEP was increased from 2 to 14 cm H2O. Tracings were analyzed to measure apparent "dynamic" auto-PEEP (decrease in esophageal pressure to generate inspiratory flow), auto-EAdi (EAdi value at the onset of inspiratory flow), and IDEAdi (inspiratory delay between the onset of EAdi and the inspiratory flow). The pressure necessary to overcome auto-PEEP, auto-EAdi, and IDEAdi was significantly lower in NAVA as compared with pressure support ventilation, decreased with increase in external PEEP, although the effect of external PEEP was less pronounced in NAVA. Both auto-EAdi and IDEAdi were tightly correlated with auto-PEEP (r = 0.94 and r = 0.75, respectively). In the presence of auto-PEEP at lower external PEEP levels, NAVA was characterized by a characteristic shape of the airway pressure. In patients with auto-PEEP, NAVA, compared with pressure support ventilation, led to a decrease in the pressure necessary to overcome auto-PEEP, which could be reliably monitored by the electrical activity of the diaphragm before inspiratory flow onset (auto-EAdi).

Uncertainties in neural network model based on carbon dioxide concentration for occupancy estimation

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Alam, Azimil Gani; Rahman, Haolia; Kim, Jung-Kyung; Han, Hwataik [Kookmin University, Seoul (Korea, Republic of)

2017-05-15

Demand control ventilation is employed to save energy by adjusting airflow rate according to the ventilation load of a building. This paper investigates a method for occupancy estimation by using a dynamic neural network model based on carbon dioxide concentration in an occupied zone. The method can be applied to most commercial and residential buildings where human effluents to be ventilated. An indoor simulation program CONTAMW is used to generate indoor CO{sub 2} data corresponding to various occupancy schedules and airflow patterns to train neural network models. Coefficients of variation are obtained depending on the complexities of the physical parameters as well as the system parameters of neural networks, such as the numbers of hidden neurons and tapped delay lines. We intend to identify the uncertainties caused by the model parameters themselves, by excluding uncertainties in input data inherent in measurement. Our results show estimation accuracy is highly influenced by the frequency of occupancy variation but not significantly influenced by fluctuation in the airflow rate. Furthermore, we discuss the applicability and validity of the present method based on passive environmental conditions for estimating occupancy in a room from the viewpoint of demand control ventilation applications.

Patient-Ventilator Dyssynchrony

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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.

Initial mechanical ventilator settings and lung protective ventilation in the ED.

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Wilcox, Susan R; Richards, Jeremy B; Fisher, Daniel F; Sankoff, Jeffrey; Seigel, Todd A

2016-08-01

Mechanical ventilation with low tidal volumes has been shown to improve outcomes for patients both with and without acute respiratory distress syndrome. This study aims to characterize mechanically ventilated patients in the emergency department (ED), describe the initial ED ventilator settings, and assess for associations between lung protective ventilation strategies in the ED and outcomes. This was a multicenter, prospective, observational study of mechanical ventilation at 3 academic EDs. We defined lung protective ventilation as a tidal volume of less than or equal to 8 mL/kg of predicted body weight and compared outcomes for patients ventilated with lung protective vs non-lung protective ventilation, including inhospital mortality, ventilator days, intensive care unit length of stay, and hospital length of stay. Data from 433 patients were analyzed. Altered mental status without respiratory pathology was the most common reason for intubation, followed by trauma and respiratory failure. Two hundred sixty-one patients (60.3%) received lung protective ventilation, but most patients were ventilated with a low positive end-expiratory pressure, high fraction of inspired oxygen strategy. Patients were ventilated in the ED for a mean of 5 hours and 7 minutes but had few ventilator adjustments. Outcomes were not significantly different between patients receiving lung protective vs non-lung protective ventilation. Nearly 40% of ED patients were ventilated with non-lung protective ventilation as well as with low positive end-expiratory pressure and high fraction of inspired oxygen. Despite a mean ED ventilation time of more than 5 hours, few patients had adjustments made to their ventilators. Copyright © 2016 Elsevier Inc. All rights reserved.

[Lung protective ventilation. Ventilatory modes and ventilator parameters].

Science.gov (United States)

Schädler, Dirk; Weiler, Norbert

2008-06-01

Mechanical ventilation has a considerable potential for injuring the lung tissue. Therefore, attention has to be paid to the proper choice of ventilatory mode and settings to secure lung-protective ventilation whenever possible. Such ventilator strategy should account for low tidal volume ventilation (6 ml/kg PBW), limited plateau pressure (30 to 35 cm H2O) and positive end-expiratory pressure (PEEP). It is unclear whether pressure controlled or volume controlled ventilation with square flow profile is beneficial. The adjustment of inspiration and expiration time should consider the actual breathing mechanics and anticipate the generation of intrinsic PEEP. Ventilatory modes with the possibility of supporting spontaneous breathing should be used as soon as possible.

Automatic adjustment of display window (gray-level condition) for MR images using neural networks

International Nuclear Information System (INIS)

Ohhashi, Akinami; Nambu, Kyojiro.

1992-01-01

We have developed a system to automatically adjust the display window width and level (WWL) for MR images using neural networks. There were three main points in the development of our system as follows: 1) We defined an index for the clarity of a displayed image, and called 'EW'. EW is a quantitative measure of the clarity of an image displayed in a certain WWL, and can be derived from the difference between gray-level with the WWL adjusted by a human expert and with a certain WWL. 2) We extracted a group of six features from a gray-level histogram of a displayed image. We designed two neural networks which are able to learn the relationship between these features and the desired output (teaching signal), 'EQ', which is normalized to 0 to 1.0 from EW. Two neural networks were used to share the patterns to be learned; one learns a variety of patterns with less accuracy, and the other learns similar patterns with accuracy. Learning was performed using a back-propagation method. As a result, the neural networks after learning are able to provide a quantitative measure, 'Q', of the clarity of images displayed in the designated WWL. 3) Using the 'Hill climbing' method, we have been able to determine the best possible WWL for a displaying image. We have tested this technique for MR brain images. The results show that this system can adjust WWL comparable to that adjusted by a human expert for the majority of test images. The neural network is effective for the automatic adjustment of the display window for MR images. We are now studying the application of this method to MR images of another regions. (author)

Could LC-NE-Dependent Adjustment of Neural Gain Drive Functional Brain Network Reorganization?

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Carole Guedj

2017-01-01

Full Text Available The locus coeruleus-norepinephrine (LC-NE system is thought to act at synaptic, cellular, microcircuit, and network levels to facilitate cognitive functions through at least two different processes, not mutually exclusive. Accordingly, as a reset signal, the LC-NE system could trigger brain network reorganizations in response to salient information in the environment and/or adjust the neural gain within its target regions to optimize behavioral responses. Here, we provide evidence of the co-occurrence of these two mechanisms at the whole-brain level, in resting-state conditions following a pharmacological stimulation of the LC-NE system. We propose that these two mechanisms are interdependent such that the LC-NE-dependent adjustment of the neural gain inferred from the clustering coefficient could drive functional brain network reorganizations through coherence in the gamma rhythm. Via the temporal dynamic of gamma-range band-limited power, the release of NE could adjust the neural gain, promoting interactions only within the neuronal populations whose amplitude envelopes are correlated, thus making it possible to reorganize neuronal ensembles, functional networks, and ultimately, behavioral responses. Thus, our proposal offers a unified framework integrating the putative influence of the LC-NE system on both local- and long-range adjustments of brain dynamics underlying behavioral flexibility.

Bilevel vs ICU ventilators providing noninvasive ventilation: effect of system leaks: a COPD lung model comparison.

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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.

Data on respiratory variables in critically ill patients with acute respiratory failure placed on proportional assist ventilation with load adjustable gain factors (PAV+

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Dimitris Georgopoulos

2016-09-01

Full Text Available The data show respiratory variables in 108 critically ill patients with acute respiratory failure placed on proportional assist ventilation with load adjustable gain factors (PAV+ after at least 36 h on passive mechanical ventilation. PAV+ was continued for 48 h until the patients met pre-defined criteria either for switching to controlled modes or for breathing without ventilator assistance. Data during passive mechanical ventilation and during PAV+ are reported. Data are acquired from the whole population, as well as from patients with and without acute respiratory distress syndrome. The reported variables are tidal volume, driving pressure (ΔP, the difference between static end-inspiratory plateau pressure and positive end-expiratory airway pressure, respiratory system compliance and resistance, and arterial blood gasses. The data are supplemental to our original research article, which described individual ΔP in these patients and examined how it related to ΔP when the same patients were ventilated with passive mechanical ventilation using the currently accepted lung-protective strategy “Driving pressure during assisted mechanical ventilation. Is it controlled by patient brain?” [1]. Keywords: Tidal volume, Compliance, Driving pressure

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

Volume-Targeted Ventilation in the Neonate: Benchmarking Ventilators on an Active Lung Model.

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Krieger, Tobias J; Wald, Martin

2017-03-01

Mechanically ventilated neonates have been observed to receive substantially different ventilation after switching ventilator models, despite identical ventilator settings. This study aims at establishing the range of output variability among 10 neonatal ventilators under various breathing conditions. Relative benchmarking test of 10 neonatal ventilators on an active neonatal lung model. Neonatal ICU. Ten current neonatal ventilators. Ventilators were set identically to flow-triggered, synchronized, volume-targeted, pressure-controlled, continuous mandatory ventilation and connected to a neonatal lung model. The latter was configured to simulate three patients (500, 1,500, and 3,500 g) in three breathing modes each (passive breathing, constant active breathing, and variable active breathing). Averaged across all weight conditions, the included ventilators delivered between 86% and 110% of the target tidal volume in the passive mode, between 88% and 126% during constant active breathing, and between 86% and 120% under variable active breathing. The largest relative deviation occurred during the 500 g constant active condition, where the highest output machine produced 147% of the tidal volume of the lowest output machine. All machines deviate significantly in volume output and ventilation regulation. These differences depend on ventilation type, respiratory force, and patient behavior, preventing the creation of a simple conversion table between ventilator models. Universal neonatal tidal volume targets for mechanical ventilation cannot be transferred from one ventilator to another without considering necessary adjustments.

Ventilation of gloveboxes and containment shells

International Nuclear Information System (INIS)

Guetron, R.

1984-01-01

In this paper are defined fundamental principles for the ventilation of containment enclosures and gloveboxes, and examined criteria required to maintain containment in normal or accidental conditions. Dimensioning of ventilation network and associated equipment (adjustement and filtering devices). Some examples are given [fr

Tracer gas evaluations of push-pull ventilation system performance.

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Ojima, Jun

2009-01-01

A push-pull ventilation system is effective for hazardous material exhaustion. Although a push-pull ventilation system has advantages over a local exhaust hood, some laborious adjustments are required. The pertinence of the adjustments is uncertain because it is difficult to evaluate the performance of a push-pull ventilation system quantitatively. In this study, a measurement of the capture efficiency of a push-pull ventilation system was carried out by means of a tracer gas method. The capture efficiency decreased to 39.3-78.5% when blockage material, a dummy worker and a cross draft, were set in the ventilation zone, but the efficiency was 95.1-97.9% when the cross draft was stopped. The results suggest that the uniform flow of a push-pull ventilation system will detour a blockage and the performance of the system will not be reduced unless a cross draft disturbs the uniform flow.

Cost per QALY (quality-adjusted life year and lifetime cost of prolonged mechanical ventilation in Taiwan.

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Mei-Chuan Hung

Full Text Available INTRODUCTION: Patients who require prolonged mechanical ventilation (PMV are increasing and producing financial burdens worldwide. This study determines the cost per QALY (quality-adjusted life year, out-of-pocket expenses, and lifetime costs for PMV patients stratified by underlying diseases and cognition levels. METHODS: A nationwide sample of 50,481 patients with continual mechanical ventilation for more than 21 days was collected during 1997-2007. After stratifying the patients according to specific diagnoses, a latent class analysis (LCA was performed to categorise PMV patients with multiple co-morbidities into several homogeneous groups. The survival functions were estimated for individual groups using the Kaplan-Meier method and extrapolated to 300 months through a semi-parametric method. The survival functions were adjusted using an EQ-5D utility value derived from a convenience sample of 142 PMV patients to estimate quality-adjusted life expectancies (QALE. Another convenience sample of 165 patients was used to estimate the out-of-pocket expenses. The lifetime expenditures paid by the single-payer National Health Insurance (NHI system and patients' families were estimated by multiplying average monthly expenditures by the survival probabilities and summing the values over lifetime. RESULTS: PMV therapy costs more than 100,000 U.S. dollars (USD per QALY for all patients with poor cognition. For patients with partial cognition, PMV therapy costs less than 56,000 USD per QALY for those with liver cirrhosis, intracranial or spinal cord injuries, and 57,000-69,000 USD for patients with multiple co-morbidities under age of 65. The average lifetime cost of PMV was usually below 56,000 USD. The out-of-pocket expenses were often more than one-third of the total cost of treatment. CONCLUSIONS: PMV treatment for patients with poor cognition would cost more than 5 times Taiwan's GDP (gross domestic products, or less cost-effective. The out

Mechanical ventilators in US acute care hospitals.

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Rubinson, Lewis; Vaughn, Frances; Nelson, Steve; Giordano, Sam; Kallstrom, Tom; Buckley, Tim; Burney, Tabinda; Hupert, Nathaniel; Mutter, Ryan; Handrigan, Michael; Yeskey, Kevin; Lurie, Nicole; Branson, Richard

2010-10-01

The supply and distribution of mechanical ventilation capacity is of profound importance for planning for severe public health emergencies. However, the capability of US health systems to provide mechanical ventilation for children and adults remains poorly quantified. The objective of this study was to determine the quantity of adult and pediatric mechanical ventilators at US acute care hospitals. A total of 5,752 US acute care hospitals included in the 2007 American Hospital Association database were surveyed. We measured the quantities of mechanical ventilators and their features. Responding to the survey were 4305 (74.8%) hospitals, which accounted for 83.8% of US intensive care unit beds. Of the 52,118 full-feature mechanical ventilators owned by respondent hospitals, 24,204 (46.4%) are pediatric/neonatal capable. Accounting for nonrespondents, we estimate that there are 62,188 full-feature mechanical ventilators owned by US acute care hospitals. The median number of full-feature mechanical ventilators per 100,000 population for individual states is 19.7 (interquartile ratio 17.2-23.1), ranging from 11.9 to 77.6. The median number of pediatric-capable device full-feature mechanical ventilators per 100,000 population younger than 14 years old is 52.3 (interquartile ratio 43.1-63.9) and the range across states is 22.1 to 206.2. In addition, respondent hospitals reported owning 82,755 ventilators other than full-feature mechanical ventilators; we estimate that there are 98,738 devices other than full-feature ventilators at all of the US acute care hospitals. The number of mechanical ventilators per US population exceeds those reported by other developed countries, but there is wide variation across states in the population-adjusted supply. There are considerably more pediatric-capable ventilators than there are for adults only on a population-adjusted basis.

Nasal mask ventilation is better than face mask ventilation in edentulous patients.

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Kapoor, Mukul Chandra; Rana, Sandeep; Singh, Arvind Kumar; Vishal, Vindhya; Sikdar, Indranil

2016-01-01

Face mask ventilation of the edentulous patient is often difficult as ineffective seating of the standard mask to the face prevents attainment of an adequate air seal. The efficacy of nasal ventilation in edentulous patients has been cited in case reports but has never been investigated. Consecutive edentulous adult patients scheduled for surgery under general anesthesia with endotracheal intubation, during a 17-month period, were prospectively evaluated. After induction of anesthesia and administration of neuromuscular blocker, lungs were ventilated with a standard anatomical face mask of appropriate size, using a volume controlled anesthesia ventilator with tidal volume set at 10 ml/kg. In case of inadequate ventilation, the mask position was adjusted to achieve best-fit. Inspired and expired tidal volumes were measured. Thereafter, the face mask was replaced by a nasal mask and after achieving best-fit, the inspired and expired tidal volumes were recorded. The difference in expired tidal volumes and airway pressures at best-fit with the use of the two masks and number of patients with inadequate ventilation with use of the masks were statistically analyzed. A total of 79 edentulous patients were recruited for the study. The difference in expiratory tidal volumes with the use of the two masks at best-fit was statistically significant (P = 0.0017). Despite the best-fit mask placement, adequacy of ventilation could not be achieved in 24.1% patients during face mask ventilation, and 12.7% patients during nasal mask ventilation and the difference was statistically significant. Nasal mask ventilation is more efficient than standard face mask ventilation in edentulous patients.

Discussion for management of ventilation system in uranium mines

International Nuclear Information System (INIS)

Li Xianjie; Ren Jianjun; Hu Penghua

2014-01-01

Radon exhaustion and ventilation are surely regarded as key links for safety production and radiation protection in underground uranium mines, and the crucial point to achieve safety production goals lies in timely and accurately adjusting and controlling of ventilation technical measures and ventilation system management with the changing operation conditions of mines. This paper proposes corresponding countermeasures based on the respectively systematical analysis of daily ventilation management, ventilation facilities and structures management, and ventilation system information management in uranium mines. Furthermore, standardized management approaches and suggestions are put forward to realize standardization of uranium mines' ventilation management and radon exhaustion technique. (authors)

Research on Environmental Adjustment of Cloud Ranch Based on BP Neural Network PID Control

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Ren, Jinzhi; Xiang, Wei; Zhao, Lin; Wu, Jianbo; Huang, Lianzhen; Tu, Qinggang; Zhao, Heming

2018-01-01

In order to make the intelligent ranch management mode replace the traditional artificial one gradually, this paper proposes a pasture environment control system based on cloud server, and puts forward the PID control algorithm based on BP neural network to control temperature and humidity better in the pasture environment. First, to model the temperature and humidity (controlled object) of the pasture, we can get the transfer function. Then the traditional PID control algorithm and the PID one based on BP neural network are applied to the transfer function. The obtained step tracking curves can be seen that the PID controller based on BP neural network has obvious superiority in adjusting time and error, etc. This algorithm, calculating reasonable control parameters of the temperature and humidity to control environment, can be better used in the cloud service platform.

Effect of an automatic triggering and cycling system on comfort and patient-ventilator synchrony during pressure support ventilation.

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Vasconcelos, Renata dos S; Melo, Luíz Henrique de P; Sales, Raquel P; Marinho, Liégina S; Deulefeu, Flávio C; Reis, Ricardo C; Alves-de-Almeida, Mirizana; Holanda, Marcelo A

2013-01-01

The digital Auto-Trak™ system is a technology capable of automatically adjusting the triggering and cycling mechanisms during pressure support ventilation (PSV). To compare Auto-Trak with conventional settings in terms of patient-ventilator synchrony and discomfort. Twelve healthy volunteers underwent PSV via the mouth by breathing through an endotracheal tube. In the conventional setting, a pressure support of 8 cm H2O with flow cycling (25% peak inspiratory flow) and a sensitivity of 1 cm H2O was adjusted. In Auto-Trak the triggering and cycling were automatically set. Discomfort, effort of breathing, and the asynchrony index (AI) were assessed. In a complementary bench study, the inspiratory and expiratory time delays were quantified for both settings in three mechanical models: 'normal', obstructive (COPD), and restrictive (ARDS), using the ASL 5000 simulator. In the volunteer study the AI and the discomfort scores did not differ statistically between the two settings. In the bench investigation the use of Auto-Trak was associated with a greater triggering delay in the COPD model and earlier expiratory cycling in the ARDS model but with no asynchronic events. Use of the Auto-Trak system during PSV showed similar results in comparison to the conventional adjustments with respect to patient-ventilator synchrony and discomfort in simulated conditions of invasive mechanical ventilation. Copyright © 2013 S. Karger AG, Basel.

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.

Ventilation practices in subarachnoid hemorrhage: a cohort study exploring the use of lung protective ventilation.

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Marhong, Jonathan D; Ferguson, Niall D; Singh, Jeffrey M

2014-10-01

consideration of adjustment of ventilator settings to meet lung protective thresholds.

Adjustment and Prediction of Machine Factors Based on Neural Artificial Intelligence

International Nuclear Information System (INIS)

Hussein, A.Z.; Amin, E.S.; Ibrahim, M.S.

2009-01-01

Since the discovery of x-ray, it is use in examination has become an integral part of medical diagnostic radiology. The use of X-ray is harmful to human beings but recent technological advances and regulatory constraints have made the medical Xray much safer than they were at the beginning of the 20th century. However, the potential benefits of the engineered safety features can not be fully realized unless the operators are aware of these safety features. The aim of this work is to adjust and predict x-ray machine factors (current and voltage) using neural artificial network in order to obtain effective dose within the range of dose limitation system and assure radiological safety.

Do new anesthesia ventilators deliver small tidal volumes accurately during volume-controlled ventilation?

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Bachiller, Patricia R; McDonough, Joseph M; Feldman, Jeffrey M

2008-05-01

During mechanical ventilation of infants and neonates, small changes in tidal volume may lead to hypo- or hyperventilation, barotrauma, or volutrauma. Partly because breathing circuit compliance and fresh gas flow affect tidal volume delivery by traditional anesthesia ventilators in volume-controlled ventilation (VCV) mode, pressure-controlled ventilation (PCV) using a circle breathing system has become a common approach to minimizing the risk of mechanical ventilation for small patients, although delivered tidal volume is not assured during PCV. A new generation of anesthesia machine ventilators addresses the problems of VCV by adjusting for fresh gas flow and for the compliance of the breathing circuit. In this study, we evaluated the accuracy of new anesthesia ventilators to deliver small tidal volumes. Four anesthesia ventilator systems were evaluated to determine the accuracy of volume delivery to the airway during VCV at tidal volume settings of 100, 200, and 500 mL under different conditions of breathing circuit compliance (fully extended and fully contracted circuits) and lung compliance. A mechanical test lung (adult and infant) was used to simulate lung compliances ranging from 0.0025 to 0.03 L/cm H(2)O. Volumes and pressures were measured using a calibrated screen pneumotachograph and custom software. We tested the Smartvent 7900, Avance, and Aisys anesthesia ventilator systems (GE Healthcare, Madison, WI) and the Apollo anesthesia ventilator (Draeger Medical, Telford, PA). The Smartvent 7900 and Avance ventilators use inspiratory flow sensors to control the volume delivered, whereas the Aisys and Apollo ventilators compensate for the compliance of the circuit. We found that the anesthesia ventilators that use compliance compensation (Aisys and Apollo) accurately delivered both large and small tidal volumes to the airway of the test lung under conditions of normal and low lung compliance during VCV (ranging from 95.5% to 106.2% of the set tidal volume

Adjusting tidal volume to stress index in an open lung condition optimizes ventilation and prevents overdistension in an experimental model of lung injury and reduced chest wall compliance.

Science.gov (United States)

Ferrando, Carlos; Suárez-Sipmann, Fernando; Gutierrez, Andrea; Tusman, Gerardo; Carbonell, Jose; García, Marisa; Piqueras, Laura; Compañ, Desamparados; Flores, Susanie; Soro, Marina; Llombart, Alicia; Belda, Francisco Javier

2015-01-13

The stress index (SI), a parameter derived from the shape of the pressure-time curve, can identify injurious mechanical ventilation. We tested the hypothesis that adjusting tidal volume (VT) to a non-injurious SI in an open lung condition avoids hypoventilation while preventing overdistension in an experimental model of combined lung injury and low chest-wall compliance (Ccw). Lung injury was induced by repeated lung lavages using warm saline solution, and Ccw was reduced by controlled intra-abdominal air-insufflation in 22 anesthetized, paralyzed and mechanically ventilated pigs. After injury animals were recruited and submitted to a positive end-expiratory pressure (PEEP) titration trial to find the PEEP level resulting in maximum compliance. During a subsequent four hours of mechanical ventilation, VT was adjusted to keep a plateau pressure (Pplat) of 30 cmH2O (Pplat-group, n = 11) or to a SI between 0.95 and 1.05 (SI-group, n = 11). Respiratory rate was adjusted to maintain a 'normal' PaCO2 (35 to 65 mmHg). SI, lung mechanics, arterial-blood gases haemodynamics pro-inflammatory cytokines and histopathology were analyzed. In addition Computed Tomography (CT) data were acquired at end expiration and end inspiration in six animals. PaCO2 was significantly higher in the Pplat-group (82 versus 53 mmHg, P = 0.01), with a resulting lower pH (7.19 versus 7.34, P = 0.01). We observed significant differences in VT (7.3 versus 5.4 mlKg(-1), P = 0.002) and Pplat values (30 versus 35 cmH2O, P = 0.001) between the Pplat-group and SI-group respectively. SI (1.03 versus 0.99, P = 0.42) and end-inspiratory transpulmonary pressure (PTP) (17 versus 18 cmH2O, P = 0.42) were similar in the Pplat- and SI-groups respectively, without differences in overinflated lung areas at end- inspiration in both groups. Cytokines and histopathology showed no differences. Setting tidal volume to a non-injurious stress index in an open lung condition improves

Survey execution to build a ventilation model, Australian style

Energy Technology Data Exchange (ETDEWEB)

Rowland, J.A. [Dallas Mining Services Pty Ltd., Wollongong, NSW (Australia)

2010-07-01

Ventilation surveys and the development of a properly tuned ventilation model are important components of a modern underground mine safety management system to ensure the safety of miners. Such systems in Australia revolve around the routine application of risk based logic. However, assessing the risk in ventilation systems always changes. Designers of ventilation circuits therefore use ventilation modeling software as a key tool to facilitate the structured process. This paper emphasized the importance of measuring the underground circuit and replicating the measurements in a working model. The most commonly used modeling program in Australia is the Ventsim software which is available as a fully graphical 3D configuration as well as a 2D version. The value of the mine ventilation survey lies in the ability of the data to be accurately replicated on a mine ventilation model. As such, much thought must be given to the ventilation survey scope of work and overall process. The surveys must satisfy operational needs and must delineate the circuit to a level that will allow a model be to accurately assembled in order to determine when minor or major ventilation circuit adjustments are needed. 1 ref., 10 figs.

Jet Ventilation during Rigid Bronchoscopy in Adults: A Focused Review

Directory of Open Access Journals (Sweden)

Laurie Putz

2016-01-01

Full Text Available The indications for rigid bronchoscopy for interventional pulmonology have increased and include stent placements and transbronchial cryobiopsy procedures. The shared airway between anesthesiologist and pulmonologist and the open airway system, requiring specific ventilation techniques such as jet ventilation, need a good understanding of the procedure to reduce potentially harmful complications. Appropriate adjustment of the ventilator settings including pause pressure and peak inspiratory pressure reduces the risk of barotrauma. High frequency jet ventilation allows adequate oxygenation and carbon dioxide removal even in cases of tracheal stenosis up to frequencies of around 150 min−1; however, in an in vivo animal model, high frequency jet ventilation along with normal frequency jet ventilation (superimposed high frequency jet ventilation has been shown to improve oxygenation by increasing lung volume and carbon dioxide removal by increasing tidal volume across a large spectrum of frequencies without increasing barotrauma. General anesthesia with a continuous, intravenous, short-acting agent is safe and effective during rigid bronchoscopy procedures.

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....

: 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...

Prophylactic Use of High-Frequency Percussive Ventilation in Patients with Inhalation Injury,

Science.gov (United States)

1991-06-01

Pneumonia ( CPAP ). The duration of the percussive phase and of the return to baseline phase are adjusted to manipulate ox- The diagnosis of pneumonia was...high-frequency ventilation than conventional support. using this form of ventilation in neonates , in which that incidence ap- Dr. Herndon asked about

Comparing the effects of rise time and inspiratory cycling criteria on 6 different mechanical ventilators.

Science.gov (United States)

Gonzales, Joshua F; Russian, Christopher J; Gregg Marshall, S; Collins, Kevin P

2013-03-01

Inspiratory rise time and cycling criteria are important settings in pressure support ventilation. The purpose of this study was to investigate the impact of minimum and maximum rise time and inspiratory cycling criteria settings on 6 new generation ventilators. Our hypothesis was there would be a difference in the exhaled tidal volume, inspiratory time, and peak flow among 6 different ventilators, based, on change in rise time and cycling criteria. The research utilized a breathing simulator and 4 different ventilator models. All mechanical ventilators were set to a spontaneous mode of ventilation with settings of pressure support 8 cm H2O and PEEP of 5 cm H2O. A minimum and maximum setting for rise time and cycling criteria were examined. Exhaled tidal volume, inspiratory time, and peak flow measurements were recorded for each simulation. Significant (P ventilator. Significant differences in exhaled tidal volume, inspiratory time, and peak flow were observed by adjusting rise time and cycling criteria. This research demonstrates that during pressure support ventilation strategy, adjustments in rise time and/or cycling criteria can produce changes in inspiratory parameters. Obviously, this finding has important implications for practitioners who utilize a similar pressure support strategy when conducting a ventilator wean. Additionally, this study outlines major differences among ventilator manufacturers when considering inspiratory rise time and cycling criteria.

Duration of Mechanical Ventilation in the Emergency Department

Directory of Open Access Journals (Sweden)

Lauren B. Angotti

2017-07-01

Full Text Available Introduction: Due to hospital crowding, mechanically ventilated patients are increasingly spending hours boarding in emergency departments (ED before intensive care unit (ICU admission. This study aims to evaluate the association between time ventilated in the ED and in-hospital mortality, duration of mechanical ventilation, ICU and hospital length of stay (LOS. Methods: This was a multi-center, prospective, observational study of patients ventilated in the ED, conducted at three academic Level I Trauma Centers from July 2011 to March 2013. All consecutive adult patients on invasive mechanical ventilation were eligible for enrollment. We performed a Cox regression to assess for a mortality effect for mechanically ventilated patients with each hour of increasing LOS in the ED and multivariable regression analyses to assess for independently significant contributors to in-hospital mortality. Our primary outcome was in-hospital mortality, with secondary outcomes of ventilator days, ICU LOS and hospital LOS. We further commented on use of lung protective ventilation and frequency of ventilator changes made in this cohort. Results: We enrolled 535 patients, of whom 525 met all inclusion criteria. Altered mental status without respiratory pathology was the most common reason for intubation, followed by trauma and respiratory failure. Using iterated Cox regression, a mortality effect occurred at ED time of mechanical ventilation > 7 hours, and the longer ED stay was also associated with a longer total duration of intubation. However, adjusted multivariable regression analysis demonstrated only older age and admission to the neurosciences ICU as independently associated with increased mortality. Of interest, only 23.8% of patients ventilated in the ED for over seven hours had changes made to their ventilator. Conclusion: In a prospective observational study of patients mechanically ventilated in the ED, there was a significant mortality benefit to

Duration of Mechanical Ventilation in the Emergency Department.

Science.gov (United States)

Angotti, Lauren B; Richards, Jeremy B; Fisher, Daniel F; Sankoff, Jeffrey D; Seigel, Todd A; Al Ashry, Haitham S; Wilcox, Susan R

2017-08-01

Due to hospital crowding, mechanically ventilated patients are increasingly spending hours boarding in emergency departments (ED) before intensive care unit (ICU) admission. This study aims to evaluate the association between time ventilated in the ED and in-hospital mortality, duration of mechanical ventilation, ICU and hospital length of stay (LOS). This was a multi-center, prospective, observational study of patients ventilated in the ED, conducted at three academic Level I Trauma Centers from July 2011 to March 2013. All consecutive adult patients on invasive mechanical ventilation were eligible for enrollment. We performed a Cox regression to assess for a mortality effect for mechanically ventilated patients with each hour of increasing LOS in the ED and multivariable regression analyses to assess for independently significant contributors to in-hospital mortality. Our primary outcome was in-hospital mortality, with secondary outcomes of ventilator days, ICU LOS and hospital LOS. We further commented on use of lung protective ventilation and frequency of ventilator changes made in this cohort. We enrolled 535 patients, of whom 525 met all inclusion criteria. Altered mental status without respiratory pathology was the most common reason for intubation, followed by trauma and respiratory failure. Using iterated Cox regression, a mortality effect occurred at ED time of mechanical ventilation > 7 hours, and the longer ED stay was also associated with a longer total duration of intubation. However, adjusted multivariable regression analysis demonstrated only older age and admission to the neurosciences ICU as independently associated with increased mortality. Of interest, only 23.8% of patients ventilated in the ED for over seven hours had changes made to their ventilator. In a prospective observational study of patients mechanically ventilated in the ED, there was a significant mortality benefit to expedited transfer of patients into an appropriate ICU setting.

Heliox allows for lower minute volume ventilation in an animal model of ventilator-induced lung injury.

Directory of Open Access Journals (Sweden)

Charlotte J Beurskens

Full Text Available BACKGROUND: Helium is a noble gas with a low density, allowing for lower driving pressures and increased carbon dioxide (CO2 diffusion. Since application of protective ventilation can be limited by the development of hypoxemia or acidosis, we hypothesized that therefore heliox facilitates ventilation in an animal model of ventilator-induced lung injury. METHODS: Sprague-Dawley rats (N=8 per group were mechanically ventilated with heliox (50% oxygen; 50% helium. Controls received a standard gas mixture (50% oxygen; 50% air. VILI was induced by application of tidal volumes of 15 mL kg(-1; lung protective ventilated animals were ventilated with 6 mL kg(-1. Respiratory parameters were monitored with a pneumotach system. Respiratory rate was adjusted to maintain arterial pCO2 within 4.5-5.5 kPa, according to hourly drawn arterial blood gases. After 4 hours, bronchoalveolar lavage fluid (BALF was obtained. Data are mean (SD. RESULTS: VILI resulted in an increase in BALF protein compared to low tidal ventilation (629 (324 vs. 290 (181 μg mL(-1; p<0.05 and IL-6 levels (640 (8.7 vs. 206 (8.7 pg mL(-1; p<0.05, whereas cell counts did not differ between groups after this short course of mechanical ventilation. Ventilation with heliox resulted in a decrease in mean respiratory minute volume ventilation compared to control (123 ± 0.6 vs. 146 ± 8.9 mL min(-1, P<0.001, due to a decrease in respiratory rate (22 (0.4 vs. 25 (2.1 breaths per minute; p<0.05, while pCO2 levels and tidal volumes remained unchanged, according to protocol. There was no effect of heliox on inspiratory pressure, while compliance was reduced. In this mild lung injury model, heliox did not exert anti-inflammatory effects. CONCLUSIONS: Heliox allowed for a reduction in respiratory rate and respiratory minute volume during VILI, while maintaining normal acid-base balance. Use of heliox may be a useful approach when protective tidal volume ventilation is limited by the development of

Adjustment and Prediction of X-Ray Machine Factors Based on Neural Artificial Inculcating

International Nuclear Information System (INIS)

Hussein, A.Z.; Amin, E.S.; Ibrahim, M.S.

2009-01-01

Since the discovery of X-rays, their use in examination has become an integral part of medical diagnostic radiology. The use of X-rays is harmful to human beings but recent technological advances and regulatory constraints have made the medical X-rays much safer than they were at the beginning of the 20th century. However, the potential benefits of the engineered safety features can not be fully realized unless the operators are aware of these safety features. The aim of this work is to adjust and predict X-ray machine factors (current and voltage) using neural artificial network in order to obtain effective dose within the range of dose limitation system and assure radiological safety.

Guidelines For Health-Based Ventilation In Europe

DEFF Research Database (Denmark)

Wargocki, Pawel; Carrer, Paolo; de Oliveira Fernandes, Eduardo

2014-01-01

The burden of disease (BoD) associated with major air exposures indoors in 26 European countries was recently accounted for loss of two million healthy life years annually expressed as disability adjusted life years (DALYs) (Jantunen et al., 2011). The development of health-based ventilation...

Ventilation of nuclear rooms and operators' protection

International Nuclear Information System (INIS)

Vavasseur, C.

1985-01-01

Ventilation systems are designed to guarantee air replacement in rooms so as to evacuate gases, odors and aerosols liable to be produced therein. This air is conditioned, filtered, heated, and the relative humidity checked. At the outlet, a filtration system adapted to the type of effluent prevents the external dispersion of toxic substances. Ventilation is defined by the air change time. A comfort rule recommends reducing the velocities reaching the person present in less than 0.2 m/sec. This reduction is achieved by adjusting the natural property of the jets, induction, by means of diffusers placed at the vents

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

Hospitals' Patterns of Use of Noninvasive Ventilation in Patients With Asthma Exacerbation.

Science.gov (United States)

Stefan, Mihaela S; Nathanson, Brian H; Priya, Aruna; Pekow, Penelope S; Lagu, Tara; Steingrub, Jay S; Hill, Nicholas S; Goldberg, Robert J; Kent, David M; Lindenauer, Peter K

2016-03-01

Limited data are available on the use of noninvasive ventilation in patients with asthma exacerbations. The objective of this study was to characterize hospital patterns of noninvasive ventilation use in patients with asthma and to evaluate the association with the use of invasive mechanical ventilation and case fatality rate. This cross-sectional study used an electronic medical record dataset, which includes comprehensive pharmacy and laboratory results from 58 hospitals. Data on 13,558 patients admitted from 2009 to 2012 were analyzed. Initial noninvasive ventilation (NIV) or invasive mechanical ventilation (IMV) was defined as the first ventilation method during hospitalization. Hospital-level risk-standardized rates of NIV among all admissions with asthma were calculated by using a hierarchical regression model. Hospitals were grouped into quartiles of NIV to compare the outcomes. Overall, 90.3% of patients with asthma were not ventilated, 4.0% were ventilated with NIV, and 5.7% were ventilated with IMV. Twenty-two (38%) hospitals did not use NIV for any included admissions. Hospital-level adjusted NIV rates varied considerably (range, 0.4-33.1; median, 5.2%). Hospitals in the highest quartile of NIV did not have lower IMV use (5.4% vs 5.7%), but they did have a small but significantly shorter length of stay. Higher NIV rates were not associated with lower risk-adjusted case fatality rates. Large variation exists in hospital use of NIV for patients with an acute exacerbation of asthma. Higher hospital rates of NIV use does not seem to be associated with lower IMV rates. These results indicate a need to understand contextual and organizational factors contributing to this variability. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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.

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.

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.

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.

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

VWPS: A Ventilator Weaning Prediction System with Artificial Intelligence

Science.gov (United States)

Chen, Austin H.; Chen, Guan-Ting

How to wean patients efficiently off mechanical ventilation continues to be a challenge for medical professionals. In this paper we have described a novel approach to the study of a ventilator weaning prediction system (VWPS). Firstly, we have developed and written three Artificial Neural Network (ANN) algorithms to predict a weaning successful rate based on the clinical data. Secondly, we have implemented two user-friendly weaning success rate prediction systems; the VWPS system and the BWAP system. Both systems could be used to help doctors objectively and effectively predict whether weaning is appropriate for patients based on the patients' clinical data. Our system utilizes the powerful processing abilities of MatLab. Thirdly, we have calculated the performance through measures such as sensitivity and accuracy for these three algorithms. The results show a very high sensitivity (around 80%) and accuracy (around 70%). To our knowledge, this is the first design approach of its kind to be used in the study of ventilator weaning success rate prediction.

Right ventricular function during one-lung ventilation: effects of pressure-controlled and volume-controlled ventilation.

Science.gov (United States)

Al Shehri, Abdullah M; El-Tahan, Mohamed R; Al Metwally, Roshdi; Qutub, Hatem; El Ghoneimy, Yasser F; Regal, Mohamed A; Zien, Haytham

2014-08-01

To test the effects of pressure-controlled (PCV) and volume-controlled (VCV) ventilation during one-lung ventilation (OLV) for thoracic surgery on right ventricular (RV) function. A prospective, randomized, double-blind, controlled, crossover study. A single university hospital. Fourteen pairs of consecutive patients scheduled for elective thoracotomy. Patients were assigned randomly to ventilate the dependent lung with PCV or VCV mode, each in a randomized crossover order using tidal volume of 6 mL/kg, I: E ratio 1: 2.5, positive end-expiratory pressure (PEEP) of 5 cm H2O and respiratory rate adjusted to maintain normocapnia. Intraoperative changes in RV function (systolic and early diastolic tricuspid annular velocity (TAV), end-systolic volume (ESV), end-diastolic volume (EDV) and fractional area changes (FAC)), airway pressures, compliance and oxygenation index were recorded. The use of PCV during OLV resulted in faster systolic (10.1±2.39 vs. 5.8±1.67 cm/s, respectively), diastolic TAV (9.2±1.99 vs. 4.6±1.42 cm/s, respectively) (prights reserved.

Influence of gestational age on dead space and alveolar ventilation in preterm infants ventilated with volume guarantee.

Science.gov (United States)

Neumann, Roland P; Pillow, Jane J; Thamrin, Cindy; Larcombe, Alexander N; Hall, Graham L; Schulzke, Sven M

2015-01-01

Ventilated preterm infant lungs are vulnerable to overdistension and underinflation. The optimal ventilator-delivered tidal volume (VT) in these infants is unknown and may depend on the extent of alveolarisation at birth. We aimed to calculate respiratory dead space (VD) from the molar mass (MM) signal of an ultrasonic flowmeter (VD,MM) in very preterm infants on volume-targeted ventilation (VT target, 4-5 ml/kg) and to study the association between gestational age (GA) and VD,MM-to-VT ratio (VD,MM/VT), alveolar tidal volume (VA) and alveolar minute volume (AMV). This was a single-centre, prospective, observational, cohort study in a neonatal intensive care unit. Tidal breathing analysis was performed in ventilated very preterm infants (GA range 23-32 weeks) on day 1 of life. Valid measurements were obtained in 43/51 (87%) infants. Tidal breathing variables were analysed using multivariable linear regression. VD,MM/VT was negatively associated with GA after adjusting for birth weight Z score (p volume guarantee setting of 4-5 ml/kg in the Dräger Babylog® 8000 plus ventilator may be inappropriate as a universal target across the GA range of 23-32 weeks. Differences between measured and set VT and the dependence of this difference on GA require further investigation. © 2014 S. Karger AG, Basel.

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.

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)

Ventilation in day-care centres and sick leave among nursery children

DEFF Research Database (Denmark)

Kolarik, Barbara; Andersen, Zorana Jovanovic; Ibfelt, Tobias

2016-01-01

ventilation in DCCs and sick leave among nursery children. Data on child sick leave within an 11 week period was obtained for 635 children attending 20 DCCs. Ventilation measurements included three proxies of ventilation: air exchange rate (ACR) measured with the decay method, ACR measured...... inverse relationship between the number of sick days and ACR measured with the decay method was found for crude and adjusted analysis, with a 12% decrease in number of sick days per 1 h(-1) increase in ACR measured with the decay method. This study suggests a relationship between sick leave among nursery...

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.

Predicting the lung compliance of mechanically ventilated patients via statistical modeling

International Nuclear Information System (INIS)

Ganzert, Steven; Kramer, Stefan; Guttmann, Josef

2012-01-01

To avoid ventilator associated lung injury (VALI) during mechanical ventilation, the ventilator is adjusted with reference to the volume distensibility or ‘compliance’ of the lung. For lung-protective ventilation, the lung should be inflated at its maximum compliance, i.e. when during inspiration a maximal intrapulmonary volume change is achieved by a minimal change of pressure. To accomplish this, one of the main parameters is the adjusted positive end-expiratory pressure (PEEP). As changing the ventilator settings usually produces an effect on patient's lung mechanics with a considerable time delay, the prediction of the compliance change associated with a planned change of PEEP could assist the physician at the bedside. This study introduces a machine learning approach to predict the nonlinear lung compliance for the individual patient by Gaussian processes, a probabilistic modeling technique. Experiments are based on time series data obtained from patients suffering from acute respiratory distress syndrome (ARDS). With a high hit ratio of up to 93%, the learned models could predict whether an increase/decrease of PEEP would lead to an increase/decrease of the compliance. However, the prediction of the complete pressure–volume relation for an individual patient has to be improved. We conclude that the approach is well suitable for the given problem domain but that an individualized feature selection should be applied for a precise prediction of individual pressure–volume curves. (paper)

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.

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.

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...

[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

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.

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)

Tidal ventilation distribution during pressure-controlled ventilation and pressure support ventilation in post-cardiac surgery patients.

Science.gov (United States)

Blankman, P; VAN DER Kreeft, S M; Gommers, D

2014-09-01

Inhomogeneous ventilation is an important contributor to ventilator-induced lung injury. Therefore, this study examines homogeneity of lung ventilation by means of electrical impedance tomography (EIT) measurements during pressure-controlled ventilation (PCV) and pressure support ventilation (PSV) using the same ventilation pressures. Twenty mechanically ventilated patients were studied after cardiac surgery. On arrival at the intensive care unit, ventilation distribution was measured with EIT just above the diaphragm for 15 min. After awakening, PCV was switched to PSV and EIT measurements were again recorded. Tidal impedance variation, a measure of tidal volume, increased during PSV compared with PCV, despite using the same ventilation pressures (P = 0.045). The distribution of tidal ventilation to the dependent lung region was more pronounced during PSV compared with PCV, especially during the first half of the inspiration. An even distribution of tidal ventilation between the dependent and non-dependent lung regions was seen during PCV at lower tidal volumes (tidal volumes (≥ 8 ml/kg). In addition, the distribution of tidal ventilation was predominantly distributed to the dependent lung during PSV at low tidal volumes. In post-cardiac surgery patients, PSV showed improved ventilation of the dependent lung region due to the contribution of the diaphragm activity, which is even more pronounced during lower assist levels. © 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

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 ...

Protective versus Conventional Ventilation for Surgery: A Systematic Review and Individual Patient Data Meta-analysis.

Science.gov (United States)

Serpa Neto, Ary; Hemmes, Sabrine N T; Barbas, Carmen S V; Beiderlinden, Martin; Biehl, Michelle; Binnekade, Jan M; Canet, Jaume; Fernandez-Bustamante, Ana; Futier, Emmanuel; Gajic, Ognjen; Hedenstierna, Göran; Hollmann, Markus W; Jaber, Samir; Kozian, Alf; Licker, Marc; Lin, Wen-Qian; Maslow, Andrew D; Memtsoudis, Stavros G; Reis Miranda, Dinis; Moine, Pierre; Ng, Thomas; Paparella, Domenico; Putensen, Christian; Ranieri, Marco; Scavonetto, Federica; Schilling, Thomas; Schmid, Werner; Selmo, Gabriele; Severgnini, Paolo; Sprung, Juraj; Sundar, Sugantha; Talmor, Daniel; Treschan, Tanja; Unzueta, Carmen; Weingarten, Toby N; Wolthuis, Esther K; Wrigge, Hermann; Gama de Abreu, Marcelo; Pelosi, Paolo; Schultz, Marcus J

2015-07-01

Recent studies show that intraoperative mechanical ventilation using low tidal volumes (VT) can prevent postoperative pulmonary complications (PPCs). The aim of this individual patient data meta-analysis is to evaluate the individual associations between VT size and positive end-expiratory pressure (PEEP) level and occurrence of PPC. Randomized controlled trials comparing protective ventilation (low VT with or without high levels of PEEP) and conventional ventilation (high VT with low PEEP) in patients undergoing general surgery. The primary outcome was development of PPC. Predefined prognostic factors were tested using multivariate logistic regression. Fifteen randomized controlled trials were included (2,127 patients). There were 97 cases of PPC in 1,118 patients (8.7%) assigned to protective ventilation and 148 cases in 1,009 patients (14.7%) assigned to conventional ventilation (adjusted relative risk, 0.64; 95% CI, 0.46 to 0.88; P ventilation with low VT and high PEEP levels and 63 cases in 525 patients (12%) assigned to ventilation with low VT and low PEEP levels (adjusted relative risk, 0.93; 95% CI, 0.64 to 1.37; P = 0.72). A dose-response relationship was found between the appearance of PPC and VT size (R2 = 0.39) but not between the appearance of PPC and PEEP level (R2 = 0.08). These data support the beneficial effects of ventilation with use of low VT in patients undergoing surgery. Further trials are necessary to define the role of intraoperative higher PEEP to prevent PPC during nonopen abdominal surgery.

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....

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.

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

Variability in the Use of Protective Mechanical Ventilation During General Anesthesia.

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Ladha, Karim S; Bateman, Brian T; Houle, Timothy T; De Jong, Myrthe A C; Vidal Melo, Marcos F; Huybrechts, Krista F; Kurth, Tobias; Eikermann, Matthias

2018-02-01

The purpose of this study was to determine whether significant variation exists in the use of protective ventilation across individual anesthesia providers and whether this difference can be explained by patient, procedure, and provider-related characteristics. The cohort consisted of 262 anesthesia providers treating 57,372 patients at a tertiary care hospital between 2007 and 2014. Protective ventilation was defined as a median positive end-expiratory pressure of 5 cm H2O or more, tidal volume of protective ventilation was modified in sensitivity analyses. In unadjusted analysis, the mean probability of administering protective ventilation was 53.8% (2.5th percentile of provider 19.9%, 97.5th percentile 80.8%). After adjustment for a large number of covariates, there was little change in the results with a mean probability of 51.1% (2.5th percentile 24.7%, 97.5th percentile 77.2%). The variations persisted when the thresholds for protective ventilation were changed. There was significant variability across individual anesthesia providers in the use of intraoperative protective mechanical ventilation. Our data suggest that this variability is highly driven by individual preference, rather than patient, procedure, or provider-related characteristics.

Impact of Prolonged Mechanical Ventilation in Very Low Birth Weight Infants: Results From a National Cohort Study.

Science.gov (United States)

Choi, Young-Bin; Lee, Juyoung; Park, Jisun; Jun, Yong Hoon

2018-03-01

To evaluate the in-hospital consequences of prolonged respiratory support with invasive mechanical ventilation in very low birth weight infants. A cohort study was performed using prospectively collected data from 69 neonatal intensive care units participating in the Korean national registry. In total, 3508 very low birth weight infants born between January 1, 2013 and December 31, 2014 were reviewed. The adjusted hazard ratio for death increased significantly for infants who received mechanical ventilation for more than 2 weeks compared with those were mechanically ventilated for 7 days or less. The individual mortality rate increased after 8 weeks, reaching 50% and 60% at 14 and 16 weeks of cumulative mechanical ventilation, respectively. After adjusting for potential confounders, the cumulative duration of mechanical ventilation was associated with a clinically significant increase in the odds of bronchopulmonary dysplasia and pulmonary hypertension. Mechanical ventilation exposure for longer than 2 weeks, compared with 7 days or less, was associated with retinopathy of prematurity requiring laser coagulation and periventricular leukomalacia. The odds of abnormal auditory screening test results were significantly increased in infants who needed mechanical ventilation for more than 4 weeks. A longer cumulative duration of mechanical ventilation was associated with increased lengths of hospitalization and parenteral nutrition and a higher probability of discharge with poor achievement of physical growth. Although mechanical ventilation is a life-saving intervention for premature infants, these results indicate that it is associated with negative consequences when applied for prolonged periods. Copyright © 2017 Elsevier Inc. All rights reserved.

Moderately high frequency ventilation with a conventional ventilator allows reduction of tidal volume without increasing mean airway pressure.

Science.gov (United States)

Cordioli, Ricardo Luiz; Park, Marcelo; Costa, Eduardo Leite Vieira; Gomes, Susimeire; Brochard, Laurent; Amato, Marcelo Britto Passos; Azevedo, Luciano Cesar Pontes

2014-12-01

The aim of this study was to explore if positive-pressure ventilation delivered by a conventional ICU ventilator at a moderately high frequency (HFPPV) allows a safe reduction of tidal volume (V T) below 6 mL/kg in a porcine model of severe acute respiratory distress syndrome (ARDS) and at a lower mean airway pressure than high-frequency oscillatory ventilation (HFOV). This is a prospective study. In eight pigs (median weight 34 [29,36] kg), ARDS was induced by pulmonary lavage and injurious ventilation. The animals were ventilated with a randomized sequence of respiratory rates: 30, 60, 90, 120, 150, followed by HFOV at 5 Hz. At each step, V T was adjusted to allow partial pressure of arterial carbon dioxide (PaCO2) to stabilize between 57 and 63 mmHg. Data are shown as median [P25th,P75th]. After lung injury, the PaO2/FiO2 (P/F) ratio was 92 [63,118] mmHg, pulmonary shunt 26 [17,31]%, and static compliance 11 [8,14] mL/cmH2O. Positive end-expiratory pressure (PEEP) was 14 [10,17] cmH2O. At 30 breaths/min, V T was higher than 6 (7.5 [6.8,10.2]) mL/kg, but at all higher frequencies, V T could be reduced and PaCO2 maintained, leading to reductions in plateau pressures and driving pressures. For frequencies of 60 to 150/min, V T progressively fell from 5.2 [5.1,5.9] to 3.8 [3.7,4.2] mL/kg (p mechanics, auto-PEEP generation, hemodynamics, or gas exchange. Mean airway pressure was maintained constant and was increased only during HFOV. During protective mechanical ventilation, HFPPV delivered by a conventional ventilator in a severe ARDS swine model safely allows further tidal volume reductions. This strategy also allowed decreasing airway pressures while maintaining stable PaCO2 levels.

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...

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.

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.

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...

Influence of tidal volume on ventilation inhomogeneity assessed by electrical impedance tomography during controlled mechanical ventilation

International Nuclear Information System (INIS)

Becher, T; Kott, M; Schädler, D; Vogt, B; Meinel, T; Weiler, N; Frerichs, I

2015-01-01

The global inhomogeneity (GI) index is a parameter of ventilation inhomogeneity that can be calculated from images of tidal ventilation distribution obtained by electrical impedance tomography (EIT). It has been suggested that the GI index may be useful for individual adjustment of positive end-expiratory pressure (PEEP) and for guidance of ventilator therapy. The aim of the present work was to assess the influence of tidal volume (V_T) on the GI index values. EIT data from 9 patients with acute respiratory distress syndrome ventilated with a low and a high V_T of 5   ±   1 (mean  ±  SD) and 9   ±   1 ml kg"−"1 predicted body weight at a high and a low level of PEEP (PEEP_h_i_g_h, PEEP_l_o_w) were analyzed. PEEP_h_i_g_h and PEEP_l_o_w were set 2 cmH_2O above and 5 cmH_2O below the lower inflection point of a quasi-static pressure volume loop, respectively. The lower inflection point was identified at 8.1   ±   1.4 (mean  ±  SD) cmH_2O, resulting in a PEEP_h_i_g_h of 10.1   ±   1.4 and a PEEP_l_o_w of 3.1   ±   1.4 cmH_2O. At PEEP_h_i_g_h, we found no significant trend in GI index with low V_T when compared to high V_T (0.49   ±   0.15 versus 0.44   ±   0.09, p = 0.13). At PEEP_l_o_w, we found a significantly higher GI index with low V_T compared to high V_T (0.66   ±   0.19 versus 0.59   ±   0.17, p = 0.01). When comparing the PEEP levels, we found a significantly lower GI index at PEEP_h_i_g_h both for high and low V_T. We conclude that high V_T may lead to a lower GI index, especially at low PEEP settings. This should be taken into account when using the GI index for individual adjustment of ventilator settings. (paper)

A Case of Shunting Postoperative Patent Foramen Ovale Under Mechanical Ventilation Controlled by Different Ventilator Settings.

Science.gov (United States)

Pragliola, Claudio; Di Michele, Sara; Galzerano, Domenico

2017-06-07

A 56-year old male with ischemic heart disease and an unremarkable preoperative echocardiogram underwent surgical coronary revascularization. An intraoperative post pump trans-esophageal echocardiogram (TOE) performed while the patient was being ventilated at a positive end expiratory pressure (PEEP) of 8 cm H 2 O demonstrated a right to left interatrial shunt across a patent foramen ovale (PFO). Whereas oxygen saturation was normal, a reduction of the PEEP to 3 cm H 2 O led to the complete resolution of the shunt with no change in arterial blood gases. Attempts to increase the PEEP level above 3 mmHg resulted in recurrence of the interatrial shunt. The remaining of the TEE was unremarkable. Mechanical ventilation, particularly with PEEP, causes an increase in intrathoracic pressure. The resulting rise in right atrial pressure, mostly during inspiration, may unveil and pop open an unrecognized PFO, thus provoking a right to left shunt across a seemingly intact interatrial septum. This phenomenon increases the risk of paradoxical embolism and can lead to hypoxemia. The immediate management would be to adjust the ventilatory settings to a lower PEEP level. A routine search for a PFO should be performed in ventilated patients who undergo a TEE.

A case of shunting postoperative patent foramen ovale under mechanical ventilation controlled by different ventilator settings

Directory of Open Access Journals (Sweden)

Claudio Pragliola

2017-08-01

Full Text Available A 56-year old male with ischemic heart disease and an unremarkable preoperative echocardiogram underwent surgical coronary revascularization. An intraoperative post pump trans-esophageal echocardiogram (TOE performed while the patient was being ventilated at a positive end expiratory pressure (PEEP of 8 cm H2O demonstrated a right to left interatrial shunt across a patent foramen ovale (PFO. Whereas oxygen saturation was normal, a reduction of the PEEP to 3 cm H2O led to the complete resolution of the shunt with no change in arterial blood gases. Attempts to increase the PEEP level above 3 mmHg resulted in recurrence of the interatrial shunt. The remaining of the TEE was unremarkable. Mechanical ventilation, particularly with PEEP, causes an increase in intrathoracic pressure. The resulting rise in right atrial pressure, mostly during inspiration, may unveil and pop open an unrecognized PFO, thus provoking a right to left shunt across a seemingly intact interatrial septum. This phenomenon increases the risk of paradoxical embolism and can lead to hypoxemia. The immediate management would be to adjust the ventilatory settings to a lower PEEP level. A routine search for a PFO should be performed in ventilated patients who undergo a TEE.

Feasibility of Protective Ventilation During Elective Supratentorial Neurosurgery: A Randomized, Crossover, Clinical Trial.

Science.gov (United States)

Ruggieri, Francesco; Beretta, Luigi; Corno, Laura; Testa, Valentina; Martino, Enrico A; Gemma, Marco

2017-06-30

Traditional ventilation approaches, providing high tidal volumes (Vt), produce excessive alveolar distention and lung injury. Protective ventilation, employing lower Vt and positive end-expiratory pressure (PEEP), is an attractive alternative also for neuroanesthesia, when prolonged mechanical ventilation is needed. Nevertheless, protective ventilation during intracranial surgery may exert dangerous effects on intracranial pressure (ICP). We tested the feasibility of a protective ventilation strategy in neurosurgery. Our monocentric, double-blind, 1:1 randomized, 2×2 crossover study aimed at studying the effect size and variability of ICP in patients undergoing elective supratentorial brain tumor removal and alternatively ventilated with Vt 9 mL/kg-PEEP 0 mm Hg and Vt 7 mL/kg-PEEP 5 mm Hg. Respiratory rate was adjusted to maintain comparable end-tidal carbon dioxide between ventilation modes. ICP was measured through a subdural catheter inserted before dural opening. Forty patients were enrolled; 8 (15%) were excluded after enrollment. ICP did not differ between traditional and protective ventilation (11.28±5.37, 11 [7 to 14.5] vs. 11.90±5.86, 11 [8 to 15] mm Hg; P=0.541). End-tidal carbon dioxide (28.91±2.28, 29 [28 to 30] vs. 28.00±2.17, 28 [27 to 29] mm Hg; Pprotective ventilation. Blood pressure, heart rate, and body temperature did not differ between ventilation modes. Dural tension was "acceptable for surgery" in all cases. ICP differences between ventilation modes were not affected by ICP values under traditional ventilation (coefficient=0.067; 95% confidence interval, -0.278 to 0.144; P=0.523). Protective ventilation is a feasible alternative to traditional ventilation during elective neurosurgery.

Coexistence of Ureaplasma and chorioamnionitis is associated with prolonged mechanical ventilation.

Science.gov (United States)

Jung, Euiseok; Choi, Chang Won; Kim, Su Yeong; Sung, Tae-Jung; Kim, Haeryoung; Park, Kyoung Un; Kim, Han-Suk; Kim, Beyong Il; Choi, Jung-Hwan

2017-01-01

Both histologic chorioamnionitis (HCAM) and Ureaplasma infection are considered important contributors to perinatal lung injury. We tested the hypothesis that coexistence of maternal HCAM and perinatal Ureaplasma exposure increases the risk of prolonged mechanical ventilation in extremely low-birthweight (ELBW) infants. A retrospective cohort study was carried out of all ELBW infants born between January 2008 and December 2013 at a single academic center. Placental pathology and gastric fluid Ureaplasma data were available for all infants. Culture and polymerase chain reaction were used to detect Ureaplasma in gastric fluid. Prolonged mechanical ventilation was defined as mechanical ventilation that began within 28 days after birth and continued. Of 111 ELBW infants enrolled, 84 survived beyond 36 weeks of postmenstrual age (PMA) and were included in the analysis. Eighteen infants (21.4%) had both HCAM and Ureaplasma exposure. Seven infants (8.3%) required mechanical ventilation beyond 36 weeks of PMA. Coexistence of HCAM and Ureaplasma in gastric fluid was significantly associated with prolonged mechanical ventilation after adjustment for gestational age, sex, mode of delivery, and use of macrolide antibiotics (OR, 8.7; 95%CI: 1.1-67.2). Coexistence of maternal HCAM and perinatal Ureaplasma exposure significantly increases the risk of prolonged mechanical ventilation in ELBW infants. © 2016 Japan Pediatric Society.

Human versus Computer Controlled Selection of Ventilator Settings: An Evaluation of Adaptive Support Ventilation and Mid-Frequency Ventilation

Directory of Open Access Journals (Sweden)

Eduardo Mireles-Cabodevila

2012-01-01

Full Text Available Background. There are modes of mechanical ventilation that can select ventilator settings with computer controlled algorithms (targeting schemes. Two examples are adaptive support ventilation (ASV and mid-frequency ventilation (MFV. We studied how different clinician-chosen ventilator settings are from these computer algorithms under different scenarios. Methods. A survey of critical care clinicians provided reference ventilator settings for a 70 kg paralyzed patient in five clinical/physiological scenarios. The survey-derived values for minute ventilation and minute alveolar ventilation were used as goals for ASV and MFV, respectively. A lung simulator programmed with each scenario’s respiratory system characteristics was ventilated using the clinician, ASV, and MFV settings. Results. Tidal volumes ranged from 6.1 to 8.3 mL/kg for the clinician, 6.7 to 11.9 mL/kg for ASV, and 3.5 to 9.9 mL/kg for MFV. Inspiratory pressures were lower for ASV and MFV. Clinician-selected tidal volumes were similar to the ASV settings for all scenarios except for asthma, in which the tidal volumes were larger for ASV and MFV. MFV delivered the same alveolar minute ventilation with higher end expiratory and lower end inspiratory volumes. Conclusions. There are differences and similarities among initial ventilator settings selected by humans and computers for various clinical scenarios. The ventilation outcomes are the result of the lung physiological characteristics and their interaction with the targeting scheme.

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.

Percutaneous Transtracheal Jet Ventilation with Various Upper Airway Obstruction

Directory of Open Access Journals (Sweden)

Tomoki Doi

2015-01-01

Full Text Available A “cannot-ventilate, cannot-intubate” situation is critical. In difficult airway management, transtracheal jet ventilation (TTJV has been recommended as an invasive procedure, but specialized equipment is required. However, the influence of upper airway resistance (UAR during TTJV has not been clarified. The aim of this study was to compare TTJV using a manual jet ventilator (MJV and the oxygen flush device of the anesthetic machine (AM. We made a model lung offering variable UAR by adjustment of tracheal tube size that can ventilate through a 14-G cannula. We measured side flow due to the Venturi effect during TTJV, inspired tidal volume (TVi, and expiratory time under various inspiratory times. No Venturi effect was detected during TTJV with either device. With the MJV, TVi tended to increase in proportion to UAR. With AM, significant variations in TVi was not detected with changes in any UAR. In conclusion, UAR influenced forward flow of TTJV in the model lung. The influence of choked flow from the Venturi effect was minimal under all UAR settings with the MJV, but the AM could not deliver sufficient flow.

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.

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...

Initial nutritional management during noninvasive ventilation and outcomes: a retrospective cohort study.

Science.gov (United States)

Terzi, Nicolas; Darmon, Michael; Reignier, Jean; Ruckly, Stéphane; Garrouste-Orgeas, Maïté; Lautrette, Alexandre; Azoulay, Elie; Mourvillier, Bruno; Argaud, Laurent; Papazian, Laurent; Gainnier, Marc; Goldgran-Toledano, Dan; Jamali, Samir; Dumenil, Anne-Sylvie; Schwebel, Carole; Timsit, Jean-François

2017-11-29

Patients starting noninvasive ventilation (NIV) to treat acute respiratory failure are often unable to eat and therefore remain in the fasting state or receive nutritional support. Maintaining a good nutritional status has been reported to improve patient outcomes. In the present study, our primary objective was to describe the nutritional management of patients starting first-line NIV, and our secondary objectives were to assess potential associations between nutritional management and outcomes. Observational retrospective cohort study of a prospective database fed by 20 French intensive care units. Adult medical patients receiving NIV for more than 2 consecutive days were included and divided into four groups on the basis of nutritional support received during the first 2 days of NIV: no nutrition, enteral nutrition, parenteral nutrition only, and oral nutrition only. Of the 16,594 patients admitted during the study period, 1075 met the inclusion criteria; of these, 622 (57.9%) received no nutrition, 28 (2.6%) received enteral nutrition, 74 (6.9%) received parenteral nutrition only, and 351 (32.7%) received oral nutrition only. After adjustment for confounders, enteral nutrition (vs. no nutrition) was associated with higher 28-day mortality (adjusted HR, 2.3; 95% CI, 1.2-4.4) and invasive mechanical ventilation needs (adjusted HR, 2.1; 95% CI, 1.1-4.2), as well as with fewer ventilator-free days by day 28 (adjusted relative risk, 0.7; 95% CI, 0.5-0.9). Nearly three-fifths of patients receiving NIV fasted for the first 2 days. Lack of feeding or underfeeding was not associated with mortality. The optimal route of nutrition for these patients needs to be investigated.

Increased respiratory neural drive and work of breathing in exercise-induced laryngeal obstruction.

Science.gov (United States)

Walsted, Emil S; Faisal, Azmy; Jolley, Caroline J; Swanton, Laura L; Pavitt, Matthew J; Luo, Yuan-Ming; Backer, Vibeke; Polkey, Michael I; Hull, James H

2018-02-01

Exercise-induced laryngeal obstruction (EILO), a phenomenon in which the larynx closes inappropriately during physical activity, is a prevalent cause of exertional dyspnea in young individuals. The physiological ventilatory impact of EILO and its relationship to dyspnea are poorly understood. The objective of this study was to evaluate exercise-related changes in laryngeal aperture on ventilation, pulmonary mechanics, and respiratory neural drive. We prospectively evaluated 12 subjects (6 with EILO and 6 healthy age- and gender-matched controls). Subjects underwent baseline spirometry and a symptom-limited incremental exercise test with simultaneous and synchronized recording of endoscopic video and gastric, esophageal, and transdiaphragmatic pressures, diaphragm electromyography, and respiratory airflow. The EILO and control groups had similar peak work rates and minute ventilation (V̇e) (work rate: 227 ± 35 vs. 237 ± 35 W; V̇e: 103 ± 20 vs. 98 ± 23 l/min; P > 0.05). At submaximal work rates (140-240 W), subjects with EILO demonstrated increased work of breathing ( P respiratory neural drive ( P respiratory mechanics and diaphragm electromyography with endoscopic video, we demonstrate, for the first time, increased work of breathing and respiratory neural drive in association with the development of EILO. Future detailed investigations are now needed to understand the role of upper airway closure in causing exertional dyspnea and exercise limitation. NEW & NOTEWORTHY Exercise-induced laryngeal obstruction is a prevalent cause of exertional dyspnea in young individuals; yet, how laryngeal closure affects breathing is unknown. In this study we synchronized endoscopic video with respiratory physiological measurements, thus providing the first detailed commensurate assessment of respiratory mechanics and neural drive in relation to laryngeal closure. Laryngeal closure was associated with increased work of breathing and respiratory neural drive preceded by an

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.

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...

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...

Ventilation systems as air cleaning devices in nuclear power plants: experience at Palisades

International Nuclear Information System (INIS)

Sullivan, T.J.; Murri, E.L.

1975-01-01

Experience at Palisades has demonstrated the importance of designing, constructing, testing and operating the ventilation system from the viewpoint of airborne radioactivity control during both normal operation and anticipated operational occurrences. An item of particular concern was the difficulty in maintaining correct non-ducted airflow patterns. Inadequate preoperational testing and system balancing led to marginal ventilation system performance. This condition was further aggravated by extensive plant maintenance and construction activities and, in some cases, by a lack of administrative control. Following completion of construction of the radwaste addition, it was possible, with minor basic design changes, to adjust and rebalance the entire ventilation system, thus assuring control of airborne radioactivity. (U.S.)

Radioaerosol ventilation imaging in ventilator-dependent patients. Technical considerations

International Nuclear Information System (INIS)

Vezina, W.; Chamberlain, M.; Vinitski, S.; King, M.; Nicholson, R.; Morgan, W.K.

1985-01-01

The differentiation of pulmonary embolism (PE) from regional ventilatory abnormalities accompanied by reduced perfusion requires contemporary perfusion and ventilation studies. Distinguishing these conditions in ventilator-dependent patients is aided by administering a Tc-99m aerosol to characterize regional ventilation, and by performing a conventional Tc-99m MAA perfusion study. The technique uses a simple in-house constructed apparatus. Simple photographic techniques suffice, but computer subtraction of perfusion from the combined perfusion-ventilation image renders interpretation easier if aerosol administration follows perfusion imaging. Multiple defects can be examined in a single study. Excluding normal or near-normal perfusion studies, PE was thought to be present in eight of 16 patients after perfusion imaging alone, but in only one of eight after added aerosol imaging. Angiography confirmed the diagnosis in that patient. Of the eight patients who had abnormal perfusion but were thought unlikely to have PE from the perfusion study alone, two had normal ventilation, and subsequently were shown to have PE by angiography. Because angiography was only performed on patients who were thought to have a high probability of PE on sequential perfusion-ventilation imaging, the true incidence of PE may have been higher. Aerosol ventilation imaging is a useful adjunct to perfusion imaging in patients on ventilators. It requires an efficient delivery system, particularly if aerosol administration follows perfusion imaging, as it does in this study

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

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...

Trigger performance of mid-level ICU mechanical ventilators during assisted ventilation: a bench study.

Science.gov (United States)

Ferreira, Juliana C; Chipman, Daniel W; Kacmarek, Robert M

2008-09-01

To compare the triggering performance of mid-level ICU mechanical ventilators with a standard ICU mechanical ventilator. Experimental bench study. The respiratory care laboratory of a university-affiliated teaching hospital. A computerized mechanical lung model, the IngMar ASL5000. Ten mid-level ICU ventilators were compared to an ICU ventilator at two levels of lung model effort, three combinations of respiratory mechanics (normal, COPD and ARDS) and two modes of ventilation, volume and pressure assist/control. A total of 12 conditions were compared. Performance varied widely among ventilators. Mean inspiratory trigger time was ventilators. The mean inspiratory delay time (time from initiation of the breath to return of airway pressure to baseline) was longer than that for the ICU ventilator for all tested ventilators except one. The pressure drop during triggering (Ptrig) was comparable with that of the ICU ventilator for only two ventilators. Expiratory Settling Time (time for pressure to return to baseline) had the greatest variability among ventilators. Triggering differences among these mid-level ICU ventilators and with the ICU ventilator were identified. Some of these ventilators had a much poorer triggering response with high inspiratory effort than the ICU ventilator. These ventilators do not perform as well as ICU ventilators in patients with high ventilatory demand.

Inhibitory Effect of Nasal Intermittent Positive Pressure Ventilation on Gastroesophageal Reflux.

Directory of Open Access Journals (Sweden)

Danny Cantin

Full Text Available Non-invasive intermittent positive pressure ventilation can lead to esophageal insufflations and in turn to gastric distension. The fact that the latter induces transient relaxation of the lower esophageal sphincter implies that it may increase gastroesophageal refluxes. We previously reported that nasal Pressure Support Ventilation (nPSV, contrary to nasal Neurally-Adjusted Ventilatory Assist (nNAVA, triggers active inspiratory laryngeal closure. This suggests that esophageal insufflations are more frequent in nPSV than in nNAVA. The objectives of the present study were to test the hypotheses that: i gastroesophageal refluxes are increased during nPSV compared to both control condition and nNAVA; ii esophageal insufflations occur more frequently during nPSV than nNAVA. Polysomnographic recordings and esophageal multichannel intraluminal impedance pHmetry were performed in nine chronically instrumented newborn lambs to study gastroesophageal refluxes, esophageal insufflations, states of alertness, laryngeal closure and respiration. Recordings were repeated without sedation in control condition, nPSV (15/4 cmH2O and nNAVA (~ 15/4 cmH2O. The number of gastroesophageal refluxes recorded over six hours, expressed as median (interquartile range, decreased during both nPSV (1 (0, 3 and nNAVA [1 (0, 3] compared to control condition (5 (3, 10, (p < 0.05. Meanwhile, the esophageal insufflation index did not differ between nPSV (40 (11, 61 h-1 and nNAVA (10 (9, 56 h-1 (p = 0.8. In conclusion, nPSV and nNAVA similarly inhibit gastroesophageal refluxes in healthy newborn lambs at pressures that do not lead to gastric distension. In addition, the occurrence of esophageal insufflations is not significantly different between nPSV and nNAVA. The strong inhibitory effect of nIPPV on gastroesophageal refluxes appears identical to that reported with nasal continuous positive airway pressure.

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

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...

Nebulized antibiotics in mechanically ventilated patients: roadmap and challenges.

Science.gov (United States)

Poulakou, G; Siakallis, G; Tsiodras, S; Arfaras-Melainis, A; Dimopoulos, G

2017-03-01

Nebulized antibiotics use has become common practice in the therapeutics of pneumonia in cystic fibrosis patients. There is an increasing interest in their use for respiratory infections in mechanically ventilated (MV) patients in order to a) overcome pharmacokinetic issues in the lung compartment with traditional systemic antibiotic use and b) prevent the emergence of multi-drug-resistant (MDR) pathogens. Areas covered: The beneficial effects of antibiotic nebulization in MV patients e.g. increasing efficacy, reduced toxicity and prevention of resistance are described. Physicochemical parameters of optimal lung deposition, characteristics of currently available nebulizers, practical aspects of the procedure, including drug preparation and adjustments of ventilator and circuit parameter are presented. Antibiotics used in nebulized route, along with efficacy in various clinical indications and safety issues are reviewed. Expert commentary: The safety of nebulization of antibiotics has been proven in numerous studies; efficacy as adjunctive treatment to intravenous regimens or as monotherapy has been demonstrated in ventilator-associated pneumonia or ventilator-associated tracheobronchitis due to MDR or susceptible pathogens. However, due to the heterogeneity of studies, multiple meta-analyses fail to demonstrate a clear effect. Clarification of indications, standardization of technique and implementation of clinical practice guidelines, based on new large-scale trials will lead to the optimal use of nebulized antibiotics.

46 CFR 111.103-1 - Power ventilation systems except machinery space ventilation systems.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Power ventilation systems except machinery space ventilation systems. 111.103-1 Section 111.103-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY... Power ventilation systems except machinery space ventilation systems. Each power ventilation system must...

[Pressure support ventilation and proportional assist ventilation during weaning from mechanical ventilation].

Science.gov (United States)

Aguirre-Bermeo, H; Bottiroli, M; Italiano, S; Roche-Campo, F; Santos, J A; Alonso, M; Mancebo, J

2014-01-01

To compare tolerance, duration of mechanical ventilation (MV) and clinical outcomes during weaning from MV in patients subjected to either pressure support ventilation (PSV) or proportional assist ventilation (PAV). A prospective, observational study was carried out. Intensive Care Unit. A total of 40 consecutive subjects were allocated to either the PSV or the PAV group until each group contained 20 patients. Patients were included in the study when they met the criteria to begin weaning and the attending physician decided to initiate the weaning process. The physician selected the modality and set the ventilatory parameters. None. Demographic data, respiratory mechanics, ventilatory parameters, duration of MV, and clinical outcomes (reintubation, tracheostomy, mortality). Baseline characteristics were similar in both groups. No significant differences were observed between the PSV and PAV groups in terms of the total duration of MV (10 [5-18] vs. 9 [7-19] days; P=.85), reintubation (5 [31%] vs. 3 [19%]; P=.69), or mortality (4 [20%] vs. 5 [25%] deaths; P=1). Eight patients (40%) in the PSV group and 6 patients (30%) in the PAV group (P=.74) required a return to volume assist-control ventilation due to clinical deterioration. Tolerance, duration of MV and clinical outcomes during weaning from mechanical ventilation were similar in PSV and PAV. Copyright © 2013 Elsevier España, S.L. and SEMICYUC. All rights reserved.

Lung-Protective Ventilation Initiated in the Emergency Department (LOV-ED): A Quasi-Experimental, Before-After Trial.

Science.gov (United States)

Fuller, Brian M; Ferguson, Ian T; Mohr, Nicholas M; Drewry, Anne M; Palmer, Christopher; Wessman, Brian T; Ablordeppey, Enyo; Keeperman, Jacob; Stephens, Robert J; Briscoe, Cristopher C; Kolomiets, Angelina A; Hotchkiss, Richard S; Kollef, Marin H

2017-09-01

We evaluated the efficacy of an emergency department (ED)-based lung-protective mechanical ventilation protocol for the prevention of pulmonary complications. This was a quasi-experimental, before-after study that consisted of a preintervention period, a run-in period of approximately 6 months, and a prospective intervention period. The intervention was a multifaceted ED-based mechanical ventilator protocol targeting lung-protective tidal volume, appropriate setting of positive end-expiratory pressure, rapid oxygen weaning, and head-of-bed elevation. A propensity score-matched analysis was used to evaluate the primary outcome, which was the composite incidence of acute respiratory distress syndrome and ventilator-associated conditions. A total of 1,192 patients in the preintervention group and 513 patients in the intervention group were included. Lung-protective ventilation increased by 48.4% in the intervention group. In the propensity score-matched analysis (n=490 in each group), the primary outcome occurred in 71 patients (14.5%) in the preintervention group compared with 36 patients (7.4%) in the intervention group (adjusted odds ratio 0.47; 95% confidence interval [CI] 0.31 to 0.71). There was an increase in ventilator-free days (mean difference 3.7; 95% CI 2.3 to 5.1), ICU-free days (mean difference 2.4; 95% CI 1.0 to 3.7), and hospital-free days (mean difference 2.4; 95% CI 1.2 to 3.6) associated with the intervention. The mortality rate was 34.1% in the preintervention group and 19.6% in the intervention group (adjusted odds ratio 0.47; 95% CI 0.35 to 0.63). Implementing a mechanical ventilator protocol in the ED is feasible and is associated with significant improvements in the delivery of safe mechanical ventilation and clinical outcome. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

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.

Evaluation of a computerized system for mechanical ventilation of infants.

Science.gov (United States)

Tehrani, Fleur T; Abbasi, Soraya

2009-04-01

To evaluate a computerized system for mechanical ventilation of infants. FLEX is a computerized system that includes the features of a patented mode known as adaptive-support ventilation (ASV). In addition, it has many other features including adjustment of positive end-expiratory pressure (PEEP), fraction of inspired oxygen (F(IO2)), minute ventilation, and control of weaning. It is used as an open-loop decision support system or as a closed-loop technique. Blood gas and ventilation data were collected from 12 infants in the neonatal intensive care at baseline and at the next round of evaluation. This data were input to open-loop version of FLEX. The system recommendations were compared to clinical determinations. FLEX recommended values for ventilation were on the average within 25% and 16.5% of the measured values at baseline and at the next round of evaluation, respectively. For F(IO2) and PEEP, FLEX recommended values were in general agreement with the clinical settings. FLEX recommendations for weaning were the same as the clinical determinations 50% of the time at baseline and 55% of the time at the next round of evaluation. FLEX did not recommend weaning for infants with weak spontaneous breathing effort or those who showed signs of dyspnea. A computerized system for mechanical ventilation is evaluated for treatment of infants. The results of the study show that the system has good potential for use in neonatal ventilatory care. Further refinements can be made in the system for very low-birth-weight infants.

Optimization of mine ventilation fan speeds according to ventilation on demand and time of use tariff

International Nuclear Information System (INIS)

Chatterjee, Arnab; Zhang, Lijun; Xia, Xiaohua

2015-01-01

Highlights: • DSM techniques are applied to an underground mine ventilation network. • A minimization model is solved to find the optimal speeds of the main mine fan. • Ventilation on demand (VOD) leads to a saving of USD 213160. • The optimal mining schedule, together with VOD, leads to a saving of USD 277035. • According to a case study, a maximum of 2 540 035 kW h can be saved per year. - Abstract: In the current situation of the energy crisis, the mining industry has been identified as a promising area for application of demand side management (DSM) techniques. This paper investigates the potential for energy-cost savings and actual energy savings, by implementation of variable speed drives to ventilation fans in underground mines. In particular, ventilation on demand is considered in the study, i.e., air volume is adjusted according to the demand at varying times. Two DSM strategies, energy efficiency (EE) and load management (LM), are formulated and analysed. By modelling the network with the aid of Kirchhoff’s laws and Tellegen’s theorem, a nonlinear constrained minimization model is developed, with the objective of achieving EE. The model is also made to adhere to the fan laws, such that the fan power at its operating points is found to achieve realistic results. LM is achieved by finding the optimal starting time of the mining schedule, according to the time of use (TOU) tariff. A case study is shown to demonstrate the effects of the optimization model. The study suggests that by combining load shifting and energy efficiency techniques, an annual energy saving of 2 540 035 kW h is possible, leading to an annual cost saving of USD 277035

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.

Automated Weaning from Mechanical Ventilation after Off-Pump Coronary Artery Bypass Grafting.

Science.gov (United States)

Fot, Evgenia V; Izotova, Natalia N; Yudina, Angelika S; Smetkin, Aleksei A; Kuzkov, Vsevolod V; Kirov, Mikhail Y

2017-01-01

The discontinuation of mechanical ventilation after coronary surgery may prolong and significantly increase the load on intensive care unit personnel. We hypothesized that automated mode using INTELLiVENT-ASV can decrease duration of postoperative mechanical ventilation, reduce workload on medical staff, and provide safe ventilation after off-pump coronary artery bypass grafting (OPCAB). The primary endpoint of our study was to assess the duration of postoperative mechanical ventilation during different modes of weaning from respiratory support (RS) after OPCAB. The secondary endpoint was to assess safety of the automated weaning mode and the number of manual interventions to the ventilator settings during the weaning process in comparison with the protocolized weaning mode. Forty adult patients undergoing elective OPCAB were enrolled into a prospective single-center study. Patients were randomized into two groups: automated weaning ( n  = 20) using INTELLiVENT-ASV mode with quick-wean option; and protocolized weaning ( n  = 20), using conventional synchronized intermittent mandatory ventilation (SIMV) + pressure support (PS) mode. We assessed the duration of postoperative ventilation, incidence and duration of unacceptable RS, and the load on medical staff. We also performed the retrospective analysis of 102 patients (standard weaning) who were weaned from ventilator with SIMV + PS mode based on physician's experience without prearranged algorithm. Realization of the automated weaning protocol required change in respiratory settings in 2 patients vs. 7 (5-9) adjustments per patient in the protocolized weaning group. Both incidence and duration of unacceptable RS were reduced significantly by means of the automated weaning approach. The FiO 2 during spontaneous breathing trials was significantly lower in the automated weaning group: 30 (30-35) vs. 40 (40-45) % in the protocolized weaning group ( p  ventilation in a more protective way, reduces the

SUPRAGLOTTIC JET VENTILATION VERSUS CONVENTIONAL ENDOTRACHEAL VENTILATION IN MINOR LARYNGEAL SURGERIES

Directory of Open Access Journals (Sweden)

Illendual Upendranath

2016-08-01

Full Text Available Any attempt at intubation will cause many cardiovascular responses and the major concern during this time is to attenuate the same. Similar response is seen during procedures on Larynx in microlaryngeal surgery which produces an intense cardiovascular stimulation during suspension laryngoscopy and intubation. AIM OF STUDY Supraglottic jet ventilation versus conventional endotracheal ventilation in minor laryngeal surgeries. To evaluate the haemodynamic response in supraglottic jet ventilation and conventional intubation in minor laryngeal surgeries. METHODS Patients were randomised to 2 Groups: 30 patients in each group; Group A - in whom supraglottic jet ventilation was planned and Group B - in whom endotracheal intubation was planned. RESULT The haemodynamic response in terms of increase in MAP and HR is significantly more with endotracheal intubation than with supraglottic jet ventilation. CONCLUSION Our study showed that supraglottic jet ventilation showed a better haemodynamic stability when compared to conventional endotracheal intubation in patients undergoing minor laryngeal surgeries. Statistical scores were also in favour of the patients treated with supraglottic jet ventilation based on the p values.

History of Mechanical Ventilation. From Vesalius to Ventilator-induced Lung Injury.

Science.gov (United States)

Slutsky, Arthur S

2015-05-15

Mechanical ventilation is a life-saving therapy that catalyzed the development of modern intensive care units. The origins of modern mechanical ventilation can be traced back about five centuries to the seminal work of Andreas Vesalius. This article is a short history of mechanical ventilation, tracing its origins over the centuries to the present day. One of the great advances in ventilatory support over the past few decades has been the development of lung-protective ventilatory strategies, based on our understanding of the iatrogenic consequences of mechanical ventilation such as ventilator-induced lung injury. These strategies have markedly improved clinical outcomes in patients with respiratory failure.

Efficacy of respiratory muscle training in weaning of mechanical ventilation in patients with mechanical ventilation for 48hours or more: A Randomized Controlled Clinical Trial.

Science.gov (United States)

Sandoval Moreno, L M; Casas Quiroga, I C; Wilches Luna, E C; García, A F

2018-02-02

To evaluate the efficacy of respiratory muscular training in the weaning of mechanical ventilation and respiratory muscle strength in patients on mechanical ventilation of 48hours or more. Randomized controlled trial of parallel groups, double-blind. Ambit: Intensive Care Unit of a IV level clinic in the city of Cali. 126 patients in mechanical ventilation for 48hours or more. The experimental group received daily a respiratory muscle training program with treshold, adjusted to 50% of maximal inspiratory pressure, additional to standard care, conventional received standard care of respiratory physiotherapy. MAIN INTEREST VARIABLES: weaning of mechanical ventilation. Other variables evaluated: respiratory muscle strength, requirement of non-invasive mechanical ventilation and frequency of reintubation. intention-to-treat analysis was performed with all variables evaluated and analysis stratified by sepsis condition. There were no statistically significant differences in the median weaning time of the MV between the groups or in the probability of extubation between groups (HR: 0.82 95% CI: 0.55-1.20 P=.29). The maximum inspiratory pressure was increased in the experimental group on average 9.43 (17.48) cmsH20 and in the conventional 5.92 (11.90) cmsH20 (P=.48). The difference between the means of change in maximal inspiratory pressure was 0.46 (P=.83 95%CI -3.85 to -4.78). respiratory muscle training did not demonstrate efficacy in the reduction of the weaning period of mechanical ventilation nor in the increase of respiratory muscle strength in the study population. Registered study at ClinicalTrials.gov (NCT02469064). Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

Ventilation patterns of the songbird lung/air sac system during different behaviors.

Science.gov (United States)

Mackelprang, Rebecca; Goller, Franz

2013-10-01

Unidirectional, continuous airflow through the avian lung is achieved through an elaborate air sac system with a sequential, posterior to anterior ventilation pattern. This classical model was established through various approaches spanning passively ventilated systems to mass spectrometry analysis of tracer gas flow into various air sacs during spontaneous breathing in restrained ducks. Information on flow patterns in other bird taxa is missing, and these techniques do not permit direct tests of whether the basic flow pattern can change during different behaviors. Here we use thermistors implanted into various locations of the respiratory system to detect small pulses of tracer gas (helium) to reconstruct airflow patterns in quietly breathing and behaving (calling, wing flapping) songbirds (zebra finch and yellow-headed blackbird). The results illustrate that the basic pattern of airflow in these two species is largely consistent with the model. However, two notable differences emerged. First, some tracer gas arrived in the anterior set of air sacs during the inspiration during which it was inhaled, suggesting a more rapid throughput through the lung than previously assumed. Second, differences in ventilation between the two anterior air sacs emerged during calling and wing flapping, indicating that adjustments in the flow pattern occur during dynamic behaviors. It is unclear whether this modulation in ventilation pattern is passive or active. This technique for studying ventilation patterns during dynamic behaviors proves useful for establishing detailed timing of airflow and modulation of ventilation in the avian respiratory system.

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).

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.

Lung protective mechanical ventilation and two year survival in patients with acute lung injury: prospective cohort study.

Science.gov (United States)

Needham, Dale M; Colantuoni, Elizabeth; Mendez-Tellez, Pedro A; Dinglas, Victor D; Sevransky, Jonathan E; Dennison Himmelfarb, Cheryl R; Desai, Sanjay V; Shanholtz, Carl; Brower, Roy G; Pronovost, Peter J

2012-04-05

To evaluate the association of volume limited and pressure limited (lung protective) mechanical ventilation with two year survival in patients with acute lung injury. Prospective cohort study. 13 intensive care units at four hospitals in Baltimore, Maryland, USA. 485 consecutive mechanically ventilated patients with acute lung injury. Two year survival after onset of acute lung injury. 485 patients contributed data for 6240 eligible ventilator settings, as measured twice daily (median of eight eligible ventilator settings per patient; 41% of which adhered to lung protective ventilation). Of these patients, 311 (64%) died within two years. After adjusting for the total duration of ventilation and other relevant covariates, each additional ventilator setting adherent to lung protective ventilation was associated with a 3% decrease in the risk of mortality over two years (hazard ratio 0.97, 95% confidence interval 0.95 to 0.99, P=0.002). Compared with no adherence, the estimated absolute risk reduction in two year mortality for a prototypical patient with 50% adherence to lung protective ventilation was 4.0% (0.8% to 7.2%, P=0.012) and with 100% adherence was 7.8% (1.6% to 14.0%, P=0.011). Lung protective mechanical ventilation was associated with a substantial long term survival benefit for patients with acute lung injury. Greater use of lung protective ventilation in routine clinical practice could reduce long term mortality in patients with acute lung injury. Clinicaltrials.gov NCT00300248.

Factors Predicting Ventilator Dependence in Patients with Ventilator-Associated Pneumonia

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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.

Complications of mechanical ventilation

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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.

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

Positive outcome of average volume-assured pressure support mode of a Respironics V60 Ventilator in acute exacerbation of chronic obstructive pulmonary disease: a case report

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Okuda Miyuki

2012-09-01

Full Text Available Abstract Introduction We were able to treat a patient with acute exacerbation of chronic obstructive pulmonary disease who also suffered from sleep-disordered breathing by using the average volume-assured pressure support mode of a Respironics V60 Ventilator (Philips Respironics: United States. This allows a target tidal volume to be set based on automatic changes in inspiratory positive airway pressure. This removed the need to change the noninvasive positive pressure ventilation settings during the day and during sleep. The Respironics V60 Ventilator, in the average volume-assured pressure support mode, was attached to our patient and improved and stabilized his sleep-related hypoventilation by automatically adjusting force to within an acceptable range. Case presentation Our patient was a 74-year-old Japanese man who was hospitalized for treatment due to worsening of dyspnea and hypoxemia. He was diagnosed with acute exacerbation of chronic obstructive pulmonary disease and full-time biphasic positive airway pressure support ventilation was initiated. Our patient was temporarily provided with portable noninvasive positive pressure ventilation at night-time following an improvement in his condition, but his chronic obstructive pulmonary disease again worsened due to the recurrence of a respiratory infection. During the initial exacerbation, his tidal volume was significantly lower during sleep (378.9 ± 72.9mL than while awake (446.5 ± 63.3mL. A ventilator that allows ventilation to be maintained by automatically adjusting the inspiratory force to within an acceptable range was attached in average volume-assured pressure support mode, improving his sleep-related hypoventilation, which is often associated with the use of the Respironics V60 Ventilator. Polysomnography performed while our patient was on noninvasive positive pressure ventilation revealed obstructive sleep apnea syndrome (apnea-hypopnea index = 14, suggesting that his chronic

Use of Respiratory Support in the Biphase Ventilation Airway Mode in the Newborn

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S. N. Koval

2006-01-01

Full Text Available Biphasic positive airway pressure (BIPAP (also known as DuoPAP, BiLevel, BiVent, PCV+, SPAP is a mode of ventilation with cycling variations between two continuous positive airway pressure levels. It is a mixture of pressure controlled ventilation and spontaneous breathing, which is unrestricted in each phase of the respiratory cycle. The volume displacement caused by the difference between Phigh and Plow airway pressure level. The phase time ratio (PTR — the BIPAP frequency is calculated as the ratio between the durations of the two pressure phases, a PTR greater than 1:1 is called APRV (airway pressure release ventilation. In patients with ARDS maintained spontaneous breathing with BIPAP resulted in lower venous admixture and better arterial blood oxygenation as compared with A/C. Only a few studies with BIPAP have been performed in newborn and infants until now. We studied the use of BIPAP in newborn (body mass > 3kg and randomised 40 patients with respiratory failure for ventilation with BIPAP (n=20 or conventional mechanical ventilatory support (assist-control A/C — synchronised intermittent mandatory ventilation (SIMV (n=20. The Pediatric Risk of Mortality score (PRISM were collected for each patient. Fentanyl, diazepam, GABA were used as sedatives and adjusted in accordance with the Cook scale. We compared ventilatory parameters, information pertaining to pulmonary function and oxygen delivery, cardiac output, additional descriptors of organ system functions, duration and complications of ventilation and number and dosages of sedatives administered. All the patients that we intended to ventilate with BIPAP were successfully ventilated, we can conclude that biphasic ventilatory support suitable mode of ventilation for newborn with a decreased need of analgetics and sedatives than A/C. Finally, BIPAP is an a effective safe, and easy to use for personal mode of mechanical ventilatory support in newborn. 

Are tidal volume measurements in neonatal pressure-controlled ventilation accurate?

Science.gov (United States)

Chow, Lily C; Vanderhal, Andre; Raber, Jorge; Sola, Augusto

2002-09-01

Bedside pulmonary mechanics monitors (PMM) have become useful in ventilatory management in neonates. These monitors are used more frequently due to recent improvements in data-processing capabilities. PMM devices are often part of the ventilator or are separate units. The accuracy and reliability of these systems have not been carefully evaluated. We compared a single ventilatory parameter, tidal volume (V(t)), as measured by several systems. We looked at two freestanding PMMs: the Ventrak Respiratory Monitoring System (Novametrix, Wallingford, CT) and the Bicore CP-100 Neonatal Pulmonary Monitor (Allied Health Care Products, Riverside, CA), and three ventilators with built-in PMM: the VIP Bird Ventilator (Bird Products Corp., Palm Springs, CA), Siemens Servo 300A (Siemens-Elema AB, Solna, Sweden), and Drager Babylog 8000 (Drager, Inc., Chantilly, VA). A calibrated syringe (Hans Rudolph, Inc., Kansas City, MO) was used to deliver tidal volumes of 4, 10, and 20 mL to each ventilator system coupled with a freestanding PMM. After achieving steady state, six consecutive V(t) readings were taken simultaneously from the freestanding PMM and each ventilator. In a second portion of the bench study, we used pressure-control ventilation and measured exhaled tidal volume (V(te)) while ventilating a Bear Test Lung with the same three ventilators. We adjusted peak inspiratory pressure (PIP) under controlled conditions to achieve the three different targeted tidal volumes on the paired freestanding PMM. Again, six V(te) measurements were recorded for each tidal volume. Means and standard deviations were calculated.The percentage difference in measurement of V(t) delivered by calibrated syringe varied greatly, with the greatest discrepancy seen in the smallest tidal volumes, by up to 28%. In pressure control mode, V(te) as measured by the Siemens was significantly overestimated by 20-95%, with the biggest discrepancy at the smallest V(te), particularly when paired with the Bicore

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.

Oral mask ventilation is more effective than face mask ventilation after nasal surgery.

Science.gov (United States)

Yazicioğlu, Dilek; Baran, Ilkay; Uzumcugil, Filiz; Ozturk, Ibrahim; Utebey, Gulten; Sayın, M Murat

2016-06-01

To evaluate and compare the face mask (FM) and oral mask (OM) ventilation techniques during anesthesia emergence regarding tidal volume, leak volume, and difficult mask ventilation (DMV) incidence. Prospective, randomized, crossover study. Operating room, training and research hospital. American Society of Anesthesiologists physical status I and II adult patients scheduled for nasal surgery. Patients in group FM-OM received FM ventilation first, followed by OM ventilation, and patients in group OM-FM received OM ventilation first, followed by FM ventilation, with spontaneous ventilation after deep extubation. The FM ventilation was applied with the 1-handed EC-clamp technique. The OM was placed only over the mouth, and the 1-handed EC-clamp technique was used again. A child's size FM was used for the OM ventilation technique, the mask was rotated, and the inferior part of the mask was placed toward the nose. The leak volume (MVleak), mean airway pressure (Pmean), and expired tidal volume (TVe) were assessed with each mask technique for 3 consecutive breaths. A mask ventilation grade ≥3 was considered DMV. DMV occurred more frequently during FM ventilation (75% with FM vs 8% with OM). In the FM-first sequence, the mean TVe was 249±61mL with the FM and 455±35mL with the OM (P=.0001), whereas in the OM-first sequence, it was 276±81mL with the FM and 409±37mL with the OM (P=.0001). Regardless of the order used, the OM technique significantly decreased the MVleak and increased the TVe when compared to the FM technique. During anesthesia emergence after nasal surgery the OM may offer an effective ventilation method as it decreases the incidence of DMV and the gas leak around the mask and provides higher tidal volume delivery compared with FM ventilation. Copyright © 2016 Elsevier Inc. All rights reserved.

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...

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.

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

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

In vitro growth and leaf anatomy of Cattleya walkeriana (Gardner, 1839 grown in natural ventilation system

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Adriano Bortolotti da Silva

2014-12-01

Full Text Available Natural ventilation system facilitates gaseous exchanges in in vitro plants promoting changes in the leaf tissue, which can be evaluated through the leaf anatomy, and it allows a cultivation closer to the photoautrophic micropropagation. The objective of this work was to evaluate the effects on in vitro growth and on the leaf anatomy of Cattleya walkeriana grown in natural and conventional ventilation system with different concentrations of sucrose (0; 15; 30 and 45 L-1 combined with different cultivation systems (conventional micropropagation and natural ventilation system. The culture medium was composed of MS salts, solidified with 7 g L-1 of agar and pH adjusted to 5.8. Forty milliliters of culture medium were distributed in 250 mL flasks, autoclaved at 120 ºC for 20 minutes. The greater plant growth, as well as the greater thickness of the mesophyll was observed with the use of 20 g L-1 sucrose in natural ventilation system. Plants grown in natural ventilation system showed a thicker leaf mesophyll, which is directly related to photoautotrophic crops. The natural ventilation system induced more elliptical stomata and probably more functional formats.

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

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

Neural computing thermal comfort index for HVAC systems

International Nuclear Information System (INIS)

Atthajariyakul, S.; Leephakpreeda, T.

2005-01-01

The primary purpose of a heating, ventilating and air conditioning (HVAC) system within a building is to make occupants comfortable. Without real time determination of human thermal comfort, it is not feasible for the HVAC system to yield controlled conditions of the air for human comfort all the time. This paper presents a practical approach to determine human thermal comfort quantitatively via neural computing. The neural network model allows real time determination of the thermal comfort index, where it is not practical to compute the conventional predicted mean vote (PMV) index itself in real time. The feed forward neural network model is proposed as an explicit function of the relation of the PMV index to accessible variables, i.e. the air temperature, wet bulb temperature, globe temperature, air velocity, clothing insulation and human activity. An experiment in an air conditioned office room was done to demonstrate the effectiveness of the proposed methodology. The results show good agreement between the thermal comfort index calculated from the neural network model in real time and those calculated from the conventional PMV model

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

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....

UNMANNED AIR VEHICLE STABILIZATION BASED ON NEURAL NETWORK REGULATOR

Directory of Open Access Journals (Sweden)

S. S. Andropov

2016-09-01

Full Text Available A problem of stabilizing for the multirotor unmanned aerial vehicle in an environment with external disturbances is researched. A classic proportional-integral-derivative controller is analyzed, its flaws are outlined: inability to respond to changing of external conditions and the need for manual adjustment of coefficients. The paper presents an adaptive adjustment method for coefficients of the proportional-integral-derivative controller based on neural networks. A neural network structure, its input and output data are described. Neural networks with three layers are used to create an adaptive stabilization system for the multirotor unmanned aerial vehicle. Training of the networks is done with the back propagation method. Each neural network produces regulator coefficients for each angle of stabilization as its output. A method for network training is explained. Several graphs of transition process on different stages of learning, including processes with external disturbances, are presented. It is shown that the system meets stabilization requirements with sufficient number of iterations. Described adjustment method for coefficients can be used in remote control of unmanned aerial vehicles, operating in the changing environment.

Is type 2 diabetes mellitus in mechanically ventilated adult trauma patients potentially related to the occurrence of ventilator-associated pneumonia?

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Hadi Darvishi Khezri

2016-01-01

Full Text Available Background: Ventilator-associated pneumonia (VAP is a type of lung infection that typically affects critically ill patients undergoing mechanical ventilation (MV in the intensive care unit (ICU. Patients with type 2 diabetes mellitus (T2DM are considered to be more susceptible to several types of infections including community-acquired pneumonia. However, it is not clear whether T2DM is a risk factor for the development of VAP. The purpose of this study was to determine the risk of VAP for diabetic and nondiabetic mechanically ventilated trauma patients. Materials and Methods: This study is a secondary analysis of a prospective observational study of the history of T2DM in the ICU over a period of 1 year at Imam Khomeini Hospital in Iran. A total of 186 critically ill trauma patients who required at least 48 h of MV were monitored for the occurrence of VAP by their clinical pulmonary infection score (CPIS until ICU discharge, VAP diagnosis, or death. Results: Forty-one of the 186 patients developed VAP. The median time from hospitalization to VAP was 29.09 days (95% CI: 26.27-31.9. The overall incidence of VAP was 18.82 cases per 1,000 days of intubation (95% CI: 13.86-25.57. Risk of VAP in diabetic patients was greater than nondiabetic patients after adjustments for other potential factors [hazard ratio (HR: 10.12 [95% confidence interval (CI: 5.1-20.2; P < 0.0001]. Conclusion: The findings show that T2DM is associated with a significant increase in the occurrence of VAP in mechanically ventilated adult trauma patients.

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....

Occupant Interactions and Effectiveness of Natural Ventilation Strategies in Contemporary New Housing in Scotland, UK

Directory of Open Access Journals (Sweden)

Tim Sharpe

2015-07-01

Full Text Available The need to reduce carbon emissions and fuel poverty has led to increased building envelope air tightness, intended to reduce uncontrolled ventilation heat losses. Ventilation strategies in dwellings still allow the use of trickle ventilators in window frames for background ventilation. The extent to which this results in “healthy” Indoor Air Quality (IAQ in recently constructed dwellings was a concern of regulators in Scotland. This paper describes research to explore this. First a review of literature was conducted, then data on occupant interactions with ventilation provisions (windows, doors, trickle vents gathered through an interview-based survey of 200 recently constructed dwellings, and measurements made on a sample of 40 of these. The main measured parameter discussed here is CO2 concentration. It was concluded after the literature review that 1000 ppm absolute was a reasonable threshold to use for “adequate” ventilation. The occupant survey found that there was very little occupant interaction with the trickle ventilators e.g., in bedrooms 63% were always closed, 28% always open, and in only 9% of cases occupants intervened to make occasional adjustments. In the measured dwellings average bedroom CO2 levels of 1520 ppm during occupied (night time hours were observed. Where windows were open the average bedroom CO2 levels were 972 ppm. With windows closed, the combination of “trickle ventilators open plus doors open” gave an average of 1021 ppm. “Trickle ventilators open” gave an average of 1571 ppm. All other combinations gave averages of 1550 to 2000 ppm. Ventilation rates and air change rates were estimated from measured CO2 levels, for all dwellings calculated ventilation rate was less than 8 L/s/p, in 42% of cases calculated air change rate was less than 0.5 ach. It was concluded that trickle ventilation as installed and used is ineffective in meeting desired ventilation rates, evidenced by high CO2 levels reported

Occupant Interactions and Effectiveness of Natural Ventilation Strategies in Contemporary New Housing in Scotland, UK.

Science.gov (United States)

Sharpe, Tim; Farren, Paul; Howieson, Stirling; Tuohy, Paul; McQuillan, Jonathan

2015-07-21

The need to reduce carbon emissions and fuel poverty has led to increased building envelope air tightness, intended to reduce uncontrolled ventilation heat losses. Ventilation strategies in dwellings still allow the use of trickle ventilators in window frames for background ventilation. The extent to which this results in "healthy" Indoor Air Quality (IAQ) in recently constructed dwellings was a concern of regulators in Scotland. This paper describes research to explore this. First a review of literature was conducted, then data on occupant interactions with ventilation provisions (windows, doors, trickle vents) gathered through an interview-based survey of 200 recently constructed dwellings, and measurements made on a sample of 40 of these. The main measured parameter discussed here is CO2 concentration. It was concluded after the literature review that 1000 ppm absolute was a reasonable threshold to use for "adequate" ventilation. The occupant survey found that there was very little occupant interaction with the trickle ventilators e.g., in bedrooms 63% were always closed, 28% always open, and in only 9% of cases occupants intervened to make occasional adjustments. In the measured dwellings average bedroom CO2 levels of 1520 ppm during occupied (night time) hours were observed. Where windows were open the average bedroom CO2 levels were 972 ppm. With windows closed, the combination of "trickle ventilators open plus doors open" gave an average of 1021 ppm. "Trickle ventilators open" gave an average of 1571 ppm. All other combinations gave averages of 1550 to 2000 ppm. Ventilation rates and air change rates were estimated from measured CO2 levels, for all dwellings calculated ventilation rate was less than 8 L/s/p, in 42% of cases calculated air change rate was less than 0.5 ach. It was concluded that trickle ventilation as installed and used is ineffective in meeting desired ventilation rates, evidenced by high CO2 levels reported across the sampled dwellings

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.

Bayesian neural adjustment of inhibitory control predicts emergence of problem stimulant use.

Science.gov (United States)

Harlé, Katia M; Stewart, Jennifer L; Zhang, Shunan; Tapert, Susan F; Yu, Angela J; Paulus, Martin P

2015-11-01

Bayesian ideal observer models quantify individuals' context- and experience-dependent beliefs and expectations about their environment, which provides a powerful approach (i) to link basic behavioural mechanisms to neural processing; and (ii) to generate clinical predictors for patient populations. Here, we focus on (ii) and determine whether individual differences in the neural representation of the need to stop in an inhibitory task can predict the development of problem use (i.e. abuse or dependence) in individuals experimenting with stimulants. One hundred and fifty-seven non-dependent occasional stimulant users, aged 18-24, completed a stop-signal task while undergoing functional magnetic resonance imaging. These individuals were prospectively followed for 3 years and evaluated for stimulant use and abuse/dependence symptoms. At follow-up, 38 occasional stimulant users met criteria for a stimulant use disorder (problem stimulant users), while 50 had discontinued use (desisted stimulant users). We found that those individuals who showed greater neural responses associated with Bayesian prediction errors, i.e. the difference between actual and expected need to stop on a given trial, in right medial prefrontal cortex/anterior cingulate cortex, caudate, anterior insula, and thalamus were more likely to exhibit problem use 3 years later. Importantly, these computationally based neural predictors outperformed clinical measures and non-model based neural variables in predicting clinical status. In conclusion, young adults who show exaggerated brain processing underlying whether to 'stop' or to 'go' are more likely to develop stimulant abuse. Thus, Bayesian cognitive models provide both a computational explanation and potential predictive biomarkers of belief processing deficits in individuals at risk for stimulant addiction. © The Author (2015). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please

Acute Parotitis as a Complication of Noninvasive Ventilation.

Science.gov (United States)

Alaya, S; Mofredj, Ali; Tassaioust, K; Bahloul, H; Mrabet, A

2016-09-01

Several conditions, including oropharyngeal dryness, pressure sores, ocular irritation, epistaxis, or gastric distension, have been described during noninvasive ventilation (NIV). Although this technique has been widely used in intensive care units and emergency wards, acute swelling of the parotid gland remains a scarcely reported complication. We describe herein the case of an 82-year-old man who developed unilateral parotitis during prolonged NIV for acute heart failure. Intravenous antibiotics, corticosteroids, and adjusting the mask laces' position allowed rapid resolution of clinical symptoms. © The Author(s) 2016.

Trends in mechanical ventilation: are we ventilating our patients in the best possible way?

Directory of Open Access Journals (Sweden)

Raffaele L. Dellaca’

2017-06-01

To learn how mechanical ventilation developed in recent decades and to provide a better understanding of the actual technology and practice. To learn how and why interdisciplinary research and competences are necessary for providing the best ventilation treatment to patients. To understand which are the most relevant technical limitations in modern mechanical ventilators that can affect their performance in delivery of the treatment. To better understand and classify ventilation modes. To learn the classification, benefits, drawbacks and future perspectives of automatic ventilation tailoring algorithms.

Simulation of static pressure reset control in comfort ventilation

DEFF Research Database (Denmark)

Koulani, Chrysanthi Sofia; Prunescu, Remus Mihail; Hviid, Christian Anker

2014-01-01

Variable air volume (VAV) ventilation systems reduce fan power consumption compared to constant air volume (CAV) systems because they supply air according to the airflow demand. However VAV ventilation systems do not take fully into account the potential energy savings as the control strategy...... management system. In this way the operation of central plant equipment is adjusted in real time according to the actual pressure demand; this control scheme can be implemented by the static pressure reset (SPR) method. The SPR control method ensures that at least one damper remains fully opened; thus...... of the art is represented by the method of trim and respond based on pressure alarms. This study investigates the operation of the SPR control method of trim and respond based on pressure alarms in a CO2 demand application where large air volumes are provided to three classrooms. The investigation was based...

Intra-operative protective mechanical ventilation in lung transplantation: a randomised, controlled trial.

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Verbeek, G L; Myles, P S; Westall, G P; Lin, E; Hastings, S L; Marasco, S F; Jaffar, J; Meehan, A C

2017-08-01

Primary graft dysfunction occurs in up to 25% of patients after lung transplantation. Contributing factors include ventilator-induced lung injury, cardiopulmonary bypass, ischaemia-reperfusion injury and excessive fluid administration. We evaluated the feasibility, safety and efficacy of an open-lung protective ventilation strategy aimed at reducing ventilator-induced lung injury. We enrolled adult patients scheduled to undergo bilateral sequential lung transplantation, and randomly assigned them to either a control group (volume-controlled ventilation with 5 cmH 2 O, positive end-expiratory pressure, low tidal volumes (two-lung ventilation 6 ml.kg -1 , one-lung ventilation 4 ml.kg -1 )) or an alveolar recruitment group (regular step-wise positive end-expiratory pressure-based alveolar recruitment manoeuvres, pressure-controlled ventilation set at 16 cmH 2 O with 10 cmH 2 O positive end-expiratory pressure). Ventilation strategies were commenced from reperfusion of the first lung allograft and continued for the duration of surgery. Regular PaO 2 /F I O 2 ratios were calculated and venous blood samples collected for inflammatory marker evaluation during the procedure and for the first 24 h of intensive care stay. The primary end-point was the PaO 2 /F I O 2 ratio at 24 h after first lung reperfusion. Thirty adult patients were studied. The primary outcome was not different between groups (mean (SD) PaO 2 /F I O 2 ratio control group 340 (111) vs. alveolar recruitment group 404 (153); adjusted p = 0.26). Patients in the control group had poorer mean (SD) PaO 2 /F I O 2 ratios at the end of the surgical procedure and a longer median (IQR [range]) time to tracheal extubation compared with the alveolar recruitment group (308 (144) vs. 402 (154) (p = 0.03) and 18 (10-27 [5-468]) h vs. 15 (11-36 [5-115]) h (p = 0.01), respectively). An open-lung protective ventilation strategy during surgery for lung transplantation is feasible, safe and achieves favourable

Standardization of pulmonary ventilation technique using volume-controlled ventilators in rats with congenital diaphragmatic hernia

Directory of Open Access Journals (Sweden)

Rodrigo Melo Gallindo

Full Text Available OBJECTIVE: To standardize a technique for ventilating rat fetuses with Congenital Diaphragmatic Hernia (CDH using a volume-controlled ventilator. METHODS: Pregnant rats were divided into the following groups: a control (C; b exposed to nitrofen with CDH (CDH; and c exposed to nitrofen without CDH (N-. Fetuses of the three groups were randomly divided into the subgroups ventilated (V and non-ventilated (N-V. Fetuses were collected on day 21.5 of gestation, weighed and ventilated for 30 minutes using a volume-controlled ventilator. Then the lungs were collected for histological study. We evaluated: body weight (BW, total lung weight (TLW, left lung weight (LLW, ratios TLW / BW and LLW / BW, morphological histology of the airways and causes of failures of ventilation. RESULTS: BW, TLW, LLW, TLW / BW and LLW / BW were higher in C compared with N- (p 0.05. The morphology of the pulmonary airways showed hypoplasia in groups N- and CDH, with no difference between V and N-V (p <0.05. The C and N- groups could be successfully ventilated using a tidal volume of 75 ìl, but the failure of ventilation in the CDH group decreased only when ventilated with 50 ìl. CONCLUSION: Volume ventilation is possible in rats with CDH for a short period and does not alter fetal or lung morphology.

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

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 ...

Evaluation of transport ventilators at mild simulated altitude: a bench study in a hypobaric chamber.

Science.gov (United States)

Boussen, Salah; Coulange, Mathieu; Fournier, Marc; Gainnier, Marc; Michelet, Pierre; Micoli, Christophe; Negrel, Lionel

2014-08-01

Previous studies on ventilators used for air transport showed significant effects of altitude, in particular with regard to accuracy of the tidal volume (VT) and breathing frequency. The aim of the study was to evaluate transport ventilators under hypobaric conditions. We conducted a bench study of 6 transport ventilators in a Comex hypobaric chamber to simulate mild altitude (1,500 m [4,920 feet] and 2,500 m [8,200 feet]). The ventilators were connected to a test lung to evaluate their accuracy: (1) to deliver a set VT under normal resistance and compliance conditions at F(IO2) = 0.6 and 1, (2) to establish a set PEEP (0, 5, 10, and 15 cm H2O), and (3) to establish a set inspiratory pressure in pressure controlled mode, (4) at a F(IO2) setting, and (5) and at a frequency setting. Four ventilators kept an average relative error in VT of ventilator was affected by the altitude only at F(IO2) = 1. The Osiris 3 ventilator had > 40% error even at 1,500 m. We found no change in frequency as a function of altitude for any ventilators studied. No clinically important differences were found between all altitudes with the PEEP or inspiratory pressure setting. Although F(IO2) was affected by altitude, the average error did not exceed 11%, and it is unclear whether this fact is an experimental artifact. We have shown that most of the new transport ventilators tested require no setting adjustment at moderate altitude and are as safe at altitude as at sea level under normal respiratory conditions. Older technologies still deliver more volume with altitude in volumetric mode.

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 PM_2.5, 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.

Performance comparison of 15 transport ventilators.

Science.gov (United States)

Chipman, Daniel W; Caramez, Maria P; Miyoshi, Eriko; Kratohvil, Joseph P; Kacmarek, Robert M

2007-06-01

Numerous mechanical ventilators are designed and marketed for use in patient transport. The complexity of these ventilators differs considerably, but very few data exist to compare their operational capabilities. Using bench and animal models, we studied 15 currently available transport ventilators with regard to their physical characteristics, gas consumption (duration of an E-size oxygen cylinder), battery life, ease of use, need for compressed gas, ability to deliver set ventilation parameters to a test lung under 3 test conditions, and ability to maintain ventilation and oxygenation in normal and lung-injured sheep. Most of the ventilators tested were relatively simple to operate and had clearly marked controls. Oxygen cylinder duration ranged from 30 min to 77 min. Battery life ranged from 70 min to 8 hours. All except 3 of the ventilators were capable of providing various F(IO2) values. Ten of the ventilators had high-pressure and patient-disconnect alarms. Only 6 of the ventilators were able to deliver all settings as specifically set on the ventilator during the bench evaluation. Only 4 of the ventilators were capable of maintaining ventilation, oxygenation, and hemodynamics in both the normal and the lung-injured sheep. Only 2 of the ventilators met all the trial targets in all the bench and animal tests. With many of the ventilators, certain of the set ventilation parameters were inaccurate (differed by > 10% from the values from a cardiopulmonary monitor). The physical characteristics and high gas consumption of some of these ventilators may render them less desirable for patient transport.

46 CFR 45.131 - Ventilators.

Science.gov (United States)

2010-10-01

... 46 Shipping 2 2010-10-01 2010-10-01 false Ventilators. 45.131 Section 45.131 Shipping COAST GUARD....131 Ventilators. (a) Ventilators passing through superstructures other than enclosed superstructures must have coamings of steel or equivalent material at the freeboard deck. (b) Ventilators in position 1...

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.

Ventilation area measured with eit in order to optimize peep settings in mechanically ventilated patients

NARCIS (Netherlands)

Blankman, P; Groot Jebbink, E; Preis, C; Bikker, I.; Gommers, D.

2012-01-01

INTRODUCTION. Electrical Impedance Tomography (EIT) is a non-invasive imaging technique, which can be used to visualize ventilation. Ventilation will be measured by impedance changes due to ventilation. OBJECTIVES. The aim of this study was to optimize PEEP settings based on the ventilation area of

Adaptive servo ventilation for central sleep apnoea in heart failure: SERVE-HF on-treatment analysis.

Science.gov (United States)

Woehrle, Holger; Cowie, Martin R; Eulenburg, Christine; Suling, Anna; Angermann, Christiane; d'Ortho, Marie-Pia; Erdmann, Erland; Levy, Patrick; Simonds, Anita K; Somers, Virend K; Zannad, Faiez; Teschler, Helmut; Wegscheider, Karl

2017-08-01

This on-treatment analysis was conducted to facilitate understanding of mechanisms underlying the increased risk of all-cause and cardiovascular mortality in heart failure patients with reduced ejection fraction and predominant central sleep apnoea randomised to adaptive servo ventilation versus the control group in the SERVE-HF trial.Time-dependent on-treatment analyses were conducted (unadjusted and adjusted for predictive covariates). A comprehensive, time-dependent model was developed to correct for asymmetric selection effects (to minimise bias).The comprehensive model showed increased cardiovascular death hazard ratios during adaptive servo ventilation usage periods, slightly lower than those in the SERVE-HF intention-to-treat analysis. Self-selection bias was evident. Patients randomised to adaptive servo ventilation who crossed over to the control group were at higher risk of cardiovascular death than controls, while control patients with crossover to adaptive servo ventilation showed a trend towards lower risk of cardiovascular death than patients randomised to adaptive servo ventilation. Cardiovascular risk did not increase as nightly adaptive servo ventilation usage increased.On-treatment analysis showed similar results to the SERVE-HF intention-to-treat analysis, with an increased risk of cardiovascular death in heart failure with reduced ejection fraction patients with predominant central sleep apnoea treated with adaptive servo ventilation. Bias is inevitable and needs to be taken into account in any kind of on-treatment analysis in positive airway pressure studies. Copyright ©ERS 2017.

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....

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.

Comparison of 4-Dimensional Computed Tomography Ventilation With Nuclear Medicine Ventilation-Perfusion Imaging: A Clinical Validation Study

International Nuclear Information System (INIS)

Vinogradskiy, Yevgeniy; Koo, Phillip J.; Castillo, Richard; Castillo, Edward; Guerrero, Thomas; Gaspar, Laurie E.; Miften, Moyed; Kavanagh, Brian D.

2014-01-01

Purpose: Four-dimensional computed tomography (4DCT) ventilation imaging provides lung function information for lung cancer patients undergoing radiation therapy. Before 4DCT-ventilation can be implemented clinically it needs to be validated against an established imaging modality. The purpose of this work was to compare 4DCT-ventilation to nuclear medicine ventilation, using clinically relevant global metrics and radiologist observations. Methods and Materials: Fifteen lung cancer patients with 16 sets of 4DCT and nuclear medicine ventilation-perfusion (VQ) images were used for the study. The VQ-ventilation images were acquired in planar mode using Tc-99m-labeled diethylenetriamine-pentaacetic acid aerosol inhalation. 4DCT data, spatial registration, and a density-change-based model were used to compute a 4DCT-based ventilation map for each patient. The percent ventilation was calculated in each lung and each lung third for both the 4DCT and VQ-ventilation scans. A nuclear medicine radiologist assessed the VQ and 4DCT scans for the presence of ventilation defects. The VQ and 4DCT-based images were compared using regional percent ventilation and radiologist clinical observations. Results: Individual patient examples demonstrate good qualitative agreement between the 4DCT and VQ-ventilation scans. The correlation coefficients were 0.68 and 0.45, using the percent ventilation in each individual lung and lung third, respectively. Using radiologist-noted presence of ventilation defects and receiver operating characteristic analysis, the sensitivity, specificity, and accuracy of the 4DCT-ventilation were 90%, 64%, and 81%, respectively. Conclusions: The current work compared 4DCT with VQ-based ventilation using clinically relevant global metrics and radiologist observations. We found good agreement between the radiologist's assessment of the 4DCT and VQ-ventilation images as well as the percent ventilation in each lung. The agreement lessened when the data were

Nonlinear control strategy based on using a shape-tunable neural controller

Energy Technology Data Exchange (ETDEWEB)

Chen, C.; Peng, S. [Feng Chia Univ, Taichung (Taiwan, Province of China). Department of chemical Engineering; Chang, W. [Feng Chia Univ, Taichung (Taiwan, Province of China). Department of Automatic Control

1997-08-01

In this paper, a nonlinear control strategy based on using a shape-tunable neural network is developed for adaptive control of nonlinear processes. Based on the steepest descent method, a learning algorithm that enables the neural controller to possess the ability of automatic controller output range adjustment is derived. The novel feature of automatic output range adjustment provides the neural controller more flexibility and capability, and therefore the scaling procedure, which is usually unavoidable for the conventional fixed-shape neural controllers, becomes unnecessary. The advantages and effectiveness of the proposed nonlinear control strategy are demonstrated through the challenge problem of controlling an open-loop unstable nonlinear continuous stirred tank reactor (CSTR). 14 refs., 11 figs.

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

Post-hypercapnic alkalosis is associated with ventilator dependence and increased ICU stay.

Science.gov (United States)

Banga, Amit; Khilnani, G C

2009-12-01

Posthypercapnic alkalosis (PHA) is frequently overlooked as a complication of mechanical ventilation in patients with exacerbation of chronic obstructive pulmonary disease (COPD). The current study was conducted to determine the incidence, risk factors for development and effect on outcome of PHA. Eighty-four patients (62 +/- 11 years, range 42-78 years, M:F 58: 26) with exacerbation of COPD with underlying chronic hypercapnic respiratory failure requiring mechanical ventilation were included in a retrospective fashion. PHA was defined as static or rising serum bicarbonate levels, 72 hours or more after return of PaCO2 to baseline, with concurrent pH > 7.44. Development of PHA was noted in 17 patients (20.2%). Corticosteroid use >or=10 days during the hospital stay was an independent risk factor for development of PHA (Adjusted OR, 95% CI: 9.4, 1.6-55.3; P = 0.013). Development of PHA was associated with an increased incidence of ventilator dependence (64.7% vs. 37.3%, OR, 95% CI: 3.1, 1.1-9.4, P = 0.04) and duration of ICU stay (14.7 +/- 6.7 vs. 9.5 +/- 5.9, P = 0.01) but no increase in hospital mortality (43.3% vs. 41.2%, P = NS). It is concluded that PHA is a common complication in patients with exacerbation of COPD requiring mechanical ventilation and is associated with increased incidence of ventilator dependence and ICU stay.

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...

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. ...

Comparison between conventional and protective one-lung ventilation for ventilator-assisted thoracic surgery.

Science.gov (United States)

Ahn, H J; Kim, J A; Yang, M; Shim, W S; Park, K J; Lee, J J

2012-09-01

Recent papers suggest protective ventilation (PV) as a primary ventilation strategy during one-lung ventilation (OLV) to reduce postoperative pulmonary morbidity. However, data regarding the advantage of the PV strategy in patients with normal preoperative pulmonary function are inconsistent, especially in the case of minimally invasive thoracic surgery. Therefore we compared conventional OLV (VT 10 ml/kg, FiO2 1.0, zero PEEP) to protective OLV (VT 6 ml/kg, FiO2 0.5, PEEP 5 cmH2O) in patients with normal preoperative pulmonary function tests undergoing video-assisted thoracic surgery. Oxygenation, respiratory mechanics, plasma interleukin-6 and malondialdehyde levels were measured at baseline, 15 and 60 minutes after OLV and 15 minutes after restoration of two-lung ventilation. PaO2 and PaO2/FiO2 were higher in conventional OLV than in protective OLV (PProtective ventilation did not provide advantages over conventional ventilation for video-assisted thoracic surgery in this group of patients with normal lung function.

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

Increasing compliance with low tidal volume ventilation in the ICU with two nudge-based interventions: evaluation through intervention time-series analyses.

Science.gov (United States)

Bourdeaux, Christopher P; Thomas, Matthew Jc; Gould, Timothy H; Malhotra, Gaurav; Jarvstad, Andreas; Jones, Timothy; Gilchrist, Iain D

2016-05-26

Low tidal volume (TVe) ventilation improves outcomes for ventilated patients, and the majority of clinicians state they implement it. Unfortunately, most patients never receive low TVes. 'Nudges' influence decision-making with subtle cognitive mechanisms and are effective in many contexts. There have been few studies examining their impact on clinical decision-making. We investigated the impact of 2 interventions designed using principles from behavioural science on the deployment of low TVe ventilation in the intensive care unit (ICU). University Hospitals Bristol, a tertiary, mixed medical and surgical ICU with 20 beds, admitting over 1300 patients per year. Data were collected from 2144 consecutive patients receiving controlled mechanical ventilation for more than 1 hour between October 2010 and September 2014. Patients on controlled mechanical ventilation for more than 20 hours were included in the final analysis. (1) Default ventilator settings were adjusted to comply with low TVe targets from the initiation of ventilation unless actively changed by a clinician. (2) A large dashboard was deployed displaying TVes in the format mL/kg ideal body weight (IBW) with alerts when TVes were excessive. TVe in mL/kg IBW. TVe was significantly lower in the defaults group. In the dashboard intervention, TVe fell more quickly and by a greater amount after a TVe of 8 mL/kg IBW was breached when compared with controls. This effect improved in each subsequent year for 3 years. This study has demonstrated that adjustment of default ventilator settings and a dashboard with alerts for excessive TVe can significantly influence clinical decision-making. This offers a promising strategy to improve compliance with low TVe ventilation, and suggests that using insights from behavioural science has potential to improve the translation of evidence into practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please

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.

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 ...

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...

Intraoperative mechanical ventilation strategies in patients undergoing one-lung ventilation: a meta-analysis.

Science.gov (United States)

Liu, Zhen; Liu, Xiaowen; Huang, Yuguang; Zhao, Jing

2016-01-01

Postoperative pulmonary complications (PPCs), which are not uncommon in one-lung ventilation, are among the main causes of postoperative death after lung surgery. Intra-operative ventilation strategies can influence the incidence of PPCs. High tidal volume (V T) and increased airway pressure may lead to lung injury, while pressure-controlled ventilation and lung-protective strategies with low V T may have protective effects against lung injury. In this meta-analysis, we aim to investigate the effects of different ventilation strategies, including pressure-controlled ventilation (PCV), volume-controlled ventilation (VCV), protective ventilation (PV) and conventional ventilation (CV), on PPCs in patients undergoing one-lung ventilation. We hypothesize that both PV with low V T and PCV have protective effects against PPCs in one-lung ventilation. A systematic search (PubMed, EMBASE, the Cochrane Library, and Ovid MEDLINE; in May 2015) was performed for randomized trials comparing PCV with VCV or comparing PV with CV in one-lung ventilation. Methodological quality was evaluated using the Cochrane tool for risk. The primary outcome was the incidence of PPCs. The secondary outcomes included the length of hospital stay, intraoperative plateau airway pressure (Pplateau), oxygen index (PaO2/FiO2) and mean arterial pressure (MAP). In this meta-analysis, 11 studies (436 patients) comparing PCV with VCV and 11 studies (657 patients) comparing PV with CV were included. Compared to CV, PV decreased the incidence of PPCs (OR 0.29; 95 % CI 0.15-0.57; P < 0.01) and intraoperative Pplateau (MD -3.75; 95 % CI -5.74 to -1.76; P < 0.01) but had no significant influence on the length of hospital stay or MAP. Compared to VCV, PCV decreased intraoperative Pplateau (MD -1.46; 95 % CI -2.54 to -0.34; P = 0.01) but had no significant influence on PPCs, PaO2/FiO2 or MAP. PV with low V T was associated with the reduced incidence of PPCs compared to CV. However, PCV and VCV had similar

Impact of Fire Ventilation on General Ventilation in the Building

Science.gov (United States)

Zender-Świercz, Ewa; Telejko, Marek

2017-10-01

The fire of building is a threat to its users. The biggest threat is generation, during lifetime of fire, hot gases and smoke. The purpose of quick and efficient evacuation from the area covered by the fire, at first step the escape routes have to be secured from smokiness. The smoke ventilation systems are used for this purpose. The proper design and execution of smoke ventilation is important not only because of the safety, but also of the maintenance of comfort in the building at a time when there is no fire. The manuscript presents the effect of incorrectly realized smoke ventilation in the stairwell of the medium building. The analysis shows that the flaps of smoke ventilation located in the stairwell may have a significant impact on the proper functioning of mechanical ventilation in the period when there is no fire. The improperly installed or incorrect insulated components cause perturbation of air flow and they change pressure distribution in the building. The conclusion of the analysis is the need to include the entire technical equipment of the building during the design and realization of its individual elements. The impact of various installations at each other is very important, and the omission of any of them can cause disturbances in the proper work of another.

Trends in mechanical ventilation: are we ventilating our patients in the best possible way?

Science.gov (United States)

Dellaca', Raffaele L; Veneroni, Chiara; Farre', Ramon

2017-06-01

This review addresses how the combination of physiology, medicine and engineering principles contributed to the development and advancement of mechanical ventilation, emphasising the most urgent needs for improvement and the most promising directions of future development. Several aspects of mechanical ventilation are introduced, highlighting on one side the importance of interdisciplinary research for further development and, on the other, the importance of training physicians sufficiently on the technological aspects of modern devices to exploit properly the great complexity and potentials of this treatment. To learn how mechanical ventilation developed in recent decades and to provide a better understanding of the actual technology and practice.To learn how and why interdisciplinary research and competences are necessary for providing the best ventilation treatment to patients.To understand which are the most relevant technical limitations in modern mechanical ventilators that can affect their performance in delivery of the treatment.To better understand and classify ventilation modes.To learn the classification, benefits, drawbacks and future perspectives of automatic ventilation tailoring algorithms.

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...

A comparison of leak compensation in acute care ventilators during noninvasive and invasive ventilation: a lung model study.

Science.gov (United States)

Oto, Jun; Chenelle, Christopher T; Marchese, Andrew D; Kacmarek, Robert M

2013-12-01

Although leak compensation has been widely introduced to acute care ventilators to improve patient-ventilator synchronization in the presence of system leaks, there are no data on these ventilators' ability to prevent triggering and cycling asynchrony. The goal of this study was to evaluate the ability of leak compensation in acute care ventilators during invasive and noninvasive ventilation (NIV). Using a lung simulator, the impact of system leaks was compared on 7 ICU ventilators and 1 dedicated NIV ventilator during triggering and cycling at 2 respiratory mechanics (COPD and ARDS models) settings, various modes of ventilation (NIV mode [pressure support ventilation], and invasive mode [pressure support and continuous mandatory ventilation]), and 2 PEEP levels (5 and 10 cm H(2)O). Leak levels used were up to 35-36 L/min in NIV mode and 26-27 L/min in invasive mode. Although all of the ventilators were able to synchronize with the simulator at baseline, only 4 of the 8 ventilators synchronized to all leaks in NIV mode, and 2 of the 8 ventilators in invasive mode. The number of breaths to synchronization was higher during increasing than during decreasing leak. In the COPD model, miss-triggering occurred more frequently and required a longer time to stabilize tidal volume than in the ARDS model. The PB840 required fewer breaths to synchronize in both invasive and noninvasive modes, compared with the other ventilators (P ventilators. The PB840 and the V60 were the only ventilators to acclimate to all leaks, but there were differences in performance between these 2 ventilators. It is not clear if these differences have clinical importance.

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.''

High-Frequency Percussive Ventilation Revisited

Science.gov (United States)

2010-01-01

be implemented. ‡ Follow the reverse of the ventilation sequence if respiratory alkalosis develops—however, start at ventilation goal sequence 1 not at...High-frequency percussive ventilation (HFPV) has demonstrated a potential role as a rescue option for refractory acute respiratory distress syndrome...frequency percussive ventilation (HFPV) has demon- strated a potential role as a salvage option for refrac- tory acute respiratory distress syndrome

Plane Stratified Flow in a Room Ventilated by Displacement Ventilation

DEFF Research Database (Denmark)

Nielsen, Peter Vilhelm; Nickel, J.; Baron, D. J. G.

2004-01-01

The air movement in the occupied zone of a room ventilated by displacement ventilation exists as a stratified flow along the floor. This flow can be radial or plane according to the number of wall-mounted diffusers and the room geometry. The paper addresses the situations where plane flow...

The effect of helium on ventilator performance: study of five ventilators and a bedside Pitot tube spirometer.

Science.gov (United States)

Oppenheim-Eden, A; Cohen, Y; Weissman, C; Pizov, R

2001-08-01

To assess in vitro the performance of five mechanical ventilators-Siemens 300 and 900C (Siemens-Elma; Solna, Sweden), Puritan Bennett 7200 (Nellcor Puritan Bennett; Pleasanton, CA), Evita 4 (Dragerwerk; Lubeck, Germany), and Bear 1000 (Bear Medical Systems; Riverside CA)-and a bedside sidestream spirometer (Datex CS3 Respiratory Module; Datex-Ohmeda; Helsinki, Finland) during ventilation with helium-oxygen mixtures. In vitro study. ICUs of two university-affiliated hospitals. Each ventilator was connected to 100% helium through compressed air inlets and then tested at three to six different tidal volume (VT) settings using various helium-oxygen concentrations (fraction of inspired oxygen [FIO(2)] of 0.2 to 1.0). FIO(2) and VT were measured with the Datex CS3 spirometer, and VT was validated with a water-displacement spirometer. The Puritan Bennett 7200 ventilator did not function with helium. With the other four ventilators, delivered FIO(2) was lower than the set FIO(2). For the Siemens 300 and 900C ventilators, this difference could be explained by the lack of 21% oxygen when helium was connected to the air supply port, while for the other two ventilators, a nonlinear relation was found. The VT of the Siemens 300 ventilator was independent of helium concentration, while for the other three ventilators, delivered VT was greater than the set VT and was dependent on helium concentration. During ventilation with 80% helium and 20% oxygen, VT increased to 125% of set VT for the Siemens 900C ventilator, and more than doubled for the Evita 4 and Bear 1000 ventilators. Under the same conditions, the Datex CS3 spirometer underestimated the delivered VT by about 33%. At present, no mechanical ventilator is calibrated for use with helium. This investigation offers correction factors for four ventilators for ventilation with helium.

[A comparison of leak compensation in six acute care ventilators during non-invasive ventilation].

Science.gov (United States)

Hu, X S; Wang, Y; Wang, Z T; Yan, P; Zhang, X G; Zhao, S F; Xie, F; Gu, H J; Xie, L X

2017-02-12

Objective: To compare the ability of leak compensation in 6 medical ventilators during non-invasive ventilation. Methods: Six medical ventilators were selected, including 3 non-invasive ventilators (V60, Flexo and Stellar150), and 3 invasive ventilators(Avea, Servo I and BellaVist). Using a lung simulator, the ability of leak compensation was evaluated during triggering and cycling in 2 respiratory mechanics conditions (high airway resistance condition and high elastance resistance condition), and each condition was performed under 2 PEEP levels (4, and 8 cmH(2)O, 1 mmHg=0.098 kPa) at 4 air leak level conditions (L0: 2-3 L/min, L1: 8-10 L/min, L2: 22-27 L/min, L3: 35-40 L/min). Results: In the high elastance resistance condition (L2, L3)with different leak levels, the number of auto-triggering and miss-triggering of the non-invasive ventilator Flexo was significantly less than those of the others (L2: 1, 1; L3: 1.67, 1.33, P ventilators ( P ventilators (1, 0.67, 0, P ventilators in both high airway resistance and high elastance resistance conditions with L0 and L1 leak levels and PEEP levels [ARDS, PEEP=4: (109.8±1.8) ms, (112.0±0.6) ms; ARDS, PEEP=8: (103.1±0.7) ms, (109.7±0.7) ms; COPD, PEEP=4: (207.3±1.1) ms, (220.8±1.1) ms; COPD, PEEP=8: (195.6±6.7) ms, (200.0±1.2) ms , P ventilators could be synchronized, among which V60, Stellar150 and Flexo presented a good performance features in specific conditions.

Prospective randomized crossover study of a new closed-loop control system versus pressure support during weaning from mechanical ventilation.

Science.gov (United States)

Clavieras, Noémie; Wysocki, Marc; Coisel, Yannael; Galia, Fabrice; Conseil, Matthieu; Chanques, Gerald; Jung, Boris; Arnal, Jean-Michel; Matecki, Stefan; Molinari, Nicolas; Jaber, Samir

2013-09-01

Intellivent is a new full closed-loop controlled ventilation that automatically adjusts both ventilation and oxygenation parameters. The authors compared gas exchange and breathing pattern variability of Intellivent and pressure support ventilation (PSV). In a prospective, randomized, single-blind design crossover study, 14 patients were ventilated during the weaning phase, with Intellivent or PSV, for two periods of 24 h in a randomized order. Arterial blood gases were obtained after 1, 8, 16, and 24 h with each mode. Ventilatory parameters were recorded continuously in a breath-by-breath basis during the two study periods. The primary endpoint was oxygenation, estimated by the calculation of the difference between the PaO2/FIO2 ratio obtained after 24 h of ventilation and the PaO2/FIO2 ratio obtained at baseline in each mode. The variability in the ventilatory parameters was also evaluated by the coefficient of variation (SD to mean ratio). There were no adverse events or safety issues requiring premature interruption of both modes. The PaO2/FIO2 (mean ± SD) ratio improved significantly from 245 ± 75 at baseline to 294 ± 123 (P = 0.03) after 24 h of Intellivent. The coefficient of variation of inspiratory pressure and positive end-expiratory pressure (median [interquartile range]) were significantly higher with Intellivent, 16 [11-21] and 15 [7-23]%, compared with 6 [5-7] and 7 [5-10]% in PSV. Inspiratory pressure, positive end-expiratory pressure, and FIO2 changes were adjusted significantly more often with Intellivent compared with PSV. Compared with PSV, Intellivent during a 24-h period improved the PaO2/FIO2 ratio in parallel with more variability in the ventilatory support and more changes in ventilation settings.

Pulmonary Mechanics and Mortality in Mechanically Ventilated Patients Without Acute Respiratory Distress Syndrome: A Cohort Study.

Science.gov (United States)

Fuller, Brian M; Page, David; Stephens, Robert J; Roberts, Brian W; Drewry, Anne M; Ablordeppey, Enyo; Mohr, Nicholas M; Kollef, Marin H

2018-03-01

Driving pressure has been proposed as a major determinant of outcome in patients with acute respiratory distress syndrome (ARDS), but there is little data examining the association between pulmonary mechanics, including driving pressure, and outcomes in mechanically ventilated patients without ARDS. Secondary analysis from 1,705 mechanically ventilated patients enrolled in a clinical study that examined outcomes associated with the use of early lung-protective mechanical ventilation. The primary outcome was mortality and the secondary outcome was the incidence of ARDS. Multivariable models were constructed to: define the association between pulmonary mechanics (driving pressure, plateau pressure, and compliance) and mortality; and evaluate if driving pressure contributed information beyond that provided by other pulmonary mechanics. The mortality rate for the entire cohort was 26.0%. Compared with survivors, non-survivors had significantly higher driving pressure [15.9 (5.4) vs. 14.9 (4.4), P = 0.005] and plateau pressure [21.4 (5.7) vs. 20.4 (4.6), P = 0.001]. Driving pressure was independently associated with mortality [adjusted OR, 1.04 (1.01-1.07)]. Models related to plateau pressure also revealed an independent association with mortality, with similar effect size and interval estimates as driving pressure. There were 152 patients who progressed to ARDS (8.9%). Along with driving pressure and plateau pressure, mechanical power [adjusted OR, 1.03 (1.00-1.06)] was also independently associated with ARDS development. In mechanically ventilated patients, driving pressure and plateau pressure are risk factors for mortality and ARDS, and provide similar information. Mechanical power is also a risk factor for ARDS.

Partial liquid ventilation improves lung function in ventilation-induced lung injury

NARCIS (Netherlands)

G.F. Vazquez de Anda; R.A. Lachmann; S.J.C. Verbrugge (Serge); D.A.M.P.J. Gommers (Diederik); J.J. Haitsma (Jack); B.F. Lachmann (Burkhard)

2001-01-01

textabstractDisturbances in lung function and lung mechanics are present after ventilation with high peak inspiratory pressures (PIP) and low levels of positive end-expiratory pressure (PEEP). Therefore, the authors investigated whether partial liquid ventilation can re-establish

Effect Of Ventilation On Chronic Health Risks In Schools And Offices

Energy Technology Data Exchange (ETDEWEB)

Parthasarathy, Srinandini [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Fisk, William J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); McKone, Thomas E. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2013-01-04

This study provides a risk assessment for chronic health risks from inhalation exposure to indoor air pollutants in offices and schools with a focus how ventilation impacts exposures to, and risks from, volatile organic compounds (VOCs) and particulate matter (PM2.5). We estimate how much health risks could change with varying ventilation rates under two scenarios: (i) halving the measured ventilation rates and (ii) doubling the measured ventilation rates. For the hazard characterization we draw upon prior papers that identified pollutants potentially affecting health with indoor air concentrations responsive to changes in ventilation rates. For exposure assessment we determine representative concentrations of pollutants using data available in current literature and model changes in exposures with changes in ventilation rates. As a metric of disease burden, we use disability adjusted life years (DALYs) to address both cancer and non-cancer effects. We also compare exposures to guidelines published by regulatory agencies to assess chronic health risks. Chronic health risks are driven primarily by particulate matter exposure, with an estimated baseline disease burden of 150 DALYs per 100,000 people in offices and 140 DALYs per 100,000 people in schools. Study results show that PM2.5-related DALYs are not very sensitive to changes in ventilation rates. Filtration is more effective at controlling PM2.5 concentrations and health effects. Non-cancer health effects contribute only a small fraction of the overall chronic health burden of populations in offices and schools (<1 DALY per 100,000 people). Cancer health effects dominate the disease burden in schools (3 DALYs per 100,000) and offices (5 DALYs per 100,000), with formaldehyde being the primary risk driver. In spite of large uncertainties in toxicological data and dose-response modeling, our results support the finding that ventilation rate changes do not have significant impacts on estimated chronic disease

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.

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...

Intraoperative protective mechanical ventilation and risk of postoperative respiratory complications: hospital based registry study.

Science.gov (United States)

Ladha, Karim; Vidal Melo, Marcos F; McLean, Duncan J; Wanderer, Jonathan P; Grabitz, Stephanie D; Kurth, Tobias; Eikermann, Matthias

2015-07-14

To evaluate the effects of intraoperative protective ventilation on major postoperative respiratory complications and to define safe intraoperative mechanical ventilator settings that do not translate into an increased risk of postoperative respiratory complications. Hospital based registry study. Academic tertiary care hospital and two affiliated community hospitals in Massachusetts, United States. 69,265 consecutively enrolled patients over the age of 18 who underwent a non-cardiac surgical procedure between January 2007 and August 2014 and required general anesthesia with endotracheal intubation. Protective ventilation, defined as a median positive end expiratory pressure (PEEP) of 5 cmH2O or more, a median tidal volume of less than 10 mL/kg of predicted body weight, and a median plateau pressure of less than 30 cmH2O. Composite outcome of major respiratory complications, including pulmonary edema, respiratory failure, pneumonia, and re-intubation. Of the 69,265 enrolled patients 34,800 (50.2%) received protective ventilation and 34,465 (49.8%) received non-protective ventilation intraoperatively. Protective ventilation was associated with a decreased risk of postoperative respiratory complications in multivariable regression (adjusted odds ratio 0.90, 95% confidence interval 0.82 to 0.98, P=0.013). The results were similar in the propensity score matched cohort (odds ratio 0.89, 95% confidence interval 0.83 to 0.97, P=0.004). A PEEP of 5 cmH2O and median plateau pressures of 16 cmH2O or less were associated with the lowest risk of postoperative respiratory complications. Intraoperative protective ventilation was associated with a decreased risk of postoperative respiratory complications. A PEEP of 5 cmH2O and a plateau pressure of 16 cmH2O or less were identified as protective mechanical ventilator settings. These findings suggest that protective thresholds differ for intraoperative ventilation in patients with normal lungs compared with those used for patients

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

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...

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....

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)

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

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...

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

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...

[Evaluation of tidal volume delivered by ventilators during volume-controlled ventilation].

Science.gov (United States)

Zhou, Juan; Yan, Yong; Cao, Desen

2014-12-01

To study the ways which ensure the delivery of enough tidal volume to patients under various conditions close to the demand of the physician. The volume control ventilation model was chosen, and the simulation lung type was active servo lung ASL 5000 or Michigan lung 1601. The air resistance, air compliance and lung type in simulation lungs were set. The tidal volume was obtained from flow analyzer PF 300. At the same tidal volume, the displaying values of tidal volume of E5, Servo i, Evital 4, and Evital XL ventilators with different lung types of patient, compliance of gas piping, leakage, gas types, etc. were evaluated. With the same setting tidal volume of a same ventilator, the tidal volume delivered to patients was different with different lung types of patient, compliance of gas piping, leakage, gas types, etc. Reducing compliance and increasing resistance of the patient lungs caused high peak airway pressure, the tidal volume was lost in gas piping, and the tidal volume be delivered to the patient lungs was decreased. If the ventilator did not compensate to leakage, the tidal volume delivered to the patient lungs was decreased. When the setting gas type of ventilator did not coincide with that applying to the patient, the tidal volume be delivered to the patient lungs might be different with the setting tidal volume of ventilator. To ensure the delivery of enough tidal volume to patients close to the demand of the physician, containable factors such as the compliance of gas piping, leakage, and gas types should be controlled.

Ventilator associated pneumonia among patients on mechanical ventilation at tertiary care centres

International Nuclear Information System (INIS)

Rafiq, M.Y.; Ikram, A.; Ayyub, M.

2018-01-01

Objective: To determine the frequency of ventilator associated pneumonia (VAP) among patients on mechanical ventilation, and to identify the causative bacterial pathogens and antibiotic susceptibility pattern of isolated microorganisms in intensive care units of tertiary care settings. Study Design: Descriptive cross sectional. Place and Duration of Study: This study was conducted at Microbiology Department, Armed Forces Institute of Pathology (AFIP), Rawalpindi, from Dec 2014 to Aug 2015. Material and Methods: A total of 176 patients on mechanical ventilation were included in the study; patients having respiratory tract infection before putting on ventilator were excluded. Endotracheal aspirate (ETA) and Bronchoalveolar lavage (BAL) samples were collected aseptically from patients on mechanical ventilation on day zero i.e. the day on which the patient was put on ventilator to rule out any previous respiratory tract infection and then after 48 hours to observe the development of VAP. Samples were processed in the laboratory by standard culture techniques, pathogens were identified and their antibiotic susceptibility was performed as per CLSI guidelines. Results: Out of 176 patients on mechanical ventilation, 59 (33.5%) developed VAP. Acinetobacter baumanii being the predominant pathogen isolated from 32 (54.2%) patients followed by MRSA 11 (18.6%), Klebsiella pneumoniae 9 (15.2%), Pseudomonas aeruginosa 5 (8.47%) and Stenotrophomonas maltophila from 2 (3.38%) patients. Conclusion: Frequency of VAP is quite high in our setup, identification of causative bacterial pathogensand their antibiotic susceptibility pattern will not only help in providing effective treatment to the patients but will also help in the formulation of antibiogram according to local resistance patterns for empirical therapy and to reduce the morbidity and mortality. (author)

Transient natural ventilation of a room with a distributed heat source

Science.gov (United States)

Fitzgerald, Shaun D.; Woods, Andrew W.

We report on an experimental and theoretical study of the transient flows which develop as a naturally ventilated room adjusts from one temperature to another. We focus on a room heated from below by a uniform heat source, with both high- and low-level ventilation openings. Depending on the initial temperature of the room relative to (i) the final equilibrium temperature and (ii) the exterior temperature, three different modes of ventilation may develop. First, if the room temperature lies between the exterior and the equilibrium temperature, the interior remains well-mixed and gradually heats up to the equilibrium temperature. Secondly, if the room is initially warmer than the equilibrium temperature, then a thermal stratification develops in which the upper layer of originally hot air is displaced upwards by a lower layer of relatively cool inflowing air. At the interface, some mixing occurs owing to the effects of penetrative convection. Thirdly, if the room is initially cooler than the exterior, then on opening the vents, the original air is displaced downwards and a layer of ambient air deepens from above. As this lower layer drains, it is eventually heated to the ambient temperature, and is then able to mix into the overlying layer of external air, and the room becomes well-mixed. For each case, we present new laboratory experiments and compare these with some new quantitative models of the transient flows. We conclude by considering the implications of our work for natural ventilation of large auditoria.

Non-invasive mechanical ventilation and mortality in elderly immunocompromised patients hospitalized with pneumonia: a retrospective cohort study.

Science.gov (United States)

Johnson, Christopher S; Frei, Christopher R; Metersky, Mark L; Anzueto, Antonio R; Mortensen, Eric M

2014-01-27

Mortality after pneumonia in immunocompromised patients is higher than for immunocompetent patients. The use of non-invasive mechanical ventilation for patients with severe pneumonia may provide beneficial outcomes while circumventing potential complications associated with invasive mechanical ventilation. The aim of our study was to determine if the use of non-invasive mechanical ventilation in elderly immunocompromised patients with pneumonia is associated with higher all-cause mortality. In this retrospective cohort study, data were obtained from the Department of Veterans Affairs administrative databases. We included veterans age ≥65 years who were immunocompromised and hospitalized due to pneumonia. Multilevel logistic regression analysis was used to determine the relationship between the use of invasive versus non-invasive mechanical ventilation and 30-day and 90-day mortality. Of 1,946 patients in our cohort, 717 received non-invasive mechanical ventilation and 1,229 received invasive mechanical ventilation. There was no significant association between all-cause 30-day mortality and non-invasive versus invasive mechanical ventilation in our adjusted model (odds ratio (OR) 0.85, 95% confidence interval (CI) 0.66-1.10). However, those patients who received non-invasive mechanical ventilation had decreased 90-day mortality (OR 0.66, 95% CI 0.52-0.84). Additionally, receipt of guideline-concordant antibiotics in our immunocompromised cohort was significantly associated with decreased odds of 30-day mortality (OR 0.31, 95% CI 0.24-0.39) and 90-day mortality (OR 0.41, 95% CI 0.31-0.53). Our findings suggest that physicians should consider the use of non-invasive mechanical ventilation, when appropriate, for elderly immunocompromised patients hospitalized with pneumonia.

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.

Neonatal and adult ICU ventilators to provide ventilation in neonates, infants, and children: a bench model study.

Science.gov (United States)

Vignaux, Laurence; Piquilloud, Lise; Tourneux, Pierre; Jolliet, Philippe; Rimensberger, Peter C

2014-10-01

Using a bench test model, we investigated the hypothesis that neonatal and/or adult ventilators equipped with neonatal/pediatric modes currently do not reliably administer pressure support (PS) in neonatal or pediatric patient groups in either the absence or presence of air leaks. PS was evaluated in 4 neonatal and 6 adult ventilators using a bench model to evaluate triggering, pressurization, and cycling in both the absence and presence of leaks. Delivered tidal volumes were also assessed. Three patients were simulated: a preterm infant (resistance 100 cm H2O/L/s, compliance 2 mL/cm H2O, inspiratory time of the patient [TI] 400 ms, inspiratory effort 1 and 2 cm H2O), a full-term infant (resistance 50 cm H2O/L/s, compliance 5 mL/cm H2O, TI 500 ms, inspiratory effort 2 and 4 cm H2O), and a child (resistance 30 cm H2O/L/s, compliance 10 mL/cm H2O, TI 600 ms, inspiratory effort 5 and 10 cm H2O). Two PS levels were tested (10 and 15 cm H2O) with and without leaks and with and without the leak compensation algorithm activated. Without leaks, only 2 neonatal ventilators and one adult ventilator had trigger delays under a given predefined acceptable limit (1/8 TI). Pressurization showed high variability between ventilators. Most ventilators showed TI in excess high enough to seriously impair patient-ventilator synchronization (> 50% of the TI of the subject). In some ventilators, leaks led to autotriggering and impairment of ventilation performance, but the influence of leaks was generally lower in neonatal ventilators. When a noninvasive ventilation algorithm was available, this was partially corrected. In general, tidal volume was calculated too low by the ventilators in the presence of leaks; the noninvasive ventilation algorithm was able to correct this difference in only 2 adult ventilators. No ventilator performed equally well under all tested conditions for all explored parameters. However, neonatal ventilators tended to perform better in the presence of leaks

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

[Nasal CPAP versus mechanical ventilation in 28 to 32-week preterm infants with early surfactant administration].

Science.gov (United States)

Pérez, Luis Alfonso; González, Diana Marcela; Álvarez, Karen Margarita de Jesús; Díaz-Martínez, Luis Alfonso

2014-01-01

Continuous positive airway pressure (CPAP) is useful in low birth weight infants with respiratory distress, but it is not known if it is a better alternative to mechanical ventilation after early pulmonary surfactant administration. To compare the incidence of adverse events in 28 to 32-week newborns with respiratory distress managed with mechanical ventilation or CPAP after early surfactant administration. In total, 176 newborns were treated with CPAP and 147 with mechanical ventilation, all with Apgar scores >3 at five minutes and without apnea. The incidence of CPAP failure was 6.5% (95% CI: 11.3-22.8%); 29 patients died: 7 with CPAP (4.0%) and 22 with mechanical ventilation (15.0%, pmechanical ventilation was 0.27 (95% CI: 0.12-0.61), but after adjusting for confounding factors, CPAP use did not imply a higher risk of dying (RR=0.60; 95% CI: 0.29-1.24). Mechanical ventilation fatality rate was 5.70 (95% CI: 3.75-8.66) deaths/1,000 days-patient, while with CPAP it was 1.37 (95% CI: 0.65-2.88, pmechanical ventilation (RR=0.71; 95% CI: 0.54-0.96), as were intracranial hemorrhage (RR=0.28, 95% CI: 0.09-0.84) and sepsis (RR=0.67; 95%CI: 0.52-0.86), and it was similar for air leaks (RR=2.51; 95% CI: 0.83-7.61) and necrotizing enterocolitis (RR=1.68, 95% CI: 0.59-4.81). CPAP exposure of premature infants with respiratory distress syndrome is protective against chronic lung disease, intraventricular hemorrhage and sepsis compared to mechanical ventilation. No differences were observed regarding air leak syndrome or death.

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...

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.

Boundary conditions for the use of personal ventilation over mixing ventilation in open plan offices

DEFF Research Database (Denmark)

Petersen, Steffen; Hviid, Christian Anker

2013-01-01

This paper investigates the boundary conditions for choosing a combined Personal Ventilation (PV) and Mixing Ventilation (MV) over conventional mixing ventilation in an office with multiple workers. A simplified procedure for annual performance assessment of PV/MV systems in terms of air quality...

21 CFR 868.5975 - Ventilator tubing.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ventilator tubing. 868.5975 Section 868.5975 Food... DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5975 Ventilator tubing. (a) Identification. Ventilator tubing is a device intended for use as a conduit for gases between a ventilator and a patient...

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.

Inactivity-induced respiratory plasticity: Protecting the drive to breathe in disorders that reduce respiratory neural activity☆

Science.gov (United States)

Strey, K.A.; Baertsch, N.A.; Baker-Herman, T.L.

2013-01-01

Multiple forms of plasticity are activated following reduced respiratory neural activity. For example, in ventilated rats, a central neural apnea elicits a rebound increase in phrenic and hypoglossal burst amplitude upon resumption of respiratory neural activity, forms of plasticity called inactivity-induced phrenic and hypoglossal motor facilitation (iPMF and iHMF), respectively. Here, we provide a conceptual framework for plasticity following reduced respiratory neural activity to guide future investigations. We review mechanisms giving rise to iPMF and iHMF, present new data suggesting that inactivity-induced plasticity is observed in inspiratory intercostals (iIMF) and point out gaps in our knowledge. We then survey conditions relevant to human health characterized by reduced respiratory neural activity and discuss evidence that inactivity-induced plasticity is elicited during these conditions. Understanding the physiological impact and circumstances in which inactivity-induced respiratory plasticity is elicited may yield novel insights into the treatment of disorders characterized by reductions in respiratory neural activity. PMID:23816599

The role of ventilation. 2 v. Proceedings

International Nuclear Information System (INIS)

1994-01-01

The 78 papers which constitute the proceedings of the conference are presented in two volumes. The papers in the first volume cover sessions dealing with the following broad topics: ventilation strategies; indoor air quality; energy impact of ventilation; building design for optimum ventilation; ventilation and energy. Volume 2 also covers ventilation strategies and ventilation and energy, and in addition: calculation, measurement and design tools; measurement and modelling. Separate abstract have been prepared for 4 papers in Volume 1 which deal with the role of ventilation in mitigating the hazard of radon in buildings. (UK)

Ventilation of radioactive enclosures; Ventilation des enceintes radioactives

Energy Technology Data Exchange (ETDEWEB)

Caminade, F; Laurent, H [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

1957-07-01

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{sup 3}). The performances of three types of 'ventilators', and the modifications provided by the addition of filters, are measured and compared. (author) [French] Les manipulations oceaniques, physiques et chimiques sur des produits radioactifs doivent s'effectuer dans des enceintes convenablement ventilees. L'air extrait ne peut etre rejete dans l'atmosphere qu'apres une filtration correcte. La puissance des installations de ventilation est fonction des dimensions de l'enceinte et de son utilisation. Le choix des types de filtres est determine par l'etat physique et la nature ehimique des corps radioactifs manipules. Notre etude porte sur l'equipement individuel d'installations de petites dimensions: boites a gants, boites a pinces et, a la rigueur, enceintes de production (volume maximum utilisable 5 m{sup 3}). Nous mesurons et comparons les performances de trois types de 'ventilateurs' et les modifications apportees par l'adjonction de filtres. (auteur)

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…

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...

Randomized, controlled trial comparing synchronized intermittent mandatory ventilation and synchronized intermittent mandatory ventilation plus pressure support in preterm infants.

Science.gov (United States)

Reyes, Zenaida C; Claure, Nelson; Tauscher, Markus K; D'Ugard, Carmen; Vanbuskirk, Silvia; Bancalari, Eduardo

2006-10-01

Prolonged mechanical ventilation is associated with lung injury in preterm infants. In these infants, weaning from synchronized intermittent mandatory ventilation may be delayed by their inability to cope with increased respiratory loads. The addition of pressure support to synchronized intermittent mandatory ventilation can offset these loads and may facilitate weaning. The purpose of this work was to compare synchronized intermittent mandatory ventilation and synchronized intermittent mandatory ventilation plus pressure support in weaning from mechanical ventilation and the duration of supplemental oxygen dependency in preterm infants with respiratory failure. Preterm infants weighing 500 to 1000 g at birth who required mechanical ventilation during the first postnatal week were randomly assigned to synchronized intermittent mandatory ventilation or synchronized intermittent mandatory ventilation plus pressure support. In both groups, weaning followed a set protocol during the first 28 days. Outcomes were assessed during the first 28 days and until discharge or death. There were 107 infants enrolled (53 synchronized intermittent mandatory ventilation plus pressure support and 54 synchronized intermittent mandatory ventilation). Demographic and perinatal data, mortality, and morbidity did not differ between groups. During the first 28 days, infants in the synchronized intermittent mandatory ventilation plus pressure support group reached minimal ventilator settings and were extubated earlier than infants in the synchronized intermittent mandatory ventilation group. Total duration of mechanical ventilation, duration of oxygen dependency, and oxygen need at 36 weeks' postmenstrual age alone or combined with death did not differ between groups. However, infants in synchronized intermittent mandatory ventilation plus pressure support within the 700- to 1000-g birth weight strata had a shorter oxygen dependency. The results of this study suggest that the addition of

Subsurface Ventilation System Description Document

Energy Technology Data Exchange (ETDEWEB)

Eric Loros

2001-07-25

The Subsurface Ventilation System supports the construction and operation of the subsurface repository by providing air for personnel and equipment and temperature control for the underground areas. Although the system is located underground, some equipment and features may be housed or located above ground. The system ventilates the underground by providing ambient air from the surface throughout the subsurface development and emplacement areas. The system provides fresh air for a safe work environment and supports potential retrieval operations by ventilating and cooling emplacement drifts. The system maintains compliance within the limits established for approved air quality standards. The system maintains separate ventilation between the development and waste emplacement areas. The system shall remove a portion of the heat generated by the waste packages during preclosure to support thermal goals. The system provides temperature control by reducing drift temperature to support potential retrieval operations. The ventilation system has the capability to ventilate selected drifts during emplacement and retrieval operations. The Subsurface Facility System is the main interface with the Subsurface Ventilation System. The location of the ducting, seals, filters, fans, emplacement doors, regulators, and electronic controls are within the envelope created by the Ground Control System in the Subsurface Facility System. The Subsurface Ventilation System also interfaces with the Subsurface Electrical System for power, the Monitored Geologic Repository Operations Monitoring and Control System to ensure proper and safe operation, the Safeguards and Security System for access to the emplacement drifts, the Subsurface Fire Protection System for fire safety, the Emplacement Drift System for repository performance, and the Backfill Emplacement and Subsurface Excavation Systems to support ventilation needs.

Subsurface Ventilation System Description Document

Energy Technology Data Exchange (ETDEWEB)

NONE

2000-10-12

The Subsurface Ventilation System supports the construction and operation of the subsurface repository by providing air for personnel and equipment and temperature control for the underground areas. Although the system is located underground, some equipment and features may be housed or located above ground. The system ventilates the underground by providing ambient air from the surface throughout the subsurface development and emplacement areas. The system provides fresh air for a safe work environment and supports potential retrieval operations by ventilating and cooling emplacement drifts. The system maintains compliance within the limits established for approved air quality standards. The system maintains separate ventilation between the development and waste emplacement areas. The system shall remove a portion of the heat generated by the waste packages during preclosure to support thermal goals. The system provides temperature control by reducing drift temperature to support potential retrieval operations. The ventilation system has the capability to ventilate selected drifts during emplacement and retrieval operations. The Subsurface Facility System is the main interface with the Subsurface Ventilation System. The location of the ducting, seals, filters, fans, emplacement doors, regulators, and electronic controls are within the envelope created by the Ground Control System in the Subsurface Facility System. The Subsurface Ventilation System also interfaces with the Subsurface Electrical System for power, the Monitored Geologic Repository Operations Monitoring and Control System to ensure proper and safe operation, the Safeguards and Security System for access to the emplacement drifts, the Subsurface Fire Protection System for fire safety, the Emplacement Drift System for repository performance, and the Backfill Emplacement and Subsurface Excavation Systems to support ventilation needs.

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.

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.

46 CFR 153.312 - Ventilation system standards.

Science.gov (United States)

2010-10-01

... 46 Shipping 5 2010-10-01 2010-10-01 false Ventilation system standards. 153.312 Section 153.312... Handling Space Ventilation § 153.312 Ventilation system standards. A cargo handling space ventilation system must meet the following: (a) A ventilation system exhaust duct must discharge no less than 10 m...

Design of Energy Efficient Hybrid Ventilation

DEFF Research Database (Denmark)

Heiselberg, Per

The focus in the development has for both systems been to minimise energy consumption while maintaining a comfortable and healthy indoor environment. The natural next step in this development is to develop ventilation concepts that utilises and combines the best features from each system......[Mechanical and natural ventilation] into a new type of ventilation system- Hybrid Ventilation....

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.

Neural network-based run-to-run controller using exposure and resist thickness adjustment

Science.gov (United States)

Geary, Shane; Barry, Ronan

2003-06-01

This paper describes the development of a run-to-run control algorithm using a feedforward neural network, trained using the backpropagation training method. The algorithm is used to predict the critical dimension of the next lot using previous lot information. It is compared to a common prediction algorithm - the exponentially weighted moving average (EWMA) and is shown to give superior prediction performance in simulations. The manufacturing implementation of the final neural network showed significantly improved process capability when compared to the case where no run-to-run control was utilised.

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.

SU-F-J-219: Predicting Ventilation Change Due to Radiation Therapy: Dependency On Pre-RT Ventilation and Effort Correction

Energy Technology Data Exchange (ETDEWEB)

Patton, T; Du, K; Bayouth, J [University of Wisconsin, Madison, WI (United States); Christensen, G; Reinhardt, J [University of Iowa, Iowa City, IA (United States)

2016-06-15

Purpose: Ventilation change caused by radiation therapy (RT) can be predicted using four-dimensional computed tomography (4DCT) and image registration. This study tested the dependency of predicted post-RT ventilation on effort correction and pre-RT lung function. Methods: Pre-RT and 3 month post-RT 4DCT images were obtained for 13 patients. The 4DCT images were used to create ventilation maps using a deformable image registration based Jacobian expansion calculation. The post-RT ventilation maps were predicted in four different ways using the dose delivered, pre-RT ventilation, and effort correction. The pre-RT ventilation and effort correction were toggled to determine dependency. The four different predicted ventilation maps were compared to the post-RT ventilation map calculated from image registration to establish the best prediction method. Gamma pass rates were used to compare the different maps with the criteria of 2mm distance-to-agreement and 6% ventilation difference. Paired t-tests of gamma pass rates were used to determine significant differences between the maps. Additional gamma pass rates were calculated using only voxels receiving over 20 Gy. Results: The predicted post-RT ventilation maps were in agreement with the actual post-RT maps in the following percentage of voxels averaged over all subjects: 71% with pre-RT ventilation and effort correction, 69% with no pre-RT ventilation and effort correction, 60% with pre-RT ventilation and no effort correction, and 58% with no pre-RT ventilation and no effort correction. When analyzing only voxels receiving over 20 Gy, the gamma pass rates were respectively 74%, 69%, 65%, and 55%. The prediction including both pre- RT ventilation and effort correction was the only prediction with significant improvement over using no prediction (p<0.02). Conclusion: Post-RT ventilation is best predicted using both pre-RT ventilation and effort correction. This is the only prediction that provided a significant

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.

Fungal volatiles associated with moldy grain in ventilated and non-ventilated bin-stored wheat.

Science.gov (United States)

Sinha, R N; Tuma, D; Abramson, D; Muir, W E

1988-01-01

The fungal odor compounds 3-methyl-1-butanol, 1-octen-3-ol and 3-octanone were monitored in nine experimental bins in Winnipeg, Manitoba containing a hard red spring wheat during the autumn, winter and summer seasons of 1984-85. Quality changes were associated with seed-borne microflora and moisture content in both ventilated and non-ventilated bins containing wheat of 15.6 and 18.2% initial moisture content. All three odor compounds occurred in considerably greater amounts in bulk wheat in non-ventilated than in ventilated bins, particularly in those with wheat having 18.2% moisture content. The presence of these compounds usually coincided with infection of the seeds by the fungi Alternaria alternata (Fr.) Keissler, Aspergillus repens DeBarry, A. versicolor (Vuill.) Tiraboschi, Penicillium crustosum Thom, P. oxalicum Currie and Thom, P. aurantiogriesum Dierckx, and P. citrinum Thom. High production of all three odor compounds in damp wheat stored in non-ventilated bins was associated with heavy fungal infection of the seeds and reduction in seed germinability. High initial moisture content of the harvested grain accelerated the production of all three fungal volatiles in non-ventilated bins.

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...

Methodology for ventilation/perfusion SPECT

DEFF Research Database (Denmark)

Bajc, Marika; Neilly, Brian; Miniati, Massimo

2010-01-01

radiolabeled liquid aerosols are not restricted to the presence of obstructive lung disease. Radiolabeled macroaggregated human albumin is the imaging agent of choice for perfusion scintigraphy. An optimal combination of nuclide activities and acquisition times for ventilation and perfusion, collimators......Ventilation/perfusion single-photon emission computed tomography (V/Q SPECT) is the scintigraphic technique of choice for the diagnosis of pulmonary embolism and many other disorders that affect lung function. Data from recent ventilation studies show that the theoretic advantages of Technegas over......, and imaging matrix yields an adequate V/Q SPECT study in approximately 20 minutes of imaging time. The recommended protocol based on the patient remaining in an unchanged position during the initial ventilation study and the perfusion study allows presentation of matching ventilation and perfusion slices...

Assisted Ventilation in Patients with Acute Respiratory Distress Syndrome: Lung-distending Pressure and Patient-Ventilator Interaction

NARCIS (Netherlands)

Doorduin, J.; Sinderby, C.A.; Beck, J.; Hoeven, J.G. van der; Heunks, L.M.

2015-01-01

BACKGROUND: In patients with acute respiratory distress syndrome (ARDS), the use of assisted mechanical ventilation is a subject of debate. Assisted ventilation has benefits over controlled ventilation, such as preserved diaphragm function and improved oxygenation. Therefore, higher level of

TS LOOP ALCOVE VENTILATION ANALYSIS

International Nuclear Information System (INIS)

T.M. Lahnalampi

2000-01-01

The scope of this analysis is to examine the existing, constructor installed, physical ventilation installations located in each of the Exploratory Studies Facility (ESF) Topopah Springs (TS) Loop Alcoves No.1, No.2, No.3, No.4, No.6, and No.7. Alcove No.5 is excluded from the scope of this analysis since it is an A/E design system. Each ventilation installation will be analyzed for the purpose of determining if requirements for acceptance into the A/E design technical baseline have been met. The ventilation installations will be evaluated using Occupational Safety and Health Administration (OSHA) standards and Exploratory Studies Facility Design Requirements (ESFDR) (YMP 1997) requirements. The end product will be a technical analysis that will define ventilation installation compliance issues, any outstanding field changes, and use-as-is design deviations that are required to bring the ventilation installations into compliance with requirements for acceptance into the A/E design technical baseline. The analysis will provide guidance for alcove ventilation component design modifications to be developed to correct any deficient components that do not meet minimum requirements and standards

Mechanical ventilation for severe asthma.

Science.gov (United States)

Leatherman, James

2015-06-01

Acute exacerbations of asthma can lead to respiratory failure requiring ventilatory assistance. Noninvasive ventilation may prevent the need for endotracheal intubation in selected patients. For patients who are intubated and undergo mechanical ventilation, a strategy that prioritizes avoidance of ventilator-related complications over correction of hypercapnia was first proposed 30 years ago and has become the preferred approach. Excessive pulmonary hyperinflation is a major cause of hypotension and barotrauma. An appreciation of the key determinants of hyperinflation is essential to rational ventilator management. Standard therapy for patients with asthma undergoing mechanical ventilation consists of inhaled bronchodilators, corticosteroids, and drugs used to facilitate controlled hypoventilation. Nonconventional interventions such as heliox, general anesthesia, bronchoscopy, and extracorporeal life support have also been advocated for patients with fulminant asthma but are rarely necessary. Immediate mortality for patients who are mechanically ventilated for acute severe asthma is very low and is often associated with out-of-hospital cardiorespiratory arrest before intubation. However, patients who have been intubated for severe asthma are at increased risk for death from subsequent exacerbations and must be managed accordingly in the outpatient setting.

Wind Extraction for Natural Ventilation

Science.gov (United States)

Fagundes, Tadeu; Yaghoobian, Neda; Kumar, Rajan; Ordonez, Juan

2017-11-01

Due to the depletion of energy resources and the environmental impact of pollution and unsustainable energy resources, energy consumption has become one of the main concerns in our rapidly growing world. Natural ventilation, a traditional method to remove anthropogenic and solar heat gains, proved to be a cost-effective, alternative method to mechanical ventilation. However, while natural ventilation is simple in theory, its detailed design can be a challenge, particularly for wind-driven ventilation, which its performance highly involves the buildings' form, surrounding topography, turbulent flow characteristics, and climate. One of the main challenges with wind-driven natural ventilation schemes is due to the turbulent and unpredictable nature of the wind around the building that impose complex pressure loads on the structure. In practice, these challenges have resulted in founding the natural ventilation mainly on buoyancy (rather than the wind), as the primary force. This study is the initial step for investigating the physical principals of wind extraction over building walls and investigating strategies to reduce the dependence of the wind extraction on the incoming flow characteristics and the target building form.

Thermal comfort of seated occupants in rooms with personalized ventilation combined with mixing or displacement ventilation

DEFF Research Database (Denmark)

Forejt, L.; Melikov, Arsen Krikor; Cermak, Radim

2004-01-01

The performance of two personalized ventilation systems combined with mixing or displacement ventilation was studied under different conditions in regard to thermal comfort of seated occupants. The cooling performance of personalized ventilation was found to be independent of room air distribution...

Low tidal volume ventilation ameliorates left ventricular dysfunction in mechanically ventilated rats following LPS-induced lung injury.

Science.gov (United States)

Cherpanath, Thomas G V; Smeding, Lonneke; Hirsch, Alexander; Lagrand, Wim K; Schultz, Marcus J; Groeneveld, A B Johan

2015-10-07

High tidal volume ventilation has shown to cause ventilator-induced lung injury (VILI), possibly contributing to concomitant extrapulmonary organ dysfunction. The present study examined whether left ventricular (LV) function is dependent on tidal volume size and whether this effect is augmented during lipopolysaccharide(LPS)-induced lung injury. Twenty male Wistar rats were sedated, paralyzed and then randomized in four groups receiving mechanical ventilation with tidal volumes of 6 ml/kg or 19 ml/kg with or without intrapulmonary administration of LPS. A conductance catheter was placed in the left ventricle to generate pressure-volume loops, which were also obtained within a few seconds of vena cava occlusion to obtain relatively load-independent LV systolic and diastolic function parameters. The end-systolic elastance / effective arterial elastance (Ees/Ea) ratio was used as the primary parameter of LV systolic function with the end-diastolic elastance (Eed) as primary LV diastolic function. Ees/Ea decreased over time in rats receiving LPS (p = 0.045) and high tidal volume ventilation (p = 0.007), with a lower Ees/Ea in the rats with high tidal volume ventilation plus LPS compared to the other groups (p tidal volume ventilation without LPS (p = 0.223). A significant interaction (p tidal ventilation and LPS for Ees/Ea and Eed, and all rats receiving high tidal volume ventilation plus LPS died before the end of the experiment. Low tidal volume ventilation ameliorated LV systolic and diastolic dysfunction while preventing death following LPS-induced lung injury in mechanically ventilated rats. Our data advocates the use of low tidal volumes, not only to avoid VILI, but to avert ventilator-induced myocardial dysfunction as well.

Lung-protective ventilation in abdominal surgery.

Science.gov (United States)

Futier, Emmanuel; Jaber, Samir

2014-08-01

To provide the most recent and relevant clinical evidence regarding the use of prophylactic lung-protective mechanical ventilation in abdominal surgery. Evidence is accumulating, suggesting an association between intraoperative mechanical ventilation strategy and postoperative pulmonary complications in patients undergoing abdominal surgery. Nonprotective ventilator settings, especially high tidal volume (>10-12 ml/kg), very low level of positive end-expiratory pressure (PEEP, ventilator-associated lung injury in patients with healthy lungs. Stimulated by the previous findings in patients with acute respiratory distress syndrome, the use of lower tidal volume ventilation is becoming increasingly more common in the operating room. However, lowering tidal volume, though important, is only part of the overall multifaceted approach of lung-protective mechanical ventilation. Recent data provide compelling evidence that prophylactic lung-protective mechanical ventilation using lower tidal volume (6-8 ml/kg of predicted body weight), moderate PEEP (6-8 cm H2O), and recruitment maneuvers is associated with improved functional or physiological and clinical postoperative outcome in patients undergoing abdominal surgery. The use of prophylactic lung-protective ventilation can help in improving the postoperative outcome.

New modes of assisted mechanical ventilation.

Science.gov (United States)

Suarez-Sipmann, F

2014-05-01

Recent major advances in mechanical ventilation have resulted in new exciting modes of assisted ventilation. Compared to traditional ventilation modes such as assisted-controlled ventilation or pressure support ventilation, these new modes offer a number of physiological advantages derived from the improved patient control over the ventilator. By implementing advanced closed-loop control systems and using information on lung mechanics, respiratory muscle function and respiratory drive, these modes are specifically designed to improve patient-ventilator synchrony and reduce the work of breathing. Depending on their specific operational characteristics, these modes can assist spontaneous breathing efforts synchronically in time and magnitude, adapt to changing patient demands, implement automated weaning protocols, and introduce a more physiological variability in the breathing pattern. Clinicians have now the possibility to individualize and optimize ventilatory assistance during the complex transition from fully controlled to spontaneous assisted ventilation. The growing evidence of the physiological and clinical benefits of these new modes is favoring their progressive introduction into clinical practice. Future clinical trials should improve our understanding of these modes and help determine whether the claimed benefits result in better outcomes. Copyright © 2013 Elsevier España, S.L. and SEMICYUC. All rights reserved.

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.

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.

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

A Porcine Model for Initial Surge Mechanical Ventilator Assessment and Evaluation of Two Limited Function Ventilators

Science.gov (United States)

Dickson, Robert P; Hotchkin, David L; Lamm, Wayne JE; Hinkson, Carl; Pierson, David J; Glenny, Robb W; Rubinson, Lewis

2013-01-01

Objective To adapt an animal model of acute lung injury for use as a standard protocol for a screening, initial evaluation of limited function, or “surge,” ventilators for use in mass casualty scenarios. Design Prospective, experimental animal study. Setting University research laboratory. Subjects 12 adult pigs. Interventions 12 spontaneously breathing pigs (6 in each group) were subjected to acute lung injury/acute respiratory distress syndrome (ALI/ARDS) via pulmonary artery infusion of oleic acid. Following development of respiratory failure, animals were mechanically ventilated with a limited function ventilator (Simplified Automatic Ventilator [SAVe] I or II; Automedx) for one hour or until the ventilator could not support the animal. The limited function ventilator was then exchanged for a full function ventilator (Servo 900C; Siemens). Measurements and Main Results Reliable and reproducible levels of ALI/ARDS were induced. The SAVe I was unable to adequately oxygenate 5 animals, with PaO2 (52.0 ± 11.1 torr) compared to the Servo (106.0 ± 25.6 torr; p=0.002). The SAVe II was able to oxygenate and ventilate all 6 animals for one hour with no difference in PaO2 (141.8 ± 169.3 torr) compared to the Servo (158.3 ± 167.7 torr). Conclusions We describe a novel in vivo model of ALI/ARDS that can be used to initially screen limited function ventilators considered for mass respiratory failure stockpiles, and is intended to be combined with additional studies to defintively assess appropriateness for mass respiratory failure. Specifically, during this study we demonstrate that the SAVe I ventilator is unable to provide sufficient gas exchange, while the SAVe II, with several more functions, was able to support the same level of hypoxemic respiratory failure secondary to ALI/ARDS for one hour. PMID:21187747

Comparison between conventional protective mechanical ventilation and high-frequency oscillatory ventilation associated with the prone position.

Science.gov (United States)

Fioretto, José Roberto; Klefens, Susiane Oliveira; Pires, Rafaelle Fernandes; Kurokawa, Cilmery Suemi; Carpi, Mario Ferreira; Bonatto, Rossano César; Moraes, Marcos Aurélio; Ronchi, Carlos Fernando

2017-01-01

To compare the effects of high-frequency oscillatory ventilation and conventional protective mechanical ventilation associated with the prone position on oxygenation, histology and pulmonary oxidative damage in an experimental model of acute lung injury. Forty-five rabbits with tracheostomy and vascular access were underwent mechanical ventilation. Acute lung injury was induced by tracheal infusion of warm saline. Three experimental groups were formed: healthy animals + conventional protective mechanical ventilation, supine position (Control Group; n = 15); animals with acute lung injury + conventional protective mechanical ventilation, prone position (CMVG; n = 15); and animals with acute lung injury + high-frequency oscillatory ventilation, prone position (HFOG; n = 15). Ten minutes after the beginning of the specific ventilation of each group, arterial gasometry was collected, with this timepoint being called time zero, after which the animal was placed in prone position and remained in this position for 4 hours. Oxidative stress was evaluated by the total antioxidant performance assay. Pulmonary tissue injury was determined by histopathological score. The level of significance was 5%. Both groups with acute lung injury showed worsening of oxygenation after induction of injury compared with the Control Group. After 4 hours, there was a significant improvement in oxygenation in the HFOG group compared with CMVG. Analysis of total antioxidant performance in plasma showed greater protection in HFOG. HFOG had a lower histopathological lesion score in lung tissue than CMVG. High-frequency oscillatory ventilation, associated with prone position, improves oxygenation and attenuates oxidative damage and histopathological lung injury compared with conventional protective mechanical ventilation.

Inactivity-induced phrenic and hypoglossal motor facilitation are differentially expressed following intermittent vs. sustained neural apnea

Science.gov (United States)

Baertsch, N. A.

2013-01-01

Reduced respiratory neural activity elicits a rebound increase in phrenic and hypoglossal motor output known as inactivity-induced phrenic and hypoglossal motor facilitation (iPMF and iHMF, respectively). We hypothesized that, similar to other forms of respiratory plasticity, iPMF and iHMF are pattern sensitive. Central respiratory neural activity was reversibly reduced in ventilated rats by hyperventilating below the CO2 apneic threshold to create brief intermittent neural apneas (5, ∼1.5 min each, separated by 5 min), a single brief massed neural apnea (7.5 min), or a single prolonged neural apnea (30 min). Upon restoration of respiratory neural activity, long-lasting (>60 min) iPMF was apparent following brief intermittent and prolonged, but not brief massed, neural apnea. Further, brief intermittent and prolonged neural apnea elicited an increase in the maximum phrenic response to high CO2, suggesting that iPMF is associated with an increase in phrenic dynamic range. By contrast, only prolonged neural apnea elicited iHMF, which was transient in duration (<15 min). Intermittent, massed, and prolonged neural apnea all elicited a modest transient facilitation of respiratory frequency. These results indicate that iPMF, but not iHMF, is pattern sensitive, and that the response to respiratory neural inactivity is motor pool specific. PMID:23493368

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.

The time-course of cortico-limbic neural responses to air hunger

OpenAIRE

Binks, Andrew P.; Evans, Karleyton C.; Reed, Jeffrey D.; Moosavi, Shakeeb H.; Banzett, Robert B.

2014-01-01

Several studies have mapped brain regions associated with acute dyspnea perception. However, the time-course of brain activity during sustained dyspnea is unknown. Our objective was to determine the time-course of neural activity when dyspnea is sustained. Eight healthy subjects underwent brain blood oxygen level dependent functional magnetic imaging (BOLD-fMRI) during mechanical ventilation with constant mild hypercapnia (~45 mmHg). Subjects rated dyspnea (air hunger) via visual analog scale...

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.

46 CFR 153.310 - Ventilation system type.

Science.gov (United States)

2010-10-01

... 46 Shipping 5 2010-10-01 2010-10-01 false Ventilation system type. 153.310 Section 153.310... Handling Space Ventilation § 153.310 Ventilation system type. A cargo handling space must have a permanent forced ventilation system of the exhaust type. ...

Neural network modeling of air pollution in tunnels according to indirect measurements

International Nuclear Information System (INIS)

Kaverzneva, T; Lazovskaya, T; Tarkhov, D; Vasilyev, A

2016-01-01

The article deals with the problem of providing the necessary parameters of air of the working area in dead-end tunnels in the case of ventilation systems powered off. An ill-posed initialboundary problem for the diffusion equation is used as a mathematical model for a description and analysis of mass transfer processes in the tunnel. The neural network approach is applied to construct an approximate solution (regularization) of the identification problem in the case of the approximate measurement data and the set of interval parameters of the modeled system. Two types of model measurements included binary data are considered. The direct problem solution and the inverse problem regularization for the offered neural network approach are constructed uniformly. (paper)

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...

Mechanical ventilation during extracorporeal membrane oxygenation.

Science.gov (United States)

Schmidt, Matthieu; Pellegrino, Vincent; Combes, Alain; Scheinkestel, Carlos; Cooper, D Jamie; Hodgson, Carol

2014-01-21

The timing of extracorporeal membrane oxygenation (ECMO) initiation and its outcome in the management of respiratory and cardiac failure have received considerable attention, but very little attention has been given to mechanical ventilation during ECMO. Mechanical ventilation settings in non-ECMO studies have been shown to have an effect on survival and may also have contributed to a treatment effect in ECMO trials. Protective lung ventilation strategies established for non-ECMO-supported respiratory failure patients may not be optimal for more severe forms of respiratory failure requiring ECMO support. The influence of positive end-expiratory pressure on the reduction of the left ventricular compliance may be a matter of concern for patients receiving ECMO support for cardiac failure. The objectives of this review were to describe potential mechanisms for lung injury during ECMO for respiratory or cardiac failure, to assess the possible benefits from the use of ultra-protective lung ventilation strategies and to review published guidelines and expert opinions available on mechanical ventilation-specific management of patients requiring ECMO, including mode and ventilator settings. Articles were identified through a detailed search of PubMed, Ovid, Cochrane databases and Google Scholar. Additional references were retrieved from the selected studies. Growing evidence suggests that mechanical ventilation settings are important in ECMO patients to minimize further lung damage and improve outcomes. An ultra-protective ventilation strategy may be optimal for mechanical ventilation during ECMO for respiratory failure. The effects of airway pressure on right and left ventricular afterload should be considered during venoarterial ECMO support of cardiac failure. Future studies are needed to better understand the potential impact of invasive mechanical ventilation modes and settings on outcomes.

Central chemoreceptors and neural mechanisms of cardiorespiratory control

Directory of Open Access Journals (Sweden)

T.S. Moreira

2011-09-01

Full Text Available The arterial partial pressure (P CO2 of carbon dioxide is virtually constant because of the close match between the metabolic production of this gas and its excretion via breathing. Blood gas homeostasis does not rely solely on changes in lung ventilation, but also to a considerable extent on circulatory adjustments that regulate the transport of CO2 from its sites of production to the lungs. The neural mechanisms that coordinate circulatory and ventilatory changes to achieve blood gas homeostasis are the subject of this review. Emphasis will be placed on the control of sympathetic outflow by central chemoreceptors. High levels of CO2 exert an excitatory effect on sympathetic outflow that is mediated by specialized chemoreceptors such as the neurons located in the retrotrapezoid region. In addition, high CO2 causes an aversive awareness in conscious animals, activating wake-promoting pathways such as the noradrenergic neurons. These neuronal groups, which may also be directly activated by brain acidification, have projections that contribute to the CO2-induced rise in breathing and sympathetic outflow. However, since the level of activity of the retrotrapezoid nucleus is regulated by converging inputs from wake-promoting systems, behavior-specific inputs from higher centers and by chemical drive, the main focus of the present manuscript is to review the contribution of central chemoreceptors to the control of autonomic and respiratory mechanisms.

[Mechanical ventilation in acute asthma crisis].

Science.gov (United States)

Barbas, Carmen Sílvia Valente; Pinheiro, Bruno do Valle; Vianna, Arthur; Magaldi, Ricardo; Casati, Ana; José, Anderson; Okamoto, Valdelis Novis

2007-06-01

The II Brazilian Consensus Conference on Mechanical Ventilation was published in 2000. Knowledge on the field of mechanical ventilation evolved rapidly since then, with the publication of numerous clinical studies with potential impact on the ventilatory management of critically ill patients. Moreover, the evolving concept of evidence - based medicine determined the grading of clinical recommendations according to the methodological value of the studies on which they are based. This explicit approach has broadened the understanding and adoption of clinical recommendations. For these reasons, AMIB - Associação de Medicina Intensiva Brasileira and SBPT - Sociedade Brasileira de Pneumologia e Tisiologia - decided to update the recommendations of the II Brazilian Consensus. Mechanical ventilation in the asthma attack has been one of the updated topics. Describe the most important topics on the mechanical ventilation during the asthma attack and suggest the main therapeutic approaches. Systematic review of the published literature and gradation of the studies in levels of evidence, using the key words "mechanical ventilation" and "asthma". We present recommendations on the ventilatory modes and settings to be adopted when ventilating a patient during an asthma attack, as well as the recommended monitoring. Alternative ventilation techniques are also presented. Protective ventilatory strategies are recommended when ventilating a patient during a severe asthma attack.

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.

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.

Synaptic E-I Balance Underlies Efficient Neural Coding.

Science.gov (United States)

Zhou, Shanglin; Yu, Yuguo

2018-01-01

Both theoretical and experimental evidence indicate that synaptic excitation and inhibition in the cerebral cortex are well-balanced during the resting state and sensory processing. Here, we briefly summarize the evidence for how neural circuits are adjusted to achieve this balance. Then, we discuss how such excitatory and inhibitory balance shapes stimulus representation and information propagation, two basic functions of neural coding. We also point out the benefit of adopting such a balance during neural coding. We conclude that excitatory and inhibitory balance may be a fundamental mechanism underlying efficient coding.

Combining neural networks for protein secondary structure prediction

DEFF Research Database (Denmark)

Riis, Søren Kamaric

1995-01-01

In this paper structured neural networks are applied to the problem of predicting the secondary structure of proteins. A hierarchical approach is used where specialized neural networks are designed for each structural class and then combined using another neural network. The submodels are designed...... by using a priori knowledge of the mapping between protein building blocks and the secondary structure and by using weight sharing. Since none of the individual networks have more than 600 adjustable weights over-fitting is avoided. When ensembles of specialized experts are combined the performance...

The fluid mechanics of natural ventilation

Science.gov (United States)

Linden, Paul

1999-11-01

Natural ventilation of buildings is the flow generated by temperature differences and by the wind. Modern buildings have extreme designs with large, tall open plan spaces and large cooling requirements. Natural ventilation offers a means of cooling these buildings and providing good indoor air quality. The essential feature of ventilation is an exchange between an interior space and the external ambient. Recent work shows that in many circumstances temperature variations play a controlling feature on the ventilation since the directional buoyancy force has a large influence on the flow patterns within the space and on the nature of the exchange with the outside. Two forms of buoyancy-driven ventilation are discussed: mixing ventilation in which the interior is at approximately uniform temperature and displacement ventilation where there is strong internal stratification. The dynamics of these flows are considered and the effects of wind on them are examined both experimentally and theoretically. The aim behind this work is to give designers rules and intuition on how air moves within a building and the research shows a fascinating branch of fluid mechanics.

Ventilation of an hydrofoil wake

Science.gov (United States)

Arndt, Roger; Lee, Seung Jae; Monson, Garrett

2013-11-01

Ventilation physics plays a role in a variety of important engineering applications. For example, hydroturbine ventilation is used for control of vibration and cavitation erosion and more recently for improving the dissolved oxygen content of the flow through the turbine. The latter technology has been the focus of an ongoing study involving the ventilation of an hydrofoil wake to determine the velocity and size distribution of bubbles in a bubbly wake. This was carried out by utilizing particle shadow velocimetry (PSV). This technique is a non-scattering approach that relies on direct in-line volume illumination by a pulsed source such as a light-emitting diode (LED). The data are compared with previous studies of ventilated flow. The theoretical results of Hinze suggest that a scaling relationship is possible that can lead to developing appropriate design parameters for a ventilation system. Sponsored by ONR and DOE.

Mine Ventilation System Variable Resistance Regulate Air Quantity Economy and Its Impacts on Artisanal Mine in Ivory Coast

Directory of Open Access Journals (Sweden)

Kouame Kouame Arthur Joseph

2016-01-01

Full Text Available The artisanal gold mining is one of the major illegal activities in Ivory Coast. Thousands of indigents and foreigners including men, women and children are involved in this dangerous activity. Contracting contagious diseases such as HIV/AIDS and multiple lung diseases are commonplace on the artisanal mining sites due to air pollution. For this reason, the differential analysis, research mine ventilation system by changing the working windage adjustment for air flow of the economy, identifies factors, obtained discriminant variable resistance air volume control economic quantitative criteria for underground actual situation of joint variable resistance method and economic variable resistance than the concept of the development of effective mine ventilation system to improve air quantity adjusting rheostat economical way. The findings of this study can help lead to better safety practices in mining in order to improve the health and safety of the miners who are involved in artisanal mining activities in Ivory Coast and other mining sites over the world.

Low-energy mechanical ventilation

DEFF Research Database (Denmark)

Andersen, Claus Wessel; Hviid, Christian Anker

2014-01-01

and with as little energy consumption as 41.1 kWh/m2/year including heating and all building services with no use of renewable energy such as PVcells or solar heating. One of the key means of reaching the objectives was to implement mechanical ventilation with low pressure loss and therefore low energy consumption....... The project consists of two buildings, building one is 6 stories high, and building two is 4 stories high. The buildings have a gross area of 50,500 m2 including underground parking. The ventilation and indoor climate concept was to use mechanical ventilation together with mechanical cooling and fanassisted......, with an average of 1.1 kJ/m3. The yearly mean SFP based on estimated runtime is approx. 0.8 kJ/m3. The case shows the unlocked potential that lies within mechanical ventilation for nearzero energy consuming buildings....

Intraoperative mechanical ventilation for the pediatric patient.

Science.gov (United States)

Kneyber, Martin C J

2015-09-01

Invasive mechanical ventilation is required when children undergo general anesthesia for any procedure. It is remarkable that one of the most practiced interventions such as pediatric mechanical ventilation is hardly supported by any scientific evidence but rather based on personal experience and data from adults, especially as ventilation itself is increasingly recognized as a harmful intervention that causes ventilator-induced lung injury. The use of low tidal volume and higher levels of positive end-expiratory pressure became an integral part of lung-protective ventilation following the outcomes of clinical trials in critically ill adults. This approach has been readily adopted in pediatric ventilation. However, a clear association between tidal volume and mortality has not been ascertained in pediatrics. In fact, experimental studies have suggested that young children might be less susceptible to ventilator-induced lung injury. As such, no recommendations on optimal lung-protective ventilation strategy in children with or without lung injury can be made. Copyright © 2015 Elsevier Ltd. All rights reserved.

Changes in lung volume and ventilation during surfactant treatment in ventilated preterm infants

NARCIS (Netherlands)

Miedema, Martijn; de Jongh, Frans H.; Frerichs, Inez; van Veenendaal, Mariëtte B.; van Kaam, Anton H.

2011-01-01

The immediate and regional effects of exogenous surfactant in open lung high-frequency oscillatory ventilated (HFOV) preterm infants are unknown. To assess regional changes in lung volume, mechanics, and ventilation during and after surfactant administration in HFOV preterm infants with respiratory

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.

A bench study of intensive-care-unit ventilators: new versus old and turbine-based versus compressed gas-based ventilators

Science.gov (United States)

Thille, Arnaud W.; Lyazidi, Aissam; Richard, Jean-Christophe M.; Galia, Fabrice; Brochard, Laurent

2009-01-01

Objective To compare 13 commercially available, new-generation, intensive-care-unit (ICU) ventilators regarding trigger function, pressurization capacity during pressure-support ventilation (PSV), accuracy of pressure measurements and expiratory resistance. Design and Setting Bench study at a research laboratory in a university hospital. Material Four turbine-based ventilators and nine conventional servo-valve compressed-gas ventilators were tested using a two-compartment lung model. Results Three levels of effort were simulated. Each ventilator was evaluated at four PSV levels (5, 10, 15, and 20 cm H2O), with and without positive end-expiratory pressure (5 cm H2O, Trigger function was assessed as the time from effort onset to detectable pressurization. Pressurization capacity was evaluated using the airway pressure-time product computed as the net area under the pressure-time curve over the first 0.3 s after inspiratory effort onset. Expiratory resistance was evaluated by measuring trapped volume in controlled ventilation. Significant differences were found across the ventilators, with a range of triggering-delay from 42 ms to 88 ms for all conditions averaged (Pventilators at PSV5 and three at PSV10, suggesting an inability to unload patient’s effort. On average, turbine-based ventilators performed better than conventional ventilators, which showed no improvement compared to a 2000 bench comparison. Conclusion Technical performances of trigger function, pressurization capacity and expiratory resistance vary considerably across new-generation ICU ventilators. ICU ventilators seem to have reached a technical ceiling in recent years, and some ventilators still perform inadequately. PMID:19352622

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.

Mechanical ventilation in abdominal surgery.

Science.gov (United States)

Futier, E; Godet, T; Millot, A; Constantin, J-M; Jaber, S

2014-01-01

One of the key challenges in perioperative care is to reduce postoperative morbidity and mortality. Patients who develop postoperative morbidity but survive to leave hospital have often reduced functional independence and long-term survival. Mechanical ventilation provides a specific example that may help us to shift thinking from treatment to prevention of postoperative complications. Mechanical ventilation in patients undergoing surgery has long been considered only as a modality to ensure gas exchange while allowing maintenance of anesthesia with delivery of inhaled anesthetics. Evidence is accumulating, however, suggesting an association between intraoperative mechanical ventilation strategy and postoperative pulmonary function and clinical outcome in patients undergoing abdominal surgery. Non-protective ventilator settings, especially high tidal volume (VT) (>10-12mL/kg) and the use of very low level of positive end-expiratory pressure (PEEP) (PEEPventilator-associated lung injury in patients with healthy lungs. Stimulated by previous findings in patients with acute respiratory distress syndrome, the use of lower tidal volume ventilation is becoming increasingly more common in the operating room. However, lowering tidal volume, though important, is only part of the overall multifaceted approach of lung protective mechanical ventilation. In this review, we aimed at providing the most recent and relevant clinical evidence regarding the use of mechanical ventilation in patients undergoing abdominal surgery. Copyright © 2014 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

Recommendations for mechanical ventilation of critically ill children from the Paediatric Mechanical Ventilation Consensus Conference (PEMVECC).

Science.gov (United States)

Kneyber, Martin C J; de Luca, Daniele; Calderini, Edoardo; Jarreau, Pierre-Henri; Javouhey, Etienne; Lopez-Herce, Jesus; Hammer, Jürg; Macrae, Duncan; Markhorst, Dick G; Medina, Alberto; Pons-Odena, Marti; Racca, Fabrizio; Wolf, Gerhard; Biban, Paolo; Brierley, Joe; Rimensberger, Peter C

2017-12-01

Much of the common practice in paediatric mechanical ventilation is based on personal experiences and what paediatric critical care practitioners have adopted from adult and neonatal experience. This presents a barrier to planning and interpretation of clinical trials on the use of specific and targeted interventions. We aim to establish a European consensus guideline on mechanical ventilation of critically children. The European Society for Paediatric and Neonatal Intensive Care initiated a consensus conference of international European experts in paediatric mechanical ventilation to provide recommendations using the Research and Development/University of California, Los Angeles, appropriateness method. An electronic literature search in PubMed and EMBASE was performed using a combination of medical subject heading terms and text words related to mechanical ventilation and disease-specific terms. The Paediatric Mechanical Ventilation Consensus Conference (PEMVECC) consisted of a panel of 15 experts who developed and voted on 152 recommendations related to the following topics: (1) general recommendations, (2) monitoring, (3) targets of oxygenation and ventilation, (4) supportive measures, (5) weaning and extubation readiness, (6) normal lungs, (7) obstructive diseases, (8) restrictive diseases, (9) mixed diseases, (10) chronically ventilated patients, (11) cardiac patients and (12) lung hypoplasia syndromes. There were 142 (93.4%) recommendations with "strong agreement". The final iteration of the recommendations had none with equipoise or disagreement. These recommendations should help to harmonise the approach to paediatric mechanical ventilation and can be proposed as a standard-of-care applicable in daily clinical practice and clinical research.

ARTIFICIAL NEURAL NETWORK AND FUZZY LOGIC CONTROLLER FOR GTAW MODELING AND CONTROL

Institute of Scientific and Technical Information of China (English)

无

2002-01-01

An artificial neural network(ANN) and a self-adjusting fuzzy logic controller(FLC) for modeling and control of gas tungsten arc welding(GTAW) process are presented. The discussion is mainly focused on the modeling and control of the weld pool depth with ANN and the intelligent control for weld seam tracking with FLC. The proposed neural network can produce highly complex nonlinear multi-variable model of the GTAW process that offers the accurate prediction of welding penetration depth. A self-adjusting fuzzy controller used for seam tracking adjusts the control parameters on-line automatically according to the tracking errors so that the torch position can be controlled accurately.

Ventilation of carbon monoxide from a biomass pellet storage tank--a study of the effects of variation of temperature and cross-ventilation on the efficiency of natural ventilation.

Science.gov (United States)

Emhofer, Waltraud; Lichtenegger, Klaus; Haslinger, Walter; Hofbauer, Hermann; Schmutzer-Roseneder, Irene; Aigenbauer, Stefan; Lienhard, Martin

2015-01-01

Wood pellets have been reported to emit toxic gaseous emissions during transport and storage. Carbon monoxide (CO) emission, due to the high toxicity of the gas and the possibility of it being present at high levels, is the most imminent threat to be considered before entering a pellet storage facility. For small-scale (ventilation, preferably natural ventilation utilizing already existing openings, has become the most favored solution to overcome the problem of high CO concentrations. However, there is little knowledge on the ventilation rates that can be reached and thus on the effectiveness of such measures. The aim of the study was to investigate ventilation rates for a specific small-scale pellet storage system depending on characteristic temperature differences. Furthermore, the influence of the implementation of a chimney and the influence of cross-ventilation on the ventilation rates were investigated. The air exchange rates observed in the experiments ranged between close to zero and up to 8 m(3) h(-1), depending largely on the existing temperature differences and the existence of cross-ventilation. The results demonstrate that implementing natural ventilation is a possible measure to enhance safety from CO emissions, but not one without limitations. © The Author 2014. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

Why this crisis in residential ventilation

NARCIS (Netherlands)

Hasselaar, E.

2008-01-01

Ventilation is the cornerstone of good indoor air quality. Ventilation requirements have major attention in building regulations, but ventilation in practice is often poor, resulting in increased concentration of pollutants and hence exposure to health risk. Inspection of 500 houses with interviews

[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.

Neural markers of errors as endophenotypes in neuropsychiatric disorders

Directory of Open Access Journals (Sweden)

Dara S Manoach

2013-07-01

Full Text Available Learning from errors is fundamental to adaptive human behavior. It requires detecting errors, evaluating what went wrong, and adjusting behavior accordingly. These dynamic adjustments are at the heart of behavioral flexibility and accumulating evidence suggests that deficient error processing contributes to maladaptively rigid and repetitive behavior in a range of neuropsychiatric disorders. Neuroimaging and electrophysiological studies reveal highly reliable neural markers of error processing. In this review, we evaluate the evidence that abnormalities in these neural markers can serve as sensitive endophenotypes of neuropsychiatric disorders. We describe the behavioral and neural hallmarks of error processing, their mediation by common genetic polymorphisms, and impairments in schizophrenia, obsessive-compulsive disorder, and autism spectrum disorders. We conclude that neural markers of errors meet several important criteria as endophenotypes including heritability, established neuroanatomical and neurochemical substrates, association with neuropsychiatric disorders, presence in syndromally-unaffected family members, and evidence of genetic mediation. Understanding the mechanisms of error processing deficits in neuropsychiatric disorders may provide novel neural and behavioral targets for treatment and sensitive surrogate markers of treatment response. Treating error processing deficits may improve functional outcome since error signals provide crucial information for flexible adaptation to changing environments. Given the dearth of effective interventions for cognitive deficits in neuropsychiatric disorders, this represents a promising approach.

Neural markers of errors as endophenotypes in neuropsychiatric disorders.

Science.gov (United States)

Manoach, Dara S; Agam, Yigal

2013-01-01

Learning from errors is fundamental to adaptive human behavior. It requires detecting errors, evaluating what went wrong, and adjusting behavior accordingly. These dynamic adjustments are at the heart of behavioral flexibility and accumulating evidence suggests that deficient error processing contributes to maladaptively rigid and repetitive behavior in a range of neuropsychiatric disorders. Neuroimaging and electrophysiological studies reveal highly reliable neural markers of error processing. In this review, we evaluate the evidence that abnormalities in these neural markers can serve as sensitive endophenotypes of neuropsychiatric disorders. We describe the behavioral and neural hallmarks of error processing, their mediation by common genetic polymorphisms, and impairments in schizophrenia, obsessive-compulsive disorder, and autism spectrum disorders. We conclude that neural markers of errors meet several important criteria as endophenotypes including heritability, established neuroanatomical and neurochemical substrates, association with neuropsychiatric disorders, presence in syndromally-unaffected family members, and evidence of genetic mediation. Understanding the mechanisms of error processing deficits in neuropsychiatric disorders may provide novel neural and behavioral targets for treatment and sensitive surrogate markers of treatment response. Treating error processing deficits may improve functional outcome since error signals provide crucial information for flexible adaptation to changing environments. Given the dearth of effective interventions for cognitive deficits in neuropsychiatric disorders, this represents a potentially promising approach.

Ventilation-perfused studies using SPECT

International Nuclear Information System (INIS)

Zwijnenburg, A.

1989-01-01

A method for the quantitative analysis of ventilation-perfusion SPECT studies is decribed and an effort is made to evaluate its usefullness. The technical details of the emthod are described. In the the transaxial reconstructions of the tomographic studies the contour of the lungs is detected and regional values of lung volume, ventilation, perfusion and ventilation-perfusion ratios are calculated. The method is operator independent. The lung volume calculations from the SPECT studies are validated by comparing them with lung volume measurements using the helium dilution technique. A good correlation (r=0.91) was found between the two volumes. SPECT volume was greater than the volume measured with helium dilution, which was attributed to non-gas-containing structures in the. lungs. The use of ventilation-perfusion ratio SPECT is described to evaluate the effect of ionizing radiation on the lungs in patients treated with mantle field irradiation for Hodgkin's disease. Perfusion changes appear as early as 2 months after the start of irradiation. Ventilation changes appear later and relatively minor. No changes are seen outside the radiation portals. The ventilation-perfusion inequality in pulmonary sarcoidosis is treated. It is suggested that the decrease D LCO in these patients may be partly due to an even distribution of ventilation perfusion ratios. An effort is made to establish the properties of a new tracer used for the assessment of the metabolic function of the pulmonary endothelium. The lung uptake of I-123 IMP mimics the distribution of a perfusion tracer and it is suggested that this tracer may be useful for the early detection of pulmonary vascular damage, even when blood flow is still intact. Some aspects of the use of Kr-81m as a ventilation tracer are discussed as well as the effect of noise on Kr-81m SPECT reconstructions. (author). 146 refs.; 39 figs.; 8 tabs

Can mechanical ventilation strategies reduce chronic lung disease?

Science.gov (United States)

Donn, Steven M; Sinha, Sunil K

2003-12-01

Chronic lung disease (CLD) continues to be a significant complication in newborn infants undergoing mechanical ventilation for respiratory failure. Although the aetiology of CLD is multifactorial, specific factors related to mechanical ventilation, including barotrauma, volutrauma and atelectrauma, have been implicated as important aetiologic mechanisms. This article discusses the ways in which these factors might be manipulated by various mechanical ventilatory strategies to reduce ventilator-induced lung injury. These include continuous positive airway pressure, permissive hypercapnia, patient-triggered ventilation, volume-targeted ventilation, proportional assist ventilation, high-frequency ventilation and real-time monitoring.

33 CFR 183.610 - Powered ventilation system.

Science.gov (United States)

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Powered ventilation system. 183... (CONTINUED) BOATING SAFETY BOATS AND ASSOCIATED EQUIPMENT Ventilation § 183.610 Powered ventilation system... must: (1) Be open to the atmosphere, or (2) Be ventilated by an exhaust blower system. (b) Each exhaust...

21 CFR 868.5895 - Continuous ventilator.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Continuous ventilator. 868.5895 Section 868.5895...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5895 Continuous ventilator. (a) Identification. A continuous ventilator (respirator) is a device intended to mechanically control or assist...

Experimental study of airflow characteristics of stratum ventilation in a multi-occupant room with comparison to mixing ventilation and displacement ventilation.

Science.gov (United States)

Cheng, Y; Lin, Z

2015-12-01

The motivation of this study is stimulated by a lack of knowledge about the difference of airflow characteristics between a novel air distribution method [i.e., stratum ventilation (SV)] and conventional air distribution methods [i.e., mixing ventilation (MV) and displacement ventilation (DV)]. Detailed air velocity and temperature measurements were conducted in the occupied zone of a classroom with dimensions of 8.8 m (L) × 6.1 m (W) × 2.4 m (H). Turbulence intensity and power spectrum of velocity fluctuation were calculated using the measured data. Thermal comfort and cooling efficiency were also compared. The results show that in the occupied zone, the airflow characteristics among MV, DV, and SV are different. The turbulent airflow fluctuation is enhanced in this classroom with multiple thermal manikins due to thermal buoyancy and airflow mixing effect. Thermal comfort evaluations indicate that in comparison with MV and DV, a higher supply air temperature should be adopted for SV to achieve general thermal comfort with low draft risk. Comparison of the mean air temperatures in the occupied zone reveals that SV is of highest cooling efficiency, followed by DV and then MV. This study reports the unique profiles of flow, temperature, turbulence intensity, and power spectrum of stratum ventilation, which can have a number of implications for both knowledge and understanding of the flow characteristics in a stratum-ventilated room. With respect to the former, it expounds the fundamental characteristics of this air distribution method; and with respect to the latter, it reveals the mechanism of thermal comfort and energy saving under stratum ventilation. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

An experimental study on effects of increased ventilation flow on students' perception of indoor environment in computer classrooms.

Science.gov (United States)

Norbäck, D; Nordström, K

2008-08-01

The effects of ventilation in computer classrooms were studied with university students (n = 355) in a blinded study, 31% were women and 3.8% had asthma. Two classrooms had a higher air exchange (4.1-5.2 ac/h); two others had a lower air exchange (2.3-2.6 ac/h). After 1 week, ventilation conditions were shifted. The students reported environmental perceptions during the last hour. Room temperature, RH, CO2, PM10 and ultra-fine particles were measured simultaneously. Mean CO2 was 1185 ppm at lower and 922 ppm at higher air exchange. Mean temperature was 23.2 degrees C at lower and 22.1 degrees C at higher air exchange. After mutual adjustment (temperature, RH, CO2, air exchange), measured temperature was associated with a perception of higher temperature (P thermal comfort and air quality. Computer classrooms are crowded indoor environments with a high thermal load from both students and computer equipment. It is important to control room temperature either by air conditioning, sun shields, or sufficiently high ventilation flow. A high ventilation flow is also crucial to achieving good perceived air quality. Personal ventilation flow should be at least 10 l/s. Possible loss of learning ability due to poor indoor air quality in university buildings deserves more attention.

Performance of ICU ventilators during noninvasive ventilation with large leaks in a total face mask: a bench study.

Science.gov (United States)

Nakamura, Maria Aparecida Miyuki; Costa, Eduardo Leite Vieira; Carvalho, Carlos Roberto Ribeiro; Tucci, Mauro Roberto

2014-01-01

Discomfort and noncompliance with noninvasive ventilation (NIV) interfaces are obstacles to NIV success. Total face masks (TFMs) are considered to be a very comfortable NIV interface. However, due to their large internal volume and consequent increased CO2 rebreathing, their orifices allow proximal leaks to enhance CO2 elimination. The ventilators used in the ICU might not adequately compensate for such leakage. In this study, we attempted to determine whether ICU ventilators in NIV mode are suitable for use with a leaky TFM. This was a bench study carried out in a university research laboratory. Eight ICU ventilators equipped with NIV mode and one NIV ventilator were connected to a TFM with major leaks. All were tested at two positive end-expiratory pressure (PEEP) levels and three pressure support levels. The variables analyzed were ventilation trigger, cycling off, total leak, and pressurization. Of the eight ICU ventilators tested, four did not work (autotriggering or inappropriate turning off due to misdetection of disconnection); three worked with some problems (low PEEP or high cycling delay); and one worked properly. The majority of the ICU ventilators tested were not suitable for NIV with a leaky TFM.

Performance of ICU ventilators during noninvasive ventilation with large leaks in a total face mask: a bench study* **

Science.gov (United States)

Nakamura, Maria Aparecida Miyuki; Costa, Eduardo Leite Vieira; Carvalho, Carlos Roberto Ribeiro; Tucci, Mauro Roberto

2014-01-01

Objective: Discomfort and noncompliance with noninvasive ventilation (NIV) interfaces are obstacles to NIV success. Total face masks (TFMs) are considered to be a very comfortable NIV interface. However, due to their large internal volume and consequent increased CO2 rebreathing, their orifices allow proximal leaks to enhance CO2 elimination. The ventilators used in the ICU might not adequately compensate for such leakage. In this study, we attempted to determine whether ICU ventilators in NIV mode are suitable for use with a leaky TFM. Methods: This was a bench study carried out in a university research laboratory. Eight ICU ventilators equipped with NIV mode and one NIV ventilator were connected to a TFM with major leaks. All were tested at two positive end-expiratory pressure (PEEP) levels and three pressure support levels. The variables analyzed were ventilation trigger, cycling off, total leak, and pressurization. Results: Of the eight ICU ventilators tested, four did not work (autotriggering or inappropriate turning off due to misdetection of disconnection); three worked with some problems (low PEEP or high cycling delay); and one worked properly. Conclusions: The majority of the ICU ventilators tested were not suitable for NIV with a leaky TFM. PMID:25029653

Ventilation Model and Analysis Report

International Nuclear Information System (INIS)

Chipman, V.

2003-01-01

This model and analysis report develops, validates, and implements a conceptual model for heat transfer in and around a ventilated emplacement drift. This conceptual model includes thermal radiation between the waste package and the drift wall, convection from the waste package and drift wall surfaces into the flowing air, and conduction in the surrounding host rock. These heat transfer processes are coupled and vary both temporally and spatially, so numerical and analytical methods are used to implement the mathematical equations which describe the conceptual model. These numerical and analytical methods predict the transient response of the system, at the drift scale, in terms of spatially varying temperatures and ventilation efficiencies. The ventilation efficiency describes the effectiveness of the ventilation process in removing radionuclide decay heat from the drift environment. An alternative conceptual model is also developed which evaluates the influence of water and water vapor mass transport on the ventilation efficiency. These effects are described using analytical methods which bound the contribution of latent heat to the system, quantify the effects of varying degrees of host rock saturation (and hence host rock thermal conductivity) on the ventilation efficiency, and evaluate the effects of vapor and enhanced vapor diffusion on the host rock thermal conductivity

Design ventilátoru

OpenAIRE

Macháčková, Petra

2013-01-01

Předmětem této bakalářské práce je návrh designu stolního ventilátoru. Hlavní myšlenkou je inovativní přístup a dodržení technických, estetických a ergonomických požadavků a současně splnění psychologických a ekonomických funkcí. Navržený ventilátor by měl využívat inovativní technologie bezlopatkových ventilátorů. Ventilátor by měl působit jako vhodný doplněk do moderního interiéru. Cílem je propojit originální design s modernizací přístroje při splnění obecných předpokladů průmyslového desi...

Control of beam halo-chaos using neural network self-adaptation method

International Nuclear Information System (INIS)

Fang Jinqing; Huang Guoxian; Luo Xiaoshu

2004-11-01

Taking the advantages of neural network control method for nonlinear complex systems, control of beam halo-chaos in the periodic focusing channels (network) of high intensity accelerators is studied by feed-forward back-propagating neural network self-adaptation method. The envelope radius of high-intensity proton beam is reached to the matching beam radius by suitably selecting the control structure of neural network and the linear feedback coefficient, adjusted the right-coefficient of neural network. The beam halo-chaos is obviously suppressed and shaking size is much largely reduced after the neural network self-adaptation control is applied. (authors)

Effect of acute kidney injury on weaning from mechanical ventilation in critically ill patients.

Science.gov (United States)

Vieira, José M; Castro, Isac; Curvello-Neto, Américo; Demarzo, Sérgio; Caruso, Pedro; Pastore, Laerte; Imanishe, Marina H; Abdulkader, Regina C R M; Deheinzelin, Daniel

2007-01-01

Acute kidney injury (AKI) worsens outcome in various scenarios. We sought to investigate whether the occurrence of AKI has any effect on weaning from mechanical ventilation. Observational, retrospective study in a 23-bed medical/surgical intensive care unit (ICU) in a cancer hospital from January to December 2003. The inclusion criterion was invasive mechanical ventilation for > or =48 hrs. AKI was defined as at least one measurement of serum creatinine of > or =1.5 mg/dL during the ICU stay. Patients were then separated into AKI and non-AKI patients (control group). The criterion for weaning was the combination of positive end-expiratory pressure of or =85% increase in baseline serum creatinine (hazard rate, 2.30; 95% confidence interval, 1.30-4.08), oliguria (hazard rate, 2.51; 95% confidence interval, 1.24-5.08), and the number of antibiotics (hazard rate, 2.64; 95% confidence interval, 1.51-4.63) predicted longer duration of weaning. The length of ICU stay and ICU mortality rate were significantly greater in the AKI patients. After adjusting for Simplified Acute Physiology Score II, oliguria (odds ratio, 30.8; 95% confidence interval, 7.7-123.0) remained as a strong risk factor for mortality. This study shows that renal dysfunction has serious consequences in the duration of mechanical ventilation, weaning from mechanical ventilation, and mortality in critically ill cancer patients.

Comparative performances analysis of neonatal ventilators.

Science.gov (United States)

Baldoli, Ilaria; Tognarelli, Selene; Scaramuzzo, Rosa T; Ciantelli, Massimiliano; Cecchi, Francesca; Gentile, Marzia; Sigali, Emilio; Ghirri, Paolo; Boldrini, Antonio; Menciassi, Arianna; Laschi, Cecilia; Cuttano, Armando

2015-02-08

Mechanical ventilation is a therapeutic action for newborns with respiratory diseases but may have side effects. Correct equipment knowledge and training may limit human errors. We aimed to test different neonatal mechanical ventilators' performances by an acquisition module (a commercial pressure sensor plus an isolated chamber and a dedicated software). The differences (ΔP) between peak pressure values and end-expiration pressure were investigated for each ventilator. We focused on discrepancies among measured and imposed pressure data. A statistical analysis was performed. We investigated the measured/imposed ΔP relation. The ΔP do not reveal univocal trends related to ventilation setting parameters and the data distributions were non-Gaussian. Measured ΔP represent a significant parameter in newborns' ventilation, due to the typical small volumes. The investigated ventilators showed different tendencies. Therefore, a deep specific knowledge of the intensive care devices is mandatory for caregivers to correctly exploit their operating principles.

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.

Prevention of ventilator-associated pneumonia

OpenAIRE

J. Oliveira; C. Zagalo; P. Cavaco-Silva

2014-01-01

Invasive mechanical ventilation (IMV) represents a risk factor for the development of ventilator-associated pneumonia (VAP), which develops at least 48 h after admission in patients ventilated through tracheostomy or endotracheal intubation. VAP is the most frequent intensive-care-unit (ICU)-acquired infection among patients receiving IMV. It contributes to an increase in hospital mortality, duration of MV and ICU and length of hospital stay. Therefore, it worsens the condition of the critica...

Contaminants in ventilated filling boxes

Science.gov (United States)

Bolster, D. T.; Linden, P. F.

While energy efficiency is important, the adoption of energy-efficient ventilation systems still requires the provision of acceptable indoor air quality. Many low-energy systems, such as displacement or natural ventilation, rely on temperature stratification within the interior environment, always extracting the warmest air from the top of the room. Understanding buoyancy-driven convection in a confined ventilated space is key to understanding the flow that develops with many of these modern low-energy ventilation schemes. In this work we study the transport of an initially uniformly distributed passive contaminant in a displacement-ventilated space. Representing a heat source as an ideal sourced of buoyancy, analytical and numerical models are developed that allow us to compare the average efficiency of contaminant removal between traditional mixing and modern low-energy systems. A set of small-scale analogue laboratory experiments was also conducted to further validate our analytical and numerical solutions.We find that on average traditional and low-energy ventilation methods are similar with regard to pollutant flushing efficiency. This is because the concentration being extracted from the system at any given time is approximately the same for both systems. However, very different vertical concentration gradients exist. For the low-energy system, a peak in contaminant concentration occurs at the temperature interface that is established within the space. This interface is typically designed to sit at some intermediate height in the space. Since this peak does not coincide with the extraction point, displacement ventilation does not offer the same benefits for pollutant flushing as it does for buoyancy removal.

14 CFR 252.9 - Ventilation systems.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Ventilation systems. 252.9 Section 252.9... REGULATIONS SMOKING ABOARD AIRCRAFT § 252.9 Ventilation systems. Air carriers shall prohibit smoking whenever the ventilation system is not fully functioning. Fully functioning for this purpose means operating so...

Ventilation in Commercial and Residential Buildings

DEFF Research Database (Denmark)

Nielsen, Peter V.

A number of areas have to be considered in connection with indoor air quality and ventilation. The selection of ventilation principle and components in the ventilation system will have influence on the indoor air quality and this subject will be discussed on the following pages. The main object o...

46 CFR 98.25-75 - Ventilation.

Science.gov (United States)

2010-10-01

... shall be fitted with efficient natural or mechanical ventilation. (b) Enclosed compartments in which... 46 Shipping 4 2010-10-01 2010-10-01 false Ventilation. 98.25-75 Section 98.25-75 Shipping COAST... Ventilation. (a) All enclosed spaces containing cargo tanks fitted with bottom outlet connections shall be...

46 CFR 194.10-25 - Ventilation.

Science.gov (United States)

2010-10-01

... magazines. (1) All integral magazines shall be provided with natural or mechanical ventilation. Design... vans shall be provided with natural ventilation sufficient to maintain the inside air temperature below... 46 Shipping 7 2010-10-01 2010-10-01 false Ventilation. 194.10-25 Section 194.10-25 Shipping COAST...

Contaminant Distribution Around Persons in Rooms Ventilated by Displacement Ventilation

DEFF Research Database (Denmark)

Brohus, Henrik; Nielsen, Peter V.

An optimal design of the ventilation system needs a proper prediction of the velocity, temperature and contaminant distribution in the room. Traditionally this is done either by the use of simplified models or by a somewhat more comprehensive CFD-simulation. Common to both methods is usually...... the lack of consideration for the persons present in the room. This paper deals with some of the effects of persons present in a displacement ventilated room, especially the effect on the contaminant distribution....

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.

Early application of airway pressure release ventilation may reduce the duration of mechanical ventilation in acute respiratory distress syndrome.

Science.gov (United States)

Zhou, Yongfang; Jin, Xiaodong; Lv, Yinxia; Wang, Peng; Yang, Yunqing; Liang, Guopeng; Wang, Bo; Kang, Yan

2017-11-01

Experimental animal models of acute respiratory distress syndrome (ARDS) have shown that the updated airway pressure release ventilation (APRV) methodologies may significantly improve oxygenation, maximize lung recruitment, and attenuate lung injury, without circulatory depression. This led us to hypothesize that early application of APRV in patients with ARDS would allow pulmonary function to recover faster and would reduce the duration of mechanical ventilation as compared with low tidal volume lung protective ventilation (LTV). A total of 138 patients with ARDS who received mechanical ventilation for mechanical ventilation from enrollment to day 28. The secondary endpoints included oxygenation, P plat , respiratory system compliance, and patient outcomes. Compared with the LTV group, patients in the APRV group had a higher median number of ventilator-free days {19 [interquartile range (IQR) 8-22] vs. 2 (IQR 0-15); P mechanical ventilation and ICU stay.

Control of autonomous robot using neural networks

Science.gov (United States)

Barton, Adam; Volna, Eva

2017-07-01

The aim of the article is to design a method of control of an autonomous robot using artificial neural networks. The introductory part describes control issues from the perspective of autonomous robot navigation and the current mobile robots controlled by neural networks. The core of the article is the design of the controlling neural network, and generation and filtration of the training set using ART1 (Adaptive Resonance Theory). The outcome of the practical part is an assembled Lego Mindstorms EV3 robot solving the problem of avoiding obstacles in space. To verify models of an autonomous robot behavior, a set of experiments was created as well as evaluation criteria. The speed of each motor was adjusted by the controlling neural network with respect to the situation in which the robot was found.

Why we ventilate our houses - An historical look

Energy Technology Data Exchange (ETDEWEB)

Matson, Nance E.; Sherman, Max H.

2004-05-14

The knowledge of how to ventilate buildings, and how much ventilation is necessary for human health and comfort, has evolved over centuries of trial and error. Humans and animals have developed successful solutions to the problems of regulating temperature and removing air pollutants through the use of ventilation. These solutions include ingenious construction methods, such as engineered passive ventilation (termite mounds and passive stacks), mechanical means (wing-powered, fans), and an evolving effort to identify problems and develop solutions. Ventilation can do more than help prevent building occupants from getting sick; it can provide an improved indoor environment. Codes and standards provide minimum legal requirements for ventilation, but the need for ventilation goes beyond code minima. In this paper we will look at indoor air pollutant sources over time, the evolution of ventilation strategies, current residential ventilation codes and standards (e.g., recently approved ASHRAE Standard 62.2), and briefly discuss ways in which we can go beyond the standards to optimize residential ventilation, reduce indoor air quality problems, and provide corresponding social and economic benefit.

Development of a Residential Integrated Ventilation Controller

Energy Technology Data Exchange (ETDEWEB)

Staff Scientist; Walker, Iain; Sherman, Max; Dickerhoff, Darryl

2011-12-01

The goal of this study was to develop a Residential Integrated Ventilation Controller (RIVEC) to reduce the energy impact of required mechanical ventilation by 20percent, maintain or improve indoor air quality and provide demand response benefits. This represents potential energy savings of about 140 GWh of electricity and 83 million therms of natural gas as well as proportional peak savings in California. The RIVEC controller is intended to meet the 2008 Title 24 requirements for residential ventilation as well as taking into account the issues of outdoor conditions, other ventilation devices (including economizers), peak demand concerns and occupant preferences. The controller is designed to manage all the residential ventilation systems that are currently available. A key innovation in this controller is the ability to implement the concept of efficacy and intermittent ventilation which allows time shifting of ventilation. Using this approach ventilation can be shifted away from times of high cost or high outdoor pollution towards times when it is cheaper and more effective. Simulations, based on the ones used to develop the new residential ventilation requirements for the California Buildings Energy code, were used to further define the specific criteria and strategies needed for the controller. These simulations provide estimates of the energy, peak power and contaminant improvement possible for different California climates for the various ventilation systems. Results from a field test of the prototype controller corroborate the predicted performance.

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.

Low Tidal Volume Ventilation in Patients without Acute Respiratory Distress Syndrome: A Paradigm Shift in Mechanical Ventilation

Directory of Open Access Journals (Sweden)

Jed Lipes

2012-01-01

Full Text Available Protective ventilation with low tidal volume has been shown to reduce morbidity and mortality in patients suffering from acute lung injury (ALI and acute respiratory distress syndrome (ARDS. Low tidal volume ventilation is associated with particular clinical challenges and is therefore often underutilized as a therapeutic option in clinical practice. Despite some potential difficulties, data have been published examining the application of protective ventilation in patients without lung injury. We will briefly review the physiologic rationale for low tidal volume ventilation and explore the current evidence for protective ventilation in patients without lung injury. In addition, we will explore some of the potential reasons for its underuse and provide strategies to overcome some of the associated clinical challenges.

Low Tidal Volume Ventilation in Patients without Acute Respiratory Distress Syndrome: A Paradigm Shift in Mechanical Ventilation

Science.gov (United States)

Lipes, Jed; Bojmehrani, Azadeh; Lellouche, Francois

2012-01-01

Protective ventilation with low tidal volume has been shown to reduce morbidity and mortality in patients suffering from acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Low tidal volume ventilation is associated with particular clinical challenges and is therefore often underutilized as a therapeutic option in clinical practice. Despite some potential difficulties, data have been published examining the application of protective ventilation in patients without lung injury. We will briefly review the physiologic rationale for low tidal volume ventilation and explore the current evidence for protective ventilation in patients without lung injury. In addition, we will explore some of the potential reasons for its underuse and provide strategies to overcome some of the associated clinical challenges. PMID:22536499

Bench test evaluation of volume delivered by modern ICU ventilators during volume-controlled ventilation.

Science.gov (United States)

Lyazidi, Aissam; Thille, Arnaud W; Carteaux, Guillaume; Galia, Fabrice; Brochard, Laurent; Richard, Jean-Christophe M

2010-12-01

During volume-controlled ventilation, part of the volume delivered is compressed into the circuit. To correct for this phenomenon, modern ventilators use compensation algorithms. Humidity and temperature also influence the delivered volume. In a bench study at a research laboratory in a university hospital, we compared nine ICU ventilators equipped with compensation algorithms, one with a proximal pneumotachograph and one without compensation. Each ventilator was evaluated under normal, obstructive, and restrictive conditions of respiratory mechanics. For each condition, three tidal volumes (V (T)) were set (300, 500, and 800 ml), with and without an inspiratory pause. The insufflated volume and the volume delivered at the Y-piece were measured independently, without a humidification device, under ambient temperature and pressure and dry gas conditions. We computed the actually delivered V (T) to the lung under body temperature and pressure and saturated water vapour conditions (BTPS). For target V (T) values of 300, 500, and 800 ml, actually delivered V (T) under BTPS conditions ranged from 261 to 396 ml (-13 to +32%), from 437 to 622 ml (-13 to +24%), and from 681 to 953 ml (-15 to +19%), respectively (p ventilators.

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

Preoperational test report, vent building ventilation system

International Nuclear Information System (INIS)

Clifton, F.T.

1997-01-01

This represents a preoperational test report for Vent Building Ventilation Systems, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system provides Heating, Ventilation, and Air Conditioning (HVAC) for the W-030 Ventilation Building. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System

Air Distribution in a Furnished Room Ventilated by Mixing Ventilation

DEFF Research Database (Denmark)

Nielsen, June Richter; Nielsen, Peter V.; Svidt, Kjeld

Using isothermal full-scale experiments and two-dimensional isothermal CFD simulations it is investigated how normal office furniture influences the air movements in a room with mixing ventilation. Three different set-ups are made in the experiments and different sizes and locations of the furnit......Using isothermal full-scale experiments and two-dimensional isothermal CFD simulations it is investigated how normal office furniture influences the air movements in a room with mixing ventilation. Three different set-ups are made in the experiments and different sizes and locations...

DCS-Neural-Network Program for Aircraft Control and Testing

Science.gov (United States)

Jorgensen, Charles C.

2006-01-01

A computer program implements a dynamic-cell-structure (DCS) artificial neural network that can perform such tasks as learning selected aerodynamic characteristics of an airplane from wind-tunnel test data and computing real-time stability and control derivatives of the airplane for use in feedback linearized control. A DCS neural network is one of several types of neural networks that can incorporate additional nodes in order to rapidly learn increasingly complex relationships between inputs and outputs. In the DCS neural network implemented by the present program, the insertion of nodes is based on accumulated error. A competitive Hebbian learning rule (a supervised-learning rule in which connection weights are adjusted to minimize differences between actual and desired outputs for training examples) is used. A Kohonen-style learning rule (derived from a relatively simple training algorithm, implements a Delaunay triangulation layout of neurons) is used to adjust node positions during training. Neighborhood topology determines which nodes are used to estimate new values. The network learns, starting with two nodes, and adds new nodes sequentially in locations chosen to maximize reductions in global error. At any given time during learning, the error becomes homogeneously distributed over all nodes.

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...

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

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)

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)

Lecture Notes on Mixing Ventilation

DEFF Research Database (Denmark)

Nielsen, Peter Vilhelm

The main task of the ventilation system or the air-conditioning system is to supply· and remove air and airborne materials and to supply or remove heat from a room. The necessary level of fresh air will be supplied to· a room by a ventilation system, and heat from equipment or solar radiation can...... be removed by an air-conditioning system. An industrial ventilation system may both take care of the occupants' comfort and the industrial processes in the area....

Effect of mechanical ventilation on systemic oxygen extraction and lactic acidosis during early septic shock in rats.

Science.gov (United States)

Griffel, M I; Astiz, M E; Rackow, E C; Weil, M H

1990-01-01

We studied the effect of mechanical ventilation on systemic oxygen extraction and lactic acidosis in peritonitis and shock in rats. Sepsis was induced by cecal ligation and perforation. After tracheostomy, rats were randomized to spontaneous breathing (S) or mechanical ventilation with paralysis (V). Five animals were studied in each group. The V animals were paralyzed with pancuronium bromide to eliminate respiratory effort. Mechanical ventilation consisted of controlled ventilation using a rodent respirator with periodic adjustment of minute ventilation to maintain PaCO2 and pH within normal range. Arterial and central venous blood gases and thermodilution cardiac output were measured at baseline before abdominal surgery, and sequentially at 0.5, 3.5, and 6 h after surgery. At 6 h, cardiac output was 193 +/- 30 ml/kg.min in S animals and 199 +/- 32 ml/kg.min in V animals (NS). The central venous oxygen saturation was 27.4 +/- 4.7% in S animals and 30.0 +/- 6.4% in V animals (NS). Systemic oxygen extraction was 70 +/- 5% in S animals and 67 +/- 6% in V animals (NS). Arterial lactate was 2.4 +/- 0.4 mmol/L in S animals and 2.2 +/- 0.5 mmol/L in V animals (NS). The S animals developed lethal hypotension at 6.6 +/- 0.4 h compared to 6.8 +/- 0.4 h in V animals (NS). These data suggest that mechanical ventilation does not decrease systemic oxygen extraction or ameliorate the development of lactic acidosis during septic shock.

Neural network-based model reference adaptive control system.

Science.gov (United States)

Patino, H D; Liu, D

2000-01-01

In this paper, an approach to model reference adaptive control based on neural networks is proposed and analyzed for a class of first-order continuous-time nonlinear dynamical systems. The controller structure can employ either a radial basis function network or a feedforward neural network to compensate adaptively the nonlinearities in the plant. A stable controller-parameter adjustment mechanism, which is determined using the Lyapunov theory, is constructed using a sigma-modification-type updating law. The evaluation of control error in terms of the neural network learning error is performed. That is, the control error converges asymptotically to a neighborhood of zero, whose size is evaluated and depends on the approximation error of the neural network. In the design and analysis of neural network-based control systems, it is important to take into account the neural network learning error and its influence on the control error of the plant. Simulation results showing the feasibility and performance of the proposed approach are given.

Control of Airborne Infectious Diseases in Ventilated Spaces

DEFF Research Database (Denmark)

Nielsen, Peter V.

2009-01-01

We protect ourselves from airborne cross-infection in the indoor environment by supplying fresh air to a room by natural or mechanical ventilation. The air is distributed in the room according to different principles: mixing ventilation, displacement ventilation, etc. A large amount of air...... to have high ventilation effectiveness. Furthermore, personalized ventilation may reduce the risk of cross-infection, and in some cases, it can also reduce the source of infection. Personalized ventilation can especially be used in hospital wards, aircraft cabins and, in general, where people are in fixed...

Iatrogenic pneumothorax related to mechanical ventilation

Science.gov (United States)

Hsu, Chien-Wei; Sun, Shu-Fen

2014-01-01

Pneumothorax is a potentially lethal complication associated with mechanical ventilation. Most of the patients with pneumothorax from mechanical ventilation have underlying lung diseases; pneumothorax is rare in intubated patients with normal lungs. Tension pneumothorax is more common in ventilated patients with prompt recognition and treatment of pneumothorax being important to minimize morbidity and mortality. Underlying lung diseases are associated with ventilator-related pneumothorax with pneumothoraces occurring most commonly during the early phase of mechanical ventilation. The diagnosis of pneumothorax in critical illness is established from the patients’ history, physical examination and radiological investigation, although the appearances of a pneumothorax on a supine radiograph may be different from the classic appearance on an erect radiograph. For this reason, ultrasonography is beneficial for excluding the diagnosis of pneumothorax. Respiration-dependent movement of the visceral pleura and lung surface with respect to the parietal pleura and chest wall can be easily visualized with transthoracic sonography given that the presence of air in the pleural space prevents sonographic visualization of visceral pleura movements. Mechanically ventilated patients with a pneumothorax require tube thoracostomy placement because of the high risk of tension pneumothorax. Small-bore catheters are now preferred in the majority of ventilated patients. Furthermore, if there are clinical signs of a tension pneumothorax, emergency needle decompression followed by tube thoracostomy is widely advocated. Patients with pneumothorax related to mechanical ventilation who have tension pneumothorax, a higher acute physiology and chronic health evaluation II score or PaO2/FiO2 < 200 mmHg were found to have higher mortality. PMID:24834397

Kontrol Kecepatan Motor Induksi menggunakan Algoritma Backpropagation Neural Network

Directory of Open Access Journals (Sweden)

MUHAMMAD RUSWANDI DJALAL

2017-07-01

Full Text Available ABSTRAKBanyak strategi kontrol berbasis kecerdasan buatan telah diusulkan dalam penelitian seperti Fuzzy Logic dan Artificial Neural Network (ANN. Tujuan dari penelitian ini adalah untuk mendesain sebuah kontrol agar kecepatan motor induksi dapat diatur sesuai kebutuhan serta membandingkan kinerja motor induksi tanpa kontrol dan dengan kontrol. Dalam penelitian ini diusulkan sebuah metode artificial neural network untuk mengontrol kecepatan motor induksi tiga fasa. Kecepatan referensi motor diatur pada kecepatan 140 rad/s, 150 rad/s, dan 130 rad/s. Perubahan kecepatan diatur pada setiap interval 0.3 detik dan waktu simulasi maksimum adalah 0,9 detik. Kasus 1 tanpa kontrol, menunjukkan respon torka dan kecepatan dari motor induksi tiga fasa tanpa kontrol. Meskipun kecepatan motor induksi tiga fasa diatur berubah pada setiap 0,3 detik tidak akan mempengaruhi torka. Selain itu, motor induksi tiga fasa tanpa kontrol memiliki kinerja yang buruk dikarenakan kecepatan motor induksi tidak dapat diatur sesuai dengan kebutuhan. Kasus 2 dengan control backpropagation neural network, meskipun kecepatan motor induksi tiga fasa berubah pada setiap 0.3 detik tidak akan mempengaruhi torsi. Selain itu, kontrol backpropagation neural network memiliki kinerja yang baik dikarenakan kecepatan motor induksi dapat diatur sesuai dengan kebutuhan.Kata kunci: Backpropagation Neural Network (BPNN, NN Training, NN Testing, Motor.ABSTRACTMany artificial intelligence-based control strategies have been proposed in research such as Fuzzy Logic and Artificial Neural Network (ANN. The purpose of this research was design a control for the induction motor speed that could be adjusted as needed and compare the performance of induction motor without control and with control. In this research, it was proposed an artificial neural network method to control the speed of three-phase induction motors. The reference speed of motor was set at the rate of 140 rad / s, 150 rad / s, and 130

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.

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.

Modelling and Simulation of Volume Controlled Mechanical Ventilation System

Directory of Open Access Journals (Sweden)

Yan Shi

2014-01-01

Full Text Available Volume controlled mechanical ventilation system is a typical time-delay system, which is applied to ventilate patients who cannot breathe adequately on their own. To illustrate the influences of key parameters of the ventilator on the dynamics of the ventilated respiratory system, this paper firstly derived a new mathematical model of the ventilation system; secondly, simulation and experimental results are compared to verify the mathematical model; lastly, the influences of key parameters of ventilator on the dynamics of the ventilated respiratory system are carried out. This study can be helpful in the VCV ventilation treatment and respiratory diagnostics.

Mechanical Ventilation: State of the Art.

Science.gov (United States)

Pham, Tài; Brochard, Laurent J; Slutsky, Arthur S

2017-09-01

Mechanical ventilation is the most used short-term life support technique worldwide and is applied daily for a diverse spectrum of indications, from scheduled surgical procedures to acute organ failure. This state-of-the-art review provides an update on the basic physiology of respiratory mechanics, the working principles, and the main ventilatory settings, as well as the potential complications of mechanical ventilation. Specific ventilatory approaches in particular situations such as acute respiratory distress syndrome and chronic obstructive pulmonary disease are detailed along with protective ventilation in patients with normal lungs. We also highlight recent data on patient-ventilator dyssynchrony, humidified high-flow oxygen through nasal cannula, extracorporeal life support, and the weaning phase. Finally, we discuss the future of mechanical ventilation, addressing avenues for improvement. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Pandemic ventilator rationing and appeals processes.

Science.gov (United States)

Patrone, Daniel; Resnik, David

2011-06-01

In a severe influenza pandemic, hospitals will likely experience serious and widespread shortages of patient pulmonary ventilators and of staff qualified to operate them. Deciding who will receive access to mechanical ventilation will often determine who lives and who dies. This prospect raises an important question whether pandemic preparedness plans should include some process by which individuals affected by ventilator rationing would have the opportunity to appeal adverse decisions. However, the issue of appeals processes to ventilator rationing decisions has been largely neglected in state pandemic planning efforts. If we are to devise just and effective plans for coping with a severe influenza pandemic, more attention to the issue of appeals processes for pandemic ventilator rationing decisions is needed. Arguments for and against appeals processes are considered, and some suggestions are offered to help efforts at devising more rational pandemic preparedness plans.

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.

Reverse ventilation--perfusion mismatch

International Nuclear Information System (INIS)

Palmaz, J.C.; Barnett, C.A.; Reich, S.B.; Krumpe, P.E.; Farrer, P.A.

1984-01-01

Patients having lobar airway obstruction or consolidation usually have decreases of both ventilation and perfusion on lung scans. We report three patients in whom hypoxic vasoconstriction was apparently incomplete, resulting in a ''reversed'' ventilation-perfusion mismatch. Perfusion of the hypoxic lobe on the radionuclide scan was associated with metabolic alkalosis, pulmonary venous and pulmonary arterial hypertension in these patients

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.

Efficacy of an expanded ventilator bundle for the reduction of ventilator-associated pneumonia in the medical intensive care unit.

Science.gov (United States)

Blamoun, John; Alfakir, Maria; Rella, Marie E; Wojcik, Janice M; Solis, Roberto A; Anees Khan, M; DeBari, Vincent A

2009-03-01

The ventilator bundle (VB) includes a group of clinical maneuvers (head-of-bed elevation, "sedation vacation," deep vein thrombosis prophylaxis, and peptic ulcer disease prophylaxis) to improve outcomes in patients undergoing mechanical ventilation. We modified the standard VB in our medical intensive care unit to include a group of respiratory therapist-driven protocols and, postimplementation, observed a statistically significant (P = .0006) reduction in ventilator-associated pneumonia (VAP), from a median of 14.1 cases/10(3) ventilator-days (interquartile range [IQR] = 12.1 to 20.6) to 0 cases/10(3) ventilator-days (IQR = 0 to 1.1).

Performance of current intensive care unit ventilators during pressure and volume ventilation.

Science.gov (United States)

Marchese, Andrew D; Sulemanji, Demet; Chipman, Daniel; Villar, Jesús; Kacmarek, Robert M

2011-07-01

Intensive-care mechanical ventilators regularly enter the market, but the gas-delivery capabilities of many have never been assessed. We evaluated 6 intensive-care ventilators in the pressure support (PS), pressure assist/control (PA/C), and volume assist/control (VA/C) modes, with lung-model mechanics combinations of compliance and resistance of 60 mL/cm H(2)O and 10 cm H(2)O/L/s, 60 mL/cm H(2)O and 5 cm H(2)O/L/s, and 30 mL/cm H(2)O and 10 cm H(2)O/L/s, and inspiratory muscle effort of 5 and 10 cm H(2)O. PS and PA/C were set to 15 cm H(2)O, and PEEP to 5 and 15 cm H(2)O in all modes. During VA/C, tidal volume was set at 500 mL and inspiratory time was set at 0.8 second. Rise time and termination criteria were set at the manufacturers' defaults, and to an optimal level during PS and PA/C. There were marked differences in ventilator performance in all 3 modes. VA/C had the greatest difficulty meeting lung model demand and the greatest variability across all tested scenarios and ventilators. From high to low inspiratory muscle effort, pressure-to-trigger, time for pressure to return to baseline, and triggering pressure-time product decreased in all modes. With increasing resistance and decreasing compliance, tidal volume, pressure-to-trigger, time-to-trigger, time for pressure to return to baseline, time to 90% of peak pressure, and pressure-time product decreased. There were large differences between the default and optimal settings for all the variables in PS and PA/C. Performance was not affected by PEEP. Most of the tested ventilators performed at an acceptable level during the majority of evaluations, but some ventilators performed inadequately during specific settings. Bedside clinical evaluation is needed.

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.

A NEW EXHAUST VENTILATION SYSTEM DESIGN SOFTWARE

Directory of Open Access Journals (Sweden)

H. Asilian Mahabady

2007-09-01

Full Text Available A Microsoft Windows based ventilation software package is developed to reduce time-consuming and boring procedure of exhaust ventilation system design. This program Assure accurate and reliable air pollution control related calculations. Herein, package is tentatively named Exhaust Ventilation Design Software which is developed in VB6 programming environment. Most important features of Exhaust Ventilation Design Software that are ignored in formerly developed packages are Collector design and fan dimension data calculations. Automatic system balance is another feature of this package. Exhaust Ventilation Design Software algorithm for design is based on two methods: Balance by design (Static pressure balance and design by Blast gate. The most important section of software is a spreadsheet that is designed based on American Conference of Governmental Industrial Hygienists calculation sheets. Exhaust Ventilation Design Software is developed so that engineers familiar with American Conference of Governmental Industrial Hygienists datasheet can easily employ it for ventilation systems design. Other sections include Collector design section (settling chamber, cyclone, and packed tower, fan geometry and dimension data section, a unit converter section (that helps engineers to deal with units, a hood design section and a Persian HTML help. Psychometric correction is also considered in Exhaust Ventilation Design Software. In Exhaust Ventilation Design Software design process, efforts are focused on improving GUI (graphical user interface and use of programming standards in software design. Reliability of software has been evaluated and results show acceptable accuracy.

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.

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

Outcomes of Noninvasive and Invasive Ventilation in Patients Hospitalized with Asthma Exacerbation.

Science.gov (United States)

Stefan, Mihaela S; Nathanson, Brian H; Lagu, Tara; Priya, Aruna; Pekow, Penelope S; Steingrub, Jay S; Hill, Nicholas S; Goldberg, Robert J; Kent, David M; Lindenauer, Peter K

2016-07-01

Little is known about the effectiveness of noninvasive ventilation for patients hospitalized with asthma exacerbation. To assess clinical outcomes of noninvasive (NIV) and invasive mechanical ventilation (IMV) and examine predictors for NIV use in patients hospitalized with asthma. This was a retrospective cohort study at 97 U.S. hospitals using an electronic medical record database. We developed a hierarchical regression model to identify factors associated with the choice of initial ventilation and used the Laboratory Acute Physiological Score to adjust for differences in the severity of illness. We assessed the outcomes of patients treated with initial NIV or IMV in a propensity-matched cohort. Among 13,930 subjects, 73% were women and 54% were white. The median age was 53 years. Overall, 1,254 patients (9%) required ventilatory support (NIV or IMV). NIV was the initial ventilation method for 556 patients (4.0%) and IMV for 668 (5.0%). Twenty-six patients (4.7% of patients treated with NIV) had to be intubated (NIV failure). The in-hospital mortality was 0.2, 2.3, 14.5, and 15.4%, and the median length of stay was 2.9, 4.1, 6.7, and 10.9 days among those not ventilated, ventilated with NIV, ventilated with IMV, and with NIV failure, respectively. Older patients were more likely to receive NIV (odds ratio, 1.06 per 5 yr; 95% confidence interval [CI], 1.01-1.11), whereas those with higher acuity (Laboratory Acute Physiological Score per 5 units: odds ratio, 0.85; 95% CI, 0.82-0.88) and those with concomitant pneumonia were less likely to receive NIV. In a propensity-matched sample, NIV was associated with a lower inpatient risk of dying (risk ratio, 0.12; 95% CI, 0.03-0.51) and shorter lengths of stay (4.3 d less; 95% CI, 2.9-5.8) than IMV. Among patients hospitalized with asthma exacerbation and requiring ventilatory support (NIV or IMV), more than 40% received NIV. Although patients successfully treated with NIV appear to have better outcomes than those treated

Influences of Duration of Inspiratory Effort, Respiratory Mechanics, and Ventilator Type on Asynchrony With Pressure Support and Proportional Assist Ventilation.

Science.gov (United States)

Vasconcelos, Renata S; Sales, Raquel P; Melo, Luíz H de P; Marinho, Liégina S; Bastos, Vasco Pd; Nogueira, Andréa da Nc; Ferreira, Juliana C; Holanda, Marcelo A

2017-05-01

Pressure support ventilation (PSV) is often associated with patient-ventilator asynchrony. Proportional assist ventilation (PAV) offers inspiratory assistance proportional to patient effort, minimizing patient-ventilator asynchrony. The objective of this study was to evaluate the influence of respiratory mechanics and patient effort on patient-ventilator asynchrony during PSV and PAV plus (PAV+). We used a mechanical lung simulator and studied 3 respiratory mechanics profiles (normal, obstructive, and restrictive), with variations in the duration of inspiratory effort: 0.5, 1.0, 1.5, and 2.0 s. The Auto-Trak system was studied in ventilators when available. Outcome measures included inspiratory trigger delay, expiratory trigger asynchrony, and tidal volume (V T ). Inspiratory trigger delay was greater in the obstructive respiratory mechanics profile and greatest with a effort of 2.0 s (160 ms); cycling asynchrony, particularly delayed cycling, was common in the obstructive profile, whereas the restrictive profile was associated with premature cycling. In comparison with PSV, PAV+ improved patient-ventilator synchrony, with a shorter triggering delay (28 ms vs 116 ms) and no cycling asynchrony in the restrictive profile. V T was lower with PAV+ than with PSV (630 mL vs 837 mL), as it was with the single-limb circuit ventilator (570 mL vs 837 mL). PAV+ mode was associated with longer cycling delays than were the other ventilation modes, especially for the obstructive profile and higher effort values. Auto-Trak eliminated automatic triggering. Mechanical ventilation asynchrony was influenced by effort, respiratory mechanics, ventilator type, and ventilation mode. In PSV mode, delayed cycling was associated with shorter effort in obstructive respiratory mechanics profiles, whereas premature cycling was more common with longer effort and a restrictive profile. PAV+ prevented premature cycling but not delayed cycling, especially in obstructive respiratory mechanics

Initial ventilator settings for critically ill patients

OpenAIRE

Kilickaya, Oguz; Gajic, Ognjen

2013-01-01

The lung-protective mechanical ventilation strategy has been standard practice for management of acute respiratory distress syndrome (ARDS) for more than a decade. Observational data, small randomized studies and two recent systematic reviews suggest that lung protective ventilation is both safe and potentially beneficial in patients who do not have ARDS at the onset of mechanical ventilation. Principles of lung-protective ventilation include: a) prevention of volutrauma (tidal volume 4 to 8 ...

Artificial humidification for the mechanically ventilated patient

OpenAIRE

Selvaraj, Nelson

2010-01-01

Caring for patients who are mechanically ventilated poses many\\ud challenges for critical care nurses. It is important to humidify the\\ud patient’s airways artificially to prevent complications such as\\ud ventilator-associated pneumonia. There is no gold standard to\\ud determine which type of humidification is best for patients who\\ud are artificially ventilated. This article provides an overview of\\ud commonly used artificial humidification for mechanically ventilated\\ud patients and discuss...

Artificial humidification for the mechanically ventilated patient.

Science.gov (United States)

Selvaraj, N

Caring for patients who are mechanically ventilated poses many challenges for critical care nurses. It is important to humidify the patient's airways artificially to prevent complications such as ventilator-associated pneumonia. There is no gold standard to determine which type of humidification is best for patients who are artificially ventilated. This article provides an overview of commonly used artificial humidification for mechanically ventilated patients and discusses nurses' responsibilities in caring for patients receiving artificial humidification.

Electrical impedance tomography: A new monitoring of regional distribution of lung ventilation (principle of work and clinical application

Directory of Open Access Journals (Sweden)

Vuković Rade

2017-01-01

Full Text Available Soon after it's discovery in the 1980s, the Electrical Impedance Tomography (EIT, became the topic of interest, primarily regarding its applicability in different diagnostic procedures and monitoring. EIT is a non-invasive procedure, with no additional harmful radiation, which can be used continuously to monitor regional distribution of ventilation, in contrast to the computerized tomography and other diagnostic procedures that have a single image of the respiratory system and its function. Additionally, EIT allows continuous visualization of the lung function at the patient bedside, with an immediate assessment of the respiratory therapeutic maneuvers effects. The results obtained by EIT are complementary to other pulmonary diagnostic procedures, primarily from radiology. In general, EIT provides additional information to the conventional pulmonary monitoring. Crucial to the implementation of lung protective ventilation concept is to determine the ideal alveolar recruitment, which maintains open and functional alveoli during ventilation, meanwhile carrying a minimal risk for lung injury with excessive breathing volume ('over distension'. EIT may be considered as a good guide for optimal adjustment of respiratory support parameters and selection of the ventilation mode. Nowadays, the technical and technological development, hardware and software improvements and experimental validation of the results in animals and volunteers, have enabled practical clinical use of EIT, a useful monitor of regional distribution of lungs ventilation.

Natural ventilation of buildings: opposing wind and buoyancy

Science.gov (United States)

Linden, Paul; Hunt, Gary

1998-11-01

The use of natural ventilation in buildings is an attractive way to reduce energy usage thereby reducing costs and CO2 emissions. Generally, it is necessary to remove excess heat from a building and the designer can use the buoyancy forces associated with the above ambient temperatures within the building to drive a flow - 'stack' ventilation. The most efficient mode is displacement ventilation where warm air accumulates near the top of the building and flows out through upper level vents and cooler air flows in at lower levels. Ventilation will also be driven between these lower and upper openings by the wind. We report on laboratory modeling and theory which investigates the effects of an opposing wind on stack ventilation driven by a constant source of heat within a space under displacement ventilation. We show that there is a critical wind speed, expressed in dimensionless terms as a critical Froude number, above which displacement ventilation is replaced by (less efficient) mixing ventilation with reversed flow. Below this critical speed, displacement ventilation, in which the interior has a two-layer stratification, is maintained. The criterion for the change in ventilation mode is derived from general considerations of mixing efficiencies in stratified flows. We conclude that even when wind effects might appear to be dominant, the inhibition of mixing by the stable stratification within the space ensures that stack ventilation can operate over a wide range of apparently adverse conditions.

Lung-protective ventilation in neonatology

NARCIS (Netherlands)

van Kaam, Anton

2011-01-01

Ventilator-induced lung injury (VILI) is considered an important risk factor in the development of bronchopulmonary dysplasia (BPD) and is primarily caused by overdistension (volutrauma) and repetitive opening and collapse (atelectrauma) of terminal lung units. Lung-protective ventilation should

[Lung protective ventilation - pathophysiology and diagnostics].

Science.gov (United States)

Uhlig, Stefan; Frerichs, Inéz

2008-06-01

Mechanical ventilation may lead to lung injury depending on the ventilatory settings (e.g. pressure amplitudes, endexpiratory pressures, frequency) and the length of mechanical ventilation. Particularly in the inhomogeneously injured lungs of ARDS patients, alveolar overextension results in volutrauma, cyclic opening and closure of alveolar units in atelectrauma. Particularly important appears to be the fact that these processes may also cause biotrauma, i.e. the ventilator-induced hyperactivation of inflammatory responses in the lung. These side effects are reduced, but not eliminated with the currently recommended ventilation strategy with a tidal volume of 6 ml/kg idealized body weight. It is our hope that in the future optimization of ventilator settings will be facilated by bedside monitoring of novel indices of respiratory mechanics such as the stress index or the Slice technique, and by innovative real-time imaging technologies such as electrical impedance tomography.

Lung-protective mechanical ventilation does not protect against acute kidney injury in patients without lung injury at onset of mechanical ventilation.

Science.gov (United States)

Cortjens, Bart; Royakkers, Annick A N M; Determann, Rogier M; van Suijlen, Jeroen D E; Kamphuis, Stephan S; Foppen, Jannetje; de Boer, Anita; Wieland, Cathrien W; Spronk, Peter E; Schultz, Marcus J; Bouman, Catherine S C

2012-06-01

Preclinical and clinical studies suggest that mechanical ventilation contributes to the development of acute kidney injury (AKI), particularly in the setting of lung-injurious ventilator strategies. To determine whether ventilator settings in critically ill patients without acute lung injury (ALI) at onset of mechanical ventilation affect the development of AKI. Secondary analysis of a randomized controlled trial (N = 150), comparing conventional tidal volume (V(T), 10 mL/kg) with low tidal volume (V(T), 6 mL/kg) mechanical ventilation in critically ill patients without ALI at randomization. During the first 5 days of mechanical ventilation, the RIFLE class was determined daily, whereas neutrophil gelatinase-associated lipocalin and cystatin C levels were measured in plasma collected on days 0, 2, and 4. Eighty-six patients had no AKI at inclusion, and 18 patients (21%) subsequently developed AKI, but without significant difference between ventilation strategies. (Cumulative hazard, 0.26 vs 0.23; P = .88.) The courses of neutrophil gelatinase-associated lipocalin and cystatin C plasma levels did not differ significantly between randomization groups. In the present study in critically patients without ALI at onset of mechanical ventilation, lower tidal volume ventilation did not reduce the development or worsening of AKI compared with conventional tidal volume ventilation. Copyright © 2012 Elsevier Inc. All rights reserved.

Can Tracheostomy Improve Outcome and Lower Resource Utilization for Patients with Prolonged Mechanical Ventilation?

Science.gov (United States)

Yuan, Ciou-Rong; Lan, Tzuo-Yun; Tang, Gau-Jun

2015-01-01

Background: It is not clear whether the benefits of tracheostomy remain the same in the population. This study aimed to better examine the effect of tracheostomy on clinical outcome among prolonged ventilator patients. Methods: Data were from the medical claims data in Taiwan. A total of 3880 patients with ventilator use for more than 14 days between 2005 and 2009 were identified. Among them, 645 patients with tracheostomy conducted within 30 days of ventilator use were compared to 2715 patients without tracheostomy on death during hospitalization and study period, and successful weaning and medical utilization during hospitalization. Cox proportional hazards and linear regression models were used to examine the associations between tracheostomy and the main outcomes. Results: The tracheostomy rate was 30%, and 55% of tracheostomies were performed within 30 days of mechanical ventilation. After adjustments, patients with tracheostomy were at a lower risk of death during hospitalization (hazard ratio [HR] =0.51; 95% confidence interval [CI] =0.43–0.61) and 5-year observation (HR = 0.73; 95% CI = 0.66–0.81), and a lower probability of successful weaning (HR = 0.88; 95% CI = 0.79–0.99). Higher medical use was also observed in patients with tracheostomy. Conclusions: The beneficial effect for tracheostomy observed in our data was the reduction of death. However, patients with tracheostomy were less likely to wean and more likely to consume medical resources. PMID:26415799

Abdominal Muscle Activity during Mechanical Ventilation Increases Lung Injury in Severe Acute Respiratory Distress Syndrome.

Directory of Open Access Journals (Sweden)

Xianming Zhang

Full Text Available It has proved that muscle paralysis was more protective for injured lung in severe acute respiratory distress syndrome (ARDS, but the precise mechanism is not clear. The purpose of this study was to test the hypothesis that abdominal muscle activity during mechanically ventilation increases lung injury in severe ARDS.Eighteen male Beagles were studied under mechanical ventilation with anesthesia. Severe ARDS was induced by repetitive oleic acid infusion. After lung injury, Beagles were randomly assigned into spontaneous breathing group (BIPAPSB and abdominal muscle paralysis group (BIPAPAP. All groups were ventilated with BIPAP model for 8h, and the high pressure titrated to reached a tidal volume of 6ml/kg, the low pressure was set at 10 cmH2O, with I:E ratio 1:1, and respiratory rate adjusted to a PaCO2 of 35-60 mmHg. Six Beagles without ventilator support comprised the control group. Respiratory variables, end-expiratory volume (EELV and gas exchange were assessed during mechanical ventilation. The levels of Interleukin (IL-6, IL-8 in lung tissue and plasma were measured by qRT-PCR and ELISA respectively. Lung injury scores were determined at end of the experiment.For the comparable ventilator setting, as compared with BIPAPSB group, the BIPAPAP group presented higher EELV (427±47 vs. 366±38 ml and oxygenation index (293±36 vs. 226±31 mmHg, lower levels of IL-6(216.6±48.0 vs. 297.5±71.2 pg/ml and IL-8(246.8±78.2 vs. 357.5±69.3 pg/ml in plasma, and lower express levels of IL-6 mRNA (15.0±3.8 vs. 21.2±3.7 and IL-8 mRNA (18.9±6.8 vs. 29.5±7.9 in lung tissues. In addition, less lung histopathology injury were revealed in the BIPAPAP group (22.5±2.0 vs. 25.2±2.1.Abdominal muscle activity during mechanically ventilation is one of the injurious factors in severe ARDS, so abdominal muscle paralysis might be an effective strategy to minimize ventilator-induce lung injury.

Abdominal Muscle Activity during Mechanical Ventilation Increases Lung Injury in Severe Acute Respiratory Distress Syndrome.

Science.gov (United States)

Zhang, Xianming; Wu, Weiliang; Zhu, Yongcheng; Jiang, Ying; Du, Juan; Chen, Rongchang

2016-01-01

It has proved that muscle paralysis was more protective for injured lung in severe acute respiratory distress syndrome (ARDS), but the precise mechanism is not clear. The purpose of this study was to test the hypothesis that abdominal muscle activity during mechanically ventilation increases lung injury in severe ARDS. Eighteen male Beagles were studied under mechanical ventilation with anesthesia. Severe ARDS was induced by repetitive oleic acid infusion. After lung injury, Beagles were randomly assigned into spontaneous breathing group (BIPAPSB) and abdominal muscle paralysis group (BIPAPAP). All groups were ventilated with BIPAP model for 8h, and the high pressure titrated to reached a tidal volume of 6ml/kg, the low pressure was set at 10 cmH2O, with I:E ratio 1:1, and respiratory rate adjusted to a PaCO2 of 35-60 mmHg. Six Beagles without ventilator support comprised the control group. Respiratory variables, end-expiratory volume (EELV) and gas exchange were assessed during mechanical ventilation. The levels of Interleukin (IL)-6, IL-8 in lung tissue and plasma were measured by qRT-PCR and ELISA respectively. Lung injury scores were determined at end of the experiment. For the comparable ventilator setting, as compared with BIPAPSB group, the BIPAPAP group presented higher EELV (427±47 vs. 366±38 ml) and oxygenation index (293±36 vs. 226±31 mmHg), lower levels of IL-6(216.6±48.0 vs. 297.5±71.2 pg/ml) and IL-8(246.8±78.2 vs. 357.5±69.3 pg/ml) in plasma, and lower express levels of IL-6 mRNA (15.0±3.8 vs. 21.2±3.7) and IL-8 mRNA (18.9±6.8 vs. 29.5±7.9) in lung tissues. In addition, less lung histopathology injury were revealed in the BIPAPAP group (22.5±2.0 vs. 25.2±2.1). Abdominal muscle activity during mechanically ventilation is one of the injurious factors in severe ARDS, so abdominal muscle paralysis might be an effective strategy to minimize ventilator-induce lung injury.

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.

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.

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

Secretion management in the mechanically ventilated patient.

Science.gov (United States)

Branson, Richard D

2007-10-01

Secretion management in the mechanically ventilated patient includes routine methods for maintaining mucociliary function, as well as techniques for secretion removal. Humidification, mobilization of the patient, and airway suctioning are all routine procedures for managing secretions in the ventilated patient. Early ambulation of the post-surgical patient and routine turning of the ventilated patient are common secretion-management techniques that have little supporting evidence of efficacy. Humidification is a standard of care and a requisite for secretion management. Both active and passive humidification can be used. The humidifier selected and the level of humidification required depend on the patient's condition and the expected duration of intubation. In patients with thick, copious secretions, heated humidification is superior to a heat and moisture exchanger. Airway suctioning is the most important secretion removal technique. Open-circuit and closed-circuit suctioning have similar efficacy. Instilling saline prior to suctioning, to thin the secretions or stimulate a cough, is not supported by the literature. Adequate humidification and as-needed suctioning are the foundation of secretion management in the mechanically ventilated patient. Intermittent therapy for secretion removal includes techniques either to simulate a cough, to mechanically loosen secretions, or both. Patient positioning for secretion drainage is also widely used. Percussion and postural drainage have been widely employed for mechanically ventilated patients but have not been shown to reduce ventilator-associated pneumonia or atelectasis. Manual hyperinflation and insufflation-exsufflation, which attempt to improve secretion removal by simulating a cough, have been described in mechanically ventilated patients, but neither has been studied sufficiently to support routine use. Continuous lateral rotation with a specialized bed reduces atelectasis in some patients, but has not been shown

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

REVERSIBLE VENTILATION SYSTEM FOR ADMINISTRATIVE BUILDINGS

Directory of Open Access Journals (Sweden)

Valery Yu. Kravchuk

2017-01-01

Full Text Available Abstract. Objectives To consider the possibility of applying the principle of reversing air flows for a centralised ventilation system; to develop a specific scheme for air exchange reversible ventilation, which will take into account the peculiarities of the microclimate of administrative buildings; to select the type of filling of the air-permeable element and justify this choice; to determine the conditions for changing the direction of air movement in the ventilation system and the area of its application; to form a list of equipment necessary for the operation of such a system; to consider the influence of supply and exhaust devices on the heat and humidity regime of claddings. Methods  To achieve this goal, the published thematic material was reviewed and a patent search carried out using Russian and European databases. Data on mathematical modelling of filtration in porous media and experimental results were used. A method for ventilating rooms in administrative building using the reversal of movement of supply and exhaust air streams along the same channels was applied. Results  Schemas for reversible ventilation systems are presented and their modes of operation considered. It is established that the idea of reversing ventilation flows has not yet been applied in the development of centralised ventilation systems. Based on these published materials, it was concluded that the proposed design of supply and exhaust devices can be used in practice. An original air exchange scheme for the ventilation of administrative buildings and design of supply and exhaust devices for this system are proposed. The conditions for changing the operating modes of the system and the scope of its application are determined. Conclusion The use of the proposed ventilation system allows normative air exchange to be provided without using a supply unit during the cold season. This application of airflow reversal allows the potential of natural forces to be used

Building ventilation, state of the art, prospective

International Nuclear Information System (INIS)

1995-10-01

This conference is composed of 21 communications and 21 posters in the domain of building ventilation and indoor air quality; the main themes are: indoor air quality assessment and optimization; performance enhancement and optimization of ventilation systems and equipment; ventilation systems for renovated and rehabilitated buildings; French and European regulations, standardizations and certifications; experimental and numerical simulation studies concerning ventilation systems, air flow, temperature distribution, air quality, radon decontamination, thermal comfort and acoustic levels in buildings

Implementation of a Goal-Directed Mechanical Ventilation Order Set Driven by Respiratory Therapists Improves Compliance With Best Practices for Mechanical Ventilation.

Science.gov (United States)

Radosevich, Misty A; Wanta, Brendan T; Meyer, Todd J; Weber, Verlin W; Brown, Daniel R; Smischney, Nathan J; Diedrich, Daniel A

2017-01-01

Data regarding best practices for ventilator management strategies that improve outcomes in acute respiratory distress syndrome (ARDS) are readily available. However, little is known regarding processes to ensure compliance with these strategies. We developed a goal-directed mechanical ventilation order set that included physician-specified lung-protective ventilation and oxygenation goals to be implemented by respiratory therapists (RTs). We sought as a primary outcome to determine whether an RT-driven order set with predefined oxygenation and ventilation goals could be implemented and associated with improved adherence with best practice. We evaluated 1302 patients undergoing invasive mechanical ventilation (1693 separate episodes of invasive mechanical ventilation) prior to and after institution of a standardized, goal-directed mechanical ventilation order set using a controlled before-and-after study design. Patient-specific goals for oxygenation partial pressure of oxygen in arterial blood (Pao 2 ), ARDS Network [Net] positive end-expiratory pressure [PEEP]/fraction of inspired oxygen [Fio 2 ] table use) and ventilation (pH, partial pressure of carbon dioxide) were selected by prescribers and implemented by RTs. Compliance with the new mechanical ventilation order set was high: 88.2% compliance versus 3.8% before implementation of the order set ( P mechanical ventilation, intensive care unit (ICU) length of stay, and in-hospital or ICU mortality. A standardized best practice mechanical ventilation order set can be implemented by a multidisciplinary team and is associated with improved compliance to written orders and adherence to the ARDSNet PEEP/Fio 2 table.

Data Driven Broiler Weight Forecasting using Dynamic Neural Network Models

DEFF Research Database (Denmark)

Johansen, Simon Vestergaard; Bendtsen, Jan Dimon; Riisgaard-Jensen, Martin

2017-01-01

In this article, the dynamic influence of environmental broiler house conditions and broiler growth is investigated. Dynamic neural network forecasting models have been trained on farm-scale broiler batch production data from 12 batches from the same house. The model forecasts future broiler weight...... and uses environmental conditions such as heating, ventilation, and temperature along with broiler behavior such as feed and water consumption. Training data and forecasting data is analyzed to explain when the model might fail at generalizing. We present ensemble broiler weight forecasts to day 7, 14, 21...

Numerical simulation and comparison of two ventilation methods for a restaurant - displacement vs mixed flow ventilation

Science.gov (United States)

Chitaru, George; Berville, Charles; Dogeanu, Angel

2018-02-01

This paper presents a comparison between a displacement ventilation method and a mixed flow ventilation method using computational fluid dynamics (CFD) approach. The paper analyses different aspects of the two systems, like the draft effect in certain areas, the air temperatureand velocity distribution in the occupied zone. The results highlighted that the displacement ventilation system presents an advantage for the current scenario, due to the increased buoyancy driven flows caused by the interior heat sources. For the displacement ventilation case the draft effect was less prone to appear in the occupied zone but the high heat emissions from the interior sources have increased the temperature gradient in the occupied zone. Both systems have been studied in similar conditions, concentrating only on the flow patterns for each case.

Functionality of Ventilated Facades: Protection of Insulation

Directory of Open Access Journals (Sweden)

Petrichenko Mikhail

2016-01-01

Full Text Available This article discusses about methods of construction of the ventilated facades. The ventilated facade is not only the element of facing, it is the supporting structure. Their main objective - creation of air ventilating space between a facade and an external wall of the building. Moving of air in this gap protects a heater from destruction, interfering with a moisture congestion. In addition, the ventilated facade protect the building from aggressive influence of external environment, have a sound and thermal insulation properties. There are several problems of systems of the ventilated facades connected with an application of a heater. For more effective using it is necessary to minimize contact of a heater with environment.

Injurious mechanical ventilation in the normal lung causes a progressive pathologic change in dynamic alveolar mechanics.

Science.gov (United States)

Pavone, Lucio A; Albert, Scott; Carney, David; Gatto, Louis A; Halter, Jeffrey M; Nieman, Gary F

2007-01-01

Acute respiratory distress syndrome causes a heterogeneous lung injury, and without protective mechanical ventilation a secondary ventilator-induced lung injury can occur. To ventilate noncompliant lung regions, high inflation pressures are required to 'pop open' the injured alveoli. The temporal impact, however, of these elevated pressures on normal alveolar mechanics (that is, the dynamic change in alveolar size and shape during ventilation) is unknown. In the present study we found that ventilating the normal lung with high peak pressure (45 cmH(2)0) and low positive end-expiratory pressure (PEEP of 3 cmH(2)O) did not initially result in altered alveolar mechanics, but alveolar instability developed over time. Anesthetized rats underwent tracheostomy, were placed on pressure control ventilation, and underwent sternotomy. Rats were then assigned to one of three ventilation strategies: control group (n = 3, P control = 14 cmH(2)O, PEEP = 3 cmH(2)O), high pressure/low PEEP group (n = 6, P control = 45 cmH(2)O, PEEP = 3 cmH(2)O), and high pressure/high PEEP group (n = 5, P control = 45 cmH(2)O, PEEP = 10 cmH(2)O). In vivo microscopic footage of subpleural alveolar stability (that is, recruitment/derecruitment) was taken at baseline and than every 15 minutes for 90 minutes following ventilator adjustments. Alveolar recruitment/derecruitment was determined by measuring the area of individual alveoli at peak inspiration (I) and end expiration (E) by computer image analysis. Alveolar recruitment/derecruitment was quantified by the percentage change in alveolar area during tidal ventilation (%I - E Delta). Alveoli were stable in the control group for the entire experiment (low %I - E Delta). Alveoli in the high pressure/low PEEP group were initially stable (low %I - E Delta), but with time alveolar recruitment/derecruitment developed. The development of alveolar instability in the high pressure/low PEEP group was associated with histologic lung injury. A large change in

Methodology for ventilation/perfusion SPECT

DEFF Research Database (Denmark)

Bajc, Marika; Neilly, Brian; Miniati, Massimo

2010-01-01

Ventilation/perfusion single-photon emission computed tomography (V/Q SPECT) is the scintigraphic technique of choice for the diagnosis of pulmonary embolism and many other disorders that affect lung function. Data from recent ventilation studies show that the theoretic advantages of Technegas ov...

Implementation of natural ventilation in pig houses

NARCIS (Netherlands)

Klooster, van 't C.E.

1994-01-01

A description of experimental work and discussion on implementation of natural ventilation in pig houses is given. A literature review describes the state of the art, animal growth data are given. It includes characterization of ventilation openings, a technique to estimate the ventilation

Echocardiographic evaluation during weaning from mechanical ventilation

Directory of Open Access Journals (Sweden)

Luciele Medianeira Schifelbain

2011-01-01

Full Text Available INTRODUCTION: Echocardiographic, electrocardiographic and other cardiorespiratory variables can change during weaning from mechanical ventilation. OBJECTIVES: To analyze changes in cardiac function, using Doppler echocardiogram, in critical patients during weaning from mechanical ventilation, using two different weaning methods: pressure support ventilation and T-tube; and comparing patient subgroups: success vs. failure in weaning. METHODS: Randomized crossover clinical trial including patients under mechanical ventilation for more than 48 h and considered ready for weaning. Cardiorespiratory variables, oxygenation, electrocardiogram and Doppler echocardiogram findings were analyzed at baseline and after 30 min in pressure support ventilation and T-tube. Pressure support ventilation vs. T-tube and weaning success vs. failure were compared using ANOVA and Student's t-test. The level of significance was p<0.05. RESULTS: Twenty-four adult patients were evaluated. Seven patients failed at the first weaning attempt. No echocardiographic or electrocardiographic differences were observed between pressure support ventilation and T-tube. Weaning failure patients presented increases in left atrium, intraventricular septum thickness, posterior wall thickness and diameter of left ventricle and shorter isovolumetric relaxation time. Successfully weaned patients had higher levels of oxygenation. CONCLUSION: No differences were observed between Doppler echocardiographic variables and electrocardiographic and other cardiorespiratory variables during pressure support ventilation and T-tube. However cardiac structures were smaller, isovolumetric relaxation time was larger, and oxygenation level was greater in successfully weaned patients

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.

Performance of Leak Compensation in All-Age ICU Ventilators During Volume-Targeted Neonatal Ventilation: A Lung Model Study.

Science.gov (United States)

Itagaki, Taiga; Bennett, Desmond J; Chenelle, Christopher T; Fisher, Daniel F; Kacmarek, Robert M

2017-01-01

Volume-targeted ventilation is increasingly used in low birthweight infants because of the potential for reducing volutrauma and avoiding hypocapnea. However, it is not known what level of air leak is acceptable during neonatal volume-targeted ventilation when leak compensation is activated concurrently. Four ICU ventilators (Servo-i, PB980, V500, and Avea) were compared in available invasive volume-targeted ventilation modes (pressure control continuous spontaneous ventilation [PC-CSV] and pressure control continuous mandatory ventilation [PC-CMV]). The Servo-i and PB980 were tested with (+) and without (-) their proximal flow sensor. The V500 and Avea were tested with their proximal flow sensor as indicated by their manufacturers. An ASL 5000 lung model was used to simulate 4 neonatal scenarios (body weight 0.5, 1, 2, and 4 kg). The ASL 5000 was ventilated via an endotracheal tube with 3 different leaks. Two minutes of data were collected after each change in leak level, and the asynchrony index was calculated. Tidal volume (V T ) before and after the change in leak was assessed. The differences in delivered V T between before and after the change in leak were within ±5% in all scenarios with the PB980 (-/+) and V500. With the Servo-i (-/+), baseline V T was ≥10% greater than set V T during PC-CSV, and delivered V T markedly changed with leak. The Avea demonstrated persistent high V T in all leak scenarios. Across all ventilators, the median asynchrony index was 1% (interquartile range 0-27%) in PC-CSV and 1.8% (0-45%) in PC-CMV. The median asynchrony index was significantly higher in the Servo-i (-/+) than in the PB980 (-/+) and V500 in 1 and 2 kg scenarios during PC-CSV and PC-CMV. The PB980 and V500 were the only ventilators to acclimate to all leak scenarios and achieve targeted V T . Further clinical investigation is needed to validate the use of leak compensation during neonatal volume-targeted ventilation. Copyright © 2017 by Daedalus Enterprises.

Prototype-Incorporated Emotional Neural Network.

Science.gov (United States)

Oyedotun, Oyebade K; Khashman, Adnan

2017-08-15

Artificial neural networks (ANNs) aim to simulate the biological neural activities. Interestingly, many ''engineering'' prospects in ANN have relied on motivations from cognition and psychology studies. So far, two important learning theories that have been subject of active research are the prototype and adaptive learning theories. The learning rules employed for ANNs can be related to adaptive learning theory, where several examples of the different classes in a task are supplied to the network for adjusting internal parameters. Conversely, the prototype-learning theory uses prototypes (representative examples); usually, one prototype per class of the different classes contained in the task. These prototypes are supplied for systematic matching with new examples so that class association can be achieved. In this paper, we propose and implement a novel neural network algorithm based on modifying the emotional neural network (EmNN) model to unify the prototype- and adaptive-learning theories. We refer to our new model as ``prototype-incorporated EmNN''. Furthermore, we apply the proposed model to two real-life challenging tasks, namely, static hand-gesture recognition and face recognition, and compare the result to those obtained using the popular back-propagation neural network (BPNN), emotional BPNN (EmNN), deep networks, an exemplar classification model, and k-nearest neighbor.

Nasal mask ventilation is better than face mask ventilation in edentulous patients

OpenAIRE

Kapoor, Mukul Chandra; Rana, Sandeep; Singh, Arvind Kumar; Vishal, Vindhya; Sikdar, Indranil

2016-01-01

Background and Aims: Face mask ventilation of the edentulous patient is often difficult as ineffective seating of the standard mask to the face prevents attainment of an adequate air seal. The efficacy of nasal ventilation in edentulous patients has been cited in case reports but has never been investigated. Material and Methods: Consecutive edentulous adult patients scheduled for surgery under general anesthesia with endotracheal intubation, during a 17-month period, were prospectively ev...

Computational modeling of particle transport and distribution emitted from a Laserjet printer in a ventilated room with different ventilation configurations

International Nuclear Information System (INIS)

Ansaripour, Mehrzad; Abdolzadeh, Morteza; Sargazizadeh, Saleh

2016-01-01

Highlights: • The distribution of emitted particles form a laserjet printer was studied in the breathing zone. • Effects of different ventilation configurations on the breathing zone concentration were investigated. • Mixing ventilation system has a low mean particle concentration in the breathing zone. - Abstract: In the present research, computational modeling of particle transport and distribution emitted from a Laserjet printer was carried out in a ventilated room. A seated manikin was integrated into the study room and the manikin was evaluated in two cases: heated and unheated. Effects of different ventilation configurations of the room on the particle distribution were studied, including three displacement ventilation systems and a mixing ventilation system. The printer was located on different sides of the manikin and the particle concentrations in the breathing zone of the manikin due to the printer’s particles were evaluated in all the ventilation configurations. The averaged particle concentration in the breathing zone of the manikin was calculated and validated with the experimental and numerical data available in the literature. The results of the present study showed that in case of the heated manikin, the particle concentration due to the printer pollutants is significant in the breathing zone of the manikin. The results also showed that when the printer is located on the front side of the manikin, the particle concentration in the breathing zone is quite high in most of the used ventilation configurations. Furthermore, it was found that the mixing ventilation system has a lower mean particle concentration in the breathing zone compared to the most displacement ventilation systems.

21 CFR 868.5925 - Powered emergency ventilator.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Powered emergency ventilator. 868.5925 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5925 Powered emergency ventilator. (a) Identification. A powered emergency ventilator is a demand valve or inhalator intended to provide emergency...

Ventilation strategies and indoor environment in classrooms

DEFF Research Database (Denmark)

Zhang, Chen; Liu, Li

2017-01-01

Compared with the other building types, the school building has much higher occupancy density and ventilation demand. In Demark, most of the school buildings are ventilated by natural manner. There is a risk of poor indoor environment associated with the lack of ventilation system or insufficient...

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.

Application of CPM procedures in mine ventilation

International Nuclear Information System (INIS)

Wang, Y.J.; Mutmansky, J.M.

1982-01-01

Mine ventilation analysis is an engineering discipline that can be considered a branch of the body of science known as network analysis. Likewise, the group of engineering procedures known as the critical path method (CPM) is considered a branch of network analysis. It is therefore not surprising that mine ventilation network analysis and CPM have many similarities. These similarities are useful in analyzing several types of mine ventilation problems and will be utilized in this paper. The analogy between the free split in a ventilation circuit and the critical path in a scheduling network has been recognized by Owili-Eger (1973). While this was recognized as a property of a general ventilation network, many important applications to controlled-splitting problems also exist. The mathematical procedures necessary to apply CPM and network methods have previously been presented (Wang, 1981; Wang, 1982). This paper will illustrate the implementation of these methods by application to mine ventilation networks

21 CFR 868.5915 - Manual emergency ventilator.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Manual emergency ventilator. 868.5915 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5915 Manual emergency ventilator. (a) Identification. A manual emergency ventilator is a device, usually incorporating a bag and valve, intended to...

Low Tidal Volume Ventilation in Patients without Acute Respiratory Distress Syndrome: A Paradigm Shift in Mechanical Ventilation

OpenAIRE

Lipes, Jed; Bojmehrani, Azadeh; Lellouche, Francois

2012-01-01

Protective ventilation with low tidal volume has been shown to reduce morbidity and mortality in patients suffering from acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Low tidal volume ventilation is associated with particular clinical challenges and is therefore often underutilized as a therapeutic option in clinical practice. Despite some potential difficulties, data have been published examining the application of protective ventilation in patients without lung inj...

Characteristics of coal mine ventilation air flows.

Science.gov (United States)

Su, Shi; Chen, Hongwei; Teakle, Philip; Xue, Sheng

2008-01-01

Coal mine methane (CMM) is not only a greenhouse gas but also a wasted energy resource if not utilised. Underground coal mining is by far the most important source of fugitive methane emissions, and approximately 70% of all coal mining related methane is emitted to the atmosphere through mine ventilation air. Therefore, research and development on mine methane mitigation and utilisation now focuses on methane emitted from underground coal mines, in particular ventilation air methane (VAM) capture and utilisation. To date, most work has focused on the oxidation of very low concentration methane. These processes may be classified based on their combustion kinetic mechanisms into thermal oxidation and catalytic oxidation. VAM mitigation/utilisation technologies are generally divided into two basic categories: ancillary uses and principal uses. However, it is possible that the characteristics of ventilation air flows, for example the variations in methane concentration and the presence of certain compounds, which have not been reported so far, could make some potential VAM mitigation and utilisation technologies unfeasible if they cannot cope with the characteristics of mine site ventilation air flows. Therefore, it is important to understand the characteristics of mine ventilation air flows. Moreover, dust, hydrogen sulphide, sulphur dioxide, and other possible compounds emitted through mine ventilation air into the atmosphere are also pollutants. Therefore, this paper presents mine-site experimental results on the characteristics of mine ventilation air flows, including methane concentration and its variations, dust loadings, particle size, mineral matter of the dust, and other compounds in the ventilation air flows. The paper also discusses possible correlations between ventilation air characteristics and underground mining activities.

A prospective evaluation of ventilator-associated conditions and infection-related ventilator-associated conditions.

Science.gov (United States)

Boyer, Anthony F; Schoenberg, Noah; Babcock, Hilary; McMullen, Kathleen M; Micek, Scott T; Kollef, Marin H

2015-01-01

The Centers for Disease Control and Prevention has shifted policy away from using ventilator-associated pneumonia (VAP) and toward using ventilator-associated conditions (VACs) as a marker of ICU quality. To date, limited prospective data regarding the incidence of VAC among medical and surgical ICU patients, the ability of VAC criteria to capture patients with VAP, and the potential clinical preventability of VACs are available. This study was a prospective 12-month cohort study (January 2013 to December 2013). We prospectively surveyed 1,209 patients ventilated for ≥ 2 calendar days. Sixty-seven VACs were identified (5.5%), of which 34 (50.7%) were classified as an infection-related VAC (IVAC) with corresponding rates of 7.0 and 3.6 per 1,000 ventilator days, respectively. The mortality rate of patients having a VAC was significantly greater than that of patients without a VAC (65.7% vs 14.4%, P VACs included IVACs (50.7%), ARDS (16.4%), pulmonary edema (14.9%), and atelectasis (9.0%). Among IVACs, 44.1% were probable VAP and 17.6% were possible VAP. Twenty-five VACs (37.3%) were adjudicated to represent potentially preventable events. Eighty-six episodes of VAP occurred in 84 patients (10.0 of 1,000 ventilator days) during the study period. The sensitivity of the VAC criteria for the detection of VAP was 25.9% (95% CI, 16.7%-34.5%). Although relatively uncommon, VACs are associated with greater mortality and morbidity when they occur. Most VACs represent nonpreventable events, and the VAC criteria capture a minority of VAP episodes.

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,

Fires in large scale ventilation systems

International Nuclear Information System (INIS)

Gregory, W.S.; Martin, R.A.; White, B.W.; Nichols, B.D.; Smith, P.R.; Leslie, I.H.; Fenton, D.L.; Gunaji, M.V.; Blythe, J.P.

1991-01-01

This paper summarizes the experience gained simulating fires in large scale ventilation systems patterned after ventilation systems found in nuclear fuel cycle facilities. The series of experiments discussed included: (1) combustion aerosol loading of 0.61x0.61 m HEPA filters with the combustion products of two organic fuels, polystyrene and polymethylemethacrylate; (2) gas dynamic and heat transport through a large scale ventilation system consisting of a 0.61x0.61 m duct 90 m in length, with dampers, HEPA filters, blowers, etc.; (3) gas dynamic and simultaneous transport of heat and solid particulate (consisting of glass beads with a mean aerodynamic diameter of 10μ) through the large scale ventilation system; and (4) the transport of heat and soot, generated by kerosene pool fires, through the large scale ventilation system. The FIRAC computer code, designed to predict fire-induced transients in nuclear fuel cycle facility ventilation systems, was used to predict the results of experiments (2) through (4). In general, the results of the predictions were satisfactory. The code predictions for the gas dynamics, heat transport, and particulate transport and deposition were within 10% of the experimentally measured values. However, the code was less successful in predicting the amount of soot generation from kerosene pool fires, probably due to the fire module of the code being a one-dimensional zone model. The experiments revealed a complicated three-dimensional combustion pattern within the fire room of the ventilation system. Further refinement of the fire module within FIRAC is needed. (orig.)

Face recognition based on improved BP neural network

Directory of Open Access Journals (Sweden)

Yue Gaili

2017-01-01

Full Text Available In order to improve the recognition rate of face recognition, face recognition algorithm based on histogram equalization, PCA and BP neural network is proposed. First, the face image is preprocessed by histogram equalization. Then, the classical PCA algorithm is used to extract the features of the histogram equalization image, and extract the principal component of the image. And then train the BP neural network using the trained training samples. This improved BP neural network weight adjustment method is used to train the network because the conventional BP algorithm has the disadvantages of slow convergence, easy to fall into local minima and training process. Finally, the BP neural network with the test sample input is trained to classify and identify the face images, and the recognition rate is obtained. Through the use of ORL database face image simulation experiment, the analysis results show that the improved BP neural network face recognition method can effectively improve the recognition rate of face recognition.

9 CFR 354.226 - Lighting and ventilation.

Science.gov (United States)

2010-01-01

... Facilities § 354.226 Lighting and ventilation. There shall be ample light, either natural or artificial or both, of good quality and well distributed, and sufficient ventilation for all rooms and compartments... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Lighting and ventilation. 354.226...

Validating and improving CT ventilation imaging by correlating with ventilation 4D-PET/CT using 68Ga-labeled nanoparticles

International Nuclear Information System (INIS)

Kipritidis, John; Keall, Paul J.; Siva, Shankar; Hofman, Michael S.; Callahan, Jason; Hicks, Rodney J.

2014-01-01

Purpose: CT ventilation imaging is a novel functional lung imaging modality based on deformable image registration. The authors present the first validation study of CT ventilation using positron emission tomography with 68 Ga-labeled nanoparticles (PET-Galligas). The authors quantify this agreement for different CT ventilation metrics and PET reconstruction parameters. Methods: PET-Galligas ventilation scans were acquired for 12 lung cancer patients using a four-dimensional (4D) PET/CT scanner. CT ventilation images were then produced by applying B-spline deformable image registration between the respiratory correlated phases of the 4D-CT. The authors test four ventilation metrics, two existing and two modified. The two existing metrics model mechanical ventilation (alveolar air-flow) based on Hounsfield unit (HU) change (V HU ) or Jacobian determinant of deformation (V Jac ). The two modified metrics incorporate a voxel-wise tissue-density scaling (ρV HU and ρV Jac ) and were hypothesized to better model the physiological ventilation. In order to assess the impact of PET image quality, comparisons were performed using both standard and respiratory-gated PET images with the former exhibiting better signal. Different median filtering kernels (σ m = 0 or 3 mm) were also applied to all images. As in previous studies, similarity metrics included the Spearman correlation coefficient r within the segmented lung volumes, and Dice coefficient d 20 for the (0 − 20)th functional percentile volumes. Results: The best agreement between CT and PET ventilation was obtained comparing standard PET images to the density-scaled HU metric (ρV HU ) with σ m = 3 mm. This leads to correlation values in the ranges 0.22 ⩽ r ⩽ 0.76 and 0.38 ⩽ d 20 ⩽ 0.68, with r ¯ =0.42±0.16 and d ¯ 20 =0.52±0.09 averaged over the 12 patients. Compared to Jacobian-based metrics, HU-based metrics lead to statistically significant improvements in r ¯ and d ¯ 20 (p ¯ than for unscaled

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.

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

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.

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...

Neural and Fuzzy Adaptive Control of Induction Motor Drives

International Nuclear Information System (INIS)

Bensalem, Y.; Sbita, L.; Abdelkrim, M. N.

2008-01-01

This paper proposes an adaptive neural network speed control scheme for an induction motor (IM) drive. The proposed scheme consists of an adaptive neural network identifier (ANNI) and an adaptive neural network controller (ANNC). For learning the quoted neural networks, a back propagation algorithm was used to automatically adjust the weights of the ANNI and ANNC in order to minimize the performance functions. Here, the ANNI can quickly estimate the plant parameters and the ANNC is used to provide on-line identification of the command and to produce a control force, such that the motor speed can accurately track the reference command. By combining artificial neural network techniques with fuzzy logic concept, a neural and fuzzy adaptive control scheme is developed. Fuzzy logic was used for the adaptation of the neural controller to improve the robustness of the generated command. The developed method is robust to load torque disturbance and the speed target variations when it ensures precise trajectory tracking with the prescribed dynamics. The algorithm was verified by simulation and the results obtained demonstrate the effectiveness of the IM designed controller

21 CFR 888.4230 - Cement ventilation tube.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cement ventilation tube. 888.4230 Section 888.4230...) MEDICAL DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4230 Cement ventilation tube. (a) Identification. A cement ventilation tube is a tube-like device usually made of plastic intended to be inserted into...

Modelling of Natural and Hybrid Ventilation

OpenAIRE

Heiselberg, Per

2006-01-01

The effectiveness of natural ventilation, i.e. its ability to ensure indoor air quality and passive cooling in a building, depends greatly on the design process. Mechanical ventilation systems can be designed separately from the design of the building in which they are installed. They can also be installed in existing buildings after a few modifications. In contrast, ventilation systems using only natural forces such as wind and thermal buoyancy need to be designed together with the building,...

Potential of Natural Ventilation in Shopping Centres

DEFF Research Database (Denmark)

Diederichsen, Alice; Friis, Kristina; Brohus, Henrik

2008-01-01

The indoor environmental quality (IEQ) is a fundamental requirement for a well performing shopping centre. This paper contains a pilot study of the potential of using hybrid ventilation (a combination of automatically controlled natural and mechanical ventilation - respectively NV and MV) in shop......The indoor environmental quality (IEQ) is a fundamental requirement for a well performing shopping centre. This paper contains a pilot study of the potential of using hybrid ventilation (a combination of automatically controlled natural and mechanical ventilation - respectively NV and MV......) in shopping centres with focus on both the achieved IEQ and energy consumptions for air movement. By thermal building simulations it is found that there exists an interesting potential for hybrid ventilation of shopping centres, which can lead to great savings in the electrical energy consumptions...

Mechanisms of natural ventilation in livestock buildings

DEFF Research Database (Denmark)

Rong, Li; Bjerg, Bjarne; Batzanas, Thomas

2016-01-01

Studies on the mechanisms of natural ventilation in livestock buildings are reviewed and influences on discharge and pressure coefficients are discussed. Compared to studies conducted on buildings for human occupation and industrial buildings which focus on thermal comfort, ventilation systems......, indoor air quality, building physics and energy etc., our understanding of the mechanisms involved in natural ventilation of livestock buildings are still limited to the application of the orifice equation. It has been observed that the assumptions made for application of the orifice equation...... are not valid for wind-induced cross ventilation through large openings. This review identifies that the power balance model, the concept of stream tube and the local dynamic similarity model has helped in the fundamental understanding of wind-induced natural ventilation in buildings for human occupation...

3 Level Ventilation: the First Clinical Experience

Directory of Open Access Journals (Sweden)

P. Torok

2008-01-01

Full Text Available Considering the issues of artificial ventilation (AV in non-homogenous pathological lung processes (acute lung injury (ALI, acute respiratory distress syndrome (ARDS, pneumonia, etc., the authors applied the three-level lung ventilation to a group of 12 patients with non-homogenous lung injury. Three-level ventilation was defined as a type (modification of AV whose basic ventilation level was produced by the modes CMV, PCV or PS (ASB and add-on level, the so-called background ventilation was generated by two levels of PEEP. PEEP (constant and PEEPh (PEEP high with varying frequency and duration of transition between the individual levels of PEEP. Objective: to elucidate whether in cases of considerably non-homogenous gas distribution in acute pathological disorders, three-level ventilation (3LV can correct gas distribution into the so-called slow bronchoalveolar compartments, by decreasing the volume load of the so-called fast compartments and to improve lung gas exchange, by following the principles of safe ventilation. Results. 3LV was applied to 12 patients with severe non-homogenous lung injury/disorder (atypic pneumonia and ARDS/ALI and low-success PCV ventilation after recruitment manoeuvre (PaO2 (kPA /FiO2 = 5—6. There were pronounced positive changes in pulmonary gas exchange within 1—4 hours after initiation of 3LV at a fPCV of 26±4 breaths/min-1 and PEEPh at a fPEEPH of 7±2 breaths/min-1 with a minute ventilation of 12±4 l/min. 3LV reduced a intrapulmonary shunt fraction 50±5 to 30±5%, increased CO2 elimination, with PaCO2 falling to the values below 6±0.3 kPa, and PaO2 to 7.5±1.2 kPa, with FiO2 being decreased to 0.8—0.4. Lung recruitment also improved gas exchange: with PEEP=1.2±0.4 kPa, static tho-racopulmonary compliance (Cst elevated from 0.18±0.02 l/kPa to 0.3±0.02 l/kPa and then to 0.38±0.05 l/kPa. Airways resistance (Raw decreased by more than 30%. Improved lung aeration was also estimated as a manifestation of

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.

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

Modes of mechanical ventilation for the operating room.

Science.gov (United States)

Ball, Lorenzo; Dameri, Maddalena; Pelosi, Paolo

2015-09-01

Most patients undergoing surgical procedures need to be mechanically ventilated, because of the impact of several drugs administered at induction and during maintenance of general anaesthesia on respiratory function. Optimization of intraoperative mechanical ventilation can reduce the incidence of post-operative pulmonary complications and improve the patient's outcome. Preoxygenation at induction of general anaesthesia prolongs the time window for safe intubation, reducing the risk of hypoxia and overweighs the potential risk of reabsorption atelectasis. Non-invasive positive pressure ventilation delivered through different interfaces should be considered at the induction of anaesthesia morbidly obese patients. Anaesthesia ventilators are becoming increasingly sophisticated, integrating many functions that were once exclusive to intensive care. Modern anaesthesia machines provide high performances in delivering the desired volumes and pressures accurately and precisely, including assisted ventilation modes. Therefore, the physicians should be familiar with the potential and pitfalls of the most commonly used intraoperative ventilation modes: volume-controlled, pressure-controlled, dual-controlled and assisted ventilation. Although there is no clear evidence to support the advantage of any one of these ventilation modes over the others, protective mechanical ventilation with low tidal volume and low levels of positive end-expiratory pressure (PEEP) should be considered in patients undergoing surgery. The target tidal volume should be calculated based on the predicted or ideal body weight rather than on the actual body weight. To optimize ventilation monitoring, anaesthesia machines should include end-inspiratory and end-expiratory pause as well as flow-volume loop curves. The routine administration of high PEEP levels should be avoided, as this may lead to haemodynamic impairment and fluid overload. Higher PEEP might be considered during surgery longer than 3 h

Cooperation of Horizontal Ground Heat Exchanger with the Ventilation Unit During Summer - Case Study

Science.gov (United States)

Romańska-Zapała, Anna; Furtak, Marcin; Dechnik, Mirosław

2017-10-01

Renewable energy sources are used in the modern energy-efficient buildings to improve their energy balance. One of them is used in the mechanical ventilation system ground air heat exchanger (earth-air heat exchanger - EAHX). This solution, right after heat recovery from exhaust air (recuperation), allows the reduction in the energy needed to obtain the desired temperature of supply air. The article presents the results of "in situ" measurements of pipe ground air heat exchanger cooperating with the air handling unit, supporting cooling the building in the summer season, in Polish climatic conditions. The laboratory consists of a ventilation unit intake - exhaust with rotor for which the source of fresh air is the air intake wall and two air intakes field cooperating with the tube with ground air heat exchangers. Selection of the source of fresh air is performed using sprocket with actuators. This system is part of the ventilation system of the Malopolska Laboratory of Energy-Efficient Building (MLBE) building of Cracow University of Technology. The measuring system are, among others, the sensors of parameters of air inlets and outlets of the heat exchanger channels EAHX and weather station that senses the local weather conditions. The measurement data are recorded and archived by the integrated process control system in the building of MLBE. During the study measurements of operating parameters of the ventilation unit cooperating with the selected source of fresh air were performed. Two cases of operation of the system: using EAHX heat exchanger and without it, were analyzed. Potentially the use of ground air heat exchanger in the mechanical ventilation system can reduce the energy demand for heating or cooling rooms by the pre-adjustment of the supply air temperature. Considering the results can be concluded that the continuous use of these exchangers is not optimal. This relationship is appropriate not only on an annual basis for the transitional periods (spring

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...

Perioperative lung protective ventilation in obese patients.

Science.gov (United States)

Fernandez-Bustamante, Ana; Hashimoto, Soshi; Serpa Neto, Ary; Moine, Pierre; Vidal Melo, Marcos F; Repine, John E

2015-05-06

The perioperative use and relevance of protective ventilation in surgical patients is being increasingly recognized. Obesity poses particular challenges to adequate mechanical ventilation in addition to surgical constraints, primarily by restricted lung mechanics due to excessive adiposity, frequent respiratory comorbidities (i.e. sleep apnea, asthma), and concerns of postoperative respiratory depression and other pulmonary complications. The number of surgical patients with obesity is increasing, and facing these challenges is common in the operating rooms and critical care units worldwide. In this review we summarize the existing literature which supports the following recommendations for the perioperative ventilation in obese patients: (1) the use of protective ventilation with low tidal volumes (approximately 8 mL/kg, calculated based on predicted -not actual- body weight) to avoid volutrauma; (2) a focus on lung recruitment by utilizing PEEP (8-15 cmH2O) in addition to recruitment maneuvers during the intraoperative period, as well as incentivized deep breathing and noninvasive ventilation early in the postoperative period, to avoid atelectasis, hypoxemia and atelectrauma; and (3) a judicious oxygen use (ideally less than 0.8) to avoid hypoxemia but also possible reabsorption atelectasis. Obesity poses an additional challenge for achieving adequate protective ventilation during one-lung ventilation, but different lung isolation techniques have been adequately performed in obese patients by experienced providers. Postoperative efforts should be directed to avoid hypoventilation, atelectasis and hypoxemia. Further studies are needed to better define optimum protective ventilation strategies and analyze their impact on the perioperative outcomes of surgical patients with obesity.

Intraoperative mechanical ventilation: state of the art.

Science.gov (United States)

Ball, Lorenzo; Costantino, Federico; Orefice, Giulia; Chandrapatham, Karthikka; Pelosi, Paolo

2017-10-01

Mechanical ventilation is a cornerstone of the intraoperative management of the surgical patient and is still mandatory in several surgical procedures. In the last decades, research focused on preventing postoperative pulmonary complications (PPCs), both improving risk stratification through the use of predictive scores and protecting the lung adopting so-called protective ventilation strategies. The aim of this review was to give an up-to-date overview of the currently suggested intraoperative ventilation strategies, along with their pathophysiologic rationale, with a focus on challenging conditions, such as obesity, one-lung ventilation and cardiopulmonary bypass. While anesthesia and mechanical ventilation are becoming increasingly safe practices, the contribution to surgical mortality attributable to postoperative lung injury is not negligible: for these reasons, the prevention of PPCs, including the use of protective mechanical ventilation is mandatory. Mechanical ventilation should be optimized providing an adequate respiratory support while minimizing unwanted negative effects. Due to the high number of surgical procedures performed daily, the impact on patients' health and healthcare costs can be relevant, even when new strategies result in an apparently small improvement of outcome. A protective intraoperative ventilation should include a low tidal volume of 6-8 mL/kg of predicted body weight, plateau pressures ideally below 16 cmH2O, the lowest possible driving pressure, moderate-low PEEP levels except in obese patients, laparoscopy and long surgical procedures that might benefit of a slightly higher PEEP. The work of the anesthesiologist should start with a careful preoperative visit to assess the risk, and a close postoperative monitoring.

Analysis on present radon ventilation situation of Chinese uranium mines

International Nuclear Information System (INIS)

Li Xianjie; Hu Penghua

2010-01-01

Mine Ventilation is the most important way in lowering radon of uranium mines. At present, radon and radon daughter concentration of underground air is 3∼5 times higher than any other air concentration of foreign uranium mines, as the same input for Protective Ventilation between Chinese uranium mines with compaction methodology and international advanced uranium mines. In this passage, through the analysis of Ventilation Radon Reduction status in Chinese uranium mines and the comparison of advantages and shortcomings between variety of ventilation and radon reduction, it illuminated the reasons of higher radon and radon daughter concentration in Chinese uranium mines and put forward some problems in three aspects, which are Ventilation Radon Reduction Theory, Ventilation Radon Reduction Measures and Ventilation Management. And to above problems, this passage put forward some proposals and measures about some aspects, such as strengthen examination and verification and monitoring practical situation, making clear ventilation plan, in according to mining sequence strictly, training Ventilation technician forcefully, enhance Ventilation System management, development of Ventilation Radon Reduction technology research in uranium mines and carrying out ventilation equipments as soon as possible in further and so on. (authors)

A historical perspective on ventilator management.

Science.gov (United States)

Shapiro, B A

1994-02-01

Paralysis via neuromuscular blockade in ICU patients requires mechanical ventilation. This review historically addresses the technological advances and scientific information upon which ventilatory management concepts are based, with special emphasis on the influence such concepts have had on the use of neuromuscular blocking agents. Specific reference is made to the scientific information and technological advances leading to the newer concepts of ventilatory management. Information from > 100 major studies in the peer-reviewed medical literature, along with the author's 25 yrs of clinical experience and academic involvement in acute respiratory care is presented. Nomenclature related to ventilatory management is specifically defined and consistently utilized to present and interpret the data. Pre-1970 ventilatory management is traced from the clinically unacceptable pressure-limited devices to the reliable performance of volume-limited ventilators. The scientific data and rationale that led to the concept of relatively large tidal volume delivery are reviewed in the light of today's concerns regarding alveolar overdistention, control-mode dyssynchrony, and auto-positive end-expiratory pressure. Also presented are the post-1970 scientific rationales for continuous positive airway pressure/positive end-expiratory pressure therapy, avoidance of alveolar hyperxia, and partial ventilatory support techniques (intermittent mandatory ventilation/synchronized intermittent mandatory ventilation). The development of pressure-support devices is discussed and the capability of pressure-control techniques is presented. The rationale for more recent concepts of total ventilatory support to avoid ventilator-induced lung injury is presented. The traditional techniques utilizing volume-preset ventilators with relatively large tidal volumes remain valid and desirable for the vast majority of patients requiring mechanical ventilation. Neuromuscular blockade is best avoided in these

Ventilation of high-speed flows, an alternating methodology for the ventilator design

International Nuclear Information System (INIS)

Saldarriaga V, Juan G.; Navarrete, J.; Galeano B, Luis A.

1996-01-01

This article is about a research developed at Universidad de los Andes on the ventilation of high velocity flows as prevention against cavitations erosion. The research was a consequence of the results found in the physical model of the Guavio River Hydroelectric Project near Bogota and was based in a general model study of a spillway with ventilation system, which did not represent a particular prototype. In the Guavio study one conclusion was obtained:in every ventilation system there are three unknowns which are the air discharge injected to the water flow (design object variable), the sub pressure under the water jet and the jump length of that jet. In the research those three variables were studied using dimensional analysis and multivariable regressions in order to find a set of three equations that allow the design of this type of structures. The new equations are more general than those reported in technical literature

Free Convection Personalized Ventilation (FCPV)

DEFF Research Database (Denmark)

Nielsen, Peter V.

Normally we supply fresh air to a room with a diffuser, and this air is distributed in the room according to different principles as: mixing ventilation, displacement ventilation etc. That means we have to supply a very large amount of air to the whole room, although a person in the room totally ...

Improvements of uranium mine ventilation system

International Nuclear Information System (INIS)

Liu Changrong; Zhou Xinghuo; Liu Zehua; Wang Zhiyong

2007-01-01

Ventilation has been proved to be a main method to eliminate radon and its daughters in uranium mines. According to the practical rectifications of uranium mine ventilation system, the improved measures are summarized. (authors)

Ventilation therapy for patients suffering from obstructive lung diseases.

Science.gov (United States)

Jungblut, Sven A; Heidelmann, Lena M; Westerfeld, Andreas; Frickmann, Hagen; Körber, Mareike K; Zautner, Andreas E

2014-01-01

Severe bronchial obstruction due to one of the major pulmonary diseases: asthma, COPD, or emphysema often requires mechanical ventilation support. Otherwise, patients are at risk of severe hypooxygenation with consecutive overloading and dilatation of the right cardiac ventricle with subsequent failure. This review focuses on how to manage a calculated ventilation therapy of patients suffering from bronchial obstruction and relevant patents. Options and pitfalls of invasive and non-invasive ventilation in the intensive care setting regarding clinical improvement and final outcome are discussed. The non-invasive ventilation is very efficient in treating acute or chronic respiratory failure in COPD patients and is capable of shortening the duration of hospitalization. Further non-invasive ventilation can successfully support the weaning after a long-lasting ventilation therapy and improve the prognosis of COPD patients. "Permissive hypercapnia" is unequivocally established in invasive ventilation therapy of severe bronchial obstruction in situations of limited ventilation. When intrinsic positive end-expiratory pressure (PEEP) and elevated airways resistance are present PEEP may be useful although external-PEEP application relieves over-inflation only in selected patients with airway obstruction during controlled mechanical ventilation. Upper limit of airways peak pressure used in "protective ventilation" of adult respiratory distress syndrome (ARDS) patients can be exceeded under certain circumstances.

RedVent. Turned off ventilation at night in schools - risks and opportunities; RedVent. Avstaengd ventilation paa natten i skolor - risker och moejligheter

Energy Technology Data Exchange (ETDEWEB)

Haegerhed Engman, Linda; Fyhr, Kristina; Langer, Sarka; Ruud, Svein; Ylmen, Peter

2011-07-01

Reduced ventilation rates or shutdown ventilation during nights is often being used in school buildings in order to save energy and can decrease the energy cost for heating and ventilation with at least 30 %. Swedish Building Regulations (BBR) allows reduced ventilation flow in non-residential buildings when no one is using the building but it must not give rise to adverse health effects or damage the building or its installations. Potential risks are mould- and moisture damages and indoor air quality problems. Another question is whether the shut down itself might lead to indoor air quality problems due to chemical reactions between outdoor air and indoor emissions built-up during the night. The study was divided into three steps; an interview with property managers and care-taker, calculations of energy saving potentials and a field study. Measurements were per-formed in one classroom for two weeks in April 2010. Different set-ups for ventilation flow during night time and air tightness of the building envelope were studied; ventilation shut down, intermittent ventilation (15 min every second hour) and continuous full speed ventilation during night. In the studied classroom, shutdown ventilation during nights did not significantly affect the indoor air quality in the classroom during the school day even though there were effects seen during the night. We found a somewhat higher moisture accumulation those nights when the ventilation was shut down and some fractions of particles during intermittent ventilation compared to continues full ventilation during night time. This specific school and classroom were well ventilated and there was no moisture supply from new building material or other types of moisture producing activities. Schools with lower day-time ventilation rates, moisture in building construction, IAQ- or dampness problems as well as buildings close to heavy traffic should analyse the conditions for the specific building before reducing ventilation to

Alternative ventilation system for operating theaters: parameter study and full-scale assessment of the performance of a local ventilation system

NARCIS (Netherlands)

J.G.H. Loogman; Dr. H.S.M. Kort; M.G.L.C. Loomans; I.M. de Visser

2016-01-01

A local operating theater ventilation device to specifically ventilate the wound area has been developed and investigated. The ventilation device is combined with a blanket which lies over the patient during the operation. Two configurations were studied: Configuration 1 where HEPA-filtered air was

Noninvasive ventilation in hypoxemic respiratory failure