WorldWideScience

Sample records for ventilation standards scoping

  1. Residential ventilation standards scoping study

    Energy Technology Data Exchange (ETDEWEB)

    McKone, Thomas E.; Sherman, Max H.

    2003-10-01

    The goals of this scoping study are to identify research needed to develop improved ventilation standards for California's Title 24 Building Energy Efficiency Standards. The 2008 Title 24 Standards are the primary target for the outcome of this research, but this scoping study is not limited to that timeframe. We prepared this scoping study to provide the California Energy Commission with broad and flexible options for developing a research plan to advance the standards. This document presents the findings of a scoping study commissioned by the Public Interest Energy Research (PIER) program of the California Energy Commission to determine what research is necessary to develop new residential ventilation requirements for California. This study is one of three companion efforts needed to complete the job of determining the ventilation needs of California residences, determining the bases for setting residential ventilation requirements, and determining appropriate ventilation technologies to meet these needs and requirements in an energy efficient manner. Rather than providing research results, this scoping study identifies important research questions along with the level of effort necessary to address these questions and the costs, risks, and benefits of pursuing alternative research questions. In approaching these questions and corresponding levels of effort, feasibility and timing were important considerations. The Commission has specified Summer 2005 as the latest date for completing this research in time to update the 2008 version of California's Energy Code (Title 24).

  2. Meeting Residential Ventilation Standards Through Dynamic Control of Ventilation Systems

    Energy Technology Data Exchange (ETDEWEB)

    Sherman, Max H.; Walker, Iain S.

    2011-04-01

    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 outdoor pollutant levels are high, the importance of minimizing energy use particularly during times of peak electricity demand, and how the energy used to condition air as part of ventilation system operation changes with outdoor conditions. Dynamic control of ventilation systems can provide ventilation equivalent to or better than what is required by standards while minimizing energy costs and can also add value by shifting load during peak times and reducing intake of outdoor air contaminants. This article describes the logic that enables dynamic control of whole-house ventilation systems to meet the intent of ventilation standards and demonstrates the dynamic ventilation system control concept through simulations and field tests of the Residential Integrated Ventilation-Energy Controller (RIVEC).

  3. Exploring the scope of communication content of mechanically ventilated patients.

    Science.gov (United States)

    Leung, Czarina C H; Pun, Jack; Lock, Graham; Slade, Diana; Gomersall, Charles D; Wong, Wai Tat; Joynt, Gavin M

    2017-10-29

    Ineffective communication during mechanical ventilation (MV) and critical illness is distressing to many patients. This study aimed to describe the scope of communication content of ventilated critically ill patients. We performed a prospective qualitative interview study in a multidisciplinary intensive care unit. Ten alert, orientated adult patients who previously underwent MV for at least 24h and were able to speak at the time of interview were recruited. Semi-structured interviews with stimulated recall technique were conducted. A descriptive thematic analysis was performed of the patient-generated content using a free coding technique, where recurrent themes and subthemes were noted, coded and analyzed. Patients' communication content included medical discussions with clinicians; communication with family to provide advice or comfort, make requests and plans, express feelings and convey personal perspectives on medical care; and expression of their own psychoemotional needs. The scope of communication content of ventilated ICU patients was broad, extending far beyond task-focused subject matter. Content ranged from conveying symptom-related messages to active participation in medical discussions, to conversing with family about a range of complex multi-dimensional issues, to sharing their own psychoemotional experiences. These patient-centered needs should be recognized and addressed in communication strategies. Copyright © 2017. Published by Elsevier Inc.

  4. 46 CFR 154.1205 - Mechanical ventilation system: Standards.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 5 2010-10-01 2010-10-01 false Mechanical ventilation system: Standards. 154.1205... Equipment Cargo Area: Mechanical Ventilation System § 154.1205 Mechanical ventilation system: Standards. (a) Each exhaust type mechanical ventilation system required under § 154.1200 (a) must have ducts for...

  5. 33 CFR 183.630 - Standards for natural ventilation.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Standards for natural ventilation... (CONTINUED) BOATING SAFETY BOATS AND ASSOCIATED EQUIPMENT Ventilation § 183.630 Standards for natural ventilation. (a) For the purpose of § 183.620, “natural ventilation” means an airflow in a compartment in a...

  6. Ventilator-delivered mask ventilation compared with three standard methods of mask ventilation in a manikin model.

    Science.gov (United States)

    Tracy, M B; Klimek, J; Coughtrey, H; Shingde, V; Ponnampalam, G; Hinder, M; Maheshwari, R; Tracy, S K

    2011-05-01

    Little is known regarding the variations in effective ventilation during bag and mask resuscitation with standard methods compared with that delivered by ventilator-delivered mask ventilation (VDMV). To measure the variations in delivered airway pressure, tidal volume (TV), minute ventilation (MV) and inspiratory time during a 3-min period of mask ventilation comparing VDMV with three commonly used hand-delivered methods of bag and mask ventilation: Laerdal self-inflating bag (SIB); anaesthetic bag and T-piece Neopuff. A modified resuscitation manikin was used to measure variation in mechanical ventilation during 3-min periods of mask ventilation. Thirty-six experienced practitioners gave positive pressure mask ventilation targeting acceptable chest wall movement with a rate of 60 inflations/min and when pressures could be targeted or set, a peak inspiratory pressure (PIP) of 18 cm water, positive end-expiratory pressure (PEEP) of 5 cm water, for 3 min with each of the four mask ventilation methods. Each mode was randomly sequenced. A total of 21 136 inflations were recorded and analysed. VDMV achieved PIP and PEEP closest to that targeted and significantly lower variation in all measured parameters (pventilation on a manikin, VDMV produced the least variation in delivered ventilation. SIB produced wide variation and unacceptably high TV and MV in experienced hands.

  7. 40 CFR 140.2 - Scope of standard.

    Science.gov (United States)

    2010-07-01

    ... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) MARINE SANITATION DEVICE STANDARD § 140.2 Scope of standard. The standard adopted herein applies only to vessels on which a marine sanitation device has been installed. The standard does not require the installation of a...

  8. Update: NI Scope and Standards of Practice, Competencies, and Certification.

    Science.gov (United States)

    Bickford, Carol J

    2016-01-01

    The new 2015 ANA Nursing Informatics: Scope and Standards of Practice, Second Edition, includes a slightly revised definition of nursing informatics, totally revised scope of practice statement, and updated standards and accompanying competencies. The competencies are now leveled for informatics nurses and informatics nurse specialists. This professional resource informs practice, education, research, administration, and the certification process. The presenters will provide details about the development of the latest NI scope and standards of practice and the contemporary ANCC certification process to stimulate group discussion and promote development of a personal action plan to integrate such content into nursing and informatics practice. The target audience includes all registered nurses, informatics nurses, informatics nurse specialists, faculty, and administrators.

  9. Randomized trial of 'intelligent' autotitrating ventilation versus standard pressure support non-invasive ventilation: impact on adherence and physiological outcomes.

    Science.gov (United States)

    Kelly, Julia L; Jaye, Jay; Pickersgill, Rachel E; Chatwin, Michelle; Morrell, Mary J; Simonds, Anita K

    2014-05-01

    Effective non-invasive ventilation (NIV) therapy is dependent on optimal ventilator settings to maximize clinical benefit and patient tolerance. Intelligent volume-assured pressure support (iVAPS) is a hybrid mode of servoventilation, providing constant automatic adjustment of pressure support (PS) to achieve a target ventilation determined by the patient's requirements. In a randomized crossover trial, we tested the hypothesis that iVAPS, with automated selection of ventilator settings, was non-inferior to standard PS ventilation, with settings determined by an experienced health-care professional, for controlling nocturnal hypoventilation in patients naive to NIV. Eighteen patients referred to a ventilator clinic with chronic obstructive or restrictive lung disease and newly diagnosed nocturnal hypoventilation (10 male, median (interquartile range): age 54(41-61) years, mean daytime PaO2 9.25(8.59-10.31) kPa, -PaCO2 6.38(5.93-6.65) kPa were randomized to iVAPS and standard PS. Polysomnography with transcutaneous CO2 monitoring was performed at baseline and 1 month after each treatment period. Nightly hours of therapy were recorded by the ventilator. iVAPS delivered a lower median PS compared with standard PS (8.3(5.6-10.4) vs 10.0(9.0-11.4) cmH2 O; P = 0.001) for the same ventilatory outcome (mean overnight: SpO2 96(95-98) vs 96(93-97)%; P = 0.13 and PtcCO2 6.5(5.8-6.8) vs 6.2(5.8-6.9); P = 0.54). There was no difference in outcome between ventilator modes for spirometry, respiratory muscle strength, sleep quality, arousals or O2 desaturation index. Adherence was greater with iVAPS (5:40(4:42-6:49) vs 4:20(2:27-6:17) hh:mm/night; P = 0.004). iVAPS servoventilation with automation of ventilation settings is as effective as PS ventilation initiated by a skilled health-care professional in controlling nocturnal hypoventilation and produced better overnight adherence in patients naive to NIV. © 2014 Asian Pacific Society of Respirology.

  10. Long-term non-invasive ventilation therapies in children: a scoping review protocol.

    Science.gov (United States)

    Castro Codesal, Maria L; Featherstone, Robin; Martinez Carrasco, Carmen; Katz, Sherri L; Chan, Elaine Y; Bendiak, Glenda N; Almeida, Fernanda R; Young, Rochelle; Olmstead, Deborah; Waters, Karen A; Sullivan, Collin; Woolf, Vicki; Hartling, Lisa; MacLean, Joanna E

    2015-08-12

    Non-invasive ventilation (NIV) in children has become an increasingly common modality of breathing support where pressure support is delivered through a mask interface or less commonly through other non-invasive interfaces. At this time, NIV is considered a first-line option for ventilatory support of chronic respiratory insufficiency associated with a range of respiratory and sleep disorders. Previous reviews on the effectiveness, complications and adherence to NIV treatment have lacked systematic methods. The purpose of this scoping review is to provide an overview of the evidence for the use of long-term NIV in children. We will use previously established scoping methodology. Ten electronic databases will be searched to identify studies in children using NIV for longer than 3 months outside an intensive care setting. Grey literature search will include conference proceedings, thesis and dissertations, unpublished trials, reports from regulatory agencies and manufacturers. Two reviewers will independently screen titles and abstracts for inclusion, followed by full-text screening of potentially relevant articles to determine final inclusion. Data synthesis will be performed at three levels: (1) an analysis of the number, publication type, publication year, and country of publication of the studies; (2) a summary of the study designs, outcomes measures used; (3) a thematic analysis of included studies by subgroups. This study will provide a wide and rigorous overview of the evidence on the use of long-term NIV in children and provide critical information for healthcare professionals and policymakers to better care for this group of children. We will disseminate our findings through conference proceedings and publications, and evaluate the results for further systematic reviews and meta-analyses. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  11. Responses to Human Bioeffluents at Levels Recommended by Ventilation Standards

    DEFF Research Database (Denmark)

    Zhang, Xiaojing; Wargocki, Pawel; Lian, Zhiwei

    2017-01-01

    was set to 33 or 4 l/s per person, creating two levels of bioeffluents with carbon dioxide (CO2) at 500 or 1600 ppm. Subjective ratings were collected, cognitive performance was examined and physiological responses were monitored. The results show that exposures to human bioeffluents at ventilation rate...... of 4 l/s per person caused sensory discomfort of visitors, reduced pNN50 (a domain of ECG measurement), but did not produce negative effects on cognitive performance or health symptoms....

  12. Procedures and Standards for Residential Ventilation System Commissioning: An Annotated Bibliography

    Energy Technology Data Exchange (ETDEWEB)

    Stratton, J. Chris [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Wray, Craig P. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2013-04-01

    Beginning with the 2008 version of Title 24, new homes in California must comply with ANSI/ASHRAE Standard 62.2-2007 requirements for residential ventilation. Where installed, the limited data available indicate that mechanical ventilation systems do not always perform optimally or even as many codes and forecasts predict. Commissioning such systems when they are installed or during subsequent building retrofits is a step towards eliminating deficiencies and optimizing the tradeoff between energy use and acceptable IAQ. Work funded by the California Energy Commission about a decade ago at Berkeley Lab documented procedures for residential commissioning, but did not focus on ventilation systems. Since then, standards and approaches for commissioning ventilation systems have been an active area of work in Europe. This report describes our efforts to collect new literature on commissioning procedures and to identify information that can be used to support the future development of residential-ventilation-specific procedures and standards. We recommend that a standardized commissioning process and a commissioning guide for practitioners be developed, along with a combined energy and IAQ benefit assessment standard and tool, and a diagnostic guide for estimating continuous pollutant emission rates of concern in residences (including a database that lists emission test data for commercially-available labeled products).

  13. Best Practices for Developing Specialty Nursing Scope and Standards of Practice.

    Science.gov (United States)

    Finnell, Deborah S; Thomas, Elizabeth L; Nehring, Wendy M; McLoughlin, Kris; Bickford, Carol J

    2015-05-31

    Nursing specialization involves focusing on nursing practice in an identified specific area within the entire field of professional nursing. A defined specialty scope of practice statement and standards of professional practice, with accompanying competencies, are unique to each nursing specialty. These documents help assure continued understanding and recognition of nursing's diverse professional contributions. The purpose of this article is to demystify the process for specialty nurses who are creating or revising their specialty nursing scope and standards of practice. We provide best practices for the developmental process based on our recently published scope and standards of specialty nursing practice. The conclusion provides strategies to disseminate scope and standards documents to appropriate stakeholders.

  14. Retention of pediatric bag-mask ventilation efficacy skill by inexperienced medical student resuscitators using standard bag-mask ventilation masks, pocket masks, and blob masks.

    Science.gov (United States)

    Kitagawa, Kory H; Nakamura, Nina M; Yamamoto, Loren

    2006-03-01

    To measure the ventilation efficacy with three single-sized mask types on infant and child manikin models. Medical students were recruited as study subjects inasmuch as they are inexperienced resuscitators. They were taught proper bag-mask ventilation (BMV) according to the American Heart Association guidelines on an infant and a child manikin. Subjects completed a BMV attempt successfully using the adult standard mask (to simulate the uncertainty of mask selection), pocket mask, and blob mask. Each attempt consisted of 5 ventilations assessed by chest rise of the manikin. Study subjects were asked which mask was easiest to use. Four to six weeks later, subjects repeated the procedure with no instructions (to simulate an emergency BMV encounter without immediate pre-encounter teaching). Forty-six volunteer subjects were studied. During the first attempt, subjects preferred the standard and blob masks over the pocket mask. For the second attempt, the blob mask was preferred over the standard mask, and few liked the pocket mask. Using the standard, blob, and pocket masks on the child manikin, 39, 42, and 20 subjects, respectively, were able to achieve adequate ventilation. Using the standard, blob, and pocket masks on the infant manikin, 45, 45, and 11 subjects, respectively, were able to achieve adequate ventilation. Both the standard and blob masks are more effective than the pocket mask at achieving adequate ventilation on infant and child manikins in this group of inexperienced medical student resuscitators, who most often preferred the blob mask.

  15. Standardized practice design with electronic support mechanisms for surgical process improvement: reducing mechanical ventilation time.

    Science.gov (United States)

    Cook, David J; Pulido, Juan N; Thompson, Jeffrey E; Dearani, Joseph A; Ritter, Matthew J; Hanson, Andrew C; Borah, Bijan J; Habermann, Elizabeth B

    2014-12-01

    Hospital surgical care is complex and subject to unwarranted variation. As part of a multiyear effort, we sought to reduce variability in intraoperative care and management of mechanical ventilation in cardiac surgery. We identified a patient population whose care could be standardized and implemented a protocol-based practice model reinforced by electronic mechanisms. In a large cardiac surgery practice, we built a standardized practice model between 2009 and 2011. We compared mechanical ventilation time before (2008) and after (2012) implementation. To ensure groups were comparable, propensity analysis matched patients from the 2 operative years. In 2012, more than 50% of all cardiac surgical patients were managed with our standardized care model; of those, 769 were one-to-one matched with patients undergoing surgery in 2008. Patients had a mix of coronary artery bypass grafting, valve surgery, and combined procedures. Our practice model reduced median mechanical ventilation duration from 9.3 to 6.3 hours (2008 and 2012) (P Variability in ventilation time was also reduced. We demonstrate that in more than 50% of all cardiac surgical patients, a standardized practice model can be used to achieve better results. Clinical outcomes are improved and unwarranted variability is reduced. Success is driven by clear patient identification and well-defined protocols that are clearly communicated both by electronic tools and by empowerment of bedside providers to advance care when clinical criteria are met.

  16. Effect of environmental condition on ventilation rate of special standard bars

    Directory of Open Access Journals (Sweden)

    Miao Qian

    2014-01-01

    Full Text Available Standard bar of ventilation is the equipment extensively used in the tobacco industry to calibrate the variety of testing machines. The bar’s performance that is usually affected by ambient conditions is numerically studied in this paper. Firstly, the geometry of standard bar is obtained by an optical microscopic 3-D measurement. Then, Solidworks is used to build the 3-D model of standard bar and Gambit is used to mesh the model. Finally, the performance of standard bar under variant ambient conditions is analyzed by Fluent. Compared with the experimental data, the numerical results are found to be quite accurate, and it is found that the ventilation rate increases linearly as temperature rise and decreases non-linearly with the growth of pressure.

  17. A Natural Ventilation Alternative to the Passivhaus Standard for a Mild Maritime Climate

    Directory of Open Access Journals (Sweden)

    Paola Sassi

    2013-01-01

    Full Text Available This study examines the need in mild maritime climates, such as the southern areas of the UK, for mechanical ventilation with heat recovery (MVHR as required by the German Passivhaus standard. It considers the comfort, air quality and energy impacts of MVHR versus natural ventilation and reviews the post-occupancy monitoring data of two flats in Cardiff designed to Passivhaus standards, one of which had been operated as a naturally ventilated building rather than with MVHR. The energy consumption of this free-running flat was significantly lower (36 kWh primary energy/m²a than the Passivhaus Planning Package modeling had predicted (93 kWh primary energy/m²a with no adverse effects on occupant comfort, air quality or excessive humidity, and advantages of lower capital cost and maintenance. The paper concludes that in climates with mild winters and cool summers the use of MVHR could be omitted without compromising comfort levels and achieving at least equivalent energy savings resulting from adopting the Passivhaus model and at a lower capital cost. This suggests the potential for a naturally ventilated, ultra-low energy model with lower capital investment requirements and lower disruption when applied to retrofit that would facilitate its mainstream adoption.

  18. Nephrology Nursing Scope and Standards of Practice: Integration into Clinical Practice.

    Science.gov (United States)

    Gomez, Norma J; Castner, Debra; Hain, Debra

    2017-01-01

    The eighth edition of the Nephrology Nursing Scope and Standards of Practice, published by the American Nephrology Nurses Association (Gomez, 2017), defines the scope of nephrology nursing practice, and provides standards of practice and professional performance in an approach similar to the American Nurses Association (ANA) 2016 standards. ANNA's eighth edition of the Nephrology Nursing Scope and Standards of Practice incorporates competencies for graduate level-prepared nurses in addition to the registered nurse (RN) and advanced practice registered nurse (APRN). The section on how to use the standards in practice has been updated with user-friendly forms. This article provides an overview of the scope of practice, standards, competencies, and situations that require intervention by the nephrology nurse. Copyright© by the American Nephrology Nurses Association.

  19. Scope and Standards: Defining the Advanced Practice Role in Genetics.

    Science.gov (United States)

    Kerber, Alice S; Ledbetter, Nancy J

    2017-06-01

    Because knowledge concerning genetics and genomics and its application to oncology care is continuing to grow, oncology nurses must be aware of appropriate advanced scope of practice roles based on education and training. All nurses must develop and maintain knowledge of the field, but advanced practice nurses working in genetics have additional competencies and management expectations. Collaboration among practice levels and disciplines is essential. This article focuses on the advanced practice role as further defined in published resources outlining scope of practice in genetics. 
.

  20. Hospital ventilation standards and energy conservation: chemical contamination of hospital air. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Rainer, D.; Michaelsen, G.S.

    1980-03-01

    In an era of increasing energy conservation consciousness, a critical reassessment of the validity of hospital ventilation and thermal standards is made. If current standards are found to be excessively conservative, major energy conservation measures could be undertaken by rebalancing and/or modification of current HVAC systems. To establish whether or not reducing ventilation rates would increase airborne chemical contamination to unacceptable levels, a field survey was conducted to develop an inventory and dosage estimates of hospital generated airborne chemical contaminants to which patients, staff, and visitors are exposed. The results of the study are presented. Emphasis is on patient exposure, but an examination of occupational exposure was also made. An in-depth assessment of the laboratory air environment is documented. Housekeeping products used in survey hospitals, hazardous properties of housekeeping chemicals and probable product composition are discussed in the appendices.

  1. 40 CFR 262.103 - What is the scope of the laboratory environmental management standard?

    Science.gov (United States)

    2010-07-01

    ... environmental management standard? 262.103 Section 262.103 Protection of Environment ENVIRONMENTAL PROTECTION... University Laboratories XL Project-Laboratory Environmental Management Standard § 262.103 What is the scope of the laboratory environmental management standard? The Laboratory Environmental Management Standard...

  2. 12 CFR 560.100 - Real estate lending standards; purpose and scope.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Real estate lending standards; purpose and... § 560.100 Real estate lending standards; purpose and scope. This section, and § 560.101 of this subpart....S.C. 1828(o), prescribe standards for real estate lending to be used by savings associations and all...

  3. 16 CFR 1616.65 - Policy scope of the standard.

    Science.gov (United States)

    2010-01-01

    ... STANDARD FOR THE FLAMMABILITY OF CHILDREN'S SLEEPWEAR: SIZES 7 THROUGH 14 (FF 5-74) Interpretations and..., or, otherwise, does not meet the requirements of the children's sleepwear flammability standards and... the children's sleepwear flammability standards in a manner that may cause the item to be viewed by...

  4. Work Scope for Developing Standards for Emergency Preparedness and Response: Fiscal Year 2004 Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Stenner, Robert D.

    2005-09-28

    Summarizes the fiscal year 2004 work completed on PNNL's Department of Homeland Security Emergency Preparedness and Response Standards Development Project. Also, the report includes key draft standards, in various stages of development and publication, that were associated with various tasks of the fiscal year 2004 scope of the project.

  5. 78 FR 38970 - California State Nonroad Engine Pollution Control Standards; Within-the-Scope Determination for...

    Science.gov (United States)

    2013-06-28

    ... AGENCY California State Nonroad Engine Pollution Control Standards; Within-the-Scope Determination for... required for new off-road engines. CARB, ``Request that Amendments to California's Airborne Toxic Control... enforce any standard or other requirement relating to the control of emissions from new nonroad engines...

  6. HOSPITAL VENTILATION STANDARDS AND ENERGY CONSERVATION: A REVIEW OF GOVERNMENTAL AND PRIVATE AGENCY ENERGY CONSERVATION INITIATIVES

    Energy Technology Data Exchange (ETDEWEB)

    Banks, Robert S.; Rainer, David

    1980-03-01

    This report presents the results of a recent research project originally concerned with review of governmental initiatives for changes to hospital design and operation standards at both the federal and state levels. However. it quickly became apparent that concern with energy conservation was not impacting hospital environmental standards, especially at the state level, irrespective of the energy implications. Consequently, the study was redirected to consider all energy conservation initiatives directed toward design and operating practices unique to the hospital environment. The scope was limited to agency programs (i.e., not undertaken at the initiative of individual hospitals), applicable to non-federal public and private hospitals.

  7. The 2014 Scope and Standards of Practice for Psychiatric Mental Health Nursing: Key Updates.

    Science.gov (United States)

    Kane, Catherine F

    2015-01-31

    The 2014 Psychiatric-Mental Health Nursing: Scope and Standards of Practice is the specialty's description of competent nursing practice. The scope portion of this document identifies the focus of the specialty by defining nursing practice extents and limits. Standards are statements that identify the duties and obligations for which specialty nurses are held accountable, including general registered nurses and advanced practice nurses. This article begins with a brief overview of the revision process. The author describes key factors that influenced the revision, such as external documents and current priorities in healthcare, and synthesizes significant changes to the document, including commentary and comparisons to the generalist Scope and Standards of Practice. Implications for nursing education and a companion resource are discussed.

  8. IPMA Standard Competence Scope in Project Management Education

    Science.gov (United States)

    Bartoška, Jan; Flégl, Martin; Jarkovská, Martina

    2012-01-01

    The authors of the paper endeavoured to find out key competences in IPMA standard for educational approaches in project management. These key competences may be used as a basis for project management university courses. An incidence matrix was set up, containing relations between IPMA competences described in IPMA competence baseline. Further,…

  9. 76 FR 61095 - California State Motor Vehicle Pollution Control Standards; Within the Scope Determination and...

    Science.gov (United States)

    2011-10-03

    ... AGENCY California State Motor Vehicle Pollution Control Standards; Within the Scope Determination and... certification, inspection or any other approval relating to the control of emissions from any new motor vehicle...) for the control of emissions from new motor vehicles or new motor engines prior to March 30, 1966,\\9...

  10. Sedation and analgesia in mechanically ventilated preterm neonates: continue standard of care or experiment?

    Science.gov (United States)

    McPherson, Christopher

    2012-10-01

    Attention to comfort and pain control are essential components of neonatal intensive care. Preterm neonates are uniquely susceptible to pain and agitation, and these exposures have a negative impact on brain development. In preterm neonates, chronic pain and agitation are common adverse effects of mechanical ventilation, and opiates or benzodiazepines are the pharmacologic agents most often used for treatment. Questions remain regarding the efficacy, safety, and neurodevelopmental impact of these therapies. Both preclinical and clinical data suggest troubling adverse drug reactions and the potential for adverse longterm neurodevelopmental impact. The negative impacts of standard pharmacologic agents suggest that alternative agents should be investigated. Dexmedetomidine is a promising alternative therapy that requires further interprofessional and multidisciplinary research in this population.

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

    Energy Technology Data Exchange (ETDEWEB)

    Mendell, Mark J.; Fisk, William J.

    2014-02-01

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

  12. ETS levels in hospitality environments satisfying ASHRAE standard 62-1989: "ventilation for acceptable indoor air quality"

    Science.gov (United States)

    Moschandreas, D. J.; Vuilleumier, K. L.

    Prior to this study, indoor air constituent levels and ventilation rates of hospitality environments had not been measured simultaneously. This investigation measured indoor Environmental Tobacco Smoke-related (ETS-related) constituent levels in two restaurants, a billiard hall and a casino. The objective of this study was to characterize ETS-related constituent levels inside hospitality environments when the ventilation rates satisfy the requirements of the ASHRAE 62-1989 Ventilation Standard. The ventilation rate of each selected hospitality environment was measured and adjusted. The study advanced only if the requirements of the ASHRAE 62-1989 Ventilation Standard - the pertinent standard of the American Society of Heating, Refrigeration and Air Conditioning Engineers - were satisfied. The supply rates of outdoor air and occupant density were measured intermittently to assure that the ventilation rate of each facility satisfied the standard under occupied conditions. Six ETS-related constituents were measured: respirable suspended particulate (RSP) matter, fluorescent particulate matter (FPM, an estimate of the ETS particle concentrations), ultraviolet particulate matter (UVPM, a second estimate of the ETS particle concentrations), solanesol, nicotine and 3-ethenylpyridine (3-EP). ETS-related constituent levels in smoking sections, non-smoking sections and outdoors were sampled daily for eight consecutive days at each hospitality environment. This study found that the difference between the concentrations of ETS-related constituents in indoor smoking and non-smoking sections was statistically significant. Differences between indoor non-smoking sections and outdoor ETS-related constituent levels were identified but were not statistically significant. Similarly, differences between weekday and weekend evenings were identified but were not statistically significant. The difference between indoor smoking sections and outdoors was statistically significant. Most

  13. VENTILATION NEEDS DURING CONSTRUCTION

    Energy Technology Data Exchange (ETDEWEB)

    C.R. Gorrell

    1998-07-23

    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.

  14. Interruptions in Chest Compressions by Surf Lifeguards: A Comparison of Face-mask Ventilation in Over-the-head CPR vs Standard CPR

    DEFF Research Database (Denmark)

    Nørkjær, Louise; Bomholt, Katrine Bjørnshave; Krogh, Kristian

    Introduction: Ventilation is a priority in drowning resuscitation. Over-the-head CPR (OH-CPR), i.e. with the rescuer located at the top of the victim’s head instead of alongside the victim’s torso, has been demonstrated to be superior when doing bag-valve-mask ventilation compared to standard CPR....... The International Life Saving Federation recommends CPR using face-mask ventilation. It is currently unknown if OH-CPR using face-mask ventilation improves CPR quality. We hypothesized that OH-CPR is superior to standard CPR with face-mask ventilation among surf lifeguards. Methods: Surf lifeguards were trained...... in OH-CPR and standard CPR with face-mask ventilation and randomized to a crossover comparison on a manikin. CPR quality data were obtained from the manikin and video recordings. Interruptions in chest compressions were used as a primary measure of CPR quality. A sample size of 14 participants...

  15. Hospital ventilation standards and energy conservation: a summary of the literature with conclusions and recommendations. Final report, FY 78

    Energy Technology Data Exchange (ETDEWEB)

    Hollowell, C.; Rosenfeld, A.

    1978-09-01

    This research examines the basis of current hospital HVAC standards and determines if they can be relaxed on criteria that do not compromise the health, safety, and comfort of patients and staff and has acceptance of the health care community. Chapter 2 summarizes existing standards in use throughout the United States governing hospital ventilation systems and the thermal environment. Chapter 3 explores the role of air in hospital-acquired infections. Chapter 4 explores the realm of indoor air quality within the hospital. Chapter 5 contains a discussion concerning the influence of thermal factors on patient comfort. Chapter 6 discusses the hospital odor problem with regards to ventilation rates. The final chapter includes conclusions and recommendations developed from the literature review and from a small working conference sponsored by the University of Minnesota School of Public Health.

  16. AuScope's use of Standards to Deliver Earth Resource Data

    Science.gov (United States)

    Woodcock, Robert; Simons, Bruce; Duclaux, Guillaume; Cox, Simon

    2010-05-01

    AuScope is an integrated national geosciences framework being built as a component of the Australian National Collaborative Research Infrastructure Strategy. The AuScope Grid element is a geoinformatics network using open standards to allow real time access to data, information and knowledge stored in distributed repositories. AuScope Grid draws together information from new initiatives and existing sources in academia, industry and government. The network is being deployed using infrastructure components from multiple open source projects in various domains. Together these provide a complete suite of tools for spatial data interoperability. The tools have been used to deploy OGC Web Map and Web Feature Services (WMS/WFS), service registration (CSW) and vocabulary services, and for the development of community application schemas. The key to linking resources in this Community Earth Model is web-service access to geoscience information holdings and computational services, using common service interfaces and standard (i.e. community agreed) information models. For example, EarthResourceML has been developed under the leadership of the Australian Government Geoscience Information Committee. EarthResourceML is an extension of GeoSciML, the IUGS developed language for exchange of geological map features. Each State and Territory Geological Survey has an earth resource database, storing information on mineral occurrences, commodities, historical production, reserves and resources, deposit classification and the like, each with its own format and sets of attributes and vocabularies. An OGC Web Feature Service has been deployed in each jurisdiction, which maps the local database to the common exchange model, thus allowing the AuScope Discovery Portal to query and consume the earth resource data from the distributed databases. This approach to interoperability is predicated on (a) community acceptance of the exchange model (b) ability and commitment by each data provider

  17. Standardizing Predicted Body Weight Equations for Mechanical Ventilation Tidal Volume Settings.

    Science.gov (United States)

    Linares-Perdomo, Olinto; East, Thomas D; Brower, Roy; Morris, Alan H

    2015-07-01

    Recent recommendations for lung protective mechanical ventilation include a tidal volume target of 6 mL/kg predicted body weight (PBW). Different PBW equations might introduce important differences in tidal volumes delivered to research subjects and patients. PBW equations use height, age, and sex as input variables. We compared National Institutes of Health (NIH) ARDS Network (ARDSNet), actuarial table (ACTUARIAL), and Stewart (STEWART) PBW equations used in clinical trials, across physiologic ranges for age and height. We used three-dimensional and two-dimensional surface analysis to compare these PBW equations. We then used age and height from actual clinical trial subjects to quantify PBW equation differences. Significant potential differences existed between these PBW predictions. The ACTUARIAL and ARDSNet surfaces for women were the only surfaces that intersected and produced both positive and negative differences. Mathematical differences between PBW equations at limits of height and age exceeded 30% in women and 24% in men for ACTUARIAL vs ARDSNet and about 25% for women and 15% for men for STEWART vs ARDSNet. The largest mathematical differences were present in older, shorter subjects, especially women. Actual differences for clinical trial subjects were as high as 15% for men and 24% for women. Significant differences between PBW equations for both men and women could be important sources of interstudy variation. Studies should adopt a standard PBW equation. We recommend using the NIH National Heart, Lung, and Blood Institute ARDS Network PBW equation because it is associated with the clinical trial that identified 6 mL/kg PBW as an appropriate target.

  18. 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...

  19. Recommended Changes to Specifications for Demand Controlled Ventilation in California's Title 24 Building Energy Efficiency Standards

    Energy Technology Data Exchange (ETDEWEB)

    Fisk, William J.; Sullivan, Douglas P.; Faulkner, David

    2010-04-08

    In demand-controlled ventilation (DCV), rates of outdoor air ventilation are automatically modulated as occupant density varies. The objective is to keep ventilation rates at or above design specifications and code requirements and also to save energy by avoiding excessive ventilation rates. DCV is most often used in spaces with highly variable and sometime dense occupancy. In almost all cases, carbon dioxide (CO{sub 2}) sensors installed in buildings provide the signal to the ventilation rate control system. People produce and exhale CO{sub 2} as a consequence of their normal metabolic processes; thus, the concentrations of CO{sub 2} inside occupied buildings are higher than the concentrations of CO{sub 2} in the outdoor air. The magnitude of the indoor-outdoor CO{sub 2} concentration difference decreases as the building's ventilation rate per person increases. The difference between the indoor and outdoor CO{sub 2} concentration is also a proxy for the indoor concentrations of other occupant-generated bioeffluents, such as body odors. Reviews of the research literature on DCV indicate a significant potential for energy savings, particularly in buildings or spaces with a high and variable occupancy. Based on modeling, cooling energy savings from applications of DCV are as high as 20%. With support from the California Energy Commission and the U.S. Department of Energy, the Lawrence Berkeley National Laboratory has performed research on the performance of CO{sub 2} sensing technologies and optical people counters for DCV. In addition, modeling was performed to evaluate the potential energy savings and cost effectiveness of using DCV in general office spaces within the range of California climates. The above-described research has implications for the specifications pertaining to DCV in section 121 of the California Title 24 Standard. Consequently, this document suggests possible changes in these specifications based on the research findings. The suggested

  20. Dexmedetomidine versus standard therapy with fentanyl for sedation in mechanically ventilated premature neonates.

    Science.gov (United States)

    O'Mara, Keliana; Gal, Peter; Wimmer, John; Ransom, J Laurence; Carlos, Rita Q; Dimaguila, Mary Ann V T; Davanzo, Christie C; Smith, McCrae

    2012-07-01

    To compare the efficacy and safety of dexmedetomidine and fentanyl for sedation in mechanically ventilated premature neonates. This was a retrospective, observational case-control study in a level III neonatal intensive care unit. Forty-eight premature neonates requiring mechanical ventilation were included. Patients received fentanyl (n=24) or dexmedetomidine (n=24) for pain or sedation. Each group also received fentanyl and lorazepam boluses as needed for agitation. The primary outcomes were efficacy and frequency of acute adverse events associated with each drug. Days on mechanical ventilation, stooling patterns, feeding tolerance, and neurologic outcomes were also evaluated. There were no significant differences in baseline demographics between the dexmedetomidine and fentanyl patients. Patients in the dexmedetomidine group required less adjunctive sedation and had more days free of additional sedation in comparison to fentanyl (54.1% vs. 16.5%, psedation in the premature neonates included in this study. Prospective randomized-controlled trials are needed before routine use of dexmedetomidine can be recommended.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-02-01

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

  2. Variation in Definition of Prolonged Mechanical Ventilation.

    Science.gov (United States)

    Rose, Louise; McGinlay, Michael; Amin, Reshma; Burns, Karen Ea; Connolly, Bronwen; Hart, Nicholas; Jouvet, Philippe; Katz, Sherri; Leasa, David; Mawdsley, Cathy; McAuley, Danny F; Schultz, Marcus J; Blackwood, Bronagh

    2017-10-01

    Consistency of definitional criteria for terminology applied to describe subject cohorts receiving mechanical ventilation within ICU and post-acute care settings is important for understanding prevalence, risk stratification, effectiveness of interventions, and projections for resource allocation. Our objective was to quantify the application and definition of terms for prolonged mechanical ventilation. We conducted a scoping review of studies (all designs except single-case study) reporting a study population (adult and pediatric) using the term prolonged mechanical ventilation or a synonym. We screened 5,331 references, reviewed 539 full-text references, and excluded 120. Of the 419 studies (representing 38 countries) meeting inclusion criteria, 297 (71%) reported data on a heterogeneous subject cohort, and 66 (16%) included surgical subjects only (46 of those 66, 70% cardiac surgery). Other studies described COPD (16, 4%), trauma (22, 5%), neuromuscular (17, 4%), and sepsis (1, 0.2%) cohorts. A total of 741 terms were used to refer to the 419 study cohorts. The most common terms were: prolonged mechanical ventilation (253, 60%), admission to specialized unit (107, 26%), and long-term mechanical ventilation (79, 19%). Some authors (282, 67%) defined their cohorts based on duration of mechanical ventilation, with 154 studies (55%) using this as the sole criterion. We identified 37 different durations of ventilation ranging from 5 h to 1 y, with > 21 d being the most common (28 of 282, 7%). For studies describing a surgical cohort, minimum ventilation duration required for inclusion was ≥ 24 h for 20 of 66 studies (30%). More than half of all studies (237, 57%) did not provide a reason/rationale for definitional criteria used, with only 28 studies (7%) referring to a consensus definition. We conclude that substantial variation exists in the terminology and definitional criteria for cohorts of subjects receiving prolonged mechanical ventilation. Standardization of

  3. Building America Top Innovations 2014 Profile: ASHRAE Standard 62.2. Ventilation and Acceptable Indoor Air Quality in Low-Rise Residential Buildings

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2014-11-01

    This 2014 Top Innovations profile describes Building America research and support in developing and gaining adoption of ASHRAE 62.2, a residential ventilation standard that is critical to transforming the U.S. housing industry to high-performance homes.

  4. Standardized Patients in Clinical Psychology and Psychotherapy: a Scoping Review of Barriers and Facilitators for Implementation.

    Science.gov (United States)

    Kühne, Franziska; Ay, Destina Sevde; Otterbeck, Mara Jasmin; Weck, Florian

    2018-02-08

    The use of simulated and standardized patients (SP) is widely accepted in the medical field and, from there, is beginning to disseminate into clinical psychology and psychotherapy. The purpose of this study was therefore to systematically review barriers and facilitators that should be considered in the implementation of SP interventions specific to clinical psychology and psychotherapy. Following current guidelines, a scoping review was conducted. The literature search focused on the MEDLINE, PsycINFO and Web of Science databases, including Dissertation Abstracts International. After screening for titles and abstracts, full texts were screened independently and in duplicate according to our inclusion criteria. For data extraction, a pre-defined form was piloted and used. Units of meaning with respect to barriers and facilitators were extracted and categorized inductively using content-analysis techniques. From the results, a matrix of interconnections and a network graph were compiled. The 41 included publications were mainly in the fields of psychiatry and mental health nursing, as well as in training and education. The detailed category system contrasts four supercategories, i.e., which organizational and economic aspects to consider, which persons to include as eligible SPs, how to develop adequate scenarios, and how to authentically and consistently portray mental health patients. Publications focused especially on the interrelation between authenticity and consistency of portrayals, on how to evoke empathy in learners, and on economic and training aspects. A variety of recommendations for implementing SP programs, from planning to training, monitoring, and debriefing, is provided, for example, ethical screening of and ongoing support for SPs.

  5. The optimal combination of standard metabolic rate and aerobic scope for somatic growth depends on food availability

    OpenAIRE

    Auer, Sonya K.; Salin, Karine; Rudolf, Agata Marta; Anderson, Graeme J.; Metcalfe, Neil B.

    2015-01-01

    Metabolic rates can vary as much as threefold among individuals of the same size and age in a population, but why such variation persists is unclear given that they determine the energetic cost of living. Relationships between standard metabolic rate (SMR), growth and survival can vary with environmental conditions, suggesting that the fitness consequences of a given metabolic phenotype may be context-dependent. Less attention has focused on the link between absolute aerobic scope (AS, the di...

  6. 76 FR 34693 - California State Motor Vehicle Pollution Control Standards; Within-the-Scope Determination for...

    Science.gov (United States)

    2011-06-14

    ...-the-scope confirmation request; the page is accessible at http://www.epa.gov/otaq/climate/ca-waiver...\\ EPA initially denied that request, and published that denial in a Federal Register notice on March 6, 2008.\\2\\ CARB subsequently submitted a request that EPA reconsider that waiver denial on January 21...

  7. Recognition of the Factoring Contracts within the scope of Turkey Accounting Standards with regard to the Buyer and Seller

    Directory of Open Access Journals (Sweden)

    Birsel Sabuncu

    2017-02-01

    Full Text Available In this study giving general information about factoring, which is an alternative financing technique, regarding the recognition of the factoring transactions within the scope of the Turkish Accounting Standards, by presenting a sample application in particular regard of an export transaction in relation to the accounting records which have to be done by the company that gives factoring service and receives the factoring service, a contribution to the accounting literature is put forward. In the study, it is shown that, even though the Uniform Accounting Plan which the factoring companies and the companies which use a factoring service in their accounting records differ from each other, recognition of it within the scope of the Turkish Accounting Standards is a basis. The fundamental principle of the accounting records of the company which assigns the receivables that generate from the exporting by entering into an agreement of factoring is the recognition of the income according to the fair value, by reflecting the amount which the income waits to gain the when assigning, and by separating the income which is actualised and not actualised. Keywords: Factoring, factoring transactions, Turkish Accounting Standards

  8. 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....

  9. Pretest Predictions for Ventilation Tests

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-01-17

    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.

  10. 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.

  11. 16 CFR 1615.64 - Policy to clarify scope of the standard.

    Science.gov (United States)

    2010-01-01

    ... REGULATIONS STANDARD FOR THE FLAMMABILITY OF CHILDREN'S SLEEPWEAR: SIZES 0 THROUGH 6X (FF 3-71... flammability standards for children's sleepwear, have an obligation not to promote or sell such fabric or... flammability standards and is not intended or suitable for use as sleepwear. “Infant garments” as defined by...

  12. National Energy Efficiency Evaluation, Measurement and Verification (EM&V) Standard: Scoping Study of Issues and Implementation Requirements

    Energy Technology Data Exchange (ETDEWEB)

    Schiller Consulting, Inc.; Schiller, Steven R.; Goldman, Charles A.; Galawish, Elsia

    2011-02-04

    This report is a scoping study that identifies issues associated with developing a national evaluation, measurement and verification (EM&V) standard for end-use, non-transportation, energy efficiency activities. The objectives of this study are to identify the scope of such a standard and define EM&V requirements and issues that will need to be addressed in a standard. To explore these issues, we provide and discuss: (1) a set of definitions applicable to an EM&V standard; (2) a literature review of existing guidelines, standards, and 'initiatives' relating to EM&V standards as well as a review of 'bottom-up' versus 'top-down' evaluation approaches; (3) a summary of EM&V related provisions of two recent federal legislative proposals (Congressman Waxman's and Markey's American Clean Energy and Security Act of 2009 and Senator Bingaman's American Clean Energy Leadership Act of 2009) that include national efficiency resource requirements; (4) an annotated list of issues that that are likely to be central to, and need to be considered when, developing a national EM&V standard; and (5) a discussion of the implications of such issues. There are three primary reasons for developing a national efficiency EM&V standard. First, some policy makers, regulators and practitioners believe that a national standard would streamline EM&V implementation, reduce costs and complexity, and improve comparability of results across jurisdictions; although there are benefits associated with each jurisdiction setting its own EM&V requirements based on their specific portfolio and evaluation budgets and objectives. Secondly, if energy efficiency is determined by the US Environmental Protection Agency to be a Best Available Control Technology (BACT) for avoiding criteria pollutant and/or greenhouse gas emissions, then a standard can be required for documenting the emission reductions resulting from efficiency actions. The third reason for a national

  13. 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.

  14. ASME N511-19XX, Standard for periodic in-service testing of nuclear air treatment, heating, ventilating and air conditioning systems

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-08-01

    A draft version of the Standard is presented in this document. The Standard covers the requirements for periodic in-service testing of nuclear safety-related air treatment, heating, ventilating, and air conditioning systems in nuclear facilities. The Standard provides a basis for the development of test programs and does not include acceptance criteria, except in cases where the results of one test influence the performance of other tests. The Standard covers general inspection and test requirements, reference values, inspection and test requirements, generic tests, acceptance criteria, in-service test requirements, testing following an abnormal incident, corrective action requirements, and quality assurance. Mandatory appendices provide a visual inspection checklist and four test procedures. Non-mandatory appendices provide additional information and guidance on mounting frame pressure leak test procedure, corrective action, challenge gas substitute selection criteria, and test program development. 8 refs., 10 tabs.

  15. 75 FR 44948 - California State Motor Vehicle Pollution Control Standards; Within-the-Scope Determination for...

    Science.gov (United States)

    2010-07-30

    ... adopt or attempt to enforce any standard relating to the control of emissions from new motor vehicles or... any other approval relating to the control of emissions from any new motor vehicle or new motor... control of emissions from new motor vehicles or new motor vehicle engines prior to March 30, 1966, if the...

  16. Hybrid Ventilation in New and Retrofitted Office Buildings

    DEFF Research Database (Denmark)

    Heiselberg, Per

    The scope of this annex is to obtain better knowledge of the use of hybrid ventilation technologies. The annex will focus on development of control strategies for hybrid ventilation, on development of methods to predict hybrid ventilation performance in office buildings and on development...

  17. 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.

  18. 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.

  19. 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...

  20. Ventilative Cooling

    DEFF Research Database (Denmark)

    Heiselberg, Per Kvols; Kolokotroni, Maria

    -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...

  1. 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...

  2. 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.

  3. Ventilator graphics.

    Science.gov (United States)

    Prabhakaran, Priya; Sasser, William C; Kalra, Yuvrai; Rutledge, Chrystal; Tofil, Nancy M

    2016-12-01

    Providing optimal mechanical ventilation to critically-ill children remains a challenge. Patient-ventilator dyssynchrony results frequently with numerous deleterious consequences on patient outcome including increased requirement for sedation, prolonged duration of ventilation, and greater imposed work of breathing. Most currently used ventilators have real-time, continuously-displayed graphics of pressure, volume, and flow versus time (scalars) as well as pressure, and flow versus volume (loops). A clear understanding of these graphics provides a lot of information about the mechanics of the respiratory system and the patient ventilator interaction in a dynamic fashion. Using this information will facilitate tailoring the support provided and the manner in which it is provided to best suit the dynamic needs of the patient. This paper starts with a description of the scalars and loops followed by a discussion of the information that can be obtained from each of these graphics. A review will follow, on the common types of dyssynchronous interactions and how each of these can be detected on the ventilator graphics. The final section discusses how graphics can be used to optimize the ventilator support provided to patients.

  4. Mechanical Ventilation

    Science.gov (United States)

    ... cared for in a hospital’s intensive care unit (ICU). People who need a ventilator for a longer time may be in a regular unit of a hospital, a rehabilitation facility, or cared for at home. Why are ...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-10-31

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

  6. Solutions for Energy Efficient and Sustainable Heating of Ventilation Air: A Review

    Directory of Open Access Journals (Sweden)

    A. Žandeckis

    2015-10-01

    Full Text Available A high energy efficiency and sustainability standards defined by modern society and legislation requires solutions in the form of complex integrated systems. The scope of this work is to provide a review on technologies and methods for the heating of ventilation air as a key aspect for high energy and environmental performance of buildings located in a cold climate. The results of this work are more relevant in the buildings where space heating consumes a significant part of the energy balance of a building, and air exchange is arranged in an organized manner. A proper design and control strategy, heat recovery, the use of renewable energy sources, and waste heat are the main aspects which must be considered for efficient and sustainable ventilation. This work focuses on these aspects. Air conditioning is not in the scope of this study.

  7. Personalized ventilation

    DEFF Research Database (Denmark)

    Melikov, Arsen Krikor

    2004-01-01

    The thermal environment and air quality in buildings affects occupants' health, comfort and performance. The heating, ventilating and air-conditioning (HVAC) of buildings today is designed to provide a uniform room environment. However, large individual differences exist between occupants in regard...... 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...

  8. Revisions to the 2009 American Society of Clinical Oncology/Oncology Nursing Society chemotherapy administration safety standards: expanding the scope to include inpatient settings.

    Science.gov (United States)

    Jacobson, Joseph O; Polovich, Martha; Gilmore, Terry R; Schulmeister, Lisa; Esper, Peg; Lefebvre, Kristine B; Neuss, Michael N

    2012-01-01

    In November 2009, the American Society of Clinical Oncology (ASCO) and the Oncology Nursing Society (ONS) jointly published a set of 31 voluntary chemotherapy safety standards for adult patients with cancer, as the end result of a highly structured, multistakeholder process. The standards were explicitly created to address patient safety in the administration of parenteral and oral chemotherapeutic agents in outpatient oncology settings. In January 2011, a workgroup consisting of ASCO and ONS members was convened to review feedback received since publication of the standards, to address interim changes in practice, and to modify the standards as needed. The most significant change to the standards is to extend their scope to the inpatient setting. This change reflects the conviction that the same standards for chemotherapy administration safety should apply in all settings. The proposed set of standards has been approved by the Board of Directors for both ASCO and ONS and has been posted for public comment. Comments were used as the basis for final editing of the revised standards. The workgroup recognizes that the safety of oral chemotherapy usage, nononcology medication reconciliation, and home chemotherapy administration are not adequately addressed in the original or revised standards. A separate process, cosponsored by ASCO and ONS, will address the development of safety standards for these areas.

  9. Personalized ventilation.

    Science.gov (United States)

    Melikov, A K

    2004-01-01

    The thermal environment and air quality in buildings affects occupants' health, comfort and performance. The heating, ventilating and air-conditioning (HVAC) of buildings today is designed to provide a uniform room environment. However, large individual differences exist between occupants in regard to physiological and psychological response, clothing insulation, activity, air temperature and air movement preference, etc. Environmental conditions acceptable for most occupants in rooms may be achieved by providing each occupant with the possibility to generate and control his/her own preferred 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. Performance criteria are defined. Recommendations for design of PV that would be in compliance with the criteria are given. Future research needed on the topic is outlined. Personalized ventilation can improve occupants' comfort, decrease SBS symptoms and reduce the risk of transmission of contagion between occupants in comparison with total volume ventilation. However in order to perform efficiently in rooms in practice, the design (air distribution, control, etc.) has to be carefully considered together with type of occupant activity (occupancy rate, occupied density, etc.).

  10. Flexible scope for ISO 15189 accreditation: a guidance prepared by the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group Accreditation and ISO/CEN standards (WG-A/ISO).

    Science.gov (United States)

    Thelen, Marc H M; Vanstapel, Florent J L A; Kroupis, Christos; Vukasovic, Ines; Boursier, Guilaime; Barrett, Edward; Bernabeu Andreu, Francisco; Brguljan, Pika Meško; Brugnoni, Duilio; Lohmander, Maria; Sprongl, Ludek; Vodnik, Tatjana; Ghita, Irina; Vaubourdolle, Michel; Huisman, Willem

    2015-07-01

    The recent revision of ISO15189 has further strengthened its position as the standard for accreditation for medical laboratories. Both for laboratories and their customers it is important that the scope of such accreditation is clear. Therefore the European co-operation for accreditation (EA) demands that the national bodies responsible for accreditation describe the scope of every laboratory accreditation in a way that leaves no room for doubt about the range of competence of the particular laboratories. According to EA recommendations scopes may be fixed, mentioning every single test that is part of the accreditation, or flexible, mentioning all combinations of medical field, examination type and materials for which the laboratory is competent. Up to now national accreditation bodies perpetuate use of fixed scopes, partly by inertia, partly out of fear that a too flexible scope may lead to over-valuation of the competence of laboratories, most countries only use fixed scopes. The EA however promotes use of flexible scopes, since this allows for more readily innovation, which contributes to quality in laboratory medicine. In this position paper, the Working Group Accreditation and ISO/CEN Standards belonging to the Quality and Regulation Committee of the EFLM recommends using an approach that has led to successful introduction of the flexible scope for ISO15189 accreditation as intended in EA-4/17 in The Netherlands. The approach is risk-based, discipline and competence-based, and focuses on defining a uniform terminology transferable across the borders of scientific disciplines, laboratories and countries.

  11. 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.

  12. ASHRAE and residential ventilation

    Energy Technology Data Exchange (ETDEWEB)

    Sherman, Max H.

    2003-10-01

    logical place to provide leadership. This leadership has been demonstrated most recently by the publication of the first nationally recognized standard on ventilation in homes, ASHRAE Standard 62.2-2003, which builds on work that has been part of ASHRAE for many years and will presumably continue. Homeowners and occupants, which includes virtually all of us, will benefit from the application of Standard 62.2 and use of the top ten list. This activity is exactly the kind of benefit to society that the founders of ASHRAE envisioned and is consistent with ASHRAE's mission and vision. ASHRAE members should be proud of their Society for taking leadership in residential ventilation.

  13. Displacement Ventilation

    DEFF Research Database (Denmark)

    Bjørn, Erik; Mattsson, Magnus; Sandberg, Mats

    Full-scale experiments were made in a displacement ventilated room with two breathing thermal manikins to study the effect of movements and breathing on the vertical contaminant distribution, and on the personal exposure of occupants. Concentrations were measured with tracer gas equipment...... in the room and in the inhalation of both manikins. Tracer gas was added in the heat plume above a sitting manikin, or in the exhalation through either the nose or the mouth. The other manikin moved back and forth at different speeds on a low trolley. The mentioned experimental conditions have a significant...

  14. Kitchen ventilation

    Energy Technology Data Exchange (ETDEWEB)

    Kelso, R.M. [Univ. of Tennessee, Knoxville, TN (United States). College of Architecture; Rousseau, C. [Newcomb and Boyd Consulting Engineers, Atlanta, GA (United States)

    1995-09-01

    Kitchen ventilation is a subject that has not received the attention that has been given to more glamorous HVAC and R topics. Consequently, its theoretical and technical development has not advanced like these topics. However, a group has been working within the ASHRAE Technical Committee (TC) and Task Group (TG) framework to correct this situation. The group is TG5.KV and it achieved TG status last year after starting as an informal group and then a sub-committee of TC9.8. One of its efforts has been to write a Handbook chapter, which will appear in the 1995 ASHRAE Handbook -- Applications. This article is a survey of that chapter.

  15. The SPICE III study protocol and analysis plan: a randomised trial of early goaldirected sedation compared with standard care in mechanically ventilated patients.

    Science.gov (United States)

    Shehabi, Yahya; Forbes, Andrew B; Arabi, Yaseen; Bass, Frances; Bellomo, Rinaldo; Kadiman, Suhaini; Howe, Belinda D; McArthur, Colin; Reade, Michael C; Seppelt, Ian; Takala, Jukka; Webb, Steve; Wise, Matthew P

    2017-12-01

    Sedation strategy in critically ill patients who are mechanically ventilated is influenced by patient-related factors, choice of sedative agent and the intensity or depth of sedation prescribed. The impact of sedation strategy on outcome, in particular when delivered early after initiation of mechanical ventilation, is uncertain. To present the protocol and analysis plan of a large randomised clinical trial investigating the effect of a sedation strategy, in critically ill patients who are mechanically ventilated, based on a protocol targeting light sedation using dexmedetomidine as the primary sedative, termed "early goal-directed sedation", compared with usual practice. This is a multinational randomised clinical trial in adult intensive care patients expected to require mechanical ventilation for longer than 24 hours. The main exclusion criteria include suspected or proven primary brain pathology or having already been intubated or sedated in an intensive care unit for longer than 12 hours. Randomisation occurs via a secured website with baseline stratification by site and suspected or proven sepsis. The primary outcome is 90-day all-cause mortality. Secondary outcomes include death, institutional dependency, cognitive function and health-related quality of life 180 days after randomisation, as well as deliriumfree, coma-free and ventilation-free days at 28 days after randomisation. A predefined subgroup analysis will also be conducted. Analyses will be on an intention-to-treat basis and in accordance with this pre-specified analysis plan. SPICE III is an ongoing large scale clinical trial. Once completed, it will inform sedation practice in critically ill patients who are ventilated.

  16. Apartment building built to passive-house standard with solar balanced ventilation system; Mehrfamilien-Passivhaus mit solarem Luftsystem. Lueftung/Luftheizung/WRG/Solarfassade an der Rychenbergstrasse, Winterthur - Schlussbericht

    Energy Technology Data Exchange (ETDEWEB)

    Guetermann, A.

    2002-04-15

    This final report for the Swiss Federal Office of Energy (SFOE) deals with an apartment building in Winterthur, Switzerland, built to passive-house standards and equipped with a solar balanced ventilation system. The building and its convective solar facade are described, as are the fan-assisted, balanced ventilation systems used. The operation of the systems in winter, during transitional periods and in summer is discussed. Domestic hot water preparation is looked at. The energy balance of the building is examined, as is the economic viability of the energy systems. The building, its energy installations and the measurement concept used are considered in detail. Finally, the findings of the study are summarised and commented on.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-08-01

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

  18. Recognition of the Factoring Contracts within the scope of Turkey Accounting Standards with regard to the Buyer and Seller

    National Research Council Canada - National Science Library

    Birsel Sabuncu

    2017-01-01

    ... Accounting Standards, by presenting a sample application in particular regard of an export transaction in relation to the accounting records which have to be done by the company that gives factoring service...

  19. Emergency medicine residents' knowledge of mechanical ventilation.

    Science.gov (United States)

    Wilcox, Susan R; Seigel, Todd A; Strout, Tania D; Schneider, Jeffrey I; Mitchell, Patricia M; Marcolini, Evie G; Cocchi, Michael N; Smithline, Howard A; Lutfy-Clayton, Lucienne; Mullen, Marie; Ilgen, Jonathan S; Richards, Jeremy B

    2015-04-01

    Although Emergency physicians frequently intubate patients, management of mechanical ventilation has not been emphasized in emergency medicine (EM) residency curricula. The objective of this study was to quantify EM residents' education, experience, and knowledge regarding mechanical ventilation. We developed a survey of residents' educational experiences with ventilators and an assessment tool with nine clinical questions. Correlation and regression analyses were performed to evaluate the relationship between residents' scores on the assessment instrument and their training, education, and comfort with ventilation. Of 312 EM residents, 218 responded (69.9%). The overall correct response rate for the assessment tool was 73.3%, standard deviation (SD) ± 22.3. Seventy-seven percent (n = 167) of respondents reported ≤ 3 h of mechanical ventilation education in their residency curricula over the past year. Residents reported frequently caring for ventilated patients in the ED, as 64% (n = 139) recalled caring for ≥ 4 ventilated patients per month. Fifty-three percent (n = 116) of residents endorsed feeling comfortable caring for mechanically ventilated ED patients. In multiregression analysis, the only significant predictor of total test score was residents' comfort with caring for mechanically ventilated patients (F = 10.963, p = 0.001). EM residents report caring for mechanically ventilated patients frequently, but receive little education on mechanical ventilation. Furthermore, as residents' performance on the assessment tool is only correlated with their self-reported comfort with caring for ventilated patients, these results demonstrate an opportunity for increased educational focus on mechanical ventilation management in EM residency training. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Variable mechanical ventilation

    Science.gov (United States)

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

    2017-01-01

    Objective To review the literature on the use of variable mechanical ventilation and the main outcomes of this technique. Methods 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". Results A total of 36 studies were selected. Of these, 24 were original studies, including 21 experimental studies and three clinical studies. Conclusion 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. PMID:28444076

  1. 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.

  2. Variable mechanical ventilation

    OpenAIRE

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

    2017-01-01

    Objective To review the literature on the use of variable mechanical ventilation and the main outcomes of this technique. Methods 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". Results A total of 36 studies were selected. ...

  3. Influence of filter ventilation on the chemical composition of cigarette mainstream smoke

    Energy Technology Data Exchange (ETDEWEB)

    Adam, Thomas, E-mail: dr-thomas-adam@gmx.net [Analytical Chemistry, Institute of Physics, University of Augsburg, 86159 Augsburg (Germany); Institute of Ecological Chemistry, Helmholtz Zentrum Muenchen, 85764 Neuherberg (Germany); McAughey, John [British American Tobacco, Group R and D, Southampton SO15 8TL (United Kingdom); Mocker, Christoph [Institute of Ecological Chemistry, Helmholtz Zentrum Muenchen, 85764 Neuherberg (Germany); Analytical Chemistry, Institute of Chemistry, University of Rostock, 18051 Rostock (Germany); McGrath, Conor [British American Tobacco, Group R and D, Southampton SO15 8TL (United Kingdom); Zimmermann, Ralf [Institute of Ecological Chemistry, Helmholtz Zentrum Muenchen, 85764 Neuherberg (Germany); BIfA-Umweltinstitut - Bavarian Institute of Applied Environmental Research and Technology GmbH, Environmental Chemistry, 86167 Augsburg (Germany); Analytical Chemistry, Institute of Chemistry, University of Rostock, 18051 Rostock (Germany)

    2010-01-04

    Total yields of cigarette smoke constituents are greatly influenced by smoking behaviour, the tobacco blend as well as a variety of cigarette design parameters. Thereby, filter ventilation, i.e. diluting the smoke by providing a zone of microscopic holes around the circumference of the filter is one method to reduce the yield of 'tar' and other smoke compounds. However, little is known how these design variations influence the combustion conditions, and therefore, the overall chemical pattern of the smoke. In this paper single photon ionization-time-of-flight mass spectrometry (SPI-TOFMS) is used to characterize and compare cigarettes on a puff-by-puff basis, which differ only in filter ventilation magnitude. The research cigarettes investigated were made from Virginia tobacco and featured filter ventilations of 0% (no ventilation), 35%, and 70%. The cigarettes were smoked under two different puffing regimes, one using the puffing parameters of the conventional International Organization for Standardization (ISO) smoking regime and a more intense smoking condition. Results show that every variation entails a change of the chemical pattern, whereby, in general, cigarettes with 0% filter ventilation as well as the intense smoking regime lead to a more complete combustion compared to the ISO smoking conditions and the high ventilated cigarettes. Changes in the overall patterns can also be observed during the smoking for individual puffs. Some substances dominate the first puff, some species are more pronounced in the middle puffs, whereas others are preferably formed in the last puffs. This demonstrates the high complexity of the occurring processes. Results might help to understand the formation and decomposition reactions taking place when a cigarette is smoked and offer scope for targeted reduction strategies for specific toxicants or groups of toxicants in the smoke.

  4. Ventilator associated pneumonia or ventilator induced pneumonia.

    Science.gov (United States)

    Khan, Zahid Hussain; Ceriana, Piero; Donner, Claudio F

    2017-01-01

    Ventilator associated pneumonia currently in vogue seems to have some pitfalls as far as the nomenclature is concerned and thus it imparts an erroneous impression to the reader. As the driving force is in fact the ventilator, the phraseology should preferably be changed to ventilator induced pneumonia to convey the in depth meaning of the term thus evading the terminology currently in practice. A new and emerging paradigm dealing with all side effects of mechanical ventilation can be helpful to solve this etymological conflict.

  5. Monitoring during Mechnical Ventilation

    Directory of Open Access Journals (Sweden)

    Dean Hess

    1996-01-01

    Full Text Available Monitoring is a continuous, or nearly continuous, evaluation of the physiological function of a patient in real time to guide management decisions, including when to make therapeutic interventions and assessment of those interventions. Pulse oximeters pass two wavelengths of light through a pulsating vascular bed and determine oxygen saturation. The accuracy of pulse oximetry is about ±4%. Capnography measures carbon dioxide at the airway and displays a waveform called the capnogram. End-tidal PCO2 represents alveolar PCO2 and is determined by the ventilation-perfusion quotient. Use of end-tidal PCO2 as an indication of arterial PCO2 is often deceiving and incorrect in critically ill patients. Because there is normally very little carbon dioxide in the stomach, a useful application of capnography is the detection of esophageal intubation. Intra-arterial blood gas systems are available, but the clinical impact and cost effectiveness of these is unclear. Mixed venous oxygenation (PvO2 or SvO2 is a global indicator of tissue oxygenation and is affected by arterial oxygen content, oxygen consumption and cardiac output. Indirect calorimetry is the calculation of energy expenditure and respiratory quotient by the measurement of oxygen consumption and carbon dioxide production. A variety of mechanics can be determined in mechanically ventilated patients including resistance, compliance, auto-peak end-expiratory pressure (PEEP and work of breathing. The static pressure-volume curve can be used to identify lower and upper infection points, which can be used to determine the appropriate PEEP setting and to avoid alveolar overdistension. Although some forms of monitoring have become a standard of care during mechanical ventilation (eg, pulse oximetry, there is little evidence that use of any monitor affects patient outcome.

  6. Scope Definition

    DEFF Research Database (Denmark)

    Bjørn, Anders; Owsianiak, Mikołaj; Laurent, Alexis

    2017-01-01

    The scope definition is the second phase of an LCA. It determines what product systems are to be assessed and how this assessment should take place. This chapter teaches how to perform a scope definition. First, important terminology and key concepts of LCA are introduced. Then, the nine items ma...

  7. Patient-Ventilator Dyssynchrony

    Directory of Open Access Journals (Sweden)

    Elvira-Markela Antonogiannaki

    2017-11-01

    Full Text Available In mechanically ventilated patients, assisted mechanical ventilation (MV is employed early, following the acute phase of critical illness, in order to eliminate the detrimental effects of controlled MV, most notably the development of ventilator-induced diaphragmatic dysfunction. Nevertheless, the benefits of assisted MV are often counteracted by the development of patient-ventilator dyssynchrony. Patient-ventilator dyssynchrony occurs when either the initiation and/or termination of mechanical breath is not in time agreement with the initiation and termination of neural inspiration, respectively, or if the magnitude of mechanical assist does not respond to the patient’s respiratory demand. As patient-ventilator dyssynchrony has been associated with several adverse effects and can adversely influence patient outcome, every effort should be made to recognize and correct this occurrence at bedside. To detect patient-ventilator dyssynchronies, the physician should assess patient comfort and carefully inspect the pressure- and flow-time waveforms, available on the ventilator screen of all modern ventilators. Modern ventilators offer several modifiable settings to improve patient-ventilator interaction. New proportional modes of ventilation are also very helpful in improving patient-ventilator interaction.

  8. Repeatability of standard metabolic rate, active metabolic rate and aerobic scope in young brown trout during a period of moderate food availability.

    Science.gov (United States)

    Norin, Tommy; Malte, Hans

    2011-05-15

    Standard metabolic rate (SMR) and active metabolic rate (AMR) are two fundamental physiological parameters providing the floor and ceiling in aerobic energy metabolism. The total amount of energy available within these two parameters confines constitutes the absolute aerobic scope (AAS). Previous studies on fish have found SMR to closely correlate with dominance and position in the social hierarchy, and to be highly repeatable over time when fish were provided an ad libitum diet. In this study we tested the temporal repeatability of individual SMR, AMR and AAS, as well as repeatability of body mass, in young brown trout (Salmo trutta L.) fed a moderately restricted diet (0.5-0.7% fish mass day⁻¹). Metabolism was estimated from measurements of oxygen consumption rate (M(.)(O₂)) and repeatability was evaluated four times across a 15-week period. Individual body mass was highly repeatable across the entire 15 week experimental period whereas residual body-mass-corrected SMR, AMR and AAS showed a gradual loss of repeatability over time. Individual residual SMR, AMR and AAS were significantly repeatable in the short term (5 weeks), gradually declined across the medium term (10 weeks) and completely disappeared in the long term (15 weeks). We suggest that this gradual decline in repeatability was due to the slightly restricted feeding regime. This is discussed in the context of phenotypic plasticity, natural selection and ecology.

  9. 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. ...

  10. 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...... momentum supply. In addition, this ventilation system uses a ceiling plenum to deliver air and requires less energy consumption for air transport than full-ducted systems. There is a growing interest in applying diffuse ceiling ventilation in offices and other commercial buildings due to the benefits from...... both thermal comfort and energy efficient aspects. The present study aims to characterize the air distribution and thermal comfort in the rooms with diffuse ceiling ventilation. Both the stand-alone ventilation system and its integration with a radiant ceiling system are investigated. This study also...

  11. Experimental study of air distribution and ventilation effectiveness in a room heated by warm air and/or floor heating

    DEFF Research Database (Denmark)

    Simone, Angela; Olesen, Bjarne W.; Krajčík, Michal

    2010-01-01

    The levels of required ventilation depend on the criteria for indoor air quality in existing standards and guidelines. On top of that, the resulting ventilation in air changes per hour is depending on the ventilation effectiveness. In the standard CR 1752 the recommended values for ventilation ef...

  12. Scope Definition

    DEFF Research Database (Denmark)

    Bjørn, Anders; Owsianiak, Mikołaj; Laurent, Alexis

    2017-01-01

    making up a scope definition are elaborately explained: (1) Deliverables. (2) Object of assessment, (3) LCI modelling framework and handling of multifunctional processes, (4) System boundaries and completeness requirements, (5) Representativeness of LCI data, (6) Preparing the basis for the impact...... assessment, (7) Special requirements for system comparisons, (8) Critical review needs and (9) Planning reporting of results. The instructions relate both to the performance and reporting of a scope definition and are largely based on ILCD.......The scope definition is the second phase of an LCA. It determines what product systems are to be assessed and how this assessment should take place. This chapter teaches how to perform a scope definition. First, important terminology and key concepts of LCA are introduced. Then, the nine items...

  13. 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.

  14. Measuring maximum and standard metabolic rates using intermittent-flow respirometry: a student laboratory investigation of aerobic metabolic scope and environmental hypoxia in aquatic breathers.

    Science.gov (United States)

    Rosewarne, P J; Wilson, J M; Svendsen, J C

    2016-01-01

    Metabolic rate is one of the most widely measured physiological traits in animals and may be influenced by both endogenous (e.g. body mass) and exogenous factors (e.g. oxygen availability and temperature). Standard metabolic rate (SMR) and maximum metabolic rate (MMR) are two fundamental physiological variables providing the floor and ceiling in aerobic energy metabolism. The total amount of energy available between these two variables constitutes the aerobic metabolic scope (AMS). A laboratory exercise aimed at an undergraduate level physiology class, which details the appropriate data acquisition methods and calculations to measure oxygen consumption rates in rainbow trout Oncorhynchus mykiss, is presented here. Specifically, the teaching exercise employs intermittent flow respirometry to measure SMR and MMR, derives AMS from the measurements and demonstrates how AMS is affected by environmental oxygen. Students' results typically reveal a decline in AMS in response to environmental hypoxia. The same techniques can be applied to investigate the influence of other key factors on metabolic rate (e.g. temperature and body mass). Discussion of the results develops students' understanding of the mechanisms underlying these fundamental physiological traits and the influence of exogenous factors. More generally, the teaching exercise outlines essential laboratory concepts in addition to metabolic rate calculations, data acquisition and unit conversions that enhance competency in quantitative analysis and reasoning. Finally, the described procedures are generally applicable to other fish species or aquatic breathers such as crustaceans (e.g. crayfish) and provide an alternative to using higher (or more derived) animals to investigate questions related to metabolic physiology. © 2016 The Fisheries Society of the British Isles.

  15. [Sanitary and epidemiological evaluation of the ventilation and air-conditioning systems of public buildings].

    Science.gov (United States)

    Dvorianov, V V

    2012-01-01

    The microbial contamination of ventilation and air conditioning systems was examined in the administrative buildings. The author proposes a set of indicators, methods for determining the scope of investigations, as well as sampling tactics and criteria for evaluating the microbial contamination of the ventilation and air-conditioning systems. The content of yeasts and molds in the delivered air has been found to be of importance for evaluating the sanitary-and epidemiological state of ventilation systems.

  16. Complications of mechanical ventilation

    Directory of Open Access Journals (Sweden)

    Drašković Biljana

    2011-01-01

    Full Text Available Mechanical ventilation of the lungs, as an important therapeutic measure, cannot be avoided in critically ill patients. However, when machines take over some of vital functions there is always a risk of complications and accidents. Complications associated with mechanical ventilation can be divided into: 1 airway-associated complications; 2 complications in the response of patients to mechanical ventilation; and 3 complications related to the patient’s response to the device for mechanical ventilation. Complications of artificial airway may be related to intubation and extubation or the endotracheal tube. Complications of mechanical ventilation, which arise because of the patient’s response to mechanical ventilation, may primarily cause significant side effects to the lungs. During the last two decades it was concluded that mechanical ventilation can worsen or cause acute lung injury. Mechanical ventilation may increase the alveolar/capillary permeability by overdistension of the lungs (volutrauma, it can exacerbate lung damage due to the recruitment/derecruitment of collapsed alveoli (atelectrauma and may cause subtle damages due to the activation of inflammatory processes (biotrauma. Complications caused by mechanical ventilation, beside those involving the lungs, can also have significant effects on other organs and organic systems, and can be a significant factor contributing to the increase of morbidity and mortality in critically ill of mechanically ventilated patients. Complications are fortunately rare and do not occur in every patient, but due to their seriousness and severity they require extensive knowledge, experience and responsibility by health-care workers.

  17. Electrical Impedance Tomography During Mechanical Ventilation.

    Science.gov (United States)

    Walsh, Brian K; Smallwood, Craig D

    2016-10-01

    Electrical impedance tomography (EIT) is a noninvasive, non-radiologic imaging modality that may be useful for the quantification of lung disorders and titration of mechanical ventilation. The principle of operation is based on changes in electrical conductivity that occur as a function of changes in lung volume during ventilation. EIT offers potentially important benefits over standard imaging modalities because the system is portable and non-radiologic and can be applied to patients for long periods of time. Rather than providing a technical dissection of the methods utilized to gather, compile, reconstruct, and display EIT images, the present article seeks to provide an overview of the clinical application of this technology as it relates to monitoring mechanical ventilation and providing decision support at the bedside. EIT has been shown to be useful in the detection of pneumothoraces, quantification of pulmonary edema and comparison of distribution of ventilation between different modes of ventilation and may offer superior individual titration of PEEP and other ventilator parameters compared with existing approaches. Although application of EIT is still primarily done within a research context, it may prove to be a useful bedside tool in the future. However, head-to-head comparisons with existing methods of mechanical ventilation titration in humans need to be conducted before its application in general ICUs can be recommended. Copyright © 2016 by Daedalus Enterprises.

  18. Infiltration as Ventilation: Weather-Induced Dilution

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-06-01

    The purpose of outdoor air ventilation is to dilute or remove indoor contaminants to which occupants are exposed. It can be provided by mechanical or natural means. In most homes, especially older homes, weather-driven infiltration provides the dominant fraction of the total ventilation. As we seek to provide good indoor air quality at minimum energy cost, it is important to neither over-ventilate nor under-ventilate. Thus, it becomes critically important to evaluate correctly the contribution infiltration makes to the total outdoor air ventilation rate. Because weather-driven infiltration is dependent on building air leakage and weather-induced pressure differences, a given amount of air leakage will provide different amounts of infiltration. Varying rates of infiltration will provide different levels of contaminant dilution and hence effective ventilation. This paper derives these interactions and then calculates the impact of weather-driven infiltration for different climates. A new “N-factor” is introduced to provide a convenient method for calculating the ventilation contribution of infiltration for over 1,000 locations across North America. The results of this work could be used in indoor air quality standards (specifically ASHRAE 62.2) to account for the contribution of weather-driven infiltration towards the dilution of indoor pollutants.

  19. Predictive value of EndTidalCO2, lung mechanics and other standard parameters for weaning neurological patients from mechanical ventilation

    Directory of Open Access Journals (Sweden)

    Hala A. Mohammad

    2016-01-01

    Conclusion: We concluded that measurements of RSBI, MIP (maximum inspiratory pressure, EndTidalCO2 and dynamic compliance were more accurate predictors of extubation failure in patients with neurological insults than other standard weaning parameters.

  20. 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....

  1. Mechanical ventilation in children.

    Science.gov (United States)

    Kendirli, Tanil; Kavaz, Asli; Yalaki, Zahide; Oztürk Hişmi, Burcu; Derelli, Emel; Ince, Erdal

    2006-01-01

    Mechanical ventilation can be lifesaving, but > 50% of complications in conditions that require intensive care are related to ventilatory support, particularly if it is prolonged. We retrospectively evaluated the medical records of patients who had mechanical ventilation in the Pediatric Intensive Care Unit (PICU) during a follow-up period between January 2002-May 2005. Medical records of 407 patients were reviewed. Ninety-one patients (22.3%) were treated with mechanical ventilation. Ages of all patients were between 1-180 (median: 8) months. The mechanical ventilation time was 18.8 +/- 14.1 days. Indication of mechanical ventilation could be divided into four groups as respiratory failure (64.8%), cardiovascular failure (19.7%), central nervous system disease (9.8%) and safety airway (5.4%). Tracheostomy was performed in four patients. The complication ratio of mechanically ventilated children was 42.8%, and diversity of complications was as follows: 26.3% atelectasia, 17.5% ventilator-associated pneumonia, 13.1% pneumothorax, 5.4% bleeding, 4.3% tracheal edema, and 2.1% chronic lung disease. The mortality rate of mechanically ventilated patients was 58.3%, but the overall mortality rate in the PICU was 12.2%. In conclusion, there are few published epidemiological data on the follow-up results and mortality in infants and children who are mechanically ventilated.

  2. 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....

  3. 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.

  4. 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.

  5. VENTILATION MODEL REPORT

    Energy Technology Data Exchange (ETDEWEB)

    V. Chipman

    2002-10-31

    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.

  6. Multifamily Ventilation Retrofit Strategies

    Energy Technology Data Exchange (ETDEWEB)

    Ueno, K.; Lstiburek, J.; Bergey, D.

    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.

  7. 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

  8. 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

  9. Academic Emergency Medicine Physicians' Knowledge of Mechanical Ventilation.

    Science.gov (United States)

    Wilcox, Susan R; Strout, Tania D; Schneider, Jeffrey I; Mitchell, Patricia M; Smith, Jessica; Lutfy-Clayton, Lucienne; Marcolini, Evie G; Aydin, Ani; Seigel, Todd A; Richards, Jeremy B

    2016-05-01

    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. 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. 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. 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 most strongly correlated with their self-reported comfort with mechanical

  10. Ventilation rates and health

    DEFF Research Database (Denmark)

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

    2011-01-01

    The scientific literature through 2005 on the effects of ventilation rates on health in indoor environments has been reviewed by a multidisciplinary group. The group judged 27 papers published in peer-reviewed scientific journals as providing sufficient information on both ventilation rates...... 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...

  11. Ventilator waveform interpretation in mechanically ventilated small animals.

    Science.gov (United States)

    Corona, Terry M; Aumann, Marcel

    2011-10-01

    To review the topic of ventilator waveforms analysis with emphasis on interpretation of ventilator waveforms and their use in the management and monitoring of mechanically ventilated small animal patients. Human clinical studies, scientific reviews, and textbooks, as well as veterinary textbooks and clinical examples of ventilator waveforms in mechanically ventilated dogs. Ventilator waveforms are graphic representations of data collected from the ventilator and reflect patient-ventilator interactions. The 4 parameters pressure, volume, flow, and time are most descriptive of mechanical ventilation. Typically, 3 different graphs, also referred to as scalars, consisting of pressure versus time, volume versus time, and flow versus time, with time always plotted on the x-axis, are used. Changes in the ventilator settings as well as in the characteristics of the lungs such as airway resistance (R(aw)) and respiratory system compliance (C(rs)) can be recognized from specific variations in the waveforms. Flow-volume and pressure-volume loops provide additional information about changes in lung function. Patient-ventilator dyssynchrony is a common problem during mechanical ventilation and can lead to patient discomfort and an increased work of breathing. Ventilator waveforms are helpful to identify dyssynchrony, which can be divided into trigger, flow, cycle, and expiratory dyssynchrony. Ventilator waveforms allow the clinician to assess changes in respiratory mechanics, and can be useful in monitoring the progression of disease pathology and response to therapy. Adjustments in ventilator settings based on proper analysis and interpretation of these waveforms can help the clinician to optimize ventilation therapy. Ventilator waveforms are graphic representations of patient-ventilator interactions. Proper interpretation of ventilator waveforms affords the critical care clinician a better understanding of the patient's respiratory function, response to therapy, and causes

  12. Calculation of Industrial Enterprise Ventilation System by Network Integral Method

    Directory of Open Access Journals (Sweden)

    Mihienkova Evgeniya I.

    2016-01-01

    Full Text Available This paper describe a ventilation system calculation of the technology building industrial enterprise. On the basis of the calculation model for the enterprise offered technical decision of ventilation systems, subject to a compliance exchange multiplicity, purification efficiency, decontamination from the work area; provided the required volume of gas extraction from process equipment according to the sanitary standards and environmental requirements. Produced selection of ventilation equipment parameters, solved the problem of the air exchange balancing between ventilation systems to prevent the emergence of parasitic flows between the rooms building. SigmaNet software package was used for the implement the calculation.

  13. Mechanical Ventilation Antioxidant Trial.

    Science.gov (United States)

    Howe, Kimberly P; Clochesy, John M; Goldstein, Lawrence S; Owen, Hugh

    2015-09-01

    Many patients each year require prolonged mechanical ventilation. Inflammatory processes may prevent successful weaning, and evidence indicates that mechanical ventilation induces oxidative stress in the diaphragm, resulting in atrophy and contractile dysfunction of diaphragmatic myofibers. Antioxidant supplementation might mitigate the harmful effects of the oxidative stress induced by mechanical ventilation. To test the clinical effectiveness of antioxidant supplementation in reducing the duration of mechanical ventilation. A randomized, prospective, placebo-controlled double-blind design was used to test whether enterally administered antioxidant supplementation would decrease the duration of mechanical ventilation, all-cause mortality, and length of stay in the intensive care unit and hospital. Patients received vitamin C 1000 mg plus vitamin E 1000 IU, vitamin C 1000 mg plus vitamin E 1000 IU plus N-acetylcysteine 400 mg, or placebo solution as a bolus injection via their enteral feeding tube every 8 hours. Clinical and statistically significant differences in duration of mechanical ventilation were seen among the 3 groups (Mantel-Cox log rank statistic = 5.69, df = 1, P = .017). The 3 groups did not differ significantly in all-cause mortality during hospitalization or in the length of stay in the intensive care unit or hospital. Enteral administration of antioxidants is a simple, safe, inexpensive, and effective intervention that decreases the duration of mechanical ventilation in critically ill adults. ©2015 American Association of Critical-Care Nurses.

  14. Multiple factors influencing OR ventilation system effectiveness

    Directory of Open Access Journals (Sweden)

    Buhl Sebastian

    2016-09-01

    Full Text Available The issue of surgical site infections has become more critical during the last years. The number of airborne microbes depends on the number released by the staff in the room or supplied from neighbouring rooms. In order to minimize the risk of nosocomial infections during surgical procedures technical developments like ventilation systems were introduced in the operating room (OR. In this study several factors like clothing and types of ventilation systems have been investigated and their impact on the effectiveness for reducing microbial burden in the OR has been assessed. In case of OR-gowns we found a benefit for a disposable Swedish clothing concept regarding microbiological contamination in comparison with the German standard multiuse clothing. Moreover our study shows that there is comparable effectiveness of a fairly novel temperature controlled airflow ventilation system (TAF compared to standard low turbulent uni-directional airflow (TAV.

  15. Chaos in Ocean Ventilation

    Science.gov (United States)

    MacGilchrist, G. A.; Marshall, D. P.; Johnson, H. L.; Lique, C.; Thomas, M. D.

    2016-02-01

    Ventilation of the subtropical ocean is important for setting the ocean stratification, the oceanic cycling of biogeochemical elements and the storage of carbon dioxide and heat on inter-annual to decadal timescales. In the textbook view, subtropical ocean ventilation is achieved through advection by the time-mean gyre circulation, with fluid parcels moving along sloping density surfaces into the ocean interior. At the same time, it is well accepted that the ocean circulation is highly nonlinear, with the kinetic energy budget dominated by mesoscale eddies. Consequently, ventilated fluid parcels, rather than remaining coherent as they move into the ocean interior, will be rapidly strained and stirred into surrounding water. To investigate the role of this nonlinear circulation in the ventilation process, we calculate a non-dimensional `filamentation number' - the ratio of the Lagrangian ventilation timescale and the timescale of strain by the nonlinear flow - across two density surfaces in the subtropical North Atlantic in an ocean circulation model. This number predicts the filament width of a ventilated fluid parcel, and is found to be large across both density surfaces (indicating small filament width), particularly on the deeper surface. A Lagrangian mapping from distributions of particles to the year in which they were ventilated is thus shown to be highly chaotic, with particles located side-by-side having been ventilated decades apart, even where the density surface is close to the ocean surface. This novel Lagrangian approach avoids the loss of information through diffusion, and emphasises the importance of mesoscale eddies in the ventilation of the subtropical ocean.

  16. Diffuse Ceiling Ventilation

    DEFF Research Database (Denmark)

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

    -cooling period and night cooling potential. The investment cost of this ventilation system is about 5-10% lower than the conventional ones, because the acoustic ceiling could be directly applied as air diffuser and the use of plenum to distribute air reduces the cost of ductwork. There is a growing interest...... in applying diffuse ceiling ventilation in offices and other commercial buildings because of the benefits from both thermal comfort and energy efficiency aspects. The design guide introduces the principle and key characteristics of room air distribution with diffuse ceiling ventilation and the design...

  17. Demand-controlled mechanical ventilation. Behovsstyret mekanisk ventilation; Fugt som reguleringsparameter - et pilotprojekt

    Energy Technology Data Exchange (ETDEWEB)

    1992-06-01

    This report presents the results from the registration throughout a month of relative humidity, temperature and outdoor air exchanger as well as the concentration of carbon dioxide in each room of an inhabited single family house, in which all rooms are ventilated by a mechanical balanced ventilation system with variable air volume. The ventilation outdoor air rate is controlled by the relative humidity, which is kept on a value adequate to reduce the living conditions for house dust mites and prevent condensation on the indoor surfaces of the building. Due to the demand control ventilation of each individual room a higher efficiency for reducing water vapors in the dwelling as a whole is likely to be achieved. The results show that it is possible with this kind of ventilation system and in the context of Danish outdoor climate to maintain humidity conditions that is anticipated to reduce the number of house dust mites in all rooms of a dwelling during more than five months of the year. In all the months the mean daily mechanical ventilation rate is estimated to be 39% below the level recommended in the Danish Building Code. At the same time indoor condensation was avoided on poorly insulated surfaces of the building. The concentration of carbon dioxide was below the level recommended in international ventilation standards. (au) (13 refs.)

  18. Controversial choice of a control intervention in a trial of ventilator therapy in ARDS: standard of care arguments in a randomised controlled trial.

    Science.gov (United States)

    Mann, H

    2005-09-01

    When evaluating an innovative intervention in a randomised controlled trial (RCT), choosing an appropriate control intervention is necessary for a clinically meaningful result. An RCT reported in 2000 addressed the relative merits of two tidal volume ventilatory strategies, 6 ml/kg (innovative) and 12 ml/kg (control), in patients with acute respiratory distress syndrome. Critics claim that the 12 ml/kg volume did not represent the clinical practice standard at that time, and that lower tidal volumes had been used in some patients prior to randomisation. The trialists responded that current practice involved the use of a broad range of tidal volumes, including 12 ml/kg. Appropriate control interventions for RCTs can be ensured by: a systematic review of the relevant literature; a formal survey of expert clinicians; and publication of the proposed research protocol to solicit critical appraisal. A global survey of experts during the RCT's design stage would have been of probative value in determining the appropriate control tidal volume. Hypothetical, but plausible, results of such a survey are presented and examined to demonstrate the value of this method.

  19. What Is a Ventilator?

    Science.gov (United States)

    ... who are on ventilators for shorter periods. The advantage of this tube is that it can be ... Privacy Policy Freedom of Information Act (FOIA) Accessibility Copyright and Usage No FEAR Act Grants and Funding ...

  20. 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 on...... temperature as well as optimizing the radiant cooling potential by combining with thermal mass is conducted and gives a direction for further investigation....

  1. Indirect Calorimetry in Mechanically Ventilated Patients

    DEFF Research Database (Denmark)

    Allingstrup, Matilde Jo; Kondrup, Jens; Perner, Anders

    2017-01-01

    Background and Aims: The 2 currently available indirect calorimeters, CCM Express Indirect Calorimeter (MedGraphics, St Paul, MN) and Quark RMR ICU Indirect Calorimeter (COSMED, Rome, Italy), have not been validated against a gold standard in mechanically ventilated patients. Our aim was to do so...

  2. Conventional mechanical ventilation

    Directory of Open Access Journals (Sweden)

    Tobias Joseph

    2010-01-01

    Full Text Available The provision of mechanical ventilation for the support of infants and children with respiratory failure or insufficiency is one of the most common techniques that are performed in the Pediatric Intensive Care Unit (PICU. Despite its widespread application in the PICUs of the 21st century, before the 1930s, respiratory failure was uniformly fatal due to the lack of equipment and techniques for airway management and ventilatory support. The operating rooms of the 1950s and 1960s provided the arena for the development of the manual skills and the refinement of the equipment needed for airway management, which subsequently led to the more widespread use of endotracheal intubation thereby ushering in the era of positive pressure ventilation. Although there seems to be an ever increasing complexity in the techniques of mechanical ventilation, its successful use in the PICU should be guided by the basic principles of gas exchange and the physiology of respiratory function. With an understanding of these key concepts and the use of basic concepts of mechanical ventilation, this technique can be successfully applied in both the PICU and the operating room. This article reviews the basic physiology of gas exchange, principles of pulmonary physiology, and the concepts of mechanical ventilation to provide an overview of the knowledge required for the provision of conventional mechanical ventilation in various clinical arenas.

  3. 78 FR 70329 - Modification to the Scopes of Recognition of Several NRTLs; Final Determination

    Science.gov (United States)

    2013-11-25

    .../nrtl/index.html . OSHA is making the following revisions to the scopes of recognition of individual... Scope of Recognition of FM Approvals LLC Replacement test Deleted test standard Reason for standard(s...

  4. Comparison of patient-ventilator asynchrony during pressure support ventilation and proportional assist ventilation modes in surgical Intensive Care Unit: A randomized crossover study.

    Science.gov (United States)

    Gautam, Parshotam Lal; Kaur, Gaganjot; Katyal, Sunil; Gupta, Ruchi; Sandhu, Preetveen; Gautam, Nikhil

    2016-12-01

    The patient-ventilator asynchrony is almost observed in all modes of ventilation, and this asynchrony affects lung mechanics adversely resulting in deleterious outcome. Innovations and advances in ventilator technology have been trying to overcome this problem by designing newer modes of ventilation. Pressure support ventilation (PSV) is a commonly used flow-cycled mode where a constant pressure is delivered by ventilator. Proportional assist ventilation (PAV) is a new dynamic inspiratory pressure assistance and is supposed to be better than PSV for synchrony and tolerance, but reports are still controversial. Moreover, most of these studies are conducted in chronic obstructive pulmonary disease patients with respiratory failure; the results of these studies may not be applicable to surgical patients. Thus, we proposed to do compare these two modes in surgical Intensive Care Unit (ICU) patients as a randomized crossover study. Comparison of patient-ventilator asynchrony between PSV and PAV plus (PAV+) in surgical patients while weaning. After approval by the Hospital Ethics Committee, we enrolled twenty patients from surgical ICU of tertiary care institute. The patients were ventilated with pressure support mode (PSV) and PAV+ for 12 h as a crossover from one mode to another after 6 h while weaning. Average age and weight of patients were 41.80 ± 15.20 years (mean ± standard deviation [SD]) and 66.50 ± 12.47 (mean ± SD) kg, respectively. Comparing the asynchronies between the two modes, the mean number of total asynchronous recorded breaths in PSV was 7.05 ± 0.83 and 4.35 ± 5.62, respectively, during sleep and awake state, while the same were 6.75 ± 112.24 and 10.85 ± 11.33 in PAV+. Both PSV and PAV+ modes of ventilation performed similarly for patient-ventilator synchrony in surgical patients. In surgical patients with acute respiratory failure, dynamic inspiratory pressure assistance modalities are not superior to PSV with respect to cardiorespiratory

  5. Phrenic pacing compared with mechanical ventilation

    DEFF Research Database (Denmark)

    Andersen, Morten Packert; Laub, Michael; Biering-Sørensen, Fin

    2017-01-01

    mechanical ventilator dependent tetraplegics met the inclusion criteria. Data were retrieved from medical records and a structured follow-up interview with seven individuals from each group. RESULTS: No significant differences were found when comparing age at injury, time since injury, length...... of hospitalization, incidence of pneumonia, number of pneumonia hospitalizations, number of tracheal suctions, speech quality and activities of daily living or quality of life. On the Short Form Health Survey (SF36) mental health summary the median for both users of phrenic nerve pacing and users of mechanical...... ventilation was one s.d. above the mean of a standard population. CONCLUSIONS: Nine people have had a phrenic nerve pacer implanted. They do not significantly differ from a group of home mechanical ventilator dependent tetraplegics on a number of performance measures, but both groups seem to have better...

  6. Triggering of the ventilator in patient-ventilator interactions.

    Science.gov (United States)

    Sassoon, Catherine Sh

    2011-01-01

    With current ventilator triggering design, in initiating ventilator breaths patient effort is only a small fraction of the total effort expended to overcome the inspiratory load. Similarly, advances in ventilator pressure or flow delivery and inspiratory flow termination improve patient effort or inspiratory muscle work during mechanical ventilation. Yet refinements in ventilator design do not necessarily allow optimal patient-ventilator interactions, as the clinician is key in managing patient factors and selecting appropriate ventilator factors to maintain patient-ventilator synchrony. In patient-ventilator interactions, unmatched patient flow demand by ventilator flow delivery results in flow asynchrony, whereas mismatches between mechanical inspiratory time (mechanical T(I)) and neural T(I) produce timing asynchrony. Wasted efforts are an example of timing asynchrony. In the triggering phase, trigger thresholds that are set too high or the type of triggering methods induces wasted efforts. Wasted efforts can be aggravated by respiratory muscle weakness or other conditions that reduce respiratory drive. In the post-triggering phase, ventilator factors play an important role in patient-ventilator interaction; this role includes the assistance level, set inspiratory flow rate, T(I), pressurization rate, and cycling-off threshold, and to some extent, applied PEEP. This paper proposes an algorithm that clinicians can use to adjust ventilator settings with the goal to eliminate or reduce patients' wasted efforts.

  7. 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.

  8. 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...

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    Pikeperch is of increasing interest to the aquaculture industry, as a novel high value species. To our knowledge there is currently no information available on the metabolic rates of adult pikeperch. The present study determined the standard and maximum metabolic rates and ventilation frequency...... at six temperatures, ranging from 13 to 28 °C, in order to identify the temperature where pikeperch has the largest metabolic scope (MS). Between 13 and 25 °C, standard metabolic rates (SMR) increased as expected with a Q10=1.8 in response to increasing temperatures, while maximum metabolic rate (MMR...... consumption rate (M_ O2), during normoxia and progressive hypoxia. A strong correlation was found between fV and M_ O2 across all temperatures, and fV could predict M_ O2 with a high degree of accuracy in normoxia...

  10. Ventilation with heat recovery

    DEFF Research Database (Denmark)

    Tommerup, Henrik M.; Svendsen, Svend

    2005-01-01

    This paper presents the experiences from the use of ventilation with heat recovery in several experimental single-family houses developed and built within the last four years to meet the new Danish energy requirements of 2005. Included are descriptions of the ventilation system components...... and the main functional demands as well as measurements of the thermal efficiency, electricity consumptions and building air tightness. The paper addresses the aspects of minimizing the heat loss from the duct system and the heat recovery unit (when placed in an unheated attic space) in order to obtain...

  11. Measure Guideline: Selecting Ventilation Systems for Existing Homes

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-02-01

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

  12. Energy efficient demand controlled ventilation in single family houses

    DEFF Research Database (Denmark)

    Nielsen, Toke Rammer; Drivsholm, Christian

    2010-01-01

    in the Danish building regulations and the low flow rate is based on minimum requirements in indoor air quality standards. Measurements were performed on an existing single family house where the controls were installed on the existing mechanical ventilation system. The results showed that the ventilation can......This paper presents a strategy for a simple demand controlled ventilation system for single family houses where all sensors and controls are located in the air handling unit. The strategy is based on sensing CO2-concentration and moisture content in the outdoor air and exhaust air. The CO2......-concentration is used to ensure adequate ventilation during occupancy and the moisture content is used to ensure adequate removal of moisture produced in the house. The ventilation rate can be switched between two flow rates: a high rate and a low rate. The high flow rate is based on existing requirements...

  13. 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

  14. Ventilation Criteria for Aeromedical Evacuation.

    Science.gov (United States)

    1986-09-01

    number) FIELD GROUP i SUB-GROUP Aeromedical evacuation; Ventilatory requirements; 06 11 06 12 iAir evacuation; and Mechanical ventilation . 19...ABSTRACT (Continue on reverse if necessary and identify by block number) -., fr evacLation of patients requiring mechanical ventilation exposes these...reasonably stable from a medical standpoint; none required mechanical ventilation . Unfortunately, we find no .- , studies that describe the

  15. The amazing Minivent ventilator

    African Journals Online (AJOL)

    TYYCVNCi2nM. Acknowledgements – The authors wish to thank Dr Christine Ball for the photograph of Dr Cohen and Dr Cohen for providing them with the last Minivent ventilator in his possession. It is still functioning and may be seen in the Nagin ...

  16. Measure Guideline: Ventilation Cooling

    Energy Technology Data Exchange (ETDEWEB)

    Springer, D.; Dakin, B.; German, A.

    2012-04-01

    The purpose of this measure guideline on ventilation cooling is to provide information on a cost-effective solution for reducing cooling system energy and demand in homes located in hot-dry and cold-dry climates. This guideline provides a prescriptive approach that outlines qualification criteria, selection considerations, and design and installation procedures.

  17. Mechanical ventilation of mice

    NARCIS (Netherlands)

    Schwarte, L. A.; Zuurbier, C. J.; Ince, C.

    2000-01-01

    Due to growing interest in murine functional genomics research, there is an increasing need for physiological stable in vivo murine models. Of special importance is support and control of ventilation by artificial respiration, which is difficult to execute as a consequence of the small size of the

  18. Ventilation for Free

    NARCIS (Netherlands)

    Scholten, R.D.; Ter Haar, J.

    2014-01-01

    This "designers' manual" is made during the TIDO-course AR0533 Innovation & Sustainability. The goal of this manual is to give a clear and simple overview of some of the possibilities for using natural ventilation in buildings. These systems are described through their formulas to give an idea of

  19. Elforbrug til mekanisk ventilation

    DEFF Research Database (Denmark)

    Olufsen, P.

    I Energi 2000 er ventilationsområdet udpeget som et af de områder, hvor der bør tages initiativ til at fremme elbesparelser. I rapporten beskrives og analyseres målinger af elforbruget til ventilation i 12 bygninger, der alle anvendes til administration eller lignende formål. På grundlag af...

  20. Effect of Ventilation Strategies on Residential Ozone Levels

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-08-01

    Elevated outdoor ozone levels are associated with adverse health effects. Because people spend the vast majority of their time indoors, reduction in indoor levels of ozone of outdoor origin would lower population exposures and might also lead to a reduction in ozone-associated adverse health effects. In most buildings, indoor ozone levels are diminished with respect to outdoor levels to an extent that depends on surface reactions and on the degree to which ozone penetrates the building envelope. Ozone enters buildings from outdoors together with the airflows that are driven by natural and mechanical means, including deliberate ventilation used to reduce concentrations of indoor-generated pollutants. When assessing the effect of deliberate ventilation on occupant health one should consider not only the positive effects on removing pollutants of indoor origin but also the possibility that enhanced ventilation might increase indoor levels of pollutants originating outdoors. This study considers how changes in residential ventilation that are designed to comply with ASHRAE Standard 62.2 might influence indoor levels of ozone. Simulation results show that the building envelope can contribute significantly to filtration of ozone. Consequently, the use of exhaust ventilation systems is predicted to produce lower indoor ozone concentrations than would occur with balanced ventilation systems operating at the same air-­exchange rate. We also investigated a strategy for reducing exposure to ozone that would deliberately reduce ventilation rates during times of high outdoor ozone concentration while still meeting daily average ventilation requirements.

  1. Experimental Investigation of Ventilation Efficiency in a Dentistry Surgical Room

    Directory of Open Access Journals (Sweden)

    Oladokun Majeed Olaide

    2016-01-01

    Full Text Available As a response to the need to provide an acceptable thermal comfort and air quality in indoor environments, various ventilation performance indicators were developed over the years. These metrics are mainly geared towards air distribution, heat and pollutant removals. Evidence exists of influencing factors on these indicators as centered on ventilation design and operations. Unlike other indoor environments, health care environment requires better performance of ventilation system to prevent an incidence of nosocomial and other hospital acquired illnesses. This study investigates, using in-situ experiments, the ventilation efficiency in a dentistry surgical room. Thermal and hygric parameters were monitored on the air terminal devices and occupied zone over a period of one week covering both occupied and unoccupied hours. The resulting time-series parameters were used to evaluate the room’s ventilation effectiveness. Also, the obtained parameters were benchmarked against ASHRAE 170 (2013 and MS1525 (2014 requirements for ventilation in health care environment and building energy efficiency respectively. The results show that the mean daily operative conditions failed to satisfy the provisions of both standards. Regarding effectiveness, the findings reveal that the surgical room ventilation is ineffective with ventilation efficiency values ranging between 0 and 0.5 indicating air distribution short-circuiting. These results suggest further investigations, through numerical simulation, on the effect of this short-circuiting on thermal comfort, infection risk assessments and possible design improvements, an endeavour that forms our next line of research inquiries.

  2. [Injury in air way of newborn with mechanical ventilation].

    Science.gov (United States)

    Flores-Nava, Gerardo; Mateos-Sánchez, Leovigildo; Jurado-Hernández, Víctor Hugo

    2008-01-01

    mechanical ventilation is used in all Neonatal Intensive Care Unit (NICU). The patients with more than a week with mechanical ventilation can develop complications in the airway. The diagnosis is carrying out with a bronchoscope. to determine the type of complications presented in a group of neonates who had received, one o more weeks, mechanical ventilation, through bronchoscopy. we realized a retrospective reviewed of the charts of patients with mechanical ventilation in a NICU during a one-year period and whom a bronchoscopy was carried out for respiratory distress after extubation. We analyzed; the type of lesion, age of gestation and birth weight, gender, mechanical ventilation days, atelectasis, age and days of extra uterine life in the moment of the bronchoscopy. In the variables we achieved frequency, averages, media and standard deviations. we reviewed 55 charts. The mean gestational age was 34 weeks, birth weight 2075 g and 38 days with mechanical ventilation. Male 52.7 %. Atelectasis in 78.7 %, a third of the patients required mechanical ventilation after extubation. The airway lesions were (%); bronchial stenosis 25.4, laryngotracheobronchitis 18.1, laryngeal edema 10.9, laryngotracheitis 7.2, laryngomalacia 7.2 %, ulcer 7.2, cord paralysis 5.4, granulom 3.6 and normal 3.6. Three required tracheotomy. subglotic stenosis was the complications more frequent. Ideally all the neonates after mechanical ventilation shoud realized a bronchoscopy for preventing complications.

  3. Patient-ventilator dyssynchrony during assisted invasive mechanical ventilation.

    Science.gov (United States)

    Murias, G; Villagra, A; Blanch, L

    2013-04-01

    Patient-ventilator dyssynchrony is common during mechanical ventilation. Dyssynchrony decreases comfort, prolongs mechanical ventilation and intensive care unit stays, and might lead to worse outcome. Dyssynchrony can occur during the triggering of the ventilator, the inspiration period after triggering, the transition from inspiration to expiration, and the expiratory phase. The most common dyssynchronies are delayed triggering, autotriggering, ineffective inspiratory efforts (which can occur at any point in the respiratory cycle), mismatch between the patient's and ventilator's inspiratory times, and double triggering. At present, the detection of dyssynchronies usually depends on healthcare staff observing ventilator waveforms; however, performance is suboptimal and many events go undetected. To date, technological complexity has made it impossible to evaluate patient-ventilator synchrony throughout the course of mechanical ventilation. Studies have shown that a high index of dyssynchrony may increase the duration of mechanical ventilation. Better training, better ventilatory modes, and/or computerized systems that permit better synchronization of patients' demands and ventilator outputs are necessary to improve patient-ventilator synchrony.

  4. Expanding Scope of Practice for Ontario Optometrists

    National Research Council Canada - National Science Library

    Emily Bray; Ivy Bourgault

    2017-01-01

    In 2011, The Optometry Act, 1991 was amended to include The Designated Drugs and Standards of Practice Regulation which expanded the scope of practice for Ontario optometrists to include prescribing...

  5. Performance of ductless personalized ventilation in conjunction with displacement ventilation

    DEFF Research Database (Denmark)

    Dalewski, Mariusz; Melikov, Arsen Krikor; Vesely, Michal

    2014-01-01

    The performance of ductless personalized ventilation (DPV) in conjunction with displacement ventilation was studied and compared with displacement ventilation alone and mixing ventilation. Thirty subjects were exposed in a climate chamber to environmental conditions representing three levels...... perception of the environment. The subjects could control the position of the DPV supply diffuser and the personalized air flow (air velocity). The use of DPV improved perceived air quality and thermal comfort compared to displacement ventilation alone. At 26 °C and 29 °C the percentage dissatisfied with air...... movement decreased with DPV compared to corresponding conditions with displacement ventilation alone and reached the same level as mixing or displacement ventilation at 23 °C. Subjects were able to control the volume and speed of the personalized air flow in order to avoid eye irritation. However...

  6. 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...

  7. Measure Guideline: Ventilation Guidance for Residential High-Performance New Construction - Multifamily

    Energy Technology Data Exchange (ETDEWEB)

    Lstiburek, Joseph [Building Science Corp., Westford, MA (United States)

    2017-01-01

    The measure guideline provides ventilation guidance for residential high performance multifamily construction that incorporates the requirements of the ASHRAE 62.2 ventilation and indoor air quality standard. The measure guideline focus is on the decision criteria for weighing cost and performance of various ventilation systems. The measure guideline is intended for contractors, builders, developers, designers and building code officials. The guide may also be helpful to building owners wishing to learn more about ventilation strategies available for their buildings. The measure guideline includes specific design and installation instructions for the most cost effective and performance effective solutions for ventilation in multifamily units that satisfies the requirements of ASHRAE 62.2-2016.

  8. A scoping review on the conduct and reporting of scoping reviews.

    Science.gov (United States)

    Tricco, Andrea C; Lillie, Erin; Zarin, Wasifa; O'Brien, Kelly; Colquhoun, Heather; Kastner, Monika; Levac, Danielle; Ng, Carmen; Sharpe, Jane Pearson; Wilson, Katherine; Kenny, Meghan; Warren, Rachel; Wilson, Charlotte; Stelfox, Henry T; Straus, Sharon E

    2016-02-09

    has steadily increased since 2012. Scoping reviews are used to inform research agendas and identify implications for policy or practice. As such, improvements in reporting and conduct are imperative. Further research on scoping review methodology is warranted, and in particular, there is need for a guideline to standardize reporting.

  9. 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...... guidelines has been recommended as one of the strategic priorities to reduce this BoD (de Oliveira-Fernandes et al., 2009), also because the current ventilation standards in Europe provide different categories of comfort, not health, as the main criteria for designing ventilation requirements (EN 13779, 2007...

  10. 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....

  11. Ventilation System Effectiveness and Tested Indoor Air Quality Impacts

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-02-01

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

  12. Ventilation System Effectiveness and Tested Indoor Air Quality Impacts

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-02-01

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

  13. [Ventilation-perfusion ratios].

    Science.gov (United States)

    Schaffartzik, W

    1994-10-01

    Knowledge of normal and impaired pulmonary gas exchange is essential to the anaesthesiologist. Analysis of an arterial blood sample allows evaluation of whether or not pulmonary gas exchange is normal. For this purpose comparison with the oxygenation index or the alveolar-arterial PO2 difference is helpful. Pathological changes of these variables are mainly caused by ventilation-perfusion (VA/Q) mismatch. In daily practice, venous admixture or intrapulmonary shunt can be calculated using arterial and mixed-venous blood. By analysing arterial and expired PCO2, dead-space ventilation can be determined, but extended analyses of VA/Q distribution are not possible in daily practice. However, knowledge of the principles of typical disturbances of pulmonary gas exchange in acute and chronic lung disease allows the use of therapeutic strategies based on the pathophysiological changes.

  14. Diffuse Ceiling Ventilation

    DEFF Research Database (Denmark)

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

    -cooling period and night cooling potential. The investment cost of this ventilation system is about 5-10% lower than the conventional ones, because the acoustic ceiling could be directly applied as air diffuser and the use of plenum to distribute air reduces the cost of ductwork. There is a growing interest...... and manufacturers and the users of diffuse ceiling technology. The design guide introduces the principle and key characteristics of room air distribution with diffuse ceiling ventilation. It provides an overview of potential benefit and limitations of this technology. The benefits include high thermal comfort, high...... cooling capacity, energy saving, low investment cost and low noise level; while the limitations include condensation risk and the limit on the room geometry. Furthermore, the crucial design parameters are summarized and their effects on the system performance are discussed. In addition to the stand...

  15. Ventilation i industrien

    DEFF Research Database (Denmark)

    Valbjørn, O.

    I en række afsnit belyses problemer med træk, kulde, varme, og luftforurening på industriens arbejdspladser, og hvordan man ved ventilation og bygningsudformning kan bekæmpe disse gener. Hvert afsnit kan i princippet læses for sig, og anvisningen kan derfor bruges som håndbog, både af de der er...

  16. Noninvasive mechanical ventilation

    OpenAIRE

    Karakurt, Sait

    2016-01-01

    Noninvasive mechanical ventilation (NIMV) has been widelyapplied to the patient with respiratory failure since 1990’s aroundthe world. The respiratory function of the patient with respiratoryfailure should be supported by using positive pressure ventilationuntil primary problem of the patient is treated. Positive pressureshould be given noninvasively or invasively. If the patient isconscious (except unconsiousness due to CO2 retention) and hasintact bulber function(sufficient cough reflex and...

  17. SEPARATION OF MECHANICAL VENTILATION

    OpenAIRE

    Ida Bagus Wisnu Parbawa Kusuma; I Nengah Kuning Atmajaya

    2014-01-01

    The weaning from mechanical ventilation can be defined as the process of letting theventilator either directly or in stages. Indication of weaning from mechanicalventilation, seen from several parameters such as disease processes, PaO2, PEEP,FiO2, pH, Hb, awareness, body temperature, cardiac function, lung function, drugssedative agent or paralysis agent, and psicologic status of patient. Based on thelength of the weaning, can be devided into two, long-term weaning dan short-termweaning. Shor...

  18. Ventilation i industrien

    DEFF Research Database (Denmark)

    Valbjørn, O.

    I en række afsnit belyses problemer med træk, kulde, varme, og luftforurening på industriens arbejdspladser, og hvordan man ved ventilation og bygningsudformning kan bekæmpe disse gener. Hvert afsnit kan i princippet læses for sig, og anvisningen kan derfor bruges som håndbog, både af de der er u...

  19. Harnessing natural ventilation benefits.

    Science.gov (United States)

    O'Leary, John

    2013-04-01

    Making sure that a healthcare establishment has a good supply of clean fresh air is an important factor in keeping patients, staff, and visitors, free from the negative effects of CO2 and other contaminants. John O'Leary of Trend Controls, a major international supplier of building energy management solutions (BEMS), examines the growing use of natural ventilation, and the health, energy-saving, and financial benefits, that it offers.

  20. Purge ventilation operability

    Energy Technology Data Exchange (ETDEWEB)

    Marella, J.R.

    1995-04-10

    A determination of minimum requirements for purge exhaust ventilation system operability has been performed. HLWE and HLW Regulatory Program personnel have evaluated the various scenarios of equipment conditions and HLWE has developed the requirements for purge exhaust systems. This report is provided to document operability requirements to assist Tank Farm personnel to determine whether a system is operable/inoperable and to define required compensatory actions.

  1. Energy efficient ventilation based on demand humidity control. Demonstration project with 49 apartments in Soenderborg

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-09-01

    The aim of the project is to demonstrate how the overall energy consumption in apartment buildings can be reduced through a combination of: 1) Energy efficient ventilation based on demand humidity control; 2) Energy efficient design of the building shell including passive solar and seasonally flexible sunspaces; 3) Use of low temperature heating system. The 3 blocks in the project, each with 16 apartments, are furnished with 3 different ventilation systems: 1) Standard exhaust system according to building codes; 2) Ventilation system with humidity control. Each room is furnished with an air inlet valve controlled by a processor, which monitors the humidity; 3) Standard ventilation system with heat recovery. (au)

  2. Optimization of Occupancy Based Demand Controlled Ventilation in Residences

    Energy Technology Data Exchange (ETDEWEB)

    Mortensen, Dorthe K.; Walker, Iain S.; Sherman, Max H.

    2011-05-01

    Although it has been used for many years in commercial buildings, the application of demand controlled ventilation in residences is limited. In this study we used occupant exposure to pollutants integrated over time (referred to as 'dose') as the metric to evaluate the effectiveness and air quality implications of demand controlled ventilation in residences. We looked at air quality for two situations. The first is that typically used in ventilation standards: the exposure over a long term. The second is to look at peak exposures that are associated with time variations in ventilation rates and pollutant generation. The pollutant generation had two components: a background rate associated with the building materials and furnishings and a second component related to occupants. The demand controlled ventilation system operated at a low airflow rate when the residence was unoccupied and at a high airflow rate when occupied. We used analytical solutions to the continuity equation to determine the ventilation effectiveness and the long-term chronic dose and peak acute exposure for a representative range of occupancy periods, pollutant generation rates and airflow rates. The results of the study showed that we can optimize the demand controlled airflow rates to reduce the quantity of air used for ventilation without introducing problematic acute conditions.

  3. Scope of practice: freedom within limits.

    Science.gov (United States)

    Schuiling, K D; Slager, J

    2000-01-01

    "Scope of practice" has a variety of meanings amongst midwives, other health professionals, health organizations, and consumers of midwifery care. For some, it refers to the Standards for the Practice of Midwifery; for others, it encompasses the legal base of practice; still others equate it with the components of the clinical parameters of practice. Because "scope of practice" is dynamic and parameters of practice can be impacted by many variables, succinctly defining "scope of practice" is difficult. This article provides a comprehensive discussion of the concept "scope of practice." Clinical scenarios are provided as case exemplars. The aim of this paper is to provide both new and experienced midwives with a substantive definition of the concept "scope of practice."

  4. Mechanical ventilation in neurosurgical patients

    OpenAIRE

    Keshav Goyal; Ranadhir Mitra; Shweta Kedia

    2013-01-01

    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 pa...

  5. 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.

  6. Ventilation Surge Techniques. Volume I

    Science.gov (United States)

    1981-12-01

    Whon Data Rntere), 20. The experimental program examined airflow patterns for both mechanically driven and thermally driven ventilation . Mechanical ...were used in the study. *The experimental program examined airflow patterns for both mechanically driven and thermally driven ventilation . Mechanical ... Ventilation can be supplied by mechanical means such as fans, blowers, and pumps or by natural forces such’as those created by wind or thermal buoyancy. The

  7. 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....

  8. 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.

  9. Long-Term Mechanical Ventilation.

    Science.gov (United States)

    Sahetya, Sarina; Allgood, Sarah; Gay, Peter C; Lechtzin, Noah

    2016-12-01

    Although precise numbers are difficult to obtain, the population of patients receiving long-term ventilation has increased over the last 20 years, and includes patients with chronic lung diseases, neuromuscular diseases, spinal cord injury, and children with complex disorders. This article reviews the equipment and logistics involved with ventilation outside of the hospital. Discussed are common locations for long-term ventilation, airway and secretion management, and many of the potential challenges faced by individuals on long-term ventilation. Published by Elsevier Inc.

  10. Measure Guideline: Selecting Ventilation Systems for Existing Homes

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-02-01

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

  11. 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...

  12. Control Strategies to Conserve Energy in All-Air Heating Ventilation and Air Conditioning Systems.

    Science.gov (United States)

    1979-05-14

    York, ASHRAE, Inc. American Society of Heating, Refrigerating and Air- Conditioning Engineers. "Standards for Natural and Mechanical Ventilation ...or REPoRT a P61mO0 COVERED 1 Control Strategies to Conserve Energy in All-Air Heating Ventilation and Air Conditioning THESIS 14Systems o ~~~sGOG...Morrison, William James (M. S., Civil Engineering) Control Strategies to Conserve Energy in All-Air Heating Ventilation and Air Conditioning Systems Report

  13. Ventilation measured on clinical 4D-CBCT

    DEFF Research Database (Denmark)

    Rørdam Jensen, Kasper; Brink, Carsten; Hansen, Olfred

    2017-01-01

    as a gold standard the current study investigates if image improvements increase the accuracy of 4D-CBCT measured ventilation. MATERIAL AND METHODS: The study consists of 4D-CBCT and 4D-CT scans of 20 non-small-cell lung cancer patients. Raw CBCT projections were subjected to a standard or an improved...... combining improved projection correction and SART reconstruction (0.34) compared to the clinical standard (0.21). The correlation further increased when averaging ventilation measured from three successive CBCT scans (0.38). CONCLUSION: The study showed that the combination of improved projection correction...... projection correction and reconstructed by the common FDK-algorithm or the more advanced SART-algorithm. Ventilation was measured as Jacobians calculated from DIR and the comparison between CBCT and CT was done by Spearman correlation. RESULTS: A significant increase in the mean correlation was observed when...

  14. Monitoring ventilation during anesthesia.

    Science.gov (United States)

    Kay, B

    1978-01-01

    In patients under anesthesia, ventilation is often monitored less adequately than circulation. A simple method, neglected in adults, is the use of a precordial or oesophageal stethoscope. Respiratory volumes may be measured directly, or inferred from flowrates or pressure changes. A rough measurement of inspired volumes may be made using a nonrebreathing valve, and controlling fresh gas input to maintain a constant underfilled reservoir bag. Spirometry of expired volumes is difficult and requires sophisticated apparatus. Respiratory volumes are easily inferred from flowrates using the Wright or Dräger respirometers. Flowrates may also be inferred from pressure changes, which are easy to record, as in the pneumotachorgraph. Accurate measurements require attention to many details, such as linearity of the transducer response over the flowrates measured. Calibration should be with the anesthetic gases used, at controlled temperature and humidity. Positive pressure ventilation peaks give a high flow artefact, and electronic drift requires regular recalibration. Electrical impedance changes may also be used to infer and record respiratory volumes, with reasonable accuracy if individual calibration is carried out. Anesthesia offers excellent opportunities to measure compliance and resistance, but itself changes these values, so that relation to normal values or changes due to pathology is difficult. Occlusion pressure is also readily measured during anesthesia, as an indication of respiratory drive, but rigid control of all other factors affecting respiratory muscle tensions is necessary.

  15. Thermal plumes in ventilated rooms

    DEFF Research Database (Denmark)

    Kofoed, Peter; Nielsen, Peter V.

    1990-01-01

    The design of a displacement ventilation system involves determination of the flow rate in the thermal plumes. The flow rate in the plumes and the vertical temperature gradient influence each other, and they are influenced by many factors. This paper shows some descriptions of these effects. Free...... to be the only possible approach to obtain the volume flow in: thermal plumes in ventilated rooms....

  16. 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...

  17. Ventilation and Heat Recovering System

    Directory of Open Access Journals (Sweden)

    Olga Bancea

    2007-01-01

    Full Text Available Some aspects concerning the heat reducing for ventilation, achieved by using heat recovering components and a combined heating--ventilating system, assuring both comfort and human health are presented. The floor imbedded systems together with air outlets elements could fulfill all the aesthetically desires, as well as comfort and they are ideal for family houses.

  18. 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,

  19. 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 ...

  20. 21 CFR 14.1 - Scope.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Scope. 14.1 Section 14.1 Food and Drugs FOOD AND... performance standard for an electronic product by the Technical Electronic Product Radiation Safety Standards... basis. (iii) A group of experts who are employed by a private company or a trade association which has...

  1. How is mechanical ventilation employed in a pediatric intensive care unit in Brazil?

    Science.gov (United States)

    Silva, Dafne Cardoso Bourguignon da; Shibata, Audrey Rie Ogawa; Farias, Julio A; Troster, Eduardo Juan

    2009-01-01

    To investigate the relationship between mechanical ventilation and mortality and the practice of mechanical ventilation applied in children admitted to a high-complexity pediatric intensive care unit in the city of São Paulo, Brazil. Prospective cohort study of all consecutive patients admitted to a Brazilian high-complexity PICU who were placed on mechanical ventilation for 24 hours or more, between October 1(st), 2005 and March 31(st), 2006. Of the 241 patients admitted, 86 (35.7%) received mechanical ventilation for 24 hours or more. Of these, 49 met inclusion criteria and were thus eligible to participate in the study. Of the 49 patients studied, 45 had chronic functional status. The median age of participants was 32 months and the median length of mechanical ventilation use was 6.5 days. The major indication for mechanical ventilation was acute respiratory failure, usually associated with severe sepsis / septic shock. Pressure ventilation modes were the standard ones. An overall 10.37% incidence of Acute Respiratory Distress Syndrome was found, in addition to tidal volumes > 8 ml/kg, as well as normo- or hypocapnia. A total of 17 children died. Risk factors for mortality within 28 days of admission were initial inspiratory pressure, pH, PaO2/FiO2 ratio, oxygenation index and also oxygenation index at 48 hours of mechanical ventilation. Initial inspiratory pressure was also a predictor of mechanical ventilation for periods longer than 7 days. Of the admitted children, 35.7% received mechanical ventilation for 24 h or more. Pressure ventilation modes were standard. Of the children studied, 91% had chronic functional status. There was a high incidence of Acute Respiratory Distress Syndrome, but a lung-protective strategy was not fully implemented. Inspiratory pressure at the beginning of mechanical ventilation was a predictor of mortality within 28 days and of a longer course of mechanical ventilation.

  2. Natural ventilation for free stall dairy barns

    OpenAIRE

    Gay, Susan Wood

    2009-01-01

    Natural ventilation is a result of a combination good construction, correct temperature, humidity control, air exchange. This publication discusses how to achieve natural ventilation in your structure.

  3. Inhalation therapy in mechanical ventilation

    Science.gov (United States)

    Maccari, Juçara Gasparetto; Teixeira, Cassiano; Gazzana, Marcelo Basso; Savi, Augusto; Dexheimer-Neto, Felippe Leopoldo; Knorst, Marli Maria

    2015-01-01

    Patients with obstructive lung disease often require ventilatory support via invasive or noninvasive mechanical ventilation, depending on the severity of the exacerbation. The use of inhaled bronchodilators can significantly reduce airway resistance, contributing to the improvement of respiratory mechanics and patient-ventilator synchrony. Although various studies have been published on this topic, little is known about the effectiveness of the bronchodilators routinely prescribed for patients on mechanical ventilation or about the deposition of those drugs throughout the lungs. The inhaled bronchodilators most commonly used in ICUs are beta adrenergic agonists and anticholinergics. Various factors might influence the effect of bronchodilators, including ventilation mode, position of the spacer in the circuit, tube size, formulation, drug dose, severity of the disease, and patient-ventilator synchrony. Knowledge of the pharmacological properties of bronchodilators and the appropriate techniques for their administration is fundamental to optimizing the treatment of these patients. PMID:26578139

  4. Inhalation therapy in mechanical ventilation.

    Science.gov (United States)

    Maccari, Juçara Gasparetto; Teixeira, Cassiano; Gazzana, Marcelo Basso; Savi, Augusto; Dexheimer-Neto, Felippe Leopoldo; Knorst, Marli Maria

    2015-01-01

    Patients with obstructive lung disease often require ventilatory support via invasive or noninvasive mechanical ventilation, depending on the severity of the exacerbation. The use of inhaled bronchodilators can significantly reduce airway resistance, contributing to the improvement of respiratory mechanics and patient-ventilator synchrony. Although various studies have been published on this topic, little is known about the effectiveness of the bronchodilators routinely prescribed for patients on mechanical ventilation or about the deposition of those drugs throughout the lungs. The inhaled bronchodilators most commonly used in ICUs are beta adrenergic agonists and anticholinergics. Various factors might influence the effect of bronchodilators, including ventilation mode, position of the spacer in the circuit, tube size, formulation, drug dose, severity of the disease, and patient-ventilator synchrony. Knowledge of the pharmacological properties of bronchodilators and the appropriate techniques for their administration is fundamental to optimizing the treatment of these patients.

  5. Automatic protective ventilation using the ARDSNet protocol with the additional monitoring of electrical impedance tomography

    Science.gov (United States)

    2014-01-01

    Introduction Automatic ventilation for patients with respiratory failure aims at reducing mortality and can minimize the workload of clinical staff, offer standardized continuous care, and ultimately save the overall cost of therapy. We therefore developed a prototype for closed-loop ventilation using acute respiratory distress syndrome network (ARDSNet) protocol, called autoARDSNet. Methods A protocol-driven ventilation using goal-oriented structural programming was implemented and used for 4 hours in seven pigs with lavage-induced acute respiratory distress syndrome (ARDS). Oxygenation, plateau pressure and pH goals were controlled during the automatic ventilation therapy using autoARDSNet. Monitoring included standard respiratory, arterial blood gas analysis and electrical impedance tomography (EIT) images. After 2-hour automatic ventilation, a disconnection of the animal from the ventilator was carried out for 10 seconds, simulating a frequent clinical scenario for routine clinical care or intra-hospital transport. Results This pilot study of seven pigs showed stable and robust response for oxygenation, plateau pressure and pH value using the automated system. A 10-second disconnection at the patient-ventilator interface caused impaired oxygenation and severe acidosis. However, the automated protocol-driven ventilation was able to solve these problems. Additionally, regional ventilation was monitored by EIT for the evaluation of ventilation in real-time at bedside with one prominent case of pneumothorax. Conclusions We implemented an automatic ventilation therapy using ARDSNet protocol with seven pigs. All positive outcomes were obtained by the closed-loop ventilation therapy, which can offer a continuous standard protocol-driven algorithm to ARDS subjects. PMID:24957974

  6. Automatic control of pressure support for ventilator weaning in surgical intensive care patients.

    Science.gov (United States)

    Schädler, Dirk; Engel, Christoph; Elke, Gunnar; Pulletz, Sven; Haake, Nils; Frerichs, Inéz; Zick, Günther; Scholz, Jens; Weiler, Norbert

    2012-03-15

    Despite its ability to reduce overall ventilation time, protocol-guided weaning from mechanical ventilation is not routinely used in daily clinical practice. Clinical implementation of weaning protocols could be facilitated by integration of knowledge-based, closed-loop controlled protocols into respirators. To determine whether automated weaning decreases overall ventilation time compared with weaning based on a standardized written protocol in an unselected surgical patient population. In this prospective controlled trial patients ventilated for longer than 9 hours were randomly allocated to receive either weaning with automatic control of pressure support ventilation (automated-weaning group) or weaning based on a standardized written protocol (control group) using the same ventilation mode. The primary end point of the study was overall ventilation time. Overall ventilation time (median [25th and 75th percentile]) did not significantly differ between the automated-weaning (31 [19-101] h; n = 150) and control groups (39 [20-118] h; n = 150; P = 0.178). Patients who underwent cardiac surgery (n = 132) exhibited significantly shorter overall ventilation times in the automated-weaning (24 [18-57] h) than in the control group (35 [20-93] h; P = 0.035). The automated-weaning group exhibited shorter ventilation times until the first spontaneous breathing trial (1 [0-15] vs. 9 [1-51] h; P = 0.001) and a trend toward fewer tracheostomies (17 vs. 28; P = 0.075). Overall ventilation times did not significantly differ between weaning using automatic control of pressure support ventilation and weaning based on a standardized written protocol. Patients after cardiac surgery may benefit from automated weaning. Implementation of additional control variables besides the level of pressure support may further improve automated-weaning systems. Clinical trial registered with www.clinicaltrials.gov (NCT 00445289).

  7. Synchronized mechanical ventilation for respiratory support in newborn infants.

    Science.gov (United States)

    Greenough, Anne; Murthy, Vadivelam; Milner, Anthony D; Rossor, Thomas E; Sundaresan, Adesh

    2016-08-19

    During synchronised mechanical ventilation, positive airway pressure and spontaneous inspiration coincide. If synchronous ventilation is provoked, adequate gas exchange should be achieved at lower peak airway pressures, potentially reducing baro/volutrauma, air leak and bronchopulmonary dysplasia. Synchronous ventilation can potentially be achieved by manipulation of rate and inspiratory time during conventional ventilation and employment of patient-triggered ventilation. To compare the efficacy of:(i) synchronised mechanical ventilation, delivered as high-frequency positive pressure ventilation (HFPPV) or patient-triggered ventilation (assist control ventilation (ACV) and synchronous intermittent mandatory ventilation (SIMV)), with conventional ventilation or high-frequency oscillation (HFO);(ii) different types of triggered ventilation (ACV, SIMV, pressure-regulated volume control ventilation (PRVCV), SIMV with pressure support (PS) and pressure support ventilation (PSV)). We used the standard search strategy of the Cochrane Neonatal Review group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 5), MEDLINE via PubMed (1966 to June 5 2016), EMBASE (1980 to June 5 2016), and CINAHL (1982 to June 5 2016). We also searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. Randomised or quasi-randomised clinical trials comparing synchronised ventilation delivered as HFPPV to CMV, or ACV/SIMV to CMV or HFO in neonates. Randomised trials comparing different triggered ventilation modes (ACV, SIMV, SIMV plus PS, PRVCV and PSV) in neonates. Data were collected regarding clinical outcomes including mortality, air leaks (pneumothorax or pulmonary interstitial emphysema (PIE)), severe intraventricular haemorrhage (grades 3 and 4), bronchopulmonary dysplasia (BPD) (oxygen dependency beyond 28 days), moderate/severe BPD (oxygen

  8. [Consequences of mechanical ventilation on diaphragmatic function].

    Science.gov (United States)

    Jung, B; Gleeton, D; Daurat, A; Conseil, M; Mahul, M; Rao, G; Matecki, S; Lacampagne, A; Jaber, S

    2015-04-01

    Mechanical ventilation is associated with ventilator-induced diaphragmatic dysfunction (VIDD) in animal models and also in humans. The main pathophysiological pathways implicated in VIDD seems to be related to muscle inactivity but may also be the consequence of high tidal volumes. Systemic insults from side effects of medication, infection, malnutrition and hypoperfusion also play a part. The diaphragm is caught in the cross-fire of ventilation-induced and systemic-induced dysfunctions. Intracellular consequences of VIDD include oxidative stress, proteolysis, impaired protein synthesis, autophagy activation and excitation-contraction decoupling. VIDD can be diagnosed at the bedside using non-invasive magnetic stimulation of the phrenic nerves which is the gold standard. Other techniques involve patient's participation such as respiratory function tests or ultrasound examination. At this date, only spontaneous ventilatory cycles and perhaps phrenic nerve stimulation appear to diminish the severity of VIDD in humans but several pathways are currently being examined using animal models. Specific pharmacological options are currently under investigation in animal models. Copyright © 2014 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  9. Performance of Portable Ventilators Following Storage at Temperature Extremes.

    Science.gov (United States)

    Blakeman, Thomas C; Rodriquez, Dario; Britton, Tyler J; Johannigman, Jay A; Petro, Michael C; Branson, Richard D

    2016-05-01

    In the current theater of operation, medical devices are often shipped and stored at ambient conditions. The effect of storage at hot and cold temperature extremes on ventilator performance is unknown. We evaluated three portable ventilators currently in use or being evaluated for use by the Department of Defense (731, Impact Instrumentation; T1, Hamilton Medical; and Revel, CareFusion) at temperature extremes in a laboratory setting. The ventilators were stored at temperatures of 60°C and -35°C for 24 hours and were allowed to acclimate to room temperature for 30 minutes before evaluation. The T1 required an extra 15 to 30 minutes of acclimation to room temperature before the ventilator would deliver breaths. All delivered tidal volumes at room temperature and after storage at temperature extremes were less than the ±10% American Society for Testing and Materials standard with the Revel. Delivered tidal volumes at the pediatric settings were less than the ±10% threshold after storage at both temperatures and at room temperature with the 731. Storage at extreme temperature affected the performance of the portable ventilators tested. This study showed that portable ventilators may need an hour or more of acclimation time at room temperature after storage at temperature extremes to operate as intended. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  10. 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 (Pao2), ARDS Network [Net] positive end-expiratory pressure [PEEP]/fraction of inspired oxygen [Fio2] 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/Fio2 table.

  11. Subjective Evaluation of the Microenvironment Generated by a Hospital Bed with Localized Ventilation System

    DEFF Research Database (Denmark)

    Kehayova, Nushka; Bolashikov, Zhecho Dimitrov; Melikov, Arsen Krikor

    2016-01-01

    A novel method for local hospital bed ventilation, called HBIVCU (Hospital Bed with Integrated Ventilation and Cleansing Unit), was studied in a human subject experiment. The goal of this study was to identify human response to the microenvironment generated by a hospital bed with installed HBIVCU...... and to compare with human response to the micro-environment at a hospital bed without local ventilation. 32 participants took part in two experimental conditions - hospital bed with and without installed HBIVCU. Subject’s votes on the bed microenvironment were collected via standardized questionnaires....... The subjects evaluated the perceived air quality in the ventilated bed as better compared to that in the non-ventilated bed. The whole body thermal sensation (WTS) and acceptability votes were decreasing over time for the non-ventilated bed condition. Significant differences in the local thermal sensation LTS...

  12. Ventilation systems for multi-unit residential buildings : performance requirements and alternative approaches

    Energy Technology Data Exchange (ETDEWEB)

    Hill, D.

    2003-09-01

    A growing proportion of housing in Canada consists of multi-unit residential buildings (MURBs). Ventilation strategies have not changed much over the past three decades. Research conducted by Canada Mortgage and Housing Corporation (CMHC) and others has shown that conventional ventilation strategies consume significant amounts of energy, are noisy, consume internal floor area, and can become conduits for pests and smoke. As a result, a research project was initiated to develop performance requirements and alternative approaches for ventilation systems in MURBs. The issues to be addressed by alternative ventilation systems were identified through literature review. The various codes and standards applicable to ventilation capacities for apartments in MURBs in Canada were evaluated. It was revealed that the ventilation system airflow rates required for any given apartment and the amount of ventilation that should be provided by infiltration varies greatly depending on the codes or standards selected. The performance parameters that were identified in this paper were: ventilation performance, capital and operating costs, maintenance, fire and smoke control, noise issues, comfort, system issues, and owner and designer construction issues. The following four different alternative ventilation systems were discussed: (1) passive vents with suite-based mechanical exhaust, (2) balanced individual suites with heat recovery (HRV) units, (3) balanced floor-by-floor systems with heat recovery, and (4) balanced central systems with heat recovery. Further testing and assessment is needed before these proposed systems can enter the marketable phase. More research is also needed into the characterization of stack and wind pressures in MURBs. 5 tabs.

  13. Computational Fluid Dynamics in Ventilation

    DEFF Research Database (Denmark)

    Nielsen, Peter V.; Allard, Francis; Awbi, Hazim B.

    2008-01-01

    Computational Fluid Dynamics in Ventilation Design is a new title in the is a new title in the REHVA guidebook series. The guidebook is written for people who need to use and discuss results based on CFD predictions, and it gives insight into the subject for those who are not used to work with CFD....... The guidebook is also written for people working with CFD which have to be more aware of how this numerical method is applied in the area of ventilation. The guidebook has, for example, chapters that are very important for CFD quality control in general and for the quality control of ventilation related...

  14. Pulmonary mechanics during mechanical ventilation.

    Science.gov (United States)

    Henderson, William R; Sheel, A William

    2012-03-15

    The use of mechanical ventilation has become widespread in the management of hypoxic respiratory failure. Investigations of pulmonary mechanics in this clinical scenario have demonstrated that there are significant differences in compliance, resistance and gas flow when compared with normal subjects. This paper will review the mechanisms by which pulmonary mechanics are assessed in mechanically ventilated patients and will review how the data can be used for investigative research purposes as well as to inform rational ventilator management. Copyright © 2011 Elsevier B.V. All rights reserved.

  15. 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 ...... 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....

  16. Mine ventilation. I. Wentylacja kopaln. I

    Energy Technology Data Exchange (ETDEWEB)

    Nedza, Z.; Rosiek, F.

    1975-01-01

    Methods of determining the following components of mine air are characterized: oxygen, nitrogen, carbon monoxide, carbon dioxide, nitrogen oxides, hydrogen sulphide, sulphur dioxide, methane, hydrogen and water vapour. Practical advice is also given on determining the composition of mine air citing relevant Polish standards concerning work safety in mines, including coal mines. Principles of work and technical specification of the individual measuring instruments are provided. Advantages and disadvantages of using various apparatus are critically evaluated. Additional problems of mine ventilation such as dustiness of mine air and combatting dustiness of mine air are also discussed. (25 refs.)

  17. Economic, Environmental and Health Implications of Enhanced Ventilation in Office Buildings.

    Science.gov (United States)

    MacNaughton, Piers; Pegues, James; Satish, Usha; Santanam, Suresh; Spengler, John; Allen, Joseph

    2015-11-18

    Current building ventilation standards are based on acceptable minimums. Three decades of research demonstrates the human health benefits of increased ventilation above these minimums. Recent research also shows the benefits on human decision-making performance in office workers, which translates to increased productivity. However, adoption of enhanced ventilation strategies is lagging. We sought to evaluate two of the perceived potential barriers to more widespread adoption-Economic and environmental costs. We estimated the energy consumption and associated per building occupant costs for office buildings in seven U.S. cities, representing different climate zones for three ventilation scenarios (standard practice (20 cfm/person), 30% enhanced ventilation, and 40 cfm/person) and four different heating, ventilation and air conditioning (HVAC) system strategies (Variable Air Volume (VAV) with reheat and a Fan Coil Unit (FCU), both with and without an energy recovery ventilator). We also estimated emissions of greenhouse gases associated with this increased energy usage, and, for comparison, converted this to the equivalent number of vehicles using greenhouse gas equivalencies. Lastly, we paired results from our previous research on cognitive function and ventilation with labor statistics to estimate the economic benefit of increased productivity associated with increasing ventilation rates. Doubling the ventilation rate from the American Society of Heating, Refrigeration and Air-Conditioning Engineers minimum cost less than $40 per person per year in all climate zones investigated. Using an energy recovery ventilation system significantly reduced energy costs, and in some scenarios led to a net savings. At the highest ventilation rate, adding an ERV essentially neutralized the environmental impact of enhanced ventilation (0.03 additional cars on the road per building across all cities). The same change in ventilation improved the performance of workers by 8

  18. Preoperational test report, vent building ventilation system

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, F.T.

    1997-11-04

    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.

  19. Performance of Portable Ventilators at Altitude

    Science.gov (United States)

    2015-03-30

    of equipment at altitude. Changes in barometric pressure can affect the performance of mechanical ventilators calibrated for operation at sea level...performance of mechanical ventilators calibrated for operation at sea level. Deploying ventilators that can maintain a consistent tidal volume (VT) delivery...temperature, density, and humidity. These changes can affect the performance of mechanical ventilators calibrated for operation at sea level. The

  20. Climate control of natural ventilated pig houses

    NARCIS (Netherlands)

    Bontsema, J.; Straten, van G.; Salomons, L.; Klooster, van 't C.E.

    1996-01-01

    Ventilation in pig houses is important for maintaining a good climate for the welfare of animals and humans and for an optimal production. Mechanical ventilation has a good performance, since the ventilation rate can easily be controlled, but it is energy demanding, whereas natural ventilation is

  1. Use of Adaptive Support Ventilation (ASV in Ventilator Associated Pneumonia (VAP - A Case Report

    Directory of Open Access Journals (Sweden)

    Bipphy Kath

    2009-01-01

    Full Text Available Prolonged ventilation leads to a higher incidence of ventilator associated pneumonia(VAP resulting in ventilator dependency, increased costs and subsequent weaning failures. Prevention and aggressive treatment of VAP alongwith patient friendly newer modes of ventilation like adaptive support ventilation go a long way in successful management of these cases.

  2. 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

  3. Mechanical ventilation in obese patients

    National Research Council Canada - National Science Library

    Leme Silva, P; Pelosi, P; Rocco, P R M

    2012-01-01

    Recent data show an alarming increasing trend in obesity around the world. Mechanical ventilation in this population requires specific ventilatory settings due to the mechanical and inflammatory alterations observed in obesity...

  4. 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....

  5. Analysis of the systems of ventilation of residential houses of Ukraine and Estonia

    Science.gov (United States)

    Savchenko, Olena; Zhelykh, Vasyl; Voll, Hendrik

    2017-12-01

    The most common ventilation system in residential buildings in Ukraine is natural ventilation. In recent years, due to increased tightness of structures, an increase in the content of synthetic finishing materials in them, the quality of microclimate parameters deteriorated. One of the measures to improve the parameters of indoor air in residential buildings is the use of mechanical inflow and exhaust ventilation system. In this article the regulatory documents concerning the design of ventilation systems in Ukraine and Estonia and the requirements for air exchange in residential buildings are considered. It is established that the existing normative documents in Ukraine are analogous to European norms, which allow design the system of ventilation of residential buildings according to European standards. However, the basis for the design of ventilation systems in Ukraine is the national standards, in which mechanical ventilation, unfortunately, is provided only for the design of high-rise buildings. To maintain acceptable microclimate parameters in residential buildings, it is advisable for designers to apply the requirements for designing ventilation systems in accordance with European standards.

  6. Innovation in home mechanical ventilation

    OpenAIRE

    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, spine deformities, lung disease or sleep apnea. Improving the quality of life by reducing the complaints of chronic respiratory failure is the ultimate goal for HMV. In the Netherlands patients hav...

  7. Adaptive heating, ventilation and solar shading for dwellings

    NARCIS (Netherlands)

    Alders, E.E.

    2017-01-01

    Calculation of various strategies for the heating of, and the prevention of overheating in, a Dutch standard dwelling that includes (automated) adaptive ventilation systems and solar shading to maintain indoor temperatures at acceptably comfortable temperatures informs this analysis of the costs,

  8. 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.

  9. Mechanical ventilation after lung transplantation.

    Science.gov (United States)

    Thakuria, Louit; Davey, Rosada; Romano, Rosalba; Carby, Martin R; Kaul, Sundeep; Griffiths, Mark J; Simon, André R; Reed, Anna K; Marczin, Nandor

    2016-02-01

    To explore the hypothesis that early ventilation strategies influence clinical outcomes in lung transplantation, we have examined our routine ventilation practices in terms of tidal volumes (Vt) and inflation pressures. A total of 124 bilateral lung transplants between 2010 and 2013 were retrospectively assigned to low (8 mL/kg) Vt groups based on ventilation characteristics during the first 6 hours after surgery. Those same 124 patients were also stratified to low-pressure (<25 cm H2O) and high-pressure (≥25 cm H2O) groups. Eighty percent of patients were ventilated using pressure control mode. Low, medium, and high Vt were applied to 10%, 43%, and 47% of patients, respectively. After correcting for patients requiring extracorporeal support, there was no difference in short-term to midterm outcomes among the different Vt groups. Low inflation pressures were applied to 61% of patients, who had a shorter length of intensive care unit stay (5 vs 12 days; P = .012), higher forced expiratory volume in 1 second at 3 months (77.8% vs 60.3%; P < .001), and increased 6-month survival rate (95% vs 77%; P = .008). Low Vt ventilation has not been fully adopted in our practice. Ventilation with higher inflation pressures, but not Vt, was significantly associated with poorer outcomes after lung transplantation. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. A protocol of no sedation for critically ill patients receiving mechanical ventilation

    DEFF Research Database (Denmark)

    Strøm, Thomas; Martinussen, Torben; Toft, Palle

    2010-01-01

    in the control group (n=11, 20%vs n=4, 7%; p=0.0400). INTERPRETATION: No sedation of critically ill patients receiving mechanical ventilation is associated with an increase in days without ventilation. A multicentre study is needed to establish whether this effect can be reproduced in other facilities. FUNDING......BACKGROUND: Standard treatment of critically ill patients undergoing mechanical ventilation is continuous sedation. Daily interruption of sedation has a beneficial effect, and in the general intesive care unit of Odense University Hospital, Denmark, standard practice is a protocol of no sedation....... We aimed to establish whether duration of mechanical ventilation could be reduced with a protocol of no sedation versus daily interruption of sedation. METHODS: Of 428 patients assessed for eligibility, we enrolled 140 critically ill adult patients who were undergoing mechanical ventilation and were...

  11. Gentamicin pharmacokinetics in term newborn infants receiving high-frequency oscillatory ventilation or conventional mechanical ventilation: a case-controlled study.

    Science.gov (United States)

    Bhatt-Mehta, Varsha; Donn, Steven M

    2003-10-01

    To compare the pharmacokinetics of gentamicin in infants receiving high-frequency oscillatory ventilation (HFOV) with infants receiving conventional mechanical ventilation. A case-controlled study design was used to compare the pharmacokinetics of gentamicin in critically ill infants receiving HFOV and conventional mechanical ventilation. Medical records of all full-term newborn infants (> or =37 weeks gestational age) who received either high-frequency mechanical ventilation or conventional mechanical ventilation between 1991 and 2001 were reviewed and relevant patient demographics, renal function tests and gentamicin administration and plasma concentration data collected. Elimination rate constant, half-life, volume of distribution and clearance for both groups were calculated using standard kinetics equations. A tertiary care children's hospital. Newborn infants, > or =37 weeks gestational age, receiving gentamicin and high-frequency mechanical ventilation or conventional mechanical ventilation. In total, 18 patients were included in the conventional mechanical ventilation group and 15 in the HFOV group. The mean gentamicin dose for conventional mechanical ventilation and HFOV groups infants were 2.52+/-0.07 and 2.5+/-0.07 mg/kg/dose, respectively. Initial dosing interval was 12 hours in all of the conventional mechanical ventilation infants and 13 of the 15 HFOV infants. The dosing interval for the remaining two HFOV infants was 18 hours. No patient in either group demonstrated oliguria. Statistical analysis using the Student t-test for unequal variances yielded significant differences between the two groups with regard to elimination rate constant, half-life, volume of distribution and clearance, with a p value of mechanical ventilation group (13.4+2.23) (p>0.05). Infants receiving HFOV had reduced gentamicin clearance. Full-term infants receiving HFOV should be initiated at gentamicin dosing intervals of 18 hours rather than the traditional 12 hours

  12. Determinants of ventilation behavior in naturally ventilated dwellings: Identification and quantification of relationships

    NARCIS (Netherlands)

    Levie, D.; Kluizenaar, Y. de; Hoes-van Oeffelen, E.C.M.; Hofstetter, H.; Janssen, S.A.; Spiekman, M.E.; Koene, F.G.H.

    2014-01-01

    Background: Ventilation in dwellings is essential for well-being and health. However, insight in determinants of ventilation behavior is still limited. Aim: Identifying determinants of ventilation behavior and quantifying relationships. Secondly, identifying households characteristics associated

  13. Closed-loop mechanical ventilation for lung injury: a novel physiological-feedback mode following the principles of the open lung concept.

    Science.gov (United States)

    Schwaiberger, David; Pickerodt, Philipp A; Pomprapa, Anake; Tjarks, Onno; Kork, Felix; Boemke, Willehad; Francis, Roland C E; Leonhardt, Steffen; Lachmann, Burkhard

    2017-06-26

    Adherence to low tidal volume (V T ) ventilation and selected positive end-expiratory pressures are low during mechanical ventilation for treatment of the acute respiratory distress syndrome. Using a pig model of severe lung injury, we tested the feasibility and physiological responses to a novel fully closed-loop mechanical ventilation algorithm based on the "open lung" concept. Lung injury was induced by surfactant washout in pigs (n = 8). Animals were ventilated following the principles of the "open lung approach" (OLA) using a fully closed-loop physiological feedback algorithm for mechanical ventilation. Standard gas exchange, respiratory- and hemodynamic parameters were measured. Electrical impedance tomography was used to quantify regional ventilation distribution during mechanical ventilation. Automatized mechanical ventilation provided strict adherence to low V T -ventilation for 6 h in severely lung injured pigs. Using the "open lung" approach, tidal volume delivery required low lung distending pressures, increased recruitment and ventilation of dorsal lung regions and improved arterial blood oxygenation. Physiological feedback closed-loop mechanical ventilation according to the principles of the open lung concept is feasible and provides low tidal volume ventilation without human intervention. Of importance, the "open lung approach"-ventilation improved gas exchange and reduced lung driving pressures by opening atelectasis and shifting of ventilation to dorsal lung regions.

  14. [Air quality control systems: heating, ventilating, and air conditioning (HVAC)].

    Science.gov (United States)

    Bellucci Sessa, R; Riccio, G

    2004-01-01

    After a brief illustration of the principal layout schemes of Heating, Ventilating, and Air Conditioning (HVAC), the first part of this paper summarizes the standards, both voluntary and compulsory, regulating HVAC facilities design and installation with regard to the question of Indoor Air Quality (IAQ). The paper then examines the problem of ventilation systems maintenance and the essential hygienistic requirements in whose absence HVAC facilities may become a risk factor for people working or living in the building. Lastly, the paper deals with HVAC design strategies and methods, which aim not only to satisfy comfort and air quality requirements, but also to ensure easy and effective maintenance procedures.

  15. Effects of ambient conditions on multi-capillary ventilation rate

    Directory of Open Access Journals (Sweden)

    Zhang Qing

    2016-01-01

    Full Text Available As a major physical parameter for the tobacco industry, the ventilation rate of cigarette should be measured reliably. Theoretical and numerical investigation on ef-fects of ambient conditions (e. g., cumulative flux of ozone and additional pressure drop on the ventilation rate was carried out. It was found that the standards exhibited a non-linear airflow component, which explains why additional pressure drop has an effect on the calibrated value, and had low sensitivity to cumulative flux of ozone.

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

    Science.gov (United States)

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

    2017-03-01

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

  17. 29 CFR 96.51 - Purpose and scope of subpart.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Purpose and scope of subpart. 96.51 Section 96.51 Labor Office of the Secretary of Labor AUDIT REQUIREMENTS FOR GRANTS, CONTRACTS, AND OTHER AGREEMENTS Audit Resolution § 96.51 Purpose and scope of subpart. This subpart prescribes standards for resolution of audit...

  18. Development, concept and scope of copyright protection in Nigeria ...

    African Journals Online (AJOL)

    Thus, it is imperative to constantly review particular copyright systems to determine conformity with basic global standards. This forms the aim of this paper which focuses essentially on basic issues relating to the development, concept and the scope of protection afforded copyright in Nigeria. The paper finds that the scope ...

  19. 5 CFR 179.301 - Scope of regulations.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Scope of regulations. 179.301 Section 179.301 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CLAIMS COLLECTION STANDARDS Administrative Offset § 179.301 Scope of regulations. These regulations apply to the...

  20. 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.

  1. Building America Case Study: Ventilation System Effectiveness and Tested Indoor Air Quality Impacts, Tyler, Texas

    Energy Technology Data Exchange (ETDEWEB)

    2015-08-01

    ?Ventilation system effectiveness testing was conducted at two unoccupied, single-family, detached lab homes at the University of Texas - Tyler. Five ventilation system tests were conducted with various whole-building ventilation systems. Multizone fan pressurization testing characterized building and zone enclosure leakage. PFT testing showed multizone air change rates and interzonal airflow filtration. Indoor air recirculation by a central air distribution system can help improve the exhaust ventilation system by way of air mixing and filtration. In contrast, the supply and balanced ventilation systems showed that there is a significant benefit to drawing outside air from a known outside location, and filtering and distributing that air. Compared to the Exhaust systems, the CFIS and ERV systems showed better ventilation air distribution and lower concentrations of particulates, formaldehyde and other VOCs. System improvement percentages were estimated based on four System Factor Categories: Balance, Distribution, Outside Air Source, and Recirculation Filtration. Recommended System Factors could be applied to reduce ventilation fan airflow rates relative to ASHRAE Standard 62.2 to save energy and reduce moisture control risk in humid climates. HVAC energy savings were predicted to be 8-10%, or $50-$75/year. Cumulative particle counts for six particle sizes, and formaldehyde and other Top 20 VOC concentrations were measured in multiple zones. The testing showed that single-point exhaust ventilation was inferior as a whole-house ventilation strategy.

  2. Application of Simple CFD Models in Smoke Ventilation Design

    DEFF Research Database (Denmark)

    Brohus, Henrik; Nielsen, Peter Vilhelm; la Cour-Harbo, Hans

    2004-01-01

    is used for the examination. The CFD model is compared with benchmark tests and results from a special application fire simulation CFD code. Apart from benchmark tests two practical applications are examined in shape of modelling a fire in a theatre and a double façade, respectively. The simple CFD model...... uses a standard k-ε turbulence model. Simulations comprise both steady-state and dynamic approaches. Several boundary conditions are tested. Finally, the paper discusses the prospects of simple CFD models in smoke ventilation design including the inherent limitations.......The paper examines the possibilities of using simple CFD models in practical smoke ventilation design. The aim is to assess if it is possible with a reasonable accuracy to predict the behaviour of smoke transport in case of a fire. A CFD code mainly applicable for “ordinary” ventilation design...

  3. Testing of mechanical ventilators and infant incubators in healthcare institutions.

    Science.gov (United States)

    Badnjevic, Almir; Gurbeta, Lejla; Jimenez, Elvira Ruiz; Iadanza, Ernesto

    2017-01-01

    The medical device industry has grown rapidly and incessantly over the past century. The sophistication and complexity of the designed instrumentation is nowadays rising and, with it, has also increased the need to develop some better, more effective and efficient maintenance processes, as part of the safety and performance requirements. This paper presents the results of performance tests conducted on 50 mechanical ventilators and 50 infant incubators used in various public healthcare institutions. Testing was conducted in accordance to safety and performance requirements stated in relevant international standards, directives and legal metrology policies. Testing of output parameters for mechanical ventilators was performed in 4 measuring points while testing of output parameters for infant incubators was performed in 7 measuring points for each infant incubator. As performance criteria, relative error of output parameters for mechanical ventilators and absolute error of output parameters for infant incubators was calculated. The ranges of permissible error, for both groups of devices, are regulated by the Rules on Metrological and Technical Requirements published in the Official Gazette of Bosnia and Herzegovina No. 75/14, which are defined based on international recommendations, standards and guidelines. All ventilators and incubators were tested by etalons calibrated in an ISO 17025 accredited laboratory, which provides compliance to international standards for all measured parameters.The results show that 30% of the tested medical devices are not operating properly and should be serviced, recalibrated and/or removed from daily application.

  4. Music interventions for mechanically ventilated patients.

    Science.gov (United States)

    Bradt, Joke; Dileo, Cheryl

    2014-01-01

    Mechanical ventilation often causes major distress and anxiety in patients. The sensation of breathlessness, frequent suctioning, inability to talk, uncertainty regarding surroundings or condition, discomfort, isolation from others, and fear contribute to high levels of anxiety. Side effects of analgesia and sedation may lead to the prolongation of mechanical ventilation and, subsequently, to a longer length of hospitalization and increased cost. Therefore, non-pharmacological interventions should be considered for anxiety and stress management. Music interventions have been used to reduce anxiety and distress and improve physiological functioning in medical patients; however, their efficacy for mechanically ventilated patients needs to be evaluated. This review was originally published in 2010 and was updated in 2014. To update the previously published review that examined the effects of music therapy or music medicine interventions (as defined by the authors) on anxiety and other outcomes in mechanically ventilated patients. Specifically, the following objectives are addressed in this review.1. To conduct a meta-analysis to compare the effects of participation in standard care combined with music therapy or music medicine interventions with standard care alone.2. To compare the effects of patient-selected music with researcher-selected music.3. To compare the effects of different types of music interventions (e.g., music therapy versus music medicine). We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 2), MEDLINE (1950 to March 2014), CINAHL (1980 to March 2014), EMBASE (1980 to March 2014), PsycINFO (1967 to March 2014), LILACS (1982 to March 2014), Science Citation Index (1980 to March 2014), www.musictherapyworld.net (1 March 2008) (database is no longer functional), CAIRSS for Music (to March 2014), Proquest Digital Dissertations (1980 to March 2014), ClinicalTrials.gov (2000 to March 2014), Current

  5. Ventilation Behavior and Household Characteristics in NewCalifornia Houses

    Energy Technology Data Exchange (ETDEWEB)

    Price, Phillip N.; Sherman, Max H.

    2006-02-01

    A survey was conducted to determine occupant use of windows and mechanical ventilation devices; barriers that inhibit their use; satisfaction with indoor air quality (IAQ); and the relationship between these factors. A questionnaire was mailed to a stratified random sample of 4,972 single-family detached homes built in 2003, and 1,448 responses were received. A convenience sample of 230 houses known to have mechanical ventilation systems resulted in another 67 completed interviews. Some results are: (1) Many houses are under-ventilated: depending on season, only 10-50% of houses meet the standard recommendation of 0.35 air changes per hour. (2) Local exhaust fans are under-utilized. For instance, about 30% of households rarely or never use their bathroom fan. (3) More than 95% of households report that indoor air quality is ''very'' or ''somewhat'' acceptable, although about 1/3 of households also report dustiness, dry air, or stagnant or humid air. (4) Except households where people cook several hours per week, there is no evidence that households with significant indoor pollutant sources get more ventilation. (5) Except households containing asthmatics, there is no evidence that health issues motivate ventilation behavior. (6) Security and energy saving are the two main reasons people close windows or keep them closed.

  6. Trial of ventilation assistance unit for administration of Technegas.

    Energy Technology Data Exchange (ETDEWEB)

    Croft, E.; McLaren, C.; Campbell, L.; Pennington, C.; Crelin, D. [The Canberra Hospital, Garran, ACT, (Australia). Department of Nuclear Medicine

    1997-09-01

    Full text: The current method used for administration of Technegas relies on patient co-operation. It requires patient compliance with breathing instructions. Administration of Technegas in non-compliant patients, for example the unconscious/ventilated patient, is very difficult. Images are frequently sub-optimal and may be impossible to achieve. In an effort to overcome these difficulties we have been trialing a prototype ventilation assistance unit (VAU). The unit comprises a light and portable attachment to the standard Technegas machine. It utilises a hand viva bag and actively forces Technegas into the patient. Two people are required to perform the ventilation. It is our experience that the VAU greatly improves the likelihood of successful administration of Technegas in these patients, and may have application in conscious patients who would be difficult to ventilate in the usual manner for a variety of reasons (e.g. tracheotomy, extreme SOB and the very elderly). Using the VAU we have increased confidence in performing ventilation studies in the more difficult patients. Our early experience will be presented along with suggestions for utilisation of the VAU.

  7. 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 (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.

  8. 46 CFR 58.16-1 - Scope.

    Science.gov (United States)

    2010-10-01

    ..., DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING MAIN AND AUXILIARY MACHINERY AND RELATED SYSTEMS Liquefied Petroleum Gases for Cooking and Heating § 58.16-1 Scope. (a) This subpart prescribes standards for the use of liquefied petroleum gas for heating and cooking on inspected vessels, except...

  9. 29 CFR 1910.331 - Scope.

    Science.gov (United States)

    2010-07-01

    .... Installations of electric conductors and equipment within or on buildings or other structures, and on other... of optical fiber cable where such installations are made along with electric conductors. Note: See... SAFETY AND HEALTH STANDARDS Electrical Safety-Related Work Practices § 1910.331 Scope. (a) Covered work...

  10. 34 CFR 32.1 - Scope.

    Science.gov (United States)

    2010-07-01

    ... DEPARTMENT OF EDUCATION EMPLOYEES § 32.1 Scope. (a) The Secretary establishes the standards and procedures in... employee of the Department of Education to recover overpayments of pay or allowances. (b) This part does... payment to an employee of the Department of Education which is expressly allowed under statutes other than...

  11. Ventilation systems for high halls

    Energy Technology Data Exchange (ETDEWEB)

    Sodec, F.; Veldboer, W.

    1982-02-01

    A ventilation system for high halls is described which meets the demands of steady air flow in spite of inverse thermal currents, intensive ventilation of working areas during heating and cooling and ventilation free of draught. The main element of the ventilation system is the air outlet in the ceiling, with variable beam direction. The horizontal, rotated beams are superimposed by a vertical beam whose strength may be varied. This way, the beam direction can be adapted to the thermal load of the hall and the height of blowout. The blowout angle is large for heating and small for cooling. Studies have shown that halls are ventilated thoroughly and free of draught by this system. The variable, rotary outlet presented in the article is best suited for heights of 4.00 to 12.00 m. The outlet, with a rated diameter of 400 mm, has been in use for two years now in fields as varied as diecasting works, halls at fairs, sports halls, etc. The air volume flow rate is 1000 to 3000 m/sup 3//h per outlet. A bigger version is now being developed; it will have a rated diameter of 710 mm and an air volume flow rate of 3000 to 9000 m/sup 3//h.

  12. 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...... of the furniture volume are simulated. The simulations are made in three different lengths of the room....

  13. RADAR PPI Scope Overlay

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — RADAR PPI Scope Overlays are used to position a RADAR image over a station at the correct resolution. The archive maintains several different RADAR resolution types,...

  14. Pneumoperitoneum associated with artificial ventilation.

    Science.gov (United States)

    Summers, B

    1979-06-09

    Four adults injured in serious road-traffic accidents developed pneumoperitoneum after artificial ventilation. No case could be attributed to injury or to perforation of a hollow viscus in the belly, but doubt about this in one patient resulted in exploratory laparotomy. In three patients the origin of intraperitoneal air was considered to be leakage through minute ruptures in alveoli subjected to the stress of artificial ventilation, with air tracking to the mediastinum, pleural space, subcutaneous tissues of the neck and chest, and peritoneal cavity. The fourth patient later developed herniation of the stomach through a rupture in the diaphragm, the presence of a pneumothorax on the same side suggesting direct passage of air through the diaphragm. Pneumoperitoneum induced by artificial ventilation is probably more common than reports suggest and should be distinguished clinically and radiologically from that caused by rupture or perforation of a hollow viscus. This will reduce the number of needles laparotomies performed on patients who are already seriously ill.

  15. Multifrequency Oscillatory Ventilation in the Premature Lung: Effects on Gas Exchange, Mechanics, and Ventilation Distribution.

    Science.gov (United States)

    Kaczka, David W; Herrmann, Jacob; Zonneveld, C Elroy; Tingay, David G; Lavizzari, Anna; Noble, Peter B; Pillow, J Jane

    2015-12-01

    Despite the theoretical benefits of high-frequency oscillatory ventilation (HFOV) in preterm infants, systematic reviews of randomized clinical trials do not confirm improved outcomes. The authors hypothesized that oscillating a premature lung with multiple frequencies simultaneously would improve gas exchange compared with traditional single-frequency oscillatory ventilation (SFOV). The goal of this study was to develop a novel method for HFOV, termed "multifrequency oscillatory ventilation" (MFOV), which relies on a broadband flow waveform more suitable for the heterogeneous mechanics of the immature lung. Thirteen intubated preterm lambs were randomly assigned to either SFOV or MFOV for 1 h, followed by crossover to the alternative regimen for 1 h. The SFOV waveform consisted of a pure sinusoidal flow at 5 Hz, whereas the customized MFOV waveform consisted of a 5-Hz fundamental with additional energy at 10 and 15 Hz. Per standardized protocol, mean pressure at airway opening ((Equation is included in full-text article.)) and inspired oxygen fraction were adjusted as needed, and root mean square of the delivered oscillatory volume waveform (Vrms) was adjusted at 15-min intervals. A ventilatory cost function for SFOV and MFOV was defined as (Equation is included in full-text article.), where Wt denotes body weight. Averaged over all time points, MFOV resulted in significantly lower VC (246.9 ± 6.0 vs. 363.5 ± 15.9 ml mmHg kg) and (Equation is included in full-text article.)(12.8 ± 0.3 vs. 14.1 ± 0.5 cm H2O) compared with SFOV, suggesting more efficient gas exchange and enhanced lung recruitment at lower mean airway pressures. Oscillation with simultaneous multiple frequencies may be a more efficient ventilator modality in premature lungs compared with traditional single-frequency HFOV.

  16. Inspired gas humidity and temperature during mechanical ventilation with the Stephanie ventilator.

    Science.gov (United States)

    Preo, Bianca L; Shadbolt, Bruce; Todd, David A

    2013-11-01

    To measure inspired gas humidity and temperature delivered by a Stephanie neonatal ventilator with variations in (i) circuit length; (ii) circuit insulation; (iii) proximal airway temperature probe (pATP) position; (iv) inspiratory temperature (offset); and (v) incubator temperatures. Using the Stephanie neonatal ventilator, inspired gas humidity and temperature were measured during mechanical ventilation at the distal inspiratory limb and 3 cm down the endotracheal tube. Measurements were made with a long or short circuit; with or without insulation of the inspiratory limb; proximal ATP (pATP) either within or external to the incubator; at two different inspiratory temperature (offset) of 37(-0.5) and 39(-2.0)°C; and at three different incubator temperatures of 32, 34.5, and 37°C. Long circuits produced significantly higher inspired humidity than short circuits at all incubator settings, while only at 32°C was the inspired temperature higher. In the long circuits, insulation further improved the inspired humidity especially at 39(-2.0)°C, while only at incubator temperatures of 32 and 37°C did insulation significantly improve inspired temperature. Positioning the pATP outside the incubator did not result in higher inspired humidity but did significantly improve inspired temperature. An inspiratory temperature (offset) of 39(-2.0)°C delivered significantly higher inspired humidity and temperature than the 37(-0.5)°C especially when insulated. Long insulated Stephanie circuits should be used for neonatal ventilation when the infant is nursed in an incubator. The recommended inspiratory temperature (offset) of 37(-0.5)°C produced inspired humidity and temperature below international standards, and we suggest an increase to 39(-2.0)°C. © 2013 John Wiley & Sons Ltd.

  17. Effectiveness of ventilation of nondependent lung for a brief period in improving arterial oxygenation during one-lung ventilation: A prospective study

    Directory of Open Access Journals (Sweden)

    Keerthi Chigurupati

    2017-01-01

    Full Text Available Background: Hypoxemia is common during one-lung ventilation(OLV, predominantly due to transpulmonary shunt. None of the strategies tried showed consistent results. We evaluated the effectiveness of ventilating the operated, non-dependent lung (NDL with small tidal volumes in improving the oxygenation during OLV. Methods: 30 ASA 1 and 2 patients undergoing elective, open thoracotomy were studied. After standard induction of anesthesia, lung seperation was acheived with left sided DLT. The ventilatory settings for two lung ventilation (TLV were: FiO 2 of 0.5, tidal volume of 8-10ml/kg and respiratory rate of 10-12/min. After initiating OLV, the dependent lung alone was ventilated with the above settings for 15 minutes and an arterial blood gas (ABG analysis was done. Then the NDL was ventilated with a separate ventilator, with FiO 2 of 1, tidal volume of 70 ml, I:E ratio of 1:10 and respiratory rate of 6/min for 15 minutes. The NDL ventilation was started early if the patients desaturated to <95%. ABG was done at 5 and 15 mins of NDL ventilation. We compared the PaO 2 values. Results: The mean PaO 2 decreased from 232.2 ± 67.2 mm of Hg (TLV-ABG1 to 91.2 ± 31.7 mm of Hg on OLV (OLV-ABG1. The ABG after 5 minutes and 15 minutes after institution of NDL ventilation during OLV showed a PaO2 of 145.7 ± 50.2 mm of Hg and 170.6 ± 50.4 mm of Hg which were significantly higher compared to the one lung ventilation values.

  18. [Mechanical ventilation in pediatrics (III). Weaning, complications and other types of ventilation. Noninvasive ventilation].

    Science.gov (United States)

    Pons Odena, M; Cambra Lasaosa, F J

    2003-08-01

    Noninvasive ventilation (NIV), i.e. without tracheal intubation, has been reintroduced for the treatment of respiratory failure to reduce the complications of mechanical ventilation. Nowadays, NIV with positive pressure is the preferred method, applied through a mask held in place by a harness. Several masks can be used (nasal, bucconasal facial) and a variety of means can be used to keep them in place. Many respirators can be selected, ranging from those traditionally used in the intensive care unit(ICU) to specific NV respirators and conventional ICU respirators with specific software for NIV. Many respiratory modalities can be used according to the respirator (biphasic positive airway pressure [BIPAP], proportional assist ventilation, pressure support, synchronized intermittent mandatory ventilation [SIMV], etc.). NIV is mainly indicated in exacerbations of chronic respiratory failure: neuromuscular diseases, pretransplantation cystic fibrosis, and obstructive sleep apnea syndrome. It is also indicated in acute respiratory failure: pneumonia, status asthmaticus, and acute lung edema. The main contraindications are a weakened airway protection reflex(absent cough reflex) and hemodynamic instabiity. The advantages of NIV derive mainly from avoiding the complications associated with invasive ventilation. NIV also presents some disadvantages, especially the greater workload involved to ensure good patient adaptation to the respirator. The most common sequelae of NIV are skin lesions due to pressure on the nasal bridge.

  19. [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.

  20. Measuring Residential Ventilation System Airflows: Part 1 – Laboratory Evaluation of Airflow Meter Devices

    Energy Technology Data Exchange (ETDEWEB)

    Stratton, J. Chris [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division; Turner, W. J. N. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division; Wray, Craig P. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division; Walker, Iain S. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division

    2012-11-12

    Building codes increasingly require tighter homes and mechanical ventilation per ASHRAE Standard 62.2. These ventilation flows must be measured so that energy is not wasted with over ventilation and occupants’ health is not compromised by under ventilation. Flow hoods are used to measure these ventilation flows, but there is currently no standard specifying the measurement procedure and measurement devices that should be used. This study evaluates the accuracy of six commercially available flow hoods under laboratory conditions configured to emulate a residential mechanical ventilation duct system. The measurements taken with the flow hoods were compared to simultaneous measurements taken by an in-line reference flow meter having a known uncertainty. Results indicate that powered flow hoods yield more accurate measurements than non-powered flow hoods, and that a majority of the flow hoods measured inlet flows more accurately than outlet flows. In several cases, there was little resemblance between the manufacturers’ stated accuracy and the accuracy we found in our laboratory measurements. It is clear that current flow hood calibration procedures may not consider field application variables such as flow asymmetry, flow angle, and flow direction. A new flow hood measurement standard that takes these ‘real world’ conditions into account should be developed to ensure that residential buildings receive the intended ventilation flows.

  1. Measuring Residential Ventilation System Airflows: Part 1 – Laboratory Evaluation of Airflow Meter Devices

    Energy Technology Data Exchange (ETDEWEB)

    Stratton, J. Chris [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division; Turner, W. J. N. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division; Wray, Craig P. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division; Walker, Iain S. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division

    2012-11-30

    Building codes increasingly require tighter homes and mechanical ventilation per ASHRAE Standard 62.2. These ventilation flows must be measured so that energy is not wasted with over ventilation and occupants’ health is not compromised by under ventilation. Flow hoods are used to measure these ventilation flows, but there is currently no standard specifying the measurement procedure and measurement devices that should be used. This study evaluates the accuracy of six commercially available flow hoods under laboratory conditions configured to emulate a residential mechanical ventilation duct system. The measurements taken with the flow hoods were compared to simultaneous measurements taken by an in-line reference flow meter having a known uncertainty. Results indicate that powered flow hoods yield more accurate measurements than non-powered flow hoods, and that a majority of the flow hoods measured inlet flows more accurately than outlet flows. In several cases, there was little resemblance between the manufacturers’ stated accuracy and the accuracy we found in our laboratory measurements. It is clear that current flow hood calibration procedures may not consider field application variables such as flow asymmetry, flow angle, and flow direction. A new flow hood measurement standard that takes these ‘real world’ conditions into account should be developed to ensure that residential buildings receive the intended ventilation flows.

  2. Liquid lung ventilation as an alternative ventilatory support

    NARCIS (Netherlands)

    S.J.C. Verbrugge (Serge); D.A.M.P.J. Gommers (Diederik); B.F. Lachmann (Burkhard)

    1995-01-01

    textabstractThe concept of liquid ventilation has evolved in recent years into the concept of partial liquid ventilation. In this technique, conventional mechanical ventilation is combined with intratracheal perfluorocarbon administration. Partial liquid ventilation is a promising technique for

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

    Science.gov (United States)

    Mireles-Cabodevila, Eduardo; Diaz-Guzman, Enrique; Arroliga, Alejandro C.; Chatburn, Robert L.

    2012-01-01

    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. PMID:23119152

  4. 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.

  5. 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.

  6. Radiant Floor Cooling Combined with Mixing Ventilation in a Residential Room

    DEFF Research Database (Denmark)

    Krajcik, Michal; Simone, Angela; Tomasi, Roberta

    and by thermal manikin equivalent temperatures. Contaminant removal effectiveness and air change efficiency were used to characterize the ventilation effectiveness. The vertical air temperature differences that occurred when floor cooling was combined with cold conditioned air supply were well within the limits...... for comfortable thermal environment recommended by the standards. The cooler supply air mixed well and the effect of the position of air terminal devices was small. When warm unconditioned outside air was supplied by mixing ventilation in combination with the radiant floor cooling, low floor temperature......Mixing air ventilation system is one of the main ventilation concepts applied in residential buildings. The effect of combining the mixing ventilation system with the radiant floor heating has been well established, whereas the validation of using the floor for cooling in summer is still...

  7. The School Advanced Ventilation Engineering Software (SAVES)

    Science.gov (United States)

    The School Advanced Ventilation Engineering Software (SAVES) package is a tool to help school designers assess the potential financial payback and indoor humidity control benefits of Energy Recovery Ventilation (ERV) systems for school applications.

  8. Perioperative lung protective ventilation in obese patients

    NARCIS (Netherlands)

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

    2015-01-01

    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

  9. Decisional responsibility for mechanical ventilation and weaning

    DEFF Research Database (Denmark)

    Rose, Louise; Blackwood, Bronagh; Egerod, Ingrid

    2011-01-01

    Optimal management of mechanical ventilation and weaning requires dynamic and collaborative decision making to minimize complications and avoid delays in the transition to extubation. In the absence of collaboration, ventilation decision making may be fragmented, inconsistent, and delayed. Our ob...

  10. Mechanisms of natural ventilation in livestock buildings

    DEFF Research Database (Denmark)

    Rong, Li; Bjerg, Bjarne Schmidt; 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...

  11. Pressure support ventilation attenuates ventilator-induced protein modifications in the diaphragm

    OpenAIRE

    Powers, Scott K; DeCramer, Marc; Gayan-Ramirez, Ghislaine; Levine, Sanford

    2008-01-01

    Common medical conditions that require mechanical ventilation include chronic obstructive lung disease, acute lung injury, sepsis, heart failure, drug overdose, neuromuscular disorders, and surgery. Although mechanical ventilation can be a life saving measure, prolonged mechanical ventilation can also present clinical problems. Indeed, numerous well-controlled animal studies have demonstrated that prolonged mechanical ventilation results in diaphragmatic weakness due to both atrophy and contr...

  12. Newer nonconventional modes of mechanical ventilation

    OpenAIRE

    Preet Mohinder Singh; Anuradha Borle; Anjan Trikha

    2014-01-01

    The conventional modes of ventilation suffer many limitations. Although they are popularly used and are well-understood, often they fail to match the patient-based requirements. Over the years, many small modifications in ventilators have been incorporated to improve patient outcome. The ventilators of newer generation respond to patient′s demands by additional feedback systems. In this review, we discuss the popular newer modes of ventilation that have been accepted in to clinical practice. ...

  13. Adequacy of Wind Ventilation in Upgraded Shelters.

    Science.gov (United States)

    1980-05-01

    etc. caused by atmospheric winds or thermal effects 2) Forced Ventilation - ventilation by artifical means using mechanical devices. If natural...through all the inlet or exit openings. The variation of ventilation throughput with the free stream wind velocity (V) is shown in araphical form in...ADEAUAC Y OF WIND VENTILATION IN UPGRADED SHELTERSG(U) NAY 80 R H HENNINGER, R J TSAL DCPAOI-78-C-0319 UNCLASSIFIED GARD-Al-11 (1713) NL

  14. Ventilation Host and Risk Area Techniques

    Science.gov (United States)

    1982-04-01

    is one option for ensuring that ventilation equipme is availabie during & crisis situation to shelters requiring mechanical ventilatioa. However...natural, wind-driven ventilation will suffice. However, for situations requiring mechanical ventilation to supply ad distribute air in shelters...Agency. DETACHABLE SUMMARY FINAL REPORT RTI/-072/O0-08F April 198• Ventilation : Most and Risk Area Technique. by S. B. York, 11I, K. J. Reeves, and R. J

  15. Evaluation of Shelter Ventilation by Model Tests

    Science.gov (United States)

    1983-03-01

    ventilation is created by mechanical devices such as pedal venti- lators and Kearny pumps. If natural ventilation in a shelter. can be predicted with...past have centered around the design, performance analysis and deployment of mechanical ventilating units (Ref. 11-14). Other studies include one on...calculated as the sum of the air volume flow rates through all the windward openings. The variation of model ventilation througnput versus wind speed

  16. Options for mechanical ventilation in neuromuscular diseases.

    Science.gov (United States)

    Unterborn, J N; Hill, N S

    1994-12-01

    A variety of mechanical devices may be used to provide assistance when ventilation and cough are severely impaired by progressive respiratory weakness caused by neuromuscular disease. Traditionally, positive pressure ventilation via a tracheostomy has been used, but if upper airway function is adequate, a variety of noninvasive devices also may be considered. Although positive pressure ventilation is the preferred noninvasive mode for assisting ventilation, other modes may be selected depending on patient needs, preferences, and physical characteristics.

  17. Comparison of patient-ventilator asynchrony during pressure support ventilation and proportional assist ventilation modes in surgical Intensive Care Unit: A randomized crossover study

    OpenAIRE

    Parshotam Lal Gautam; Gaganjot Kaur; Sunil Katyal; Ruchi Gupta; Preetveen Sandhu; Nikhil Gautam

    2016-01-01

    Background: The patient-ventilator asynchrony is almost observed in all modes of ventilation, and this asynchrony affects lung mechanics adversely resulting in deleterious outcome. Innovations and advances in ventilator technology have been trying to overcome this problem by designing newer modes of ventilation. Pressure support ventilation (PSV) is a commonly used flow-cycled mode where a constant pressure is delivered by ventilator. Proportional assist ventilation (PAV) is a new dynamic ins...

  18. Neonatal mechanical ventilation: Indications and outcome

    OpenAIRE

    Qazi Iqbal; Mir M Younus; Asif Ahmed; Ikhlas Ahmad; Javed Iqbal; Bashir A Charoo; S Wajid Ali

    2015-01-01

    Background and Aims: Decreasing mortality in sick and ventilated neonates is an endeavor of all neonatologists. To reduce the high mortality in this group of neonates, identification of risk factors is important. This study was undertaken to find out the indications of ventilation and complications in ventilated neonates and also study possible predictors of outcome. Subjects: Age

  19. 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...

  20. 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...

  1. 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...

  2. 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

  3. Padronização do desmame da ventilação mecânica em Unidade de Terapia Intensiva: resultados após um ano Standardization of weaning of the mechanical ventilation in a Intensive Care Unit: results afterwards one year

    Directory of Open Access Journals (Sweden)

    Luiz Rogério de Carvalho Oliveira

    2006-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O desmame da ventilação mecânica é o processo de transição da ventilação mecânica para a espontânea. A prática atual do desmame mostra que o empirismo é insuficiente e inadequado. Em contrapartida, as padronizações de desmame proporcionam melhor condução no processo. O objetivo deste estudo foi avaliar os efeitos da aplicação de um protocolo de desmame da ventilação mecânica em uma unidade de terapia intensiva. MÉTODO: Foram incluídos no estudo todos os pacientes em programa de liberação da ventilação mecânica, em que se acompanhou a evolução do desmame com utilização de um protocolo pré-estabelecido pelo serviço já publicado. RESULTADOS: Foram estudados 127 pacientes. Houve sucesso no desmame em 91% (115 e insucesso em 9% (12. A ventilação não-invasiva após a extubação foi utilizada em 19% (24 deles. Nenhum óbito foi observado. Comparando-se o grupo de pacientes em que houve sucesso com o grupo em que houve falha, não foi encontrada diferença estatística significativa quanto ao sexo (p = 0,96, APACHE II (19,5 versus 18,6 p = 0,75, risco de óbito (29% versus 22% p = 0,54, Pimáx (38 versus 32 cmH2O p = 0,17, tempo de ventilação mecânica (6 versus 7 dias p = 0,70, relação PaO2/FiO2 (324 versus 312 p = 0,83, modalidade de desmame (PSV ou Tubo T p = 0,29. Foram encontradas diferenças significativas no valor de índice de respiração rápida superficial (IRRS (59 versus 77 p = 0,02 e no tempo de desmame (1 versus 30 horas p BACKGROUND AND OBJECTIVES: The weaning of mechanical ventilation is the process of transition from mechanical ventilation to spontaneous. The actual practice weaning reveals that the empirism is insufficient and inadequate. On the other side, the standardization of the weaning provides best conductions in the process. The objective of this study was to evaluate the effects of the application of a weaning protocol in an intensive care unit. METHODS

  4. Displacement Ventilation in Hospital Environments

    DEFF Research Database (Denmark)

    Li, Yuguo; Nielsen, Peter V.; Sandberg, Mats

    2011-01-01

    Hospital differ from conventional buildings in terms of ventilation needs. Exhaled infectious droplets or droplet nuclei of an infected patient need to be removed in general wards, waiting areas and isolation rooms to minimize transmission to health-care workers, other patients and visitors...

  5. Non-invasive mechanical ventilation

    African Journals Online (AJOL)

    Nicky

    2005-07-10

    Jul 10, 2005 ... Drinker P, McKahnn C. The use of a new apparatus for the prolonged administration of artificial respiration. JAMA 1929; 92: 1658-1660. 5. Emerson J. Some reflections on Iron Lungs and other inventions. Respiratory Care 1998;. 43: 574-583. 6. Brigg C. The benefits of non-invasive ventilation and CPAP ...

  6. Thermal Plumes in Ventilated Rooms

    DEFF Research Database (Denmark)

    Kofoed, Peter; Nielsen, Peter V.

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

  7. Cardiogenic oscillation induced ventilator autotriggering

    Directory of Open Access Journals (Sweden)

    Narender Kaloria

    2015-01-01

    Full Text Available Cardiogenic oscillation during mechanical ventilation can auto-trigger the ventilator resembling patient initiated breadth. This gives a false sense of intact respiratory drive and determination brain death, even if other tests are positive, is not appropriate in such a situation. It will prolong the ICU stay and confound the brain-death determination. In this case report, we describe a 35 year old man who was brought to the hospital after many hours of critical delay following multiple gun shot injuries. The patient suffered a cardiac arrest while on the way from another hospital. After an emergency laparotomy, patient was shifted to Intensive Care Unit (ICU with Glasgow Coma Scale (GCS score of E1VTM1 and was mechanically ventilated. Despite absence of brainstem reflexes, the ventilator continued to be triggered on continuous positive airway pressure (CPAP mode and the patient maintained normal oxygen saturation and acceptable levels of carbon dioxide. An apnoea test confirmed absent respiratory drive. Ventilatory waveform graph analysis, revealed cardiogenic oscillation as the cause for autotrigerring.

  8. Thermal Plumes in Ventilated Rooms

    DEFF Research Database (Denmark)

    Kofoed, Peter; Nielsen, Peter V.

    Ventilation systems with vertical displacement flow have been used in industrial areas with extensive heat loads for many years. Hot and contaminant air is carried directly from the occupied zone towards the ceiling by hot processes and other activities which create a natural convection flow....

  9. International Ventilation Cooling Application Database

    DEFF Research Database (Denmark)

    Holzer, Peter; Psomas, Theofanis Ch.; OSullivan, Paul

    2016-01-01

    The currently running International Energy Agency, Energy and Conservation in Buildings, Annex 62 Ventilative Cooling (VC) project, is coordinating research towards extended use of VC. Within this Annex 62 the joint research activity of International VC Application Database has been carried out, ...

  10. Effects of ventilation behaviour on indoor heat load based on test reference years

    Science.gov (United States)

    Rosenfelder, Madeleine; Koppe, Christina; Pfafferott, Jens; Matzarakis, Andreas

    2016-02-01

    Since 2003, most European countries established heat health warning systems to alert the population to heat load. Heat health warning systems are based on predicted meteorological conditions outdoors. But the majority of the European population spends a substantial amount of time indoors, and indoor thermal conditions can differ substantially from outdoor conditions. The German Meteorological Service (Deutscher Wetterdienst, DWD) extended the existing heat health warning system (HHWS) with a thermal building simulation model to consider heat load indoors. In this study, the thermal building simulation model is used to simulate a standardized building representing a modern nursing home, because elderly and sick people are most sensitive to heat stress. Different types of natural ventilation were simulated. Based on current and future test reference years, changes in the future heat load indoors were analyzed. Results show differences between the various ventilation options and the possibility to minimize the thermal heat stress during summer by using an appropriate ventilation method. Nighttime ventilation for indoor thermal comfort is most important. A fully opened window at nighttime and the 2-h ventilation in the morning and evening are more sufficient to avoid heat stress than a tilted window at nighttime and the 1-h ventilation in the morning and the evening. Especially the ventilation in the morning seems to be effective to keep the heat load indoors low. Comparing the results for the current and the future test reference years, an increase of heat stress on all ventilation types can be recognized.

  11. Late tracheotomy is associated with higher morbidity and mortality in mechanically ventilated patients.

    Science.gov (United States)

    Patel, Sapna A; Plowman, Emily K; Halum, Stacey; Merati, Albert L; Sardesai, Maya G

    2015-09-01

    To determine whether the timing of tracheotomy placement impacts ventilation weaning status and mortality. Multi-institution retrospective cohort study. Demographic data, procedural details, and clinical outcomes were recorded for patients undergoing tracheotomy for prolonged mechanical ventilation across eight sites. The study group was divided into two groups: those undergoing tracheotomy within 14 days of initiation of mechanical ventilation and those undergoing tracheotomy at or after 14 days. Groups were compared for primary outcome measures of mortality and ability to wean from mechanical ventilation within the study period. Of the 539 patients intubated for ventilator dependence with complete data available, 280 (51.9%) underwent tracheotomy within 14 days. Patients who underwent late tracheotomy were 1.72 times more likely to remain ventilator dependent during the follow-up period (95% confidence interval [CI]: 1.12-2.66), and had a 40% increased risk of death (odds ratio: 1.4, 95% CI: 0.96-1.99). In this multicenter retrospective review of tracheotomy outcomes, late tracheotomy placement (>14 days) was associated with increased mortality and prolonged ventilator dependence. Standardized multidisciplinary management protocols for prolonged mechanical ventilation are recommended, and future work should confirm these results in a prospective manner. 4. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  12. Lung recruitment and endotracheal suction in ventilated preterm infants measured with electrical impedance tomography.

    Science.gov (United States)

    Hough, Judith L; Shearman, Andrew D; Liley, Helen; Grant, Caroline A; Schibler, Andreas

    2014-11-01

    Although suctioning is a standard airway maintenance procedure, there are significant associated risks, such as loss of lung volume due to high negative suction pressures. This study aims to assess the extent and duration of change in end-expiratory level (EEL) resulting from endotracheal tube (ETT) suction and to examine the relationship between EEL and regional lung ventilation in ventilated preterm infants with respiratory distress syndrome. A prospective observational clinical study of the effect of ETT suction on 20 non-muscle-relaxed preterm infants with respiratory distress syndrome (RDS) on conventional mechanical ventilation was conducted in a neonatal intensive care unit. Ventilation distribution was measured with regional impedance amplitudes and EEL using electrical impedance tomography. ETT suction resulted in a significant increase in EEL post-suction (P suction, suggesting heterogeneity. Tidal volume was significantly lower in volume-guarantee ventilation compared with pressure-controlled ventilation (P = 0.04). ETT suction in non-muscle-relaxed and ventilated preterm infants with RDS results in significant lung volume increase that is maintained for at least 90 min. Regional differences in distribution of ventilation with ETT suction suggest that the behaviour of the lung is heterogeneous in nature. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  13. 16 CFR 1615.2 - Scope and application.

    Science.gov (United States)

    2010-01-01

    ... FLAMMABILITY OF CHILDREN'S SLEEPWEAR: SIZES 0 THROUGH 6X (FF 3-71) The Standard § 1615.2 Scope and application. (a) This Standard provides a test method to determine the flammability of items as defined in § 1615... flammability standards for clothing textiles and vinyl plastic film, parts 1610 and 1611 of this chapter, are...

  14. Oxidizer Scoping Studies

    Energy Technology Data Exchange (ETDEWEB)

    Chancellor, Christopher John [Los Alamos National Laboratory

    2016-11-07

    The purpose of this report is to present the results of the acceptable knowledge (AK) review of oxidizers present in active waste streams, provide a technical analysis of the oxidizers, and report the results of the scoping study testing. This report will determine the fastest burning oxidizer to be used in the development of a Test Plan for Preparation and Testing of Sorbents Mixed with Oxidizer found in Transuranic Waste (DWT-TP-001). The companion report, DWT-RPT-002, Sorbent Scoping Studies, contains similar information for sorbents identified during the AK review of TRU waste streams. The results of the oxidizer and sorbent scoping studies will be used to inform the QL1 test plan. The QL1 test results will support the development of a basis of knowledge document that will evaluate oxidizing chemicals and sorbents in TRU waste and provide guidance for treatment.

  15. Scoping Memo Response

    Energy Technology Data Exchange (ETDEWEB)

    Goldstein, Noah [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Stewart, Jeff [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Lamont, Alan [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Dube, Evi [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Gansemer, Jim [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2010-06-25

    What follows is a response to the questions posed in the May 21, 2010 document "Assigned Commissioner's Ruling and Scoping Memo, Phase 1", pertaining to Rulemaking 09-11-014, also referred to as the "Scoping Memo". The questions refer to the specific components of the CPUC Energy Efficiency (EE) Evaluation, Measurement, and Verification (EM&V) program, currently in its 2010-2012 cycle. In the Scoping Memo, there was reference to the need to update the policy and methodological framework of EM&V, due to changes in law (AB32), policy (California Long Term Energy Efficiency Strategic Plan), the availability of new data, and challenges to previous EM&V cycles.

  16. Contaminant levels, source strengths, and ventilation rates in California retail stores.

    Science.gov (United States)

    Chan, W R; Cohn, S; Sidheswaran, M; Sullivan, D P; Fisk, W J

    2015-08-01

    This field study measured ventilation rates and indoor air quality in 21 visits to retail stores in California. Three types of stores, such as grocery, furniture/hardware stores, and apparel, were sampled. Ventilation rates measured using a tracer gas decay method exceeded the minimum requirement of California's Title 24 Standard in all but one store. Concentrations of volatile organic compounds (VOCs), ozone, and carbon dioxide measured indoors and outdoors were analyzed. Even though there was adequate ventilation according to standard, concentrations of formaldehyde and acetaldehyde exceeded the most stringent chronic health guidelines in many of the sampled stores. The whole-building emission rates of VOCs were estimated from the measured ventilation rates and the concentrations measured indoor and outdoor. Estimated formaldehyde emission rates suggest that retail stores would need to ventilate at levels far exceeding the current Title 24 requirement to lower indoor concentrations below California's stringent formaldehyde reference level. Given the high costs of providing ventilation, effective source control is an attractive alternative. Field measurements suggest that California retail stores were well ventilated relative to the minimum ventilation rate requirement specified in the Building Energy Efficiency Standards Title 24. Concentrations of formaldehyde found in retail stores were low relative to levels found in homes but exceeded the most stringent chronic health guideline. Looking ahead, California is mandating zero energy commercial buildings by 2030. To reduce the energy use from building ventilation while maintaining or even lowering formaldehyde in retail stores, effective formaldehyde source control measures are vitally important. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

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

    Science.gov (United States)

    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.

  18. Personalizing mechanical ventilation according to physiologic parameters to stabilize alveoli and minimize ventilator induced lung injury (VILI).

    Science.gov (United States)

    Nieman, Gary F; Satalin, Joshua; Andrews, Penny; Aiash, Hani; Habashi, Nader M; Gatto, Louis A

    2017-12-01

    It has been shown that mechanical ventilation in patients with, or at high-risk for, the development of acute respiratory distress syndrome (ARDS) can be a double-edged sword. If the mechanical breath is improperly set, it can amplify the lung injury associated with ARDS, causing a secondary ventilator-induced lung injury (VILI). Conversely, the mechanical breath can be adjusted to minimize VILI, which can reduce ARDS mortality. The current standard of care ventilation strategy to minimize VILI attempts to reduce alveolar over-distension and recruitment-derecruitment (R/D) by lowering tidal volume (Vt) to 6 cc/kg combined with adjusting positive-end expiratory pressure (PEEP) based on a sliding scale directed by changes in oxygenation. Thus, Vt is often but not always set as a "one-size-fits-all" approach and although PEEP is often set arbitrarily at 5 cmH2O, it may be personalized according to changes in a physiologic parameter, most often to oxygenation. However, there is evidence that oxygenation as a method to optimize PEEP is not congruent with the PEEP levels necessary to maintain an open and stable lung. Thus, optimal PEEP might not be personalized to the lung pathology of an individual patient using oxygenation as the physiologic feedback system. Multiple methods of personalizing PEEP have been tested and include dead space, lung compliance, lung stress and strain, ventilation patterns using computed tomography (CT) or electrical impedance tomography (EIT), inflection points on the pressure/volume curve (P/V), and the slope of the expiratory flow curve using airway pressure release ventilation (APRV). Although many studies have shown that personalizing PEEP is possible, there is no consensus as to the optimal technique. This review will assess various methods used to personalize PEEP, directed by physiologic parameters, necessary to adaptively adjust ventilator settings with progressive changes in lung pathophysiology.

  19. Influence of Persons' Movements on Ventilation Effectiveness

    DEFF Research Database (Denmark)

    Brohus, Henrik; Hyldig, Mikkel; Kamper, Simon

    2008-01-01

    Most often the ventilation effectiveness of a ventilated room is determined without considering the influence of persons´ movements. Even though the main reason for supplying the ventilation may be to create a healthy and productive environment for the occupants, their own influence...... on the ventilation is usually disregarded. This paper presents results from a systematic investigation of the movements´ influence on the ventilation effectiveness using human subjects combined with tracer gas measurements. Several typical "movements" are defined and carefully repeated to determine the influence......, even though the movements reduce the effectiveness. Furthermore, it is found that the influence of the different movements vary substantially....

  20. The Impact of Ventilation and Early Diagnosis on Tuberculosis Transmission in Brazilian Prisons.

    Science.gov (United States)

    Urrego, Juliana; Ko, Albert I; da Silva Santos Carbone, Andrea; Paião, Dayse Sanchez Guimarães; Sgarbi, Renata Viebrantz Enne; Yeckel, Catherine W; Andrews, Jason R; Croda, Julio

    2015-10-01

    Prisoners have among the highest incidence of tuberculosis (TB) globally. However, the contribution of the prison environment on transmission is not well understood and structural characteristics have received little attention as effective epidemiological interventions in TB control. We evaluated architectural characteristics and estimated ventilation rates in 141 cells in three prisons in central west Brazil using steady-state exhaled carbon dioxide (CO2) levels. We used a modified Wells-Riley equation to estimate the probability of infection for inmates sharing a cell with an infectious case and projected the impact of interventions, including early diagnosis and improved ventilation. Overall, prison cells were densely populated (mean 2.1 m(2) per occupant) and poorly ventilated, with only three cells meeting World Health Organization (WHO) standards for per-person ventilation (60 L/s) applied in infection control settings. In the absence of interventions, projected mean risk of infection was 78.0% during a 6-month period. Decreasing time-to-diagnosis by 25% reduced transmission risk by 8.3%. Improving ventilation to WHO standards decreased transmission by 38.2%, whereas optimizing cross-ventilation reduced transmission by 64.4%. Prison environments promote high infection risk over short-time intervals. In this context, enhanced diagnostics have a limited impact on reducing transmission. Improving natural ventilation may be required to effectively control TB in prisons. © The American Society of Tropical Medicine and Hygiene.

  1. Computational study of smoke flow control in garage fires and optimization of the ventilation system

    Directory of Open Access Journals (Sweden)

    Banjac Miloš J.

    2009-01-01

    Full Text Available With the aim of evaluating capabilities of a ventilation system to control the spread of smoke in the emergency operating mode, thereby providing conditions for safe evacuation of people from a fire-struck area, computational fluid dynamics simulation of a fire in a semi-bedded garage was conducted. Using the experimental results of combustion dynamics of a passenger car on fire, optimal positions of ventilation openings were determined. According to recommendations by DIN EN 12101 standard, the operating modes of a ventilation system were verified and optimal start time of the smoke extraction system was defined.

  2. Field and Laboratory Testing of Approaches to Smart Whole-House Mechanical Ventilation Control

    Energy Technology Data Exchange (ETDEWEB)

    Martin, Eric [Florida Solar Energy Center, Cocoa, FL (United States); Fenaughty, Karen [Florida Solar Energy Center, Cocoa, FL (United States); Parker, Danny [Florida Solar Energy Center, Cocoa, FL (United States)

    2018-01-15

    Whole-house mechanical ventilation is a critical component to a comprehensive strategy for good indoor air quality (IAQ). However, due to lack of integration with standard heating and cooling systems, and perceptions from a portion of the homebuilding industry about risks related to increased energy use, increased cost, and decreased comfort, voluntary and code-required adoption varies amongst regions. Smart ventilation controls (SVC) balance energy consumption, comfort, and IAQ by optimizing mechanical ventilation operation to reduce the heating and/or cooling loads, improve management of indoor moisture, and maintain IAQ equivalence according to ASHRAE 62.2.

  3. Field and Laboratory Testing of Approaches to Smart Whole-House Mechanical Ventilation Control

    Energy Technology Data Exchange (ETDEWEB)

    Martin, Eric; Fenaughty, Karen; Parker, Danny; Lubiner, Michael : Howard, Luke

    2018-01-29

    Whole-house mechanical ventilation is a critical component to a comprehensive strategy for good indoor air quality (IAQ). However, due to lack of integration with standard heating and cooling systems, and perceptions from a portion of the homebuilding industry about risks related to increased energy use, increased cost, and decreased comfort, voluntary and code-required adoption varies among regions. Smart ventilation controls (SVC) balance energy consumption, comfort, and IAQ by optimizing mechanical ventilation operation to reduce the heating and/or cooling loads, improve management of indoor moisture, and maintain IAQ equivalence according to ASHRAE 62.2.

  4. Change-over natural and mechanical ventilation system energy consumption in single-family buildings

    Science.gov (United States)

    Kostka, Maria; Szulgowska-Zgrzywa, Małgorzata

    2017-11-01

    The parameters of the outside air in Poland cause that in winter it is reasonable to use a mechanical ventilation equipped with a heat recovery exchanger. The time of spring, autumn, summer evenings and nights are often characterized by the parameters of the air, which allow for a natural ventilation and reduce the electricity consumption. The article presents the possibilities of energy consumption reduction for three energy standards of buildings located in Poland, ventilated by a change-over hybrid system. The analysis was prepared on the assumption that the air-to-water heat pump is the heat source for the buildings.

  5. Clinical review: liberation from mechanical ventilation.

    Science.gov (United States)

    El-Khatib, Mohamad F; Bou-Khalil, Pierre

    2008-01-01

    Mechanical ventilation is the defining event of intensive care unit (ICU) management. Although it is a life saving intervention in patients with acute respiratory failure and other disease entities, a major goal of critical care clinicians should be to liberate patients from mechanical ventilation as early as possible to avoid the multitude of complications and risks associated with prolonged unnecessary mechanical ventilation, including ventilator induced lung injury, ventilator associated pneumonia, increased length of ICU and hospital stay, and increased cost of care delivery. This review highlights the recent developments in assessing and testing for readiness of liberation from mechanical ventilation, the etiology of weaning failure, the value of weaning protocols, and a simple practical approach for liberation from mechanical ventilation.

  6. Short-term airing by natural ventilation

    DEFF Research Database (Denmark)

    Perino, Marco; Heiselberg, Per

    2009-01-01

    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.......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...

  7. Ventilator-associated pneumonia rates after introducing selective digestive tract decontamination.

    Science.gov (United States)

    Schnabel, Ronny M; Scholte, Johannes B J; Van Der Velden, Kim E H M; Roekaerts, Paul M H J; Bergmans, Dennis C J J

    2015-09-01

    The incidence of ventilator-associated pneumonia (VAP) before and after the introduction of selective oral decontamination (SOD) only and selective digestive tract decontamination (SDD) in a general intensive care population was examined. SOD as standard of care was introduced in December 2010 and SDD, including SOD, in January 2012 for all patients with an expected length of intensive care unit (ICU) stay of at least 48 h. The diagnosis of VAP was based on clinical criteria and quantitative cultures of bronchoalveolar lavage fluid. A total of 4945 mechanically ventilated patients accounting for 37 554 ventilator days in the period from 2005 to 2013 were analyzed. The incidence of VAP per 1000 ventilator days declined significantly from 4.38 ± 1.64 before to 1.64 ± 0.43 after introduction of SOD/SDD (p = 0.007). Implementation of SOD/SDD as standard of care in ICUs may thus be effective in preventing VAP.

  8. 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

  9. Non-invasive Mechanical Ventilation Enhances Patient Autonomy in Decision-Making Regarding Chronic Ventilation.

    Science.gov (United States)

    Sviri, S; Linton, D M; van Heerden, P V

    2005-06-01

    Patients with respiratory failure due to progressive muscle weakness often require chronic ventilatory support, but many do not make decisions regarding ventilation prior to a crisis. We studied the use of non-invasive ventilation as a tool to enable communication and facilitate decision-making regarding chronic ventilation. Patients with profound muscle weakness and acute respiratory failure, were supported or weaned by non-invasive positive or negative pressure ventilation. The patients were then interviewed and their informed autonomous decisions were used to plan their future management. Non-invasive ventilation could be used safely to support patients with acute respiratory failure until decisions regarding chronic ventilation are made and as an alternative means of ventilation for those who refuse tracheostomy. Non-invasive ventilation may be used in patients with profound muscle weakness, as a means of enhancing patient autonomy by improving communication and maintaining ventilation until decisions about ongoing care are made.

  10. Cosmetology: Scope and Sequence.

    Science.gov (United States)

    Nashville - Davidson County Metropolitan Public Schools, TN.

    This scope and sequence guide, developed for a cosmetology vocational education program, represents an initial step in the development of a systemwide articulated curriculum sequence for all vocational programs within the Metropolitan Nashville Public School System. It was developed as a result of needs expressed by teachers, parents, and the…

  11. Assist-control mechanical ventilation attenuates ventilator-induced diaphragmatic dysfunction.

    Science.gov (United States)

    Sassoon, Catherine S H; Zhu, Ercheng; Caiozzo, Vincent J

    2004-09-15

    Controlled mechanical ventilation induced a profound diaphragm muscle dysfunction and atrophy. The effects of diaphragmatic contractions with assisted mechanical ventilation on diaphragmatic isometric, isotonic contractile properties, or the expression of muscle atrophy factor-box (MAF-box), the gene responsible for muscle atrophy, are unknown. We hypothesize that assisted mechanical ventilation will preserve diaphragmatic force and prevent overexpression of MAF-box. Studying sedated rabbits randomized equally into control animals, those with 3 days of assisted ventilation, and those with controlled ventilation, we assessed in vitro diaphragmatic isometric and isotonic contractile function. The concentrations of contractile proteins, myosin heavy chain isoform, and MAF-box mRNA were measured. Tetanic force decreased by 14% with assisted ventilation and 48% with controlled ventilation. Maximum shortening velocity tended to increase with controlled compared with assisted ventilation and control. Peak power output decreased 20% with assisted ventilation and 41% with controlled ventilation. Contractile proteins were unchanged with either modes of ventilation; myosin heavy chain 2X mRNA tended to increase and that of 2A to decrease with controlled ventilation. MAF-box gene was overexpressed with controlled ventilation. We conclude that preserving diaphragmatic contractions during mechanical ventilation attenuates the force loss induced by complete inactivity and maintains MAF-box gene expression in control.

  12. Evaluation of single-sided natural ventilation using a simplified and fair calculation method

    DEFF Research Database (Denmark)

    Plesner, Christoffer; Larsen, Tine Steen; Leprince, Valérie

    2016-01-01

    The overall objective of this paper is to evaluate design expressions for single-sided ventilation and find the most suitable that would in average perform well, while reducing the risk of overestimating air flows in individual cases. The design expression needs to be both simple and fair to fit...... improve the support of ventilative cooling in future standards and regulations, by making it simple to predict the air flows in buildings....

  13. Possible scenarios for a safety upgrade of the ventilation system

    CERN Document Server

    Inigo-Golfin, J

    2009-01-01

    This paper/presentation describes the existing LHC ventilation (HVAC) system, the design principle followed for the LEP Project and the modifications implemented for the LHC Project. A discussion on possible referential standards to compare the existing system with is presented and possible axes for its improvement, based on these referentials, are discussed. Finally, some recommendations are given based on the system's present capabilities and the estimated investment necessary to achieve compliance to the referentials chosen.

  14. Ventilation and oxygen consumption in the hagfish, Myxine glutinosa L

    DEFF Research Database (Denmark)

    STEFFENSEN, JF; JOHANSEN, K; SINDBERG, CD

    1984-01-01

    Ventilation was measured directly in the hagfish, Myxine glutinosa L., by means of an electro-magnetic blood flowmeter. Ventilatory flow and frequency increased from 0.86 ± 0.27 mlmin-, and 18.2 ± 5.1min-, respectively, at 7°C to 1.70 ± 0.20 mlmin-, and 70.1 ± 9.5min- at 15 C. Standard oxygen...

  15. A Comprehensive Approach for the Ergonomic Evaluation of 13 Emergency and Transport Ventilators.

    Science.gov (United States)

    Marjanovic, Nicolas; L'Her, Erwan

    2016-05-01

    Mechanical ventilation is an important part of emergency medicine and is frequently used for transportation. Human errors during ventilator settings are frequent and may be associated with high morbidity/mortality. The aim of the study was to provide a complete ergonomic evaluation of emergency and transport ventilators, taking into account objective and subjective human-machine interface assessments and individual mental work load. We performed a prospective bench ergonomic evaluation of 13 emergency and transport ventilators, using standardized conditions and a global methodological approach. The study was performed in an evaluation laboratory dedicated to respiratory care, and 12 emergency physicians unfamiliar with the tested devices were included in the evaluation. The ventilators were classified into 3 categories (simple, sophisticated, and ICU-like). Objective chronometric evaluations were conducted considering 9 tasks, and subjective evaluations were performed (ease of use, willingness to use, and user-friendliness of monitoring) using Likert scales. Mental work load evaluation was performed using the NASA Task Load Index scale. Overall task failure rate represented 4% of all attempts. Setting modifications, ventilation mode changes, and powering down durations were different between simple and other emergency and transport ventilator categories (P ergonomic evaluation provides valuable information while investigating operational friendliness in emergency and transport ventilators. The choice of a device not only depends on its technical characteristics but should take into account its clinical operational setting and ergonomics in order to decrease mental work load. Sophisticated emergency and transport ventilators should only be used by clinicians who demonstrate expertise in mechanical ventilation. Copyright © 2016 by Daedalus Enterprises.

  16. Projected incidence of mechanical ventilation in Ontario to 2026: Preparing for the aging baby boomers.

    Science.gov (United States)

    Needham, Dale M; Bronskill, Susan E; Calinawan, Jonah R; Sibbald, William J; Pronovost, Peter J; Laupacis, Andreas

    2005-03-01

    The aging baby boomers are expected to have a significant impact on the healthcare system. Mechanical ventilation is an age-dependent, costly, and relatively nondiscretionary medical service that may be particularly affected by the aging population. We forecast the future incidence of mechanical ventilation to the year 2026 to understand the impact of aging baby boomers on critical care resources. Population-based, sex-specific, and age-specific mechanical ventilation incidences for adults for the year 2000 were directly standardized to population projections to estimate the incidence of mechanical ventilation, in 5-yr intervals, from 2006 to 2026. Sensitivity analyses were performed by varying population projections and mechanical ventilation incidence for the elderly. Province of Ontario, Canada. Noncardiac surgery, mechanically ventilated adults. None. The projected number of ventilated patients in 2026 was 34,478, representing an 80% increase from 2000. The crude incidence increased 31%, from 222 to 291 per 100,000 adults. The annually compounded projected growth rate during this 26-yr period was 2.3%, similar to the actual growth rate experienced in the 1990s. The projected incidence was relatively insensitive to changes in assumptions, with estimates for 2026 ranging from 31,473 to 36,313 ventilated adults. The incidence of mechanical ventilation projected to the year 2026 will steadily increase and outpace population growth as occurred in the 1990s. In the current environment in which intensive care unit resources are limited and ventilated patients already use a significant proportion of acute care resources, planning for this continued growth is necessary. Existing evidence-based strategies that improve both the efficiency and efficacy of critical care services should be carefully evaluated for widespread implementation.

  17. EarthScope Education and Outreach: Accomplishments and Emerging Opportunities

    Science.gov (United States)

    Robinson, S.; Ellins, K. K.; Semken, S. C.; Arrowsmith, R.

    2014-12-01

    EarthScope's Education and Outreach (E&O) program aims to increase public awareness of Earth science and enhance geoscience education at the K-12 and college level. The program is distinctive among major geoscience programs in two ways. First, planning for education and public engagement occurred in tandem with planning for the science mission. Second, the NSF EarthScope program includes funding support for education and outreach. In this presentation, we highlight key examples of the program's accomplishments and identify emerging E&O opportunities. E&O efforts have been collaboratively led by the EarthScope National Office (ESNO), IRIS, UNAVCO, the EarthScope Education and Outreach Subcommittee (EEOSC) and PI-driven EarthScope projects. Efforts by the EEOSC, guided by an EarthScope Education and Outreach Implementation Plan that is periodically updated, focus EarthScope E&O. EarthScope demonstrated early success in engaging undergraduate students (and teachers) in its mission through their involvement in siting USArray across the contiguous U.S. Funded E&O programs such as TOTLE, Illinois EarthScope, CEETEP (for K-12), InTeGrate and GETSI (for undergraduates) foster use of freely available EarthScope data and research findings. The Next Generation Science Standards, which stress science and engineering practices, offer an opportunity for alignment with existing EarthScope K-12 educational resources, and the EEOSC recommends focusing efforts on this task. The EEOSC recognizes the rapidly growing use of mobile smart devices by the public and in formal classrooms, which bring new opportunities to connect with the public and students. This will capitalize on EarthScope's already prominent social media presence, an effort that developed to accomplish one of the primary goals of the EarthScope E&O Implementation Plan to "Create a high-profile public identity for EarthScope" and to "Promote science literacy and understanding of EarthScope among all audiences through

  18. Evaluation of Ventilation Strategies in New Construction Multifamily Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Maxwell, S. [Consortium for Advanced Residential Buildings (CARB), Norwalk, CT (United States); Berger, D. [Consortium for Advanced Residential Buildings (CARB), Norwalk, CT (United States); Zuluaga, M. [Consortium for Advanced Residential Buildings (CARB), Norwalk, CT (United States)

    2014-07-01

    In multifamily buildings, particularly in the Northeast, exhaust ventilation strategies are the norm as a means of meeting both local exhaust and whole-unit mechanical ventilation rates. The issue of where the "fresh" air is coming from is gaining significance as air-tightness standards for enclosures become more stringent. CARB researchers have found that most new high performance, multifamily housing in the Northeast use one of four strategies for ventilation: continuous exhaust only with no designated supply or make-up air source, continuous exhaust with ducted make-up air to apartments, continuous exhaust with supply through a make-up air device integral to the unit HVAC, and continuous exhaust with supply through a passive inlet device, such as a trickle vent. Insufficient information is available to designers on how these various systems are best applied. Product performance data are based on laboratory tests, but there is no guarantee that those conditions will exist consistently in the finished building. In this research project, CARB evaluated the four ventilation strategies in the field to validate system performance.

  19. 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.

  20. Energy Use Consequences of Ventilating a Net-Zero Energy House

    Science.gov (United States)

    Ng, Lisa C.; Payne, W. Vance

    2016-01-01

    A Net-Zero Energy Residential Test Facility (NZERTF) has been constructed at the National Institute of Standards and Technology (NIST) in Gaithersburg, Maryland to demonstrate that a home similar in size, aesthetics, and amenities to those in the surrounding communities can achieve net-zero energy use over the course of a year while meeting the average electricity and water use needs of a family of four in the United States. The facility incorporates renewable energy and energy efficient technologies, including an air-to-air heat pump system, a solar photovoltaic system, a solar thermal domestic hot water system, and a heat recovery ventilation system sized to meet American Society of Heating, Refrigeration, and Air-Conditioning Engineers (ASHRAE) Standard 62.2-2010 ventilation requirements. The largest energy end use within the home was space conditioning, which included heat loss through the building envelope, ventilation air supplied by the heat recovery ventilator (HRV), and internal loads. While HRVs are often described as being able to save energy when compared to ventilating without heat recovery, there have been no studies using a full year of measured data that determine the thermal load and energy impacts of HRV-based ventilation on the central heating and cooling system. Over the course of a year, continuous operation of the HRV at the NZERTF resulted in an annual savings of 7 % in heat pump energy use compared with the hypothetical case of ventilating without heat recovery. The heat pump electrical use varied from an increase of 5 % in the cooling months to 36 % savings in the heating months compared with ventilation without heat recovery. The increase in the cooling months occurred when the outdoor temperature was lower than the indoor temperature, during which the availability of an economizer mode would have been beneficial. Nevertheless, the fan energy required to operate the selected HRV at the NZERTF paid for itself in the heat pump energy saved

  1. Energy Use Consequences of Ventilating a Net-Zero Energy House.

    Science.gov (United States)

    Ng, Lisa C; Payne, W Vance

    2016-03-05

    A Net-Zero Energy Residential Test Facility (NZERTF) has been constructed at the National Institute of Standards and Technology (NIST) in Gaithersburg, Maryland to demonstrate that a home similar in size, aesthetics, and amenities to those in the surrounding communities can achieve net-zero energy use over the course of a year while meeting the average electricity and water use needs of a family of four in the United States. The facility incorporates renewable energy and energy efficient technologies, including an air-to-air heat pump system, a solar photovoltaic system, a solar thermal domestic hot water system, and a heat recovery ventilation system sized to meet American Society of Heating, Refrigeration, and Air-Conditioning Engineers (ASHRAE) Standard 62.2-2010 ventilation requirements. The largest energy end use within the home was space conditioning, which included heat loss through the building envelope, ventilation air supplied by the heat recovery ventilator (HRV), and internal loads. While HRVs are often described as being able to save energy when compared to ventilating without heat recovery, there have been no studies using a full year of measured data that determine the thermal load and energy impacts of HRV-based ventilation on the central heating and cooling system. Over the course of a year, continuous operation of the HRV at the NZERTF resulted in an annual savings of 7 % in heat pump energy use compared with the hypothetical case of ventilating without heat recovery. The heat pump electrical use varied from an increase of 5 % in the cooling months to 36 % savings in the heating months compared with ventilation without heat recovery. The increase in the cooling months occurred when the outdoor temperature was lower than the indoor temperature, during which the availability of an economizer mode would have been beneficial. Nevertheless, the fan energy required to operate the selected HRV at the NZERTF paid for itself in the heat pump energy saved

  2. Classroom HVAC: Improving ventilation and saving energy -- field study plan

    Energy Technology Data Exchange (ETDEWEB)

    Apte, Michael G.; Faulkner, David; Hodgson, Alfred T.; Sullivan, Douglas P.

    2004-10-14

    The primary goals of this research effort are to develop, evaluate, and demonstrate a very practical HVAC system for classrooms that consistently provides classrooms (CRs) with the quantity of ventilation in current minimum standards, while saving energy, and reducing HVAC-related noise levels. This research is motivated by the public benefits of energy efficiency, evidence that many CRs are under-ventilated, and public concerns about indoor environmental quality in CRs. This document provides a summary of the detailed plans developed for the field study that will take place in 2005 to evaluate the energy and IAQ performance of a new classroom HVAC technology. The field study will include measurements of HVAC energy use, ventilation rates, and IEQ conditions in 10 classrooms with the new HVAC technology and in six control classrooms with a standard HVAC system. Energy use and many IEQ parameters will be monitored continuously, while other IEQ measurements will be will be performed seasonally. Continuously monitored data will be remotely accessed via a LonWorks network. Instrument calibration plans that vary with the type of instrumentation used are established. Statistical tests will be employed to compare energy use and IEQ conditions with the new and standard HVAC systems. Strengths of this study plan include the collection of real time data for a full school year, the use of high quality instrumentation, the incorporation of many quality control measures, and the extensive collaborations with industry that limit costs to the sponsors.

  3. Indoor air quality in mechanically ventilated residential dwellings/low-rise buildings: A review of existing information

    DEFF Research Database (Denmark)

    Aganovic, Amar; Hamon, Mathieu; Kolarik, Jakub

    Mechanical ventilation has become a mandatory requirement in multiple European standards addressing indoor air quality (IAQ) and ventilation in residential dwellings (single family houses and low-rise apartment buildings). This article presents the state of the art study through a review of the e......Mechanical ventilation has become a mandatory requirement in multiple European standards addressing indoor air quality (IAQ) and ventilation in residential dwellings (single family houses and low-rise apartment buildings). This article presents the state of the art study through a review...... concentrations. The authors additionally noted that the literature frequently reported the role of improper maintenance and use on deterioration of IAQ in residential dwellings. The summarized data and comments may provide useful information for future guidelines related to ventilation strategies designed...

  4. 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.

  5. Scope of Practice Among Recent Family Medicine Residency Graduates.

    Science.gov (United States)

    Eiff, M Patrice; Hollander-Rodriguez, Joyce; Skariah, Joe; Young, Richard; Waller, Elaine; Dexter, Eve; O'Neill, Thomas R; Peabody, Michael R; Green, Larry A; Carney, Patricia A

    2017-09-01

    The scope of practice among primary care providers varies, and studies have shown that family physicians' scope may be shrinking. We studied the scope of practice among graduates of residencies associated with Preparing the Personal Physician for Practice (P4) and how length of training and individualized education innovations may influence scope. We surveyed graduates 18 months after residency between 2008 and 2014. The survey measured self-reported practice characteristics, scope of practice and career satisfaction. We assessed scope using individual practice components (25 clinical activities, 30 procedures) and a scaled score (P4-SOP) that measured breadth of practice scope. We conducted subgroup analyses according to exposure to innovations over the project period and exposure to specific innovations. No significant differences were found in mean P4-SOP scores between the Pre and Full P4 groups. Compared to national data, P4 graduates reported higher rates for vaginal deliveries (19.3% vs 9.2%), adult inpatient care (48.5% vs 33.7%) and nursing home care (25.4 vs 11.7%) in practice. Graduates exposed to innovations that lengthened training, compared to standard training length, were more likely to include adult hospital care (58.2% vs 38.5%, P=0.002), adult ICU care (30.6% vs 19.2%, P=0.047) and newborn resuscitation (25.6% vs 14%, P=0.028) in their practice and performed 19/30 procedures at higher rates. Graduates of programs with individualized training innovations reported no significant differences in scope compared to graduates without this innovation. Graduates of residencies engaged in significant educational redesign report a broad scope of practice. Innovations around the length of training may broaden scope and individualized education appears not to constrict scope.

  6. Particle deposition in ventilation ducts

    Energy Technology Data Exchange (ETDEWEB)

    Sippola, Mark Raymond [Univ. of California, Berkeley, CA (United States)

    2002-09-01

    Exposure to airborne particles is detrimental to human health and indoor exposures dominate total exposures for most people. The accidental or intentional release of aerosolized chemical and biological agents within or near a building can lead to exposures of building occupants to hazardous agents and costly building remediation. Particle deposition in heating, ventilation and air-conditioning (HVAC) systems may significantly influence exposures to particles indoors, diminish HVAC performance and lead to secondary pollutant release within buildings. This dissertation advances the understanding of particle behavior in HVAC systems and the fates of indoor particles by means of experiments and modeling. Laboratory experiments were conducted to quantify particle deposition rates in horizontal ventilation ducts using real HVAC materials. Particle deposition experiments were conducted in steel and internally insulated ducts at air speeds typically found in ventilation ducts, 2-9 m/s. Behaviors of monodisperse particles with diameters in the size range 1-16 μm were investigated. Deposition rates were measured in straight ducts with a fully developed turbulent flow profile, straight ducts with a developing turbulent flow profile, in duct bends and at S-connector pieces located at duct junctions. In straight ducts with fully developed turbulence, experiments showed deposition rates to be highest at duct floors, intermediate at duct walls, and lowest at duct ceilings. Deposition rates to a given surface increased with an increase in particle size or air speed. Deposition was much higher in internally insulated ducts than in uninsulated steel ducts. In most cases, deposition in straight ducts with developing turbulence, in duct bends and at S-connectors at duct junctions was higher than in straight ducts with fully developed turbulence. Measured deposition rates were generally higher than predicted by published models. A model incorporating empirical equations based on the

  7. Neuromuscular paralysis for newborn infants receiving mechanical ventilation.

    Science.gov (United States)

    Cools, F; Offringa, M

    2005-04-18

    Ventilated newborn infants breathing in asynchrony with the ventilator are at risk for complications during mechanical ventilation, such as pneumothorax or intraventricular hemorrhage, and are exposed to more severe barotrauma, which consequently could impair their clinical outcome. Neuromuscular paralysis, which eliminates spontaneous breathing efforts of the infant, has potential advantages in this respect. However, a number of complications have been reported with muscle relaxation in infants, so that concerns exist regarding the safety of prolonged neuromuscular paralysis in newborn infants. To determine whether routine neuromuscular paralysis of newborn infants receiving mechanical ventilation compared with no routine paralysis results in clinically important benefits or harms. The Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1, 2004), MEDLINE (from 1966 to April 2004) and EMBASE (from 1988 to April 2004) were searched. References of review articles were hand searched. Language restriction was not imposed. All trials using random or quasi-random patient allocation, in which the routine use of neuromuscular blocking agents during mechanical ventilation was compared to no paralysis or selective paralysis in newborn infants. Methodological quality was assessed blindly and independently by the two authors. Data were abstracted using standard methods of the Cochrane Collaboration and its Neonatal Review Group, with independent evaluation of trial quality, and abstraction and synthesis of data by both authors. Treatment effect was analysed using relative risk, risk difference and weighted mean difference. Ten possibly eligible trials were identified, of which six were included in the review. All the included trials studied preterm infants ventilated for respiratory distress syndrome, and used pancuronium as the neuromuscular blocking agent. In the analysis of the results of all trials, no significant difference was found in

  8. Effect of body position on ventilation distribution in ventilated preterm infants.

    Science.gov (United States)

    Hough, Judith L; Johnston, Leanne; Brauer, Sandy; Woodgate, Paul; Schibler, Andreas

    2013-02-01

    Positioning is considered vital to the maintenance of good lung ventilation by optimizing oxygen transport and gas exchange in ventilated premature infants. Previous studies suggest that the prone position is advantageous; however, no data exist on regional ventilation distribution for this age group. To investigate the effect of body position on regional ventilation distribution in ventilated and nonventilated preterm infants using electrical impedance tomography. Randomized crossover study design. Neonatal ICU. A total of 24 ventilated preterm infants were compared with six spontaneously breathing preterm infants. Random assignment of the order of the positions supine, prone, and quarter prone. Ventilation distribution was measured with regional impedance amplitudes and global inhomogeneity indices using electrical impedance tomography. In the spontaneously breathing infants, regional impedance amplitudes were increased in the posterior compared with the anterior lung (p < 0.01) and in the right compared with the left lung (p = 0.03). No differences were found in the ventilated infants. Ventilation was more inhomogeneous in the ventilated compared with the healthy infants (p < 0.01). Assessment of temporal regional lung filling showed that the posterior lung filled earlier than the anterior lung in the spontaneously breathing infants (p < 0.02) whereas in the in the ventilated infants the right lung filled before the left lung (p < 0.01). In contrast to previous studies showing that ventilation is distributed to the nondependent lung in infants and children, this study shows that gravity has little effect on regional ventilation distribution.

  9. Should Title 24 Ventilation Requirements Be Amended to include an Indoor Air Quality Procedure?

    Energy Technology Data Exchange (ETDEWEB)

    Dutton, Spencer M.; Mendell, Mark J.; Chan, Wanyu R.

    2013-05-13

    Minimum outdoor air ventilation rates (VRs) for buildings are specified in standards, including California?s Title 24 standards. The ASHRAE ventilation standard includes two options for mechanically-ventilated buildings ? a prescriptive ventilation rate procedure (VRP) that specifies minimum VRs that vary among occupancy classes, and a performance-based indoor air quality procedure (IAQP) that may result in lower VRs than the VRP, with associated energy savings, if IAQ meeting specified criteria can be demonstrated. The California Energy Commission has been considering the addition of an IAQP to the Title 24 standards. This paper, based on a review of prior data and new analyses of the IAQP, evaluates four future options for Title 24: no IAQP; adding an alternate VRP, adding an equivalent indoor air quality procedure (EIAQP), and adding an improved ASHRAE-like IAQP. Criteria were established for selecting among options, and feedback was obtained in a workshop of stakeholders. Based on this review, the addition of an alternate VRP is recommended. This procedure would allow lower minimum VRs if a specified set of actions were taken to maintain acceptable IAQ. An alternate VRP could also be a valuable supplement to ASHRAE?s ventilation standard.

  10. Economies of scope in Danish primary care practices

    DEFF Research Database (Denmark)

    Kristensen, Troels; Rose Olsen, Kim

    2011-01-01

    Aim: We analyze total operating costs and activities in Danish General Practice units to assess whether there are unexploited economies of scope in the production of primary care services. Methods: We apply stochastic frontier analysis to derive cost functions and associated cost complementarities...... between GP services and overall economies of scope. Data: Cross-section data for a sample of 331 primary care practices with 1-8 GPs from the year 2006. This is a unique combined dataset consisting of survey and register data. Results: We find a trend towards cost complementarities between the production...... economies of scope in the production of GP services. Conclusions: Our preliminary results show that there were overall economies of scope associated with the joint production of a) standard consultations, b) email/phone consultations and c) home visits. Cost complementarities between standard consultations...

  11. Continuous Procedural Full-Lung Ventilation During Minimally Invasive Coronary Bypass Grafting.

    Science.gov (United States)

    Sixt, Stephan; Aubin, Hug; Kalb, Robert; Rellecke, Philipp; Lichtenberg, Artur; Albert, Alexander

    2017-12-01

    In the past, minimally invasive cardiac surgery (MICS)- coronary artery bypass graft surgery (CABG) alternatives have been introduced that dramatically reduce the invasiveness of standard operative procedures while still showing excellent clinical outcomes. However, in patients with high morbidity, reduced lung function impeding single-lung ventilation is one of the major concerns for MICS-CABG procedures, although those patients might reap the largest benefit from a procedure of reduced invasiveness. Here, we describe a simple surgical technique-the fan technique-that allows for continuous full-lung ventilation with unimpeded surgical view during common MICS-CABG procedures. To evaluate the procedural feasibility of this technique, we analyzed intraoperative ventilation measurements of 22 consecutive MICS-CABG patients in whom the fan technique was used. This study demonstrates a significant improvement of standard respiratory measurements during procedural full-lung ventilation using the fan technique as compared with conventional single-lung ventilation (ventilation pressure 21.4 ± 3.2 versus 26.6 ± 3 mbar, p ventilation 294.9 ± 74.6 versus 153.2 ± 71 mm Hg, p single-lung ventilation owing to reduced pulmonary function, but also may soon also become a standard procedure for MICS-CABG surgery, especially with regard to procedures involving complex and time-consuming multivessel revascularizations. However, further studies are strongly warranted to assess whether the fan technique may also decrease postoperative pulmonary complications and benefit clinical outcome indicators. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  12. Weaning injured patients with prolonged pulmonary failure from mechanical ventilation in a non-intensive care unit setting.

    Science.gov (United States)

    deBoisblanc, M W; Goldman, R K; Mayberry, J C; Brand, D M; Pangburn, P D; Soifer, B E; Mullins, R J

    2000-08-01

    (n = 37). Implementation of a program using bilevel ventilation to support the terminal phase of weaning seriously injured patients from mechanical ventilation was successful. After initiating this mode in the ICU, it was satisfactorily continued in standard surgical wards. Because this method enabled the withdrawal of ventilatory support in a non-ICU setting, its major advantage was reducing ICU length of stay.

  13. Implications of natural occlusion of ventilated racks on ammonia and sanitation practices.

    Science.gov (United States)

    Creamer, Michelle A; Petty, Joann; Martin, Tara; Bergdall, Valerie; Hickman-Davis, Judy M

    2014-03-01

    Examination of ventilated rat racks prior to semiannual sanitation revealed silicone nozzles and ventilation ports that were partially or completely occluded with granular debris. We subsequently sought to document performance standards for rack sanitation and investigate the effect of ventilation port occlusion on rack function and animal husbandry practices. We hypothesized that individually ventilated cages with occluded airflow would require more frequent cage changes, comparable to those for static cages (that is, every 3 to 4 d). Sprague-Dawley rats were housed under one of 4 conditions: no airflow occlusion, occluded air-supply inlet, occluded air-exhaust outlet, and occlusion of both inlet and outlet. Cages were changed when daily ammonia concentration exceeded 20 ppm or after 14 d had elapsed. Most cages with unoccluded or partial airflow occlusion remained below the 20 ppm limit until day 12 or 13. Cages with occlusion of both inlet and outlet exceeded 20 ppm ammonia by as early as day 5. Airflow was significantly lower in cages with occlusion of both inlet and outlet airflow. Weekly inspection revealed that occlusion of ventilation ports was detectable by 3 mo after semiannual sanitation. This study demonstrates that silicone nozzles should be removed prior to rack sanitation to improve the effectiveness of cleaning ventilation ports and nozzles. While the rack is in use, silicone nozzles and ventilation ports should be inspected regularly to identify occlusion that is likely to diminish environmental quality in the cage. Intracage ammonia levels are significantly higher when both inlet and outlet airflow are occluded.

  14. Fire protection countermeasures for containment ventilation systems

    Energy Technology Data Exchange (ETDEWEB)

    Alvares, N.; Beason, D.; Bergman, V.; Creighton, J.; Ford, H.; Lipska, A.

    1980-08-25

    The goal of this project is to find countermeasures to protect High Efficiency Particulate Air (HEPA) filters, in exit ventilation ducts, from the heat and smoke generated by fire. Initially, methods were developed to cool fire-heated air by fine water spray upstream of the filters. It was recognized that smoke aerosol exposure to HEPA filters could also cause disruption of the containment system. Through testing and analysis, several methods to partially mitigate the smoke exposure to the HEPA filters were identified. A continuous, movable, high-efficiency prefilter using modified commercial equipment was designed. The technique is capable of protecting HEPA filters over the total time duration of the test fires. The reason for success involved the modification of the prefiltration media. Commercially available filter media has particle sorption efficiency that is inversely proportional to media strength. To achieve properties of both efficiency and strength, rolling filter media were laminated with the desired properties. The approach was Edisonian, but truncation in short order to a combination of prefilters was effective. The application of this technique was qualified, since it is of use only to protect HEPA filters from fire-generated smoke aerosols. It is not believed that this technique is cost effective in the total spectrum of containment systems, especially if standard fire protection systems are available in the space. But in areas of high-fire risk, where the potential fuel load is large and ignition sources are plentiful, the complication of a rolling prefilter in exit ventilation ducts to protect HEPA filters from smoke aerosols is definitely justified.

  15. Safety and Effectiveness of a Novel Facemask for Positive Pressure Ventilation.

    Science.gov (United States)

    Brown, Tod A; Szabo, Tamas A; Bridges, Kathryn H; Sabbagh, Michel J; Hand, William R; Wolf, Bethany J; Warters, Robert D

    2017-11-10

    Manual positive pressure ventilation is an essential skill in a variety of clinical situations. The C&E technique is commonly used with standard facemasks to provide effective ventilation. The Tao mask is a novel design that allows a more ergonomic grip. A seal between the mask and face is made with downward pressure of the palm, centered on the mask, and jaw lift is achieved with 4 fingers centered under the mandible. The purpose of this study was to evaluate the safety and effectiveness of the Tao mask compared to a standard mask before and after the administration of neuromuscular blockade (NMB) using 2 previously established ventilation scales. One hundred fifty-two patients >18 years of age who were scheduled for general anesthesia were recruited. All care team members were shown a brief instructional video on the use of the Tao mask. After induction of general anesthesia with a standardized protocol, each patient was ventilated with both the standard (Vital Signs #082510) and Tao masks and effectiveness was measured using the Han and Warters scales. This process was repeated after NMB. The sequence of masks was determined with a random-number generator. Tao mask ventilation scores were significantly better than standard mask scores on both the Han scale and the Warters scale before the administration of NMB (P effectiveness compared to a standard mask. The study design favored the standard mask because all participating practitioners had multiple years of experience with the standard mask and no prior experience with the Tao mask. Since the incidence of inadequate mask ventilation goes up significantly with inexperienced operators, the improved effectiveness of the Tao mask could be even more profound with novice operators.

  16. 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....... The indoor climate and the energy consumption were estimated based on a simplified calculation of the variation of the water content within the bathroom during a day. The results showed that the DCV system controlled by occupancy and relative humidity had an improved energy performance and an improved indoor...

  17. Noninvasive ventilation for acute respiratory failure.

    Science.gov (United States)

    Jasmer, R M; Matthay, M A

    2000-01-01

    Noninvasive ventilation refers to any form of ventilatory support applied without the use of an endotracheal tube. It offers the potential to provide primary treatment for acute respiratory failure while avoiding complications associated with mechanical ventilation with endotracheal intubation. Noninvasive ventilation has been most commonly studied in hypercapnic respiratory failure. A review of randomized, controlled studies shows mixed results and methodologic limitations affect the interpretation of current evidence. Patient selection is clearly the most important issue in considering noninvasive ventilation for acute respiratory failure. Unfortunately, patients who benefit from noninvasive ventilation represent only a minority of the total group with any one disease, and thus it is difficult to make broad conclusions concerning applicability of this treatment modality. Future studies are needed to focus on determining the specific patient populations who will benefit the most, evaluating the optimal ventilatory mode and mask for providing noninvasive ventilation, and clarifying its impact on clinical outcomes.

  18. Mechanical ventilation in patients in the intensive care unit of a general university hospital in southern Brazil: an epidemiological study.

    Science.gov (United States)

    Fialkow, Léa; Farenzena, Maurício; Wawrzeniak, Iuri Christmann; Brauner, Janete Salles; Vieira, Sílvia Regina Rios; Vigo, Alvaro; Bozzetti, Mary Clarisse

    2016-03-01

    To determine the characteristics, the frequency and the mortality rates of patients needing mechanical ventilation and to identify the risk factors associated with mortality in the intensive care unit (ICU) of a general university hospital in southern Brazil. Prospective cohort study in patients admitted to the ICU who needed mechanical ventilation for at least 24 hours between March 2004 and April 2007. A total of 1,115 patients admitted to the ICU needed mechanical ventilation. The mortality rate was 51%. The mean age (± standard deviation) was 57±18 years, and the mean Acute Physiology and Chronic Health Evaluation II (APACHE II) score was 22.6±8.3. The variables independently associated with mortality were (i) conditions present at the beginning of mechanical ventilation, age (hazard ratio: 1.01; pmechanical ventilation; and renal (hazard ratio: 1.29; p=0.011) and neurological (hazard ratio: 1.25; p=0.024) failure, and (ii) conditions occurring during the course of mechanical ventilation, acute lung injuri/acute respiratory distress syndrome (hazard ratio: 1.31; pmechanical ventilation patients in South America. The mortality rate of patients who required mechanical ventilation was higher, which may have been related to the severity of illness of the patients admitted to our ICU. Risk factors for hospital mortality included conditions present at the start of mechanical ventilation conditions that occurred during mechanical support.

  19. Sorbent Scoping Studies

    Energy Technology Data Exchange (ETDEWEB)

    Chancellor, Christopher John [Los Alamos National Lab. (LANL), Carlsbad, NM (United States). Difficult Waste Team

    2016-11-14

    The Los Alamos National Laboratory–Carlsbad Operations (LANL-CO) office was tasked by the DOE CBFO, Office of the Manager to perform a review of the acceptable knowledge (AK) to identify the oxidizers and sorbents in transuranic (TRU) waste streams, to conduct scoping studies on the oxidizers and sorbents identified in AK review to inform the Quality Level 1 (QL1) testing, and to conduct a series of QL1 tests to provide the scientific data to support a basis of knowledge document for determining the criteria for (1) accepting waste at the Waste Isolation Pilot Plant (WIPP) without treatment, (2) determining waste that will require treatment, and (3) if treatment is required, how the treatment must be performed. The purpose of this report is to present the results of the AK review of sorbents present in active waste streams, provide a technical analysis of the sorbent list, report the results of the scoping studies for the fastest-burning organic sorbent, and provide the list of organic and inorganic sorbents to be used in the development of a Test Plan for Preparation and Testing of Sorbents Mixed with Oxidizer found in Transuranic Waste (DWT-TP-001). The companion report, DWT-RPT-001, Oxidizer Scoping Studies, has similar information for oxidizers identified during the AK review of TRU waste streams. The results of the oxidizer and sorbent scoping studies will be used to inform the QL1 test plan. The QL1 test results will support the development of a basis of knowledge document that will evaluate oxidizing chemicals and sorbents in TRU waste and provide guidance for treatment.

  20. Scoping endangered futures

    DEFF Research Database (Denmark)

    Blok, Anders

    2017-01-01

    -media events, drawing on scientific, artistic, and mass media registers, and embodied in what Karin Knorr Cetina call scoping devices of information and visualization, involving particular ‘fateful’ time transactions. These conceptual suggestions are illustrated and elaborated by drawing on auto......-ethnographic observations during a particular event of intense futurity, that of the international COP15 climate change conference held in Copenhagen during December of 2009....

  1. Lower-Temperature Subsurface Layout and Ventilation Concepts

    Energy Technology Data Exchange (ETDEWEB)

    Christine L. Linden; Edward G. Thomas

    2001-06-20

    This analysis combines work scope identified as subsurface facility (SSF) low temperature (LT) Facilities System and SSF LT Ventilation System in the Technical Work Plan for Subsurface Design Section FY 01 Work Activities (CRWMS M&O 2001b, pp. 6 and 7, and pp. 13 and 14). In accordance with this technical work plan (TWP), this analysis is performed using AP-3.10Q, Analyses and Models. It also incorporates the procedure AP-SI.1Q, Software Management. The purpose of this analysis is to develop an overall subsurface layout system and the overall ventilation system concepts that address a lower-temperature operating mode for the Monitored Geologic Repository (MGR). The objective of this analysis is to provide a technical design product that supports the lower-temperature operating mode concept for the revision of the system description documents and to provide a basis for the system description document design descriptions. The overall subsurface layout analysis develops and describes the overall subsurface layout, including performance confirmation facilities (also referred to as Test and Evaluation Facilities) for the Site Recommendation design. This analysis also incorporates current program directives for thermal management.

  2. Academy of Nutrition and Dietetics: Scope of Practice for the Registered Dietitian.

    Science.gov (United States)

    2013-06-01

    The Scope of Practice for the RD provides standards and tools to guide competence in performing nutrition and dietetics practice. Composed of statutory and individual components, the RD's scope of practice is determined by state statute and the RD's individual scope of practice is based on education, training, credentialing, and demonstrated and documented competence in practice. The Scope of Practice for the RD reflects the Academy's position on the RD's scope of practice and the essential role of the RD in directing and coordinating safe, timely, person-centered care for the delivery of quality food and nutrition services.

  3. Patient-ventilator asynchrony during noninvasive ventilation: a bench and clinical study

    National Research Council Canada - National Science Library

    Carteaux, Guillaume; Lyazidi, Aissam; Cordoba-Izquierdo, Ana; Vignaux, Laurence; Jolliet, Philippe; Thille, Arnaud W; Richard, Jean-Christophe M; Brochard, Laurent

    2012-01-01

    ...—and dedicated NIV ventilators. First, a bench model simulating spontaneous breathing efforts was used to assess the respective impact of inspiratory and expiratory leaks on cycling and triggering functions in 19 ventilators...

  4. Luftkvalitet i nyere skoler uden mekanisk ventilation

    DEFF Research Database (Denmark)

    Aggerholm, Søren

    I skoler uden mekanisk ventilation må der udluftes konsekvent for at forbedre luftkvaliteten. Rapporten viser resultatet af målinger af kuldioxidkoncentrationen i fire skoler uden mekanisk ventilation og én skole med mekanisk udsugning. Kuldioxidkoncentrationen er brugt som indikator...... for luftkvaliteten. Rapporten beskriver desuden de energimæssige konsekvenser ved at etablere mekanisk ventilation. Resultaterne har især interesse for skoleforvaltninger og rådgivende teknikere....

  5. Advanced Uses of Pulse Oximetry for Monitoring Mechanically Ventilated Patients.

    Science.gov (United States)

    Tusman, Gerardo; Bohm, Stephan H; Suarez-Sipmann, Fernando

    2017-01-01

    Pulse oximetry is an undisputable standard of care in clinical monitoring. It combines a spectrometer to detect hypoxemia with a plethysmograph for the diagnosis, monitoring, and follow-up of cardiovascular diseases. These pulse oximetry capabilities are extremely useful for assessing the respiratory and circulatory status and for monitoring of mechanically ventilated patients. On the one hand, the key spectrography-derived function of pulse oximetry is to evaluate a patient's gas exchange that results from a particular ventilatory treatment by continuously and noninvasively measuring arterial hemoglobin saturation (SpO2). This information helps to maintain patients above the hypoxemic levels, leading to appropriate ventilator settings and inspired oxygen fractions. However, whenever higher than normal oxygen fractions are used, SpO2 can mask existing oxygenation defects in ventilated patients. This limitation, resulting from the S shape of the oxyhemoglobin saturation curve, can be overcome by reducing the oxygen fraction delivered to the patient in a controlled and stepwise manner. This results in a SpO2/FIO2 diagram, which allows a rough characterization of a patient's gas exchange, shunt, and the amount of lung area with a low ventilation/perfusion ratio without the need of blood sampling. On the other hand, the photoplethysmography-derived oximeter function has barely been exploited for the purpose of monitoring hemodynamics in mechanically ventilated patients. The analysis of the photoplethysmography contour provides useful real-time and noninvasive information about the interaction of heart and lungs during positive pressure ventilation. These hemodynamic monitoring capabilities are related to both the assessment of preload dependency-mainly by analyzing the breath-by-breath variation of the photoplethysmographic signals-and the analysis of arterial impedance, which examines the changes in the plethysmographic amplitude, contour, and derived indexes. In this

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-06-01

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

  7. Predicting Ventilation Failure in Children with Inhalation Injury.

    Science.gov (United States)

    1994-08-01

    tracheobron- supported adequately by mechanical ventilation would chitis and oxygenation abnormalities after 2 to 4 weeks of allow rapid enrollment of...these patients in trials of mechanical ventilation . Ventilatory indexes obtained early in new support techniques such as extracorporeal CO2 the...not be adequately supported by mechanical ventilation after smoke monary ventilation , combined liquid-gas ventilation , inhalation injury. Early

  8. Outcomes of Mechanically Ventilated Critically Ill Geriatric Patients in Intensive Care Unit.

    Science.gov (United States)

    Aggarwal, Vivek; Singh, Rajeshwar; Singh, Jung Bahadur; Bawa, Jps; Gaur, Nimish; Kumar, Sandeep; Nagesh, I V

    2017-07-01

    Increase in life expectancy across the globe has led to rise in geriatric population. Geriatric population is now living longer and healthier. This rise in geriatric population has also led to increase in the geriatric ailments leading to increased number of geriatric patients requiring intensive care including mechanical ventilation. Data on outcomes of geriatric patients requiring mechanical ventilation from India is scarce. To study the profile and outcome of geriatric patients more than equal to 60 years requiring mechanical ventilation in Intensive Care Unit (ICU). The data of all the geriatric patients, more than 60 years of age, admitted to ICU between January 2008 to August 2014 requiring mechanical ventilation for various reasons were extracted from the hospital records. Various reasons for ventilation, duration of ventilation/hospital stay, mortality and associated comorbidities were recorded and analysed. Total 140 geriatric patients were mechanically ventilated in the study period, out of which 43.5% (61/140) were above 70 years of age and 67.8% (95/140) were above 65 years of age. Chronic Obstructive Pulmonary Disease (COPD) was the most common cause for mechanical ventilation constituting 20% of patients followed by severe sepsis (17.8%), cerebro-vascular accident (12.8%), post-surgical patients (12.8%) and Coronary Artery Disease (CAD) in 10%. In our study, 44.28% of the geriatric patients requiring mechanical ventilation in the ICU were successfully weaned off the ventilator. Early tracheostomy helped in weaning off from ventilator as 83.33% (5/6) of patients requiring tracheostomy could be weaned off the ventilator suggesting that tracheostomy may help in improving the outcome. Reintubation carried a very poor prognosis and increased mortality, as 80% (4/5) of the patients who were reintubated in our study could not survive. Our study revealed that in appropriate intensive care setting and with standard protocol based therapy for primary ailments

  9. Recent Development to Integrate Ventilative Cooling in the Danish Regulatory Context

    DEFF Research Database (Denmark)

    Heiselberg, Per; Duer, Karsten

    2013-01-01

    The paper describes the actual and recent developments with regard to integration of ventilative cooling in building regulations, standards and energy compliance tool in Denmark. The paper also gives some recommendation on what is needed in the future in standards and compliance tools....

  10. High-Frequency Percussive Ventilation and Low Tidal Volume Ventilation in Burns: A Randomized Controlled Trial

    Science.gov (United States)

    2010-01-01

    care units, high-frequency percussive ventilation is preferentially used to provide mechanical ventilation in support of patients with acute lung... mechanical ventilation were admitted to the burn intensive care unit. The study was conducted over a 3-yr period between April 2006 and May 2009. This trial...was registered with ClinicalTrials.gov as NCT00351741. Interventions: Subjects were randomly assigned to receive mechanical ventilation through a high

  11. Comparison of Work of Breathing During Mechanical Ventilation Using Assist Control and Intermittent Mandatory Ventilation

    Science.gov (United States)

    1994-07-19

    AD-A285 516 AD MIPR NO: 92MM2539 TITLE: COMPARISON OF WORK OF BREATHING DURING MECHANICAL VENTILATION USING ASSIST CONTROL AND INTERMITTENT MANDATORY...1993, for the subject MIPR, titled: Comparison of Work of Breathing During Mechanical Ventilation Using Assist Control and Intermittent Mandatory...MIPR 92MM2539, titled: Comparison of Work of Breathing During Mechanical Ventilation Using Assist Control and Intermittent Mandatory Ventilation . 2

  12. Neurally adjusted ventilatory assist: a ventilation tool or a ventilation toy?

    Science.gov (United States)

    Verbrugghe, Walter; Jorens, Philippe G

    2011-03-01

    Mechanical ventilation has, since its introduction into clinical practice, undergone a major evolution from controlled ventilation to various modes of assisted ventilation. Neurally adjusted ventilatory assist (NAVA) is the newest development. The implementation of NAVA requires the introduction of a catheter to measure the electrical activity of the diaphragm (EA(di)). NAVA relies, opposite to conventional assisted ventilation modes, on the EA(di) to trigger the ventilator breath and to adjust the ventilatory assist to the neural drive. The amplitude of the ventilator assist is determined by the instantaneous EA(di) and the NAVA level set by the clinician. The NAVA level amplifies the EA(di) signal and determines instantaneous ventilator assist on a breath-to-breath basis. Experimental and clinical data suggest superior patient-ventilator synchrony with NAVA. Patient-ventilator asynchrony is present in 25% of mechanically ventilated patients in the intensive care unit and may contribute to patient discomfort, sleep fragmentation, higher use of sedation, development of delirium, ventilator-induced lung injury, prolonged mechanical ventilation, and ultimately mortality. With NAVA, the reliance on the EA(di) signal, together with an intact ventilatory drive and intact breathing reflexes, allows integration of the ventilator in the neuro-ventilatory coupling on a higher level than conventional ventilation modes. The simple monitoring of the EA(di) signal alone may provide the clinician with important information to guide ventilator management, especially during the weaning process. Although, until now, little evidence proves the superiority of NAVA on clinically relevant end points, it seems evident that patient populations (eg, COPD and small children) with major patient-ventilator asynchrony may benefit from this new ventilatory tool.

  13. Elective high frequency oscillatory ventilation versus conventional ventilation for acute pulmonary dysfunction in preterm infants.

    Science.gov (United States)

    Cools, Filip; Offringa, Martin; Askie, Lisa M

    2015-03-19

    Respiratory failure due to lung immaturity is a major cause of mortality in preterm infants. Although the use of intermittent positive pressure ventilation (IPPV) in neonates with respiratory failure saves lives, its use is associated with lung injury and chronic lung disease. A newer form of ventilation called high frequency oscillatory ventilation has been shown in experimental studies to result in less lung injury. The objective of this review was to determine the effect of the elective use of high frequency oscillatory ventilation (HFOV) as compared to conventional ventilation (CV) on the incidence of chronic lung disease (CLD), mortality and other complications associated with prematurity and assisted ventilation in preterm infants who were mechanically ventilated for respiratory distress syndrome (RDS). Searches were made of the Oxford Database of Perinatal Trials, MEDLINE, EMBASE, previous reviews including cross references, abstracts, conference and symposia proceedings; and from expert informants and handsearching of journals by The Cochrane Collaboration, mainly in the English language. The search was updated in January 2009 and again in November 2014. Randomised controlled trials comparing HFOV and CV in preterm or low birth weight infants with pulmonary dysfunction, mainly due to RDS, who required assisted ventilation. Randomisation and commencement of treatment needed to be as soon as possible after the start of CV and usually in the first 12 hours of life. The methodological quality of each trial was independently reviewed by the review authors. The standard effect measures were relative risk (RR) and risk difference (RD). From 1/RD the number needed to benefit (NNTB) to produce one outcome was calculated. For all measures of effect, 95% confidence intervals (CIs) were used. For interpretation of subgroup analyses, a P value for subgroup differences as well as the I(2) statistic for between-subgroup heterogeneity were calculated. Meta-analysis was

  14. Concentration Distribution in a Mixing Ventilated Room

    DEFF Research Database (Denmark)

    Jensen, Rasmus Lund; Pedersen, D. N.; Nielsen, Peter Vilhelm

    2001-01-01

    Today there is an increasing focus on the importance of a proper ventilation system to obtain good working conditions in the term of air and thermal quality to ensure high productivity. Different ventilation principles are used, e.g., mixing ventilation and displacement ventilation. In order....... Full scale experiments along with a breathing thermal manikin (BTM) have been used. The results show that the location of the sources is of great importance, just as well as temperature differences. Furthermore, the concentration in the breathing zone showed large differences throughout the room....

  15. Sleep and Mechanical Ventilation in Critical Care.

    Science.gov (United States)

    Blissitt, Patricia A

    2016-06-01

    Sleep disturbances in critically ill mechanically ventilated patients are common. Although many factors may potentially contribute to sleep loss in critical care, issues around mechanical ventilation are among the more complex. Sleep deprivation has systemic effects that may prolong the need for mechanical ventilation and length of stay in critical care and result in worse outcomes. This article provides a brief review of the physiology of sleep, physiologic changes in breathing associated with sleep, and the impact of mechanical ventilation on sleep. A summary of the issues regarding research studies to date is also included. Recommendations for the critical care nurse are provided. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Mechanical ventilation of the anesthetized patient.

    Science.gov (United States)

    Damico, Nicole K

    2015-03-01

    Patients who require general anesthesia to undergo a surgical procedure often require mechanical ventilation during the perioperative period. Ventilators incorporated into modern anesthesia machines offer various options for patient management. The unique effects of general anesthesia and surgery on pulmonary physiology must be considered when selecting an individualized plan for mechanical ventilation during the perioperative period. In this article, the pulmonary effects of general anesthesia are reviewed and available options for mechanical ventilation of the anesthetized patient during the perioperative period are presented. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Concentration Distribution in a Mixing Ventilated Room

    DEFF Research Database (Denmark)

    Jensen, Rasmus Lund; Pedersen, D.N.; Nielsen, Peter V.

    2001-01-01

    Today there is an increasing focus on the importance of a proper ventilation system to obtain good working conditions in the term of air and thermal quality to ensure high productivity. Different ventilation principles are used, e.g., mixing ventilation and displacement ventilation. In order...... that the air is fully mixed. The objective of this work is to determine the influence of the location of a pollutant, temperature differences and whether the room is furnished or not. It is also investigated if it is sufficient to determine the mean concentration in the room to determine the personal exposure...

  18. Fractal nature of regional ventilation distribution.

    Science.gov (United States)

    Altemeier, W A; McKinney, S; Glenny, R W

    2000-05-01

    High-resolution measurements of pulmonary perfusion reveal substantial spatial heterogeneity that is fractally distributed. This observation led to the hypothesis that the vascular tree is the principal determinant of regional blood flow. Recent studies using aerosol deposition show similar ventilation heterogeneity that is closely correlated with perfusion. We hypothesize that ventilation has fractal characteristics similar to blood flow. We measured regional ventilation and perfusion with aerosolized and injected fluorescent microspheres in six anesthetized, mechanically ventilated pigs in both prone and supine postures. Adjacent regions were clustered into progressively larger groups. Coefficients of variation were calculated for each cluster size to determine fractal dimensions. At the smallest size lung piece, local ventilation and perfusion are highly correlated, with no significant difference between ventilation and perfusion heterogeneity. On average, the fractal dimension of ventilation is 1.16 in the prone posture and 1. 09 in the supine posture. Ventilation has fractal properties similar to perfusion. Efficient gas exchange is preserved, despite ventilation and perfusion heterogeneity, through close correlation. One potential explanation is the similar geometry of bronchial and vascular structures.

  19. [VENTILOP survey. Survey in peroperative mechanical ventilation].

    Science.gov (United States)

    Fischer, F; Collange, O; Mahoudeau, G; Simon, M; Moussa, H; Thibaud, A; Steib, A; Pottecher, T; Mertes, M

    2014-06-01

    Mechanical ventilation can initiate ventilator-associated lung injury and postoperative pulmonary complications. The aim of this study was to evaluate (1) how mechanical ventilation was comprehended by anaesthetists (physician and nurses) and (2) the need for educational programs. A computing questionnary was sent by electronic-mail to the entire anaesthetist from Alsace region in France (297 physicians), and to a pool of 99 nurse anaesthetists. Mechanical ventilation during anaesthesia was considered as optimized when low tidal volume (6-8mL) of ideal body weight was associated with positive end expiratory pressure, FiO2 less than 50%, I/E adjustment and recruitment maneuvers. The participation rate was 50.5% (172 professionals). Only 2.3% of professionals used the five parameters for optimized ventilation. Majority of professionals considered that mechanical ventilation adjustment influenced the patients' postoperative outcome. Majority of the professionals asked for a specific educational program in the field of mechanical ventilation. Only 2.3% of professionals optimized mechanical ventilation during anaesthesia. Guidelines and specific educational programs in the field of mechanical ventilation are widely expected. Copyright © 2014 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

  20. Incidence and prognosis of ventilator-associated tracheobronchitis (TAVeM): a multicentre, prospective, observational study.

    Science.gov (United States)

    Martin-Loeches, Ignacio; Povoa, Pedro; Rodríguez, Alejandro; Curcio, Daniel; Suarez, David; Mira, Jean-Paul; Cordero, Maria Lourdes; Lepecq, Raphaël; Girault, Christophe; Candeias, Carlos; Seguin, Philippe; Paulino, Carolina; Messika, Jonathan; Castro, Alejandro G; Valles, Jordi; Coelho, Luis; Rabello, Ligia; Lisboa, Thiago; Collins, Daniel; Torres, Antonio; Salluh, Jorge; Nseir, Saad

    2015-11-01

    Ventilator-associated tracheobronchitis has been suggested as an intermediate process between tracheobronchial colonisation and ventilator-associated pneumonia in patients receiving mechanical ventilation. We aimed to establish the incidence and effect of ventilator-associated tracheobronchitis in a large, international patient cohort. We did a multicentre, prospective, observational study in 114 intensive care units (ICU) in Spain, France, Portugal, Brazil, Argentina, Ecuador, Bolivia, and Colombia over a preplanned time of 10 months. All patients older than 18 years admitted to an ICU who received invasive mechanical ventilation for more than 48 h were eligible. We prospectively obtained data for incidence of ventilator-associated lower respiratory tract infections, defined as ventilator-associated tracheobronchitis or ventilator-associated pneumonia. We grouped patients according to the presence or absence of such infections, and obtained data for the effect of appropriate antibiotics on progression of tracheobronchitis to pneumonia. Patients were followed up until death or discharge from hospital. To account for centre effects with a binary outcome, we fitted a generalised estimating equation model with a logit link, exchangeable correlation structure, and non-robust standard errors. This trial is registered with ClinicalTrials.gov, number NCT01791530. Between Sept 1, 2013, and July 31, 2014, we obtained data for 2960 eligible patients, of whom 689 (23%) developed ventilator-associated lower respiratory tract infections. The incidence of ventilator-associated tracheobronchitis and that of ventilator-associated pneumonia at baseline were similar (320 [11%; 10·2 of 1000 mechanically ventilated days] vs 369 [12%; 8·8 of 1000 mechanically ventilated days], p=0·48). Of the 320 patients with tracheobronchitis, 250 received appropriate antibiotic treatment and 70 received inappropriate antibiotics. 39 patients with tracheobronchitis progressed to pneumonia; however

  1. Aerosol penetration ratio: a new index of ventilation

    Energy Technology Data Exchange (ETDEWEB)

    Sirr, S.A.; Elliott, G.R.; Regelmann, W.E.; Juenemann, P.J.; Morin, R.L.; Boudreau, R.J.; Warwick, W.J.; Loken, M.K.

    1986-08-01

    Superimposition of nuclear medicine scintigrams and standard radiographs provides a unique opportunity for merging functional information intrinsic to nuclear medicine images with the high resolution anatomic detail of radiographs. A newly developed image processing system allows the merging of two separate films of greatly varying sizes to form a single composite image. Subsequent quantitative analysis of the composite image may be performed. Using the superimposition technique, (/sup 99m/Tc)DTPA aerosol ventilation scans (4.5 X 4.5 cm) were superimposed upon chest radiographs (35.6 X 43.2 cm) in 17 cystic fibrosis (CF) patients. Subsequent quantification of the area of nuclear scan ventilation and the radiographic lung area was then performed. A new quantitative radiologic index of ventilation, the aerosol penetration ratio (APR), was defined. Linear correlation of aerosol penetration ratio with residual volume (RV) as percent of total lung capacity (TLC) measured by body plethysmography was good. We conclude that the APR has validity as a physiologic parameter which localized regional excessive residual volume and correlates well with RV/TLC, the gold standard pulmonary function index of obstructive airway disease.

  2. 76 FR 17577 - Increased Scope of Coverage for Electric Motors

    Science.gov (United States)

    2011-03-30

    ... Part 431 RIN 1904-AC28 Increased Scope of Coverage for Electric Motors AGENCY: Office of Energy... rulemaking to set energy conservation standards for electric motors. Specifically, DOE seeks information to assist DOE in determining whether to develop energy conservation standards for certain types of electric...

  3. 16 CFR 1616.1 - Scope and application.

    Science.gov (United States)

    2010-01-01

    ... FLAMMABILITY OF CHILDREN'S SLEEPWEAR: SIZES 7 THROUGH 14 (FF 5-74) The Standard § 1616.1 Scope and application. (a) This Standard provides a test method to determine the flammability of children's sleepwear, sizes... Flammability of Children's Sleepwear: Sizes 0 through 6X (FF 3-71) (subpart A of part 1615 of this chapter) are...

  4. 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,...

  5. Ventilation strategies and outcome in randomised trials of high frequency ventilation

    OpenAIRE

    Thome, U; Carlo, W; Pohlandt, F

    2005-01-01

    Objective: Randomised controlled trials comparing elective use of high frequency ventilation (HFV) with conventional mechanical ventilation (CMV) in preterm infants have yielded conflicting results. We hypothesised that the variability of results may be explained by differences in study design, ventilation strategies, delay in initiation of HFV, and use of permissive hypercapnia.

  6. Speaking valves in tracheostomised ICU patients weaning off mechanical ventilation--do they facilitate lung recruitment?

    Science.gov (United States)

    Sutt, Anna-Liisa; Caruana, Lawrence R; Dunster, Kimble R; Cornwell, Petrea L; Anstey, Chris M; Fraser, John F

    2016-04-01

    Patients who require positive pressure ventilation through a tracheostomy are unable to phonate due to the inflated tracheostomy cuff. Whilst a speaking valve (SV) can be used on a tracheostomy tube, its use in ventilated ICU patients has been inhibited by concerns regarding potential deleterious effects to recovering lungs. The objective of this study was to assess end expiratory lung impedance (EELI) and standard bedside respiratory parameters before, during and after SV use in tracheostomised patients weaning from mechanical ventilation. A prospective observational study was conducted in a cardio-thoracic adult ICU. 20 consecutive tracheostomised patients weaning from mechanical ventilation and using a SV were recruited. Electrical Impedance Tomography (EIT) was used to monitor patients' EELI. Changes in lung impedance and standard bedside respiratory data were analysed pre, during and post SV use. Use of in-line SVs resulted in significant increase of EELI. This effect grew and was maintained for at least 15 minutes after removal of the SV (p patients' respiratory requirements at time of recruitment. In this cohort of critically ill ventilated patients, SVs did not cause derecruitment of the lungs when used in the ventilator weaning period. Deflating the tracheostomy cuff and restoring the airflow via the upper airway with a one-way valve may facilitate lung recruitment during and after SV use, as indicated by increased EELI. Anna-Liisa Sutt, Australian New Zealand Clinical Trials Registry (ANZCTR). ACTRN12615000589583. 4/6/2015.

  7. Technical Note: Correction for the effect of breathing variations in CT pulmonary ventilation imaging.

    Science.gov (United States)

    Yamamoto, Tokihiro; Kabus, Sven

    2017-10-26

    The accuracy and precision of computed tomography (CT) pulmonary ventilation imaging with conventional CT scanners are limited by breathing variations. We propose a method to correct for the effect of breathing variations in CT ventilation imaging based on external respiratory signals acquired throughout a scan. The proposed method is based on: (a) calculating voxel-by-voxel abdominal surface motion ranges using four-dimensional (4D) CT image datasets spatiotemporally correlated with external respiratory monitor data, and (b) applying the correction factor, which is defined as the ratio of the overall mean of the abdominal surface motion range in the lungs to that of each voxel, to the CT ventilation value. The performance of the proposed method was investigated by comparing voxel-wise correlations of the uncorrected and corrected CT ventilation images with single-photon emission CT (SPECT) ventilation images as a ground truth for nine patients. CT ventilation images were calculated by deformable image registration of the 4D-CT image datasets, followed by calculation of regional volume changes. A Steiger's Z-test was used to determine the statistical significance of the difference between the correlations for the uncorrected and corrected CT ventilation images. The proposed correction method resulted in significant increases (P ventilation in three patients, trends toward significant increase (P: 0.13-0.18) in two patients, no significant differences in three patients, and a significantly decreased correlation in one patient. The average standard deviation of the abdominal surface motion range in three patients showing significant increases was 0.27 (range 0.10-0.37), which was greater than 0.17 (range 0.07-0.38) in the other six patients. The proposed method to correct for the effect of breathing variations could be readily implemented and has the potential to improve the accuracy of CT ventilation imaging as demonstrated in a nine-patient study. © 2017 American

  8. 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.

  9. ROV inspection inside ventilation ducts

    Energy Technology Data Exchange (ETDEWEB)

    Sharp, R.E.; Street, P.F.; Cole, G.V. [AEA Technology, Harwell (United Kingdom)

    1996-12-31

    An instrumentation package for carrying out visual inspections and radiation monitoring within radioactive duct-work has been developed. This paper describes the first application of the package in the main ventilation duct of the Dounreay fuel cycle area. The package was deployed via a commerical ROV within a duct consisting of two parallel runs, over 300 metres long, between 0.9 and 1.7 metres high and 1.1 metres wide. An integrated, computer-controlled station was used for data collection, recording in digital form and on video tape. (Author).

  10. Potential energy savings with personalized ventilation coupled with passive chilled beams

    DEFF Research Database (Denmark)

    Lyubenova, Velina S.; Holsøe, Jan W.; Melikov, Arsen Krikor

    2011-01-01

    20% (and up to 40% when extending the temperature in the room by 2 °C above the upper limit recommended in the standards) compared to mixing ventilation only. When PV was combined with passive chilled beams, the reduction of the supplied air was up to 80%. This ventiltion strategy may lead to energy......Personalized ventilation (PV) is an individually controlled air distribution system aimed at improving inhaled air quality and thermal comfort of each occupant. Numerous studies have shown that PV may improve occupants’ health, comfort and performance in comparison with traditional total volume air...... in the present standards were considered. The most effective energy saving strategy with PV in use was to expand the upper room temperature limit as defined in the present standards. When PV was coupled with background mixing ventilation, the possible reduction of the air supplied to the room was approximately...

  11. Aerosol delivery with two ventilation modes during mechanical ventilation: a randomized study.

    Science.gov (United States)

    Dugernier, Jonathan; Reychler, Gregory; Wittebole, Xavier; Roeseler, Jean; Depoortere, Virginie; Sottiaux, Thierry; Michotte, Jean-Bernard; Vanbever, Rita; Dugernier, Thierry; Goffette, Pierre; Docquier, Marie-Agnes; Raftopoulos, Christian; Hantson, Philippe; Jamar, François; Laterre, Pierre-François

    2016-12-01

    Volume-controlled ventilation has been suggested to optimize lung deposition during nebulization although promoting spontaneous ventilation is targeted to avoid ventilator-induced diaphragmatic dysfunction. Comparing topographic aerosol lung deposition during volume-controlled ventilation and spontaneous ventilation in pressure support has never been performed. The aim of this study was to compare lung deposition of a radiolabeled aerosol generated with a vibrating-mesh nebulizer during invasive mechanical ventilation, with two modes: pressure support ventilation and volume-controlled ventilation. Seventeen postoperative neurosurgery patients without pulmonary disease were randomly ventilated in pressure support or volume-controlled ventilation. Diethylenetriaminepentaacetic acid labeled with technetium-99m (2 mCi/3 mL) was administrated using a vibrating-mesh nebulizer (Aerogen Solo(®), provided by Aerogen Ltd, Galway, Ireland) connected to the endotracheal tube. Pulmonary and extrapulmonary particles deposition was analyzed using planar scintigraphy. Lung deposition was 10.5 ± 3.0 and 15.1 ± 5.0 % of the nominal dose during pressure support and volume-controlled ventilation, respectively (p ventilation (27.4 ± 6.6 vs. 20.7 ± 6.0 %, p ventilation modes. A high intersubject variability of lung deposition was observed with both modes regarding lung doses, aerosol penetration and distribution between the right and the left lung. In the specific conditions of the study, volume-controlled ventilation was associated with higher lung deposition of nebulized particles as compared to pressure support ventilation. The clinical benefit of this effect warrants further studies. Clinical trial registration NCT01879488.

  12. Frequently Asked Questions about Ventilator-Associated Pneumonia

    Science.gov (United States)

    ... Vaccine Safety Frequently Asked Questions about Ventilator-associated Pneumonia Recommend on Facebook Tweet Share Compartir What is a Ventilator-associated Pneumonia (VAP)? Ventilator-associated pneumonia (VAP) is a lung ...

  13. Performances of domiciliary ventilators compared by using a parametric procedure

    Directory of Open Access Journals (Sweden)

    Fresnel Emeline

    2016-12-01

    Performances of domiciliary ventilators strongly depend not only on the breathing dynamics but also on the ventilator strategy. One given ventilator may be more adequate than another one for a given patient.

  14. Neuromuscular paralysis for newborn infants receiving mechanical ventilation

    NARCIS (Netherlands)

    Cools, F.; Offringa, M.

    2005-01-01

    BACKGROUND: Ventilated newborn infants breathing in asynchrony with the ventilator are at risk for complications during mechanical ventilation, such as pneumothorax or intraventricular hemorrhage, and are exposed to more severe barotrauma, which consequently could impair their clinical outcome.

  15. Hypercapnia attenuates ventilator-induced diaphragm atrophy and modulates dysfunction

    NARCIS (Netherlands)

    Schellekens, W.J.M.; Hees, H.W.H. van; Kox, M.; Linkels, M.; Acuna, G.L.; Dekhuijzen, P.N.R.; Scheffer, G.J.; Hoeven, J.G. van der; Heunks, L.M.A.

    2014-01-01

    INTRODUCTION: Diaphragm weakness induced by prolonged mechanical ventilation may contribute to difficult weaning from the ventilator. Hypercapnia is an accepted side effect of low tidal volume mechanical ventilation, but the effects of hypercapnia on respiratory muscle function are largely unknown.

  16. 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.

  17. 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....... Differences between the personalized air terminal devices were identified in terms of the cooling distribution over the manikin¿s body. The personalized ventilation supplying air from the front towards the face provided a more uniform cooling of the body than the personalized ventilation supplying air from...

  18. 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.

  19. Healthcare Technology Management (HTM) of mechanical ventilators by clinical engineers.

    Science.gov (United States)

    Yoshioka, Jun; Nakane, Masaki; Kawamae, Kaneyuki

    2014-01-01

    Mechanical ventilator failures expose patients to unacceptable risks, and maintaining mechanical ventilator safety is an important issue. We examined the usefulness of maintaining mechanical ventilators by clinical engineers (CEs) using a specialized calibrator. These evaluations and the ability to make in-house repairs proved useful for obviating the need to rent ventilators which, in turn, might prove faulty themselves. The CEs' involvement in maintaining mechanical ventilators is desirable, ensures prompt service, and, most importantly, enhances safe management of mechanical ventilators.

  20. Preoperational test report, primary ventilation system

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, F.T.

    1997-11-04

    This represents a preoperational test report for Primary Ventilation Systems, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system provides vapor space filtered venting of tanks AY101, AY102, AZ101, AZ102. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

  1. 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...

  2. YMP Engineered Barrier Systems Scaled Ventilation Testing

    Energy Technology Data Exchange (ETDEWEB)

    S.D. Dunn; B. Lowry; B. Walsh; J.D. Mar; C. Howard; R. Johnston; T. Williams

    2002-11-22

    Yucca Mountain, approximately 100 miles northwest of Las Vegas, Nevada, has been selected as the site for the nation's first geologic repository for high level nuclear waste. The Yucca Mountain Project (YMP) is currently developing the design for the underground facilities. Ventilation is a key component of the design as a way to maintain the desired thermal conditions in the emplacement drifts prior to closure. As a means of determining the effects of continuous ventilation on heat removal from the emplacement drifts two series of scaled ventilation tests have been performed. Both test series were performed in the DOE/North Las Vegas Atlas facility. The tests provided scaled (nominally 25% of the full scale emplacement drift design) thermal and flow process data that will be used to validate YMP heat and mass transport codes. The Phase I Ventilation Test series evaluated the ability of ambient ventilation air to remove energy under varying flow and input power conditions. The Phase II Ventilation Test series evaluated the ability of pre-conditioned ventilation air to remove energy under varying flow, input temperature and moisture content, and simulated waste package input power conditions. Twenty-two distinct ventilation tests were run.

  3. Hybrid ventilation systems and high performance buildings

    Energy Technology Data Exchange (ETDEWEB)

    Utzinger, D.M. [Wisconsin Univ., Milwaukee, WI (United States). School of Architecture and Urban Planning

    2009-07-01

    This paper described hybrid ventilation design strategies and their impact on 3 high performance buildings located in southern Wisconsin. The Hybrid ventilation systems combined occupant controlled natural ventilation with mechanical ventilation systems. Natural ventilation was shown to provide adequate ventilation when appropriately designed. Proper control integration of natural ventilation into hybrid systems was shown to reduce energy consumption in high performance buildings. This paper also described the lessons learned from the 3 buildings. The author served as energy consultant on all three projects and had the responsibility of designing and integrating the natural ventilation systems into the HVAC control strategy. A post occupancy evaluation of building energy performance has provided learning material for architecture students. The 3 buildings included the Schlitz Audubon Nature Center completed in 2003; the Urban Ecology Center completed in 2004; and the Aldo Leopold Legacy Center completed in 2007. This paper included the size, measured energy utilization intensity and percentage of energy supplied by renewable solar power and bio-fuels on site for each building. 6 refs., 2 tabs., 6 figs.

  4. Endotoxemia accelerates diaphragm dysfunction in ventilated rabbits.

    Science.gov (United States)

    Yang, Yi; Yu, Tao; Pan, Chun; Longhini, Federico; Liu, Ling; Huang, Yingzi; Guo, Fengmei; Qiu, Haibo

    2016-12-01

    Ventilators may induce diaphragm dysfunction, and most of the septic population who are admitted to the intensive care unit require mechanical ventilation. However, there is no evidence that sepsis accelerates the onset of ventilator-induced diaphragm dysfunction or affects the microcirculation. Our study investigated whether lipopolysaccharide (LPS)-induced endotoxemia accelerated diaphragm dysfunction in ventilated rabbits by evaluating microcirculation, lipid accumulation, and diaphragm contractility. After anesthesia and tracheostomy, 25 invasively monitored and mechanically ventilated New Zealand white rabbits were randomized to control (n = 5), controlled mechanical ventilation (CMV) (n = 5), pressure support ventilation (PSV; n = 5), CMV or PSV with LPS-induced endotoxemia (CMV-LPS and PSV-LPS, respectively; n = 5 for each). Rabbits were anesthetized and ventilated for 24 h, except the control rabbits (30 min). Diaphragmatic contractility was evaluated using neuromechanical and neuroventilatory efficiency. We evaluated the following at the end of the protocol: (1) diaphragm microcirculation; (2) lipid accumulation; and (3) diaphragm muscular fibers structure. Diaphragm contractility, microcirculation, lipid accumulation, and fiber structures were severely compromised in endotoxemic animals after 24 h compared to nonendotoxemic rabbits. Moreover, a slight but significant increase in lipid accumulation was observed in CMV and PSV groups compared with controls (P rabbits, affects the microcirculation, and results in diaphragmatic lipid accumulation and contractility impairment. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Simulating People Moving in Displacement Ventilated Rooms

    DEFF Research Database (Denmark)

    Mattsson, M.; Bjørn, Erik; Sandberg, M.

    A displacement ventilation system works better the more uni-directional the air flow through the ventilated room is: from floor to ceiling. Thus, from an air quality point of view, there should be as little vertical mixing of the room air as possible. It is therefore comprehensible that physical...

  6. Naturlig ventilation og træk

    DEFF Research Database (Denmark)

    Nielsen, Peter Vilhelm

    2002-01-01

    Nye ventilationsprincipper som naturlig ventilation er med til at sætte fokus på de strømningselementer, der skal anvendes til dimensionering af luftfordelingen i et rum. Artiklen anviser, hvordan træk fra vinduer og tagåbninger i rum med naturlig ventilation kan beregnes ved hjælp af...

  7. 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

  8. Carbon dioxide production during mechanical ventilation

    DEFF Research Database (Denmark)

    Henneberg, S; Söderberg, D; Groth, T

    1987-01-01

    studied CO2 production (VCO2) and oxygen consumption (VO2) in mechanically ventilated ICU patients, where CO2 stores were altered by: a) changing minute ventilation by 15%, b) reducing body temperature, and c) changing the level of sedation. Expired gases went through a mixing chamber and were analyzed...

  9. 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.

  10. Evaporation Controlled Emission in Ventilated Rooms

    DEFF Research Database (Denmark)

    Topp, Claus; Nielsen, Peter V.; Heiselberg, Per

    -scale ventilated room when the emission is fully or partly evaporation controlled. The objective of the present research work has been to investigate the change of emission rates from small-scale experiments to full-scale ventilated rooms and to investigate the influence of the local air velocity field near...

  11. Infant position in neonates receiving mechanical ventilation.

    Science.gov (United States)

    Rivas-Fernandez, May; Roqué I Figuls, Marta; Diez-Izquierdo, Ana; Escribano, Joaquin; Balaguer, Albert

    2016-11-07

    In patients of various ages undergoing mechanical ventilation (MV), it has been observed that positions other than the standard supine position, such as the prone position, may improve respiratory parameters. The benefits of these positions have not been clearly defined for critically ill newborns receiving MV.This is an update of a review first published in 2005 and last updated in 2013. Primary objectiveTo assess the effects of different positioning of newborn infants receiving MV (supine vs prone, lateral decubitus or quarter turn from prone) in improving short-term respiratory outcomes. Secondary objectiveTo assess the effects of different positioning of newborn infants receiving MV on mortality and neuromotor and developmental outcomes over the long term, and on other complications of prematurity. We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 8), MEDLINE via PubMed (1966 to 22 August 2016), Embase (1980 to 22 August 2016) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1982 to 22 August 2016). We also searched clinical trials databases, conference proceedings and reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. Randomised and quasi-randomised clinical trials comparing different positions in newborns receiving mechanical ventilation. Three unblinded review authors independently assessed trials for inclusion in the review and extracted study data. We used standard methodological procedures as expected by The Cochrane Collaboration and assessed the quality of the evidence using the GRADE approach. If the meta-analysis was not appropriate owing to substantial clinical heterogeneity between trials, we presented review findings in narrative format. We included in this review 19 trials involving 516 participants. Seven of the included studies (N = 222) had not been evaluated in the

  12. 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

  13. Effects of manual hyperinflation and suctioning in respiratory mechanics in mechanically ventilated patients with ventilator-associated pneumonia

    National Research Council Canada - National Science Library

    Choi, Jessica Siu-Ping; Jones, Alice Yee-Men

    2005-01-01

    ... in ventilator-associated pneumonia. Tracheal suction is often employed by nursing staff in the management of mechanically ventilated patients with ventilator-associated pneumonia but this technique has the potential to increase respiratory resistance...

  14. 4D CT lung ventilation images are affected by the 4D CT sorting method

    Science.gov (United States)

    Yamamoto, Tokihiro; Kabus, Sven; Lorenz, Cristian; Johnston, Eric; Maxim, Peter G.; Diehn, Maximilian; Eclov, Neville; Barquero, Cristian; Loo, Billy W.; Keall, Paul J.

    2013-01-01

    Purpose: Four-dimensional (4D) computed tomography (CT) ventilation imaging is a novel promising technique for lung functional imaging. The current standard 4D CT technique using phase-based sorting frequently results in artifacts, which may deteriorate the accuracy of ventilation imaging. The purpose of this study was to quantify the variability of 4D CT ventilation imaging due to 4D CT sorting. Methods: 4D CT image sets from nine lung cancer patients were each sorted by the phase-based method and anatomic similarity-based method, designed to reduce artifacts, with corresponding ventilation images created for each method. Artifacts in the resulting 4D CT images were quantified with the artifact score which was defined based on the difference between the normalized cross correlation for CT slices within a CT data segment and that for CT slices bordering the interface between adjacent CT data segments. The ventilation variation was quantified using voxel-based Spearman rank correlation coefficients for all lung voxels, and Dice similarity coefficients (DSC) for the spatial overlap of low-functional lung volumes. Furthermore, the correlations with matching single-photon emission CT (SPECT) ventilation images (assumed ground truth) were evaluated for three patients to investigate which sorting method provides higher physiologic accuracy. Results: Anatomic similarity-based sorting reduced 4D CT artifacts compared to phase-based sorting (artifact score, 0.45 ± 0.14 vs 0.58 ± 0.24, p = 0.10 at peak-exhale; 0.63 ± 0.19 vs 0.71 ± 0.31, p = 0.25 at peak-inhale). The voxel-based correlation between the two ventilation images was 0.69 ± 0.26 on average, ranging from 0.03 to 0.85. The DSC was 0.71 ± 0.13 on average. Anatomic similarity-based sorting yielded significantly fewer lung voxels with paradoxical negative ventilation values than phase-based sorting (5.0 ± 2.6% vs 9.7 ± 8.4%, p = 0.05), and improved the correlation with SPECT ventilation regionally. Conclusions

  15. 4D CT lung ventilation images are affected by the 4D CT sorting method.

    Science.gov (United States)

    Yamamoto, Tokihiro; Kabus, Sven; Lorenz, Cristian; Johnston, Eric; Maxim, Peter G; Diehn, Maximilian; Eclov, Neville; Barquero, Cristian; Loo, Billy W; Keall, Paul J

    2013-10-01

    Four-dimensional (4D) computed tomography (CT) ventilation imaging is a novel promising technique for lung functional imaging. The current standard 4D CT technique using phase-based sorting frequently results in artifacts, which may deteriorate the accuracy of ventilation imaging. The purpose of this study was to quantify the variability of 4D CT ventilation imaging due to 4D CT sorting. 4D CT image sets from nine lung cancer patients were each sorted by the phase-based method and anatomic similarity-based method, designed to reduce artifacts, with corresponding ventilation images created for each method. Artifacts in the resulting 4D CT images were quantified with the artifact score which was defined based on the difference between the normalized cross correlation for CT slices within a CT data segment and that for CT slices bordering the interface between adjacent CT data segments. The ventilation variation was quantified using voxel-based Spearman rank correlation coefficients for all lung voxels, and Dice similarity coefficients (DSC) for the spatial overlap of low-functional lung volumes. Furthermore, the correlations with matching single-photon emission CT (SPECT) ventilation images (assumed ground truth) were evaluated for three patients to investigate which sorting method provides higher physiologic accuracy. Anatomic similarity-based sorting reduced 4D CT artifacts compared to phase-based sorting (artifact score, 0.45 ± 0.14 vs 0.58 ± 0.24, p = 0.10 at peak-exhale; 0.63 ± 0.19 vs 0.71 ± 0.31, p = 0.25 at peak-inhale). The voxel-based correlation between the two ventilation images was 0.69 ± 0.26 on average, ranging from 0.03 to 0.85. The DSC was 0.71 ± 0.13 on average. Anatomic similarity-based sorting yielded significantly fewer lung voxels with paradoxical negative ventilation values than phase-based sorting (5.0 ± 2.6% vs 9.7 ± 8.4%, p = 0.05), and improved the correlation with SPECT ventilation regionally. The variability of 4D CT ventilation

  16. Scale and scope efficiencies through hospital consolidations.

    Science.gov (United States)

    Preyra, Colin; Pink, George

    2006-11-01

    The hospital sector in the Province of Ontario has recently completed a large scale restructuring marked by wide ranging hospital closures, mergers and program transfers. Given a generally inconclusive economics literature, regulators used an accounting, as opposed to an economic, approach when predicting gains to consolidations. This paper uses an economic cost function to examine economies of scale and scope in the years preceding restructuring, where there was little doubt that economies were possible. Issues relating to output aggregation, functional form, and scale and scope testing are addressed and an equilibrium cost function is derived from an estimated short run function to measure the cost concepts of interest. Using index and direct approaches, we examine a variety of potential reconfigurations and conclude that there were indeed large scale unexploited gains to strategic consolidation in the hospital sector. Furthermore, these gains may not have been detected using standard approaches in the literature.

  17. 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.

  18. 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 over...... 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......, 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...

  19. Short Term Airing by Natural Ventilation

    DEFF Research Database (Denmark)

    Heiselberg, Per; Perino, M.

    2010-01-01

    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......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...... principles is necessary. The present study analyses and presents the results of an experimental evaluation of airing performance in terms of ventilation characteristics, IAQ and thermal comfort. It includes investigations of the consequences of opening time, opening frequency, opening area and expected...

  20. 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.

  1. 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...

  2. 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.

  3. Housing and natural ventilation. Indoor climate, energy, reliability; Bolig og naturlig ventilation: indeklima energi driftssikkerhed

    Energy Technology Data Exchange (ETDEWEB)

    Marsh, R.; Lauring, M. (eds.)

    2003-07-01

    The aim of this book is to show how natural ventilation can be used successfully in housing. Housing ventilation aims at balancing complex and often diametrically opposed demands. This book examines the complexity with different quantitative and qualitative approaches. In the first chapter, History, the Danish housing ventilation from 1850-2002 is examined. The requirements for natural ventilation have developed historically, based upon a spatial organisation with fresh air supply to the less polluted rooms and stack effect removal from the more polluted rooms. A series of important factors relating to a healthy indoor climate, energy savings and demands for functional stability have affected this development. In the second chapter, Models, a series of architectural models for natural ventilated large building types are analysed. There has for many years been much R and D activity aimed at using natural ventilation in large buildings. Much of the knowledge about the requirements for natural ventilation (spatial organisation, fresh air supply and stack effect removal) can therefore be used in the development of naturally ventilated housing. The third chapter, Principles, develops a set of principles for naturally ventilated housing by examining the requirements relating to spatial organisation, fresh air supply, and stack effect removal. By optimizing the architectural and technical design of a typical terraced house, the three aims for the successful use of natural ventilation in housing can be achieved; a very low energy consumption and environmental impact, a healthy indoor climate and a functionally stable ventilation system. The fourth chapter, Houses, presents architectural designs for a series of naturally ventilated terraced houses. The designs focus on the use of spatial organisation, fresh air supply and stack removal to optimize the natural ventilation. Architecture and technology are integrated in the design to achieve low energy consumption, a healthy

  4. Both high level pressure support ventilation and controlled mechanical ventilation induce diaphragm dysfunction and atrophy.

    Science.gov (United States)

    Hudson, Matthew B; Smuder, Ashley J; Nelson, W Bradley; Bruells, Christian S; Levine, Sanford; Powers, Scott K

    2012-04-01

    Previous workers have demonstrated that controlled mechanical ventilation results in diaphragm inactivity and elicits a rapid development of diaphragm weakness as a result of both contractile dysfunction and fiber atrophy. Limited data exist regarding the impact of pressure support ventilation, a commonly used mode of mechanical ventilation-that permits partial mechanical activity of the diaphragm-on diaphragm structure and function. We carried out the present study to test the hypothesis that high-level pressure support ventilation decreases the diaphragm pathology associated with CMV. Sprague-Dawley rats were randomly assigned to one of the following five groups:1) control (no mechanical ventilation); 2) 12 hrs of controlled mechanical ventilation (12CMV); 3) 18 hrs of controlled mechanical ventilation (18CMV); 4) 12 hrs of pressure support ventilation (12PSV); or 5) 18 hrs of pressure support ventilation (18PSV). We carried out the following measurements on diaphragm specimens: 4-hydroxynonenal-a marker of oxidative stress, active caspase-3 (casp-3), active calpain-1 (calp-1), fiber type cross-sectional area, and specific force (sp F). Compared with the control, both 12PSV and 18PSV promoted a significant decrement in diaphragmatic specific force production, but to a lesser degree than 12CMV and 18CMV. Furthermore, 12CMV, 18PSV, and 18CMV resulted in significant atrophy in all diaphragm fiber types as well as significant increases in a biomarker of oxidative stress (4-hydroxynonenal) and increased proteolytic activity (20S proteasome, calpain-1, and caspase-3). Furthermore, although no inspiratory effort occurs during controlled mechanical ventilation, it was observed that pressure support ventilation resulted in large decrement, approximately 96%, in inspiratory effort compared with spontaneously breathing animals. High levels of prolonged pressure support ventilation promote diaphragmatic atrophy and contractile dysfunction. Furthermore, similar to controlled

  5. An evaluation of ventilator reliability: a multivariate, failure time analysis of 5 common ventilator brands.

    Science.gov (United States)

    Blanch, P B

    2001-08-01

    Mechanical ventilator failures expose patients to unacceptable risks and are expensive. By identifying factors that correlate with the amount of time between consecutive ventilator failures, we might reduce patient risk, save money, and shed light on a number of important questions concerning whether reliability changes as a function of time. Investigate the correlation between several explanatory variables and the time between consecutive ventilator failures and address the following questions: (1) Are ventilators as safe and reliable following repairs as they were before failing? (2) Does reliability change significantly as a ventilator is used or ages? (3) Does a hospital's particular operating environment play a role in ventilator reliability? (4) Are ventilator service contracts worth the money? A retrospective review was conducted using repair and maintenance records from 2 hospitals: a 570-bed teaching hospital and a 410-bed local community hospital. Records were examined from a total of 66 individual ventilators, of 5 different brands, used between July 1, 1991, and January 3, 2001. The ventilators included 13 Tyco-Mallinckrodt Infant Star, 10 Bird VIP, 11 Bird 6400ST, 16 Bird 8400STi, and 16 Tyco-Mallinckrodt 7200ae. The dependent variable was the operating time between or before unexpected mechanical failures; this was determined by the difference between hours logged on the ventilator hour meter at the time of failure and that recorded when the study began, or when the ventilator was new. Thereafter (when applicable), the time before failure was the difference in hours at consecutive failures. Seven independent explanatory covariates were selected and analyzed as potential correlates with time between failures. Another independent variable, the site of ventilator use (community or teaching hospital), was also tested for significance. Data were analyzed using the Cox proportional hazard model, the multiple-groups survival statistic, and the Cox

  6. Mechanical ventilation during extracorporeal membrane oxygenation

    Science.gov (United States)

    2014-01-01

    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. PMID:24447458

  7. Evaluation of manual and automatic manually triggered ventilation performance and ergonomics using a simulation model.

    Science.gov (United States)

    Marjanovic, Nicolas; Le Floch, Soizig; Jaffrelot, Morgan; L'Her, Erwan

    2014-05-01

    In the absence of endotracheal intubation, the manual bag-valve-mask (BVM) is the most frequently used ventilation technique during resuscitation. The efficiency of other devices has been poorly studied. The bench-test study described here was designed to evaluate the effectiveness of an automatic, manually triggered system, and to compare it with manual BVM ventilation. A respiratory system bench model was assembled using a lung simulator connected to a manikin to simulate a patient with unprotected airways. Fifty health-care providers from different professional groups (emergency physicians, residents, advanced paramedics, nurses, and paramedics; n = 10 per group) evaluated manual BVM ventilation, and compared it with an automatic manually triggered device (EasyCPR). Three pathological situations were simulated (restrictive, obstructive, normal). Standard ventilation parameters were recorded; the ergonomics of the system were assessed by the health-care professionals using a standard numerical scale once the recordings were completed. The tidal volume fell within the standard range (400-600 mL) for 25.6% of breaths (0.6-45 breaths) using manual BVM ventilation, and for 28.6% of breaths (0.3-80 breaths) using the automatic manually triggered device (EasyCPR) (P manually triggered device (EasyCPR) (10.6 ± 5 vs 15.9 ± 10 cm H2O, P manually triggered device (EasyCPR) only (10.3 ± 2 vs 17.6 ± 6, P manual BVM device during the normal and obstructive sequences. The nurses and paramedics considered the ergonomics of the automatic manually triggered device (EasyCPR) to be better than those of the manual device. The use of an automatic manually triggered device may improve ventilation efficiency and decrease the risk of pulmonary overdistention, while decreasing the ventilation rate.

  8. The impact of daily evaluation and spontaneous breathing test on the duration of pediatric mechanical ventilation: a randomized controlled trial.

    Science.gov (United States)

    Foronda, Flávia K; Troster, Eduardo J; Farias, Julio A; Barbas, Carmen S; Ferraro, Alexandre A; Faria, Lucília S; Bousso, Albert; Panico, Flávia F; Delgado, Artur F

    2011-11-01

    To assess whether the combination of daily evaluation and use of a spontaneous breathing test could shorten the duration of mechanical ventilation as compared with weaning based on our standard of care. Secondary outcome measures included extubation failure rate and the need for noninvasive ventilation. A prospective, randomized controlled trial. Two pediatric intensive care units at university hospitals in Brazil. The trial involved children between 28 days and 15 yrs of age who were receiving mechanical ventilation for at least 24 hrs. Patients were randomly assigned to one of two weaning protocols. In the test group, the children underwent a daily evaluation to check readiness for weaning with a spontaneous breathing test with 10 cm H2O pressure support and a positive end-expiratory pressure of 5 cm H2O for 2 hrs. The spontaneous breathing test was repeated the next day for children who failed it. In the control group, weaning was performed according to standard care procedures. A total of 294 eligible children were randomized, with 155 to the test group and 139 to the control group. The time to extubation was shorter in the test group, where the median mechanical ventilation duration was 3.5 days (95% confidence interval, 3.0 to 4.0) as compared to 4.7 days (95% confidence interval, 4.1 to 5.3) in the control group (p = .0127). This significant reduction in the mechanical ventilation duration for the intervention group was not associated with increased rates of extubation failure or noninvasive ventilation. It represents a 30% reduction in the risk of remaining on mechanical ventilation (hazard ratio: 0.70). A daily evaluation to check readiness for weaning combined with a spontaneous breathing test reduced the mechanical ventilation duration for children on mechanical ventilation for >24 hrs, without increasing the extubation failure rate or the need for noninvasive ventilation.

  9. Clonidine for sedation and analgesia for neonates receiving mechanical ventilation.

    Science.gov (United States)

    Romantsik, Olga; Calevo, Maria Grazia; Norman, Elisabeth; Bruschettini, Matteo

    2017-05-10

    Although routine administration of pharmacologic sedation or analgesia during mechanical ventilation in preterm neonates is not recommended, its use in clinical practice remains common. Alpha-2 agonists, mainly clonidine and dexmedetomidine, are used as adjunctive (or alternative) sedative agents alongside opioids and benzodiazepines. Clonidine has not been systematically assessed for use in neonatal sedation during ventilation. To assess whether clonidine administered to term and preterm newborn infants receiving mechanical ventilation reduces morbidity and mortality rates. To compare the intervention versus placebo, no treatment, and dexmedetomidine; and to assess the safety of clonidine infusion for potential harms.To perform subgroup analyses according to gestational age; birth weight; administration method (infusion or bolus therapy); dose, duration, and route of clonidine administration; and pharmacologic sedation as a co-intervention. We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 12) in the Cochrane Library, MEDLINE via PubMed (1966 to January 10, 2017), Embase (1980 to January 10, 2017), and the Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1982 to January 10, 2017). We also searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles for randomized controlled trials and quasi-randomized trials. We searched for randomized controlled trials, quasi-randomized controlled trials, and cluster trials comparing clonidine versus placebo, no treatment, or dexmedetomidine administered to term and preterm newborns receiving mechanical ventilation via an endotracheal tube. For the included trial, two review authors independently extracted data (e.g. number of participants, birth weight, gestational age, all-cause death during initial hospitalization, duration of respiratory support, sedation

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

    Directory of Open Access Journals (Sweden)

    Douglas A McKim

    2011-01-01

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

  11. Evaluation of Ventilation Strategies in New Construction Multifamily Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Maxwell, S.; Berger, D.; Zuluaga, M.

    2014-07-01

    In multifamily buildings, particularly in the Northeast, exhaust ventilation strategies are the norm as a means of meeting both local exhaust and whole-unit mechanical ventilation rates. The issue of where the 'fresh' air is coming from is gaining significance as air-tightness standards for enclosures become more stringent, and the 'normal leakage paths through the building envelope' disappear. CARB researchers have found that the majority of high performance, new construction, multifamily housing in the Northeast use one of four general strategies for ventilation: continuous exhaust only with no designated supply or make-up air source, continuous exhaust with ducted make-up air to apartments, continuous exhaust with supply through a make-up air device integral to the unit HVAC, and continuous exhaust with supply through a passive inlet device, such as a trickle vent. Insufficient information is available to designers on how these various systems are best applied. Product performance data are based on laboratory tests, and the assumption is that products will perform similarly in the field. Proper application involves matching expected performance at expected building pressures, but there is no guarantee that those conditions will exist consistently in the finished building. This research effort, which included several weeks of building pressure monitoring, sought to provide field validation of system performance. The performance of four substantially different strategies for providing make-up air to apartments was evaluated.

  12. Noninvasive positive pressure ventilation in acute asthmatic attack

    Directory of Open Access Journals (Sweden)

    A. Soroksky

    2010-03-01

    Full Text Available Asthma is characterised by reversible airway obstruction. In most patients, control of disease activity is easily achieved. However, in a small minority, asthma may be fatal. Between the two extremes lie patients with severe asthmatic attacks, refractory to standard treatment. These patients are at an increased risk of recurrent severe attacks, with respiratory failure, and mechanical ventilation. Invasive mechanical ventilation of the asthmatic patient is associated with a higher risk of complications and, therefore, is a measure of last resort. Noninvasive positive pressure ventilation (NPPV is another treatment modality that may be beneficial in patients with severe asthmatic attack who are at an increased risk of developing respiratory failure. These patients have the potential to benefit from early respiratory support in the form of NPPV. However, reports of NPPV in asthmatic patients are scarce, and its usage in asthmatic attacks is, therefore, still controversial. Only a few reports of NPPV in asthma have been published over the last decade. These studies mostly involve small numbers of patients and those who have problematic methodology. In this article we review the available evidence for NPPV in asthma and try to formulate our recommendations for NPPV application in asthma based on the available evidence and reports.

  13. G Plus Industrial touts new ventilation ducting product

    Energy Technology Data Exchange (ETDEWEB)

    Larmour, A.

    2010-09-01

    This article discussed a new line of industrial-strength plastic duct work for underground mine ventilation. G Plus Industrial Plastics manufactures an extensive line of industrial-strength plastic products that help solve corrosion, wear, impact, and weight problems commonly found in mining and related industries. The new ventilation ducting product is impact and corrosion resistant, and it produces better air-flow resulting in significant cost savings. Plastic helps overcome wear and corrosion problems encountered in mines, and it can be designed to be stronger than aluminum, wood, or steel because it reacts better to impact and slides better. Standard duct work for mine ventilation is either flexible vinyl cloth or sheet metal, both of which create air restriction and weaknesses causing cracks, resulting in air loss. Plastic performs better, requiring less energy to bring the same amount of air to the end point. The ducting has been in development for almost a year. With the high energy rates in Ontario, plastic ducting is expected to result in substantial cost savings. 1 fig.

  14. Different effectiveness of closed embryo culture system with time-lapse imaging (EmbryoScope(TM)) in comparison to standard manual embryology in good and poor prognosis patients: a prospectively randomized pilot study.

    Science.gov (United States)

    Wu, Yan-Guang; Lazzaroni-Tealdi, Emanuela; Wang, Qi; Zhang, Lin; Barad, David H; Kushnir, Vitaly A; Darmon, Sarah K; Albertini, David F; Gleicher, Norbert

    2016-08-24

    Previously manual human embryology in many in vitro fertilization (IVF) centers is rapidly being replaced by closed embryo incubation systems with time-lapse imaging. Whether such systems perform comparably to manual embryology in different IVF patient populations has, however, never before been investigated. We, therefore, prospectively compared embryo quality following closed system culture with time-lapse photography (EmbryoScope™) and standard embryology. We performed a two-part prospectively randomized study in IVF (clinical trial # NCT92256309). Part A involved 31 infertile poor prognosis patients prospectively randomized to EmbryoScope™ and standard embryology. Part B involved embryos from 17 egg donor-recipient cycles resulting in large egg/embryo numbers, thus permitting prospectively alternative embryo assignments to EmbryoScope™ and standard embryology. We then compared pregnancy rates and embryo quality on day-3 after fertilization and embryologist time utilized per processed embryo. Part A revealed in poor prognosis patients no differences in day-3 embryo scores, implantation and clinical pregnancy rates between EmbryoScope™ and standard embryology. The EmbryoScope™, however, more than doubled embryology staff time (P embryology. Appropriately designed and powered prospectively randomized studies appear urgently needed in well-defined patient populations before the uncontrolled utilization of these instruments further expands. NCT02246309 Registered September 18, 2014.

  15. Single-lung ventilation with carbon dioxide hemipneumothorax: hemodynamic and respiratory effects in piglets.

    Science.gov (United States)

    Witt, Lars; Osthaus, Wilhelm Alexander; Schröder, Timon; Teich, Natascha; Dingemann, Carmen; Kübler, Joachim; Böthig, Dietmar; Sümpelmann, Robert

    2012-08-01

    Video-assisted thoracoscopic surgery (VATS) has become a standard procedure in pediatric surgery. To facilitate surgical access, the dependent lung has to collapse using intrathoracic carbon dioxide insufflation and/or single-lung ventilation. These procedures can induce hemodynamic deteriorations in adults. The potential impacts of single-lung ventilation in combination with capnothorax on hemodynamics in infants have never been studied before. We conducted a randomized experimental study focusing on hemodynamic and respiratory changes during single-lung ventilation with or without capnothorax in a pediatric animal model. Twelve piglets were randomly assigned to receive single-lung ventilation with (SLV-CO(2) ) or without (SLV) capnothorax with an insufflation pressure of 5 mmHg for a period of two hours. Before, during, and after single-lung ventilation, hemodynamic and respiratory parameters were measured. Although mean arterial pressure remained stable during the course of the study and no critical incidents were monitored, cardiac index (CI) decreased significantly with SLV-CO(2) (baseline 3.6 ± 1.6 l · min(-1) · m(-2) vs 2.9 ± 1.1 l · min(-1) · m(-2) at 120 min, P single-lung ventilation and low-pressure capnothorax was well tolerated in piglets and could justify further clinical studies to be performed in infants and children focusing on hemodynamic and respiratory changes during VATS. © 2011 Blackwell Publishing Ltd.

  16. Peripheral muscle strength and correlates of muscle weakness in patients receiving mechanical ventilation.

    Science.gov (United States)

    Chlan, Linda L; Tracy, Mary Fran; Guttormson, Jill; Savik, Kay

    2015-11-01

    Intensive care unit-acquired weakness is a frequent complication of critical illness because of patients' immobility and prolonged use of mechanical ventilation. To describe daily measurements of peripheral muscle strength in patients receiving mechanical ventilation and explore relationships among factors that influence intensive care unit-acquired weakness. Peripheral muscle strength of 120 critically ill patients receiving mechanical ventilation was measured daily by using a standardized handgrip dynamometry protocol. Three grip measurements for each hand were recorded in pounds-force; the mean of these 3 assessments was used in the analysis. Correlates of intensive care unit-acquired weakness (age, sex, illness severity, duration of mechanical ventilation, medications) were analyzed by using mixed models to explore the relationship to grip strength. Median baseline grip strength was variable yet diminished (7.7 pounds-force), with either a pattern of diminishing grip strength or maintenance of the baseline low grip strength over time. With controls for days of measurement, female sex (β = -10.4; P mechanical ventilation (β = -0.34; P = .005) explained a significant amount of variance in grip strength over time. Patients receiving prolonged mechanical ventilation had marked decrements in grip strength, measured by hand dynamometry, a marker for peripheral muscle strength. Hand dynamometry is a reliable method for measuring muscle strength in cooperative critically ill patients and can be used to develop interventions to prevent intensive care unit-acquired weakness. ©2015 American Association of Critical-Care Nurses.

  17. 29 CFR 780.150 - Scope and limits of “preparation for market.”

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Scope and limits of âpreparation for market.â 780.150... STANDARDS ACT General Scope of Agriculture Preparation for Market § 780.150 Scope and limits of “preparation for market.” “Preparation for market” is also named as one of the practices which may be included in...

  18. A ventilation intervention study in classrooms to improve indoor air quality: the FRESH study.

    Science.gov (United States)

    Rosbach, Jeannette T M; Vonk, Machiel; Duijm, Frans; van Ginkel, Jan T; Gehring, Ulrike; Brunekreef, Bert

    2013-12-17

    Classroom ventilation rates often do not meet building standards, although it is considered to be important to improve indoor air quality. Poor indoor air quality is thought to influence both children's health and performance. Poor ventilation in The Netherlands most often occurs in the heating season. To improve classroom ventilation a tailor made mechanical ventilation device was developed to improve outdoor air supply. This paper studies the effect of this intervention. The FRESH study (Forced-ventilation Related Environmental School Health) was designed to investigate the effect of a CO2 controlled mechanical ventilation intervention on classroom CO2 levels using a longitudinal cross-over design. Target CO2 concentrations were 800 and 1200 parts per million (ppm), respectively. The study included 18 classrooms from 17 schools from the north-eastern part of The Netherlands, 12 experimental classrooms and 6 control classrooms. Data on indoor levels of CO2, temperature and relative humidity were collected during three consecutive weeks per school during the heating seasons of 2010-2012. Associations between the intervention and weekly average indoor CO2 levels, classroom temperature and relative humidity were assessed by means of mixed models with random school-effects. At baseline, mean CO2 concentration for all schools was 1335 ppm (range: 763-2000 ppm). The intervention was able to significantly decrease CO2 levels in the intervention classrooms (F (2,10) = 17.59, p device was not capable of precisely achieving the two predefined levels of CO2, our study showed that classroom CO2 levels can be reduced by intervening on classroom ventilation using a CO2 controlled mechanical ventilation system.

  19. Ventilation monitoring during moderate sedation in GI patients.

    Science.gov (United States)

    Ebert, Thomas J; Middleton, Austin H; Makhija, Nikhil

    2017-02-01

    Sedation in locations outside the operating room (OR) is common. Guidelines for safe patient monitoring have been updated by the American Society of Anesthesiology to include monitoring of ventilation and/or carbon dioxide (CO2). Although technologies exist to monitor these variables, the quality and/or availability of these measurements in non-OR settings is not optimal. This quality improvement project assessed the value of impedance technology for monitoring minute ventilation (MV) compared to standard end-tidal monitoring of CO2 (ETCO2). Patients undergoing GI exams with moderate sedation provided by anesthesia providers were monitored for MV with a respiratory volume monitor (ExSpiron 1Xi, Respiratory Motion, Waltham, MA) and ETCO2 via nasal cannula (NC). Calibration and baseline data were collected prior to sedation. Continuous MV and ETCO2 data were collected and averaged, providing minute values after sedation medications throughout the procedure. Stable periods of reduced MV were averaged and used in comparison to ETCO2. Data from 20 patients were evaluated. After sedation, the expected decrease in MV after sedation was observed in 18 of 20 patients (average -47.82 %), while an increase in ETCO2 was observed in just 10 of 20 patients (average -5.17 mm Hg). The correlation coefficient between changes in MV and ETCO2 in response to sedation administration was positive and not significant, r = 0.223. Ventilation monitoring may provide an element of safety for earlier and more reliable detection of reduced ventilation compared to a surrogate for hypoventilation, ETCO2, in patients undergoing sedation for GI procedures outside of the OR.

  20. Comparative usability of modern anaesthesia ventilators: a human factors study.

    Science.gov (United States)

    Spaeth, J; Schweizer, T; Schmutz, A; Buerkle, H; Schumann, S

    2017-11-01

    The anaesthesia ventilator represents the key equipment for intraoperative respiratory care. Improper operation of this device may threaten a patient's health. A self-explanatory interface facilitates handling and decreases the risk of operating errors. This study systematically evaluates the usability of user interfaces in four modern anaesthesia ventilators. Twenty naïve operators were asked to execute 20 tasks on each of four different anaesthesia ventilators (Avance CS2™, GE Healthcare; Flow-i™, Maquet; and Perseus™ and Primus™, Dräger) in a randomized order. The success of task execution, frequency of requests for assistance, and processing times were recorded. During the tasks, the operators' visual focus was measured via eye-tracking. Additionally, subjective assessments of usability were evaluated by a standardized questionnaire. For comparison, six experienced operators undertook the same protocol. The overall rate of falsely executed tasks was low. Naïve operators requested assistance least when using the Perseus (26). Pooled processing times were shortest for the Perseus (222 s), followed by the Primus (223 s), the Avance (238 s), and the Flow-i (353 s). Task-specific processing times differed considerably between the devices. Eye-tracking analyses revealed associated interface issues that impeded the operators' performance. Operators rated usability best for the Perseus [mean (sd): 67 (17) arbitrary units] and worst for the Flow-i [50 (16) arbitrary units]. Results from experienced operators support these findings by trend. The usability of modern anaesthesia ventilators differs considerably. Interface issues of specific tasks impair the operator's efficiency. Eliminating the specific usability issues might improve the operator's performance and, as a consequence, the patient's safety.

  1. Layperson Surf Lifeguards Deliver High-quality Ventilations Compared with Experienced Nurse Anesthetists

    DEFF Research Database (Denmark)

    Nørkjær, Louise; Stærk, Mathilde; Glerup Lauridsen, Kasper

    Introduction: Every year approximately 360,000 people die following asphyxial cardiac arrest due to drowning. Effective ventilation by surf lifeguards should be initiated as soon as possible to improve survival. The use of a supraglottic airway (SGA) may help deliver effective ventilations. SGA...... is widely used by nurse anesthetists as a standard for airway management, but it is unknown whether surf lifeguards, who are often non-healthcare providers, can use SGA effectively. SGA used by nurse anesthetists may be considered as a gold standard. Aim: To compare the use of a SGA by surf lifeguards...... and nurse anesthetists. Methods: In a simulation study, surf lifeguards without healthcare background and nurse anesthetists were asked to insert a SGA (i-gelO2, size 4, Intersurgical) in a resuscitation manikin (AMBU Man ALS, AMBU) and perform ventilations. Tidal volume was analyzed via manikin software...

  2. Applications and Energy Consumption of Demand Controlled Ventilation Systems. Modelling, Simulation and Implementation of Modular Built Dynamical VAV Systems and Control Strategies

    Energy Technology Data Exchange (ETDEWEB)

    Soerensen, Bjoern R.

    2002-07-01

    This thesis discusses many topics of heating and ventilation. This is because the ventilation system is an integrated part of its host building. The functionality and effectiveness of the ventilation system are very much dependent on the building's architectural design, its internal materials, its occupants, its air tightness characteristics and its placement in the terrain. Although this thesis emphasizes strongly on VAV (Variable Air Volume) systems and, in particular, modelling and simulation of such systems, it touches a range of important HVAC related issues. The scope is however, limited to the field of comfort ventilation. That is because ventilation in industrial environments often is subject to separate regulations, and requires other and specialized methods of design and evaluation of ventilation performance. The main objectives have been to: (1) Develop mathematical models for VAV components and systems. (2) Evaluate existing and develop new strategies for VAV demand controlled ventilation by system simulation. (3) Investigate the potential for saving energy and the impact on indoor climate. The development of mathematical models and simulation of VAV systems are given quite much attention compared to the other topics discussed.

  3. Preoperational test report, primary ventilation condensate system

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, F.T.

    1997-01-29

    Preoperational test report for Primary Ventilation Condensate System, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system provides a collection point for condensate generated by the W-030 primary vent offgas cooling system serving tanks AYIOI, AY102, AZIOI, AZI02. The system is located inside a shielded ventilation equipment cell and consists of a condensate seal pot, sampling features, a drain line to existing Catch Tank 241-AZ-151, and a cell sump jet pump. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

  4. Multilevel Ventilation: Theory and Simplified Mathematical Model

    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, acute respiratory distress syndrome, pneumonia, etc., the authors created a mathematical model of multicompartment non-homogenous injured lungs that were ventilated by a new mode of AV, the so-called three-level ventilation. Multilevel ventilation was defined a type (modification of ALV whose basic ventilation level was produced by the modes CMV, PCV or PS (ASB and add-on level, and the so-called background ventilation was generated by the levels of PEEP and high PEEP (PEEPh with varying frequency and duration. Multi-level ventilation on 3 pressure levels was realized by the mathematical model as a combination of pressure-controlled ventilation (PCV and two levels of PEEP and PEEPh. The objective was to prove that in cases of considerably non-homogenous gas distribution in acute pathological disorders of lungs, gas entry into the so-called slow bronchoalveolar compartments could be improved by multilevel AV, without substabtially changing the volume of so-called fast compartments. Material and Method. Multi-level ventilation at 3 pressure levels was realized by the mathematical model as a combination of PCV and two levels of PEEP and PEEPh. Results. By comparing the single-level AV in the PCV mode with the so-called three-level ventilation defined as a combination of PCV+PEEPh/PEEP, the authors have discovered that the loading of slow compartments in the model was considerably improved by 50—60% as compared with the baseline values. In absolute terms, this difference was as many as 2—10 times of the volume. Conclusion. The mathematical model may demonstrate that the application of the so-called three-level AV causes considerable changes in gas distribution in the lung parenchyma disordered by a non-homogenous pathological process. The authors state that the proposed mathematical model requires clinical verification in order

  5. 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

  6. Special Considerations in Neonatal Mechanical Ventilation.

    Science.gov (United States)

    Dalgleish, Stacey; Kostecky, Linda; Charania, Irina

    2016-12-01

    Care of infants supported with mechanical ventilation is complex, time intensive, and requires constant vigilance by an expertly prepared health care team. Current evidence must guide nursing practice regarding ventilated neonates. This article highlights the importance of common language to establish a shared mental model and enhance clear communication among the interprofessional team. Knowledge regarding the underpinnings of an open lung strategy and the interplay between the pathophysiology and individual infant's response to a specific ventilator strategy is most likely to result in a positive clinical outcome. Copyright © 2016 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    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

  8. 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.

  9. Fatal pneumomediastinum associated with use of noninvasive mechanical ventilation

    Science.gov (United States)

    Ruggeri, Paolo; Girbino, Giuseppe

    2014-01-01

    We present a case of fatal pneumomediastinum in a patient with acute respiratory failure caused by acute exacerbated chronic obstructive pulmonary disease (AECOPD) and interstitial lung disease (ILD) precipitated by noninvasive mechanical ventilation (NIMV). To our knowledge, this is the first case reported in the literature. NIMV is very useful to treat acute respiratory failure due to AECOPD improving survival and avoiding endotracheal intubation. Use of NIMV in end stage ILD is not standardized and efficacy is to be proven. No data are reported to manage patient with concomitant COPD and ILD. Pathophysiological mechanisms underlying this fatal complication are explained and suggestions to treat this subgroup of patients discussed. PMID:25530859

  10. Liberation from prolonged mechanical ventilation.

    Science.gov (United States)

    Scheinhorn, David J; Chao, David C; Stearn-Hassenpflug, Meg

    2002-07-01

    After weaning from PMV, patients are usually far from ready to resume normal activities. A prolonged recovery period after catastrophic illness is the rule, with multidisciplinary rehabilitation and discharge planning efforts. Following such efforts, reports of success of restorative care are institutional and population specific. That all PMV patients are not "chronically critically ill" introduces selection factors that make comparisons between institutions even more difficult. Half of the authors' patients were able to go home in past years [14], although more recently, with patients admitted more debilitated and more ill, the percent returning home has gradually declined to the low 20% range. Bagley et al [11] report discharge to home in 31% of patients weaned. Gracey et al [6,133], treating younger, postsurgical patients, have reported the highest discharge to home rate, 57%; over 70% were eventually discharged to home after first being transferred to a rehabilitation unit. On the other hand, the few reports of survival 1 or more years after discharge are in the 50% range at best (Table 2). Carson and colleagues [9] report a 23% 1-year survival in 133 PMV patients. Their premorbid functional status and age analysis showed younger and more independent patients having a better mortality (56%), and older and more dependent patients having a 95% mortality at 1 year. Nasraway et al [25] report a 1-year mortality of 50.5% in 97 patients transferred from five ICUs to multiple ECFs. Most of these patients would probably meet criteria for PMV, with median time mechanically ventilated 33 days, and 71 ventilator dependent at the time of ICU discharge. A report from 25 Vencor Hospitals [134] not included in Table 2 because weaning outcome was not reported, examines mortality and cost in patients > 65 years of age primarily referred for failure to wean from mechanical ventilation (91% of the cohort of 1619 patients.) There was a 58% in-hospital mortality by day 102 (28

  11. 33 CFR 183.620 - Natural ventilation system.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Natural ventilation system. 183... (CONTINUED) BOATING SAFETY BOATS AND ASSOCIATED EQUIPMENT Ventilation § 183.620 Natural ventilation system. (a) Except for compartments open to the atmosphere, a natural ventilation system that meets the...

  12. 46 CFR 154.1200 - Mechanical ventilation system: General.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 5 2010-10-01 2010-10-01 false Mechanical ventilation system: General. 154.1200 Section... Equipment Cargo Area: Mechanical Ventilation System § 154.1200 Mechanical ventilation system: General. (a... cargo handling equipment must have a fixed, exhaust-type mechanical ventilation system. (b) The...

  13. [Prognostic criteria of the premature infants weaning from mechanical ventilation during trigger ventilation].

    Science.gov (United States)

    Grebennikov, V A; Kriakvina, O A; Bolunova, E S; Degtiareva, M V

    2013-01-01

    Modern mechanical ventilation modes do not prevent ventilator-associated lung injury therefore respiratory cessation must be stopped as soon as possible. However extubation recommendations absence makes difficulties in process of weaning the infants from the mechanical ventilation. To assess the prognostic criteria of the extubating and weaning from mechanical ventilation in premature infants during trigger ventilation (PSV/PSV + VG). 66 Pediatric patients were divided into two groups during the period of weaning from mechanical ventilation: PSV + PG ventilation mode was used in the group 1 (n = 33), and PSV in the group 2 (n = 33). Basic characteristics were same in both groups: gestational age 31.1 +/- 2.5 weeks, mass of body 1586.2 +/- 356.8 grams. Extubation was successful if reintubation was not needed during 48 hrs. 90% of successful extubations were done when the compliance was over 1.1 ml mbar(-1). Compliance decrease under 0.75 ml mbar(-1) was an adverse prognostic criterion of the weaning from mechanical ventilation and extubation. Index breathing rate/breathing volume (RVR) can be used as general criterion of the weaning from mechanical ventilation. Progressive RVR increase to 8 is an adverse prognostic criterion of PSV/ PSV + VG mode use during the period of weaning from mechanical ventilation. Parameters of mechanical ventilation which maintain acceptable gas composition of blood and SpO2 mast be considered before extubation. Positive dynamics and stabilization of compliance and resistance are essential criteria of the successful weaning from mechanical ventilation and extubation. RVR can be used as objective criterion of an extubation.

  14. Neurally adjusted ventilatory assist improves patient–ventilator interaction in infants as compared with conventional ventilation.

    Science.gov (United States)

    Bordessoule, Alice; Emeriaud, Guillaume; Morneau, Sylvain; Jouvet, Philippe; Beck, Jennifer

    2012-08-01

    Neurally adjusted ventilatory assist (NAVA) is a mode of ventilation controlled by the electrical activity of the diaphragm (Edi). The aim was to evaluate patient-ventilator interaction in infants during NAVA as compared with conventional ventilation. Infants were successively ventilated with NAVA, pressure control ventilation (PCV), and pressure support ventilation (PSV). Edi and ventilator pressure (Pvent) waveforms were compared and their variability was assessed by coefficients of variation. Ten patients (mean age 4.3 ± 2.4 mo and weight 5.9 ± 2.2 kg) were studied. In PCV and PSV, 4 ± 4.6% and 6.5 ± 7.7% of the neural efforts failed to trigger the ventilator. This did not occur during NAVA. Trigger delays were shorter with NAVA as compared with PCV and PSV (93 ± 20 ms vs. 193 ± 87 ms and 135 ± 29 ms). During PCV and PSV, the ventilator cycled off before the end of neural inspiration in 12 ± 13% and 21 ± 19% of the breaths (0 ± 0% during NAVA). During PCV and PSV, 24 ± 11% and 25 ± 9% of the neural breath cycle was asynchronous with the ventilator as compared with 11 ± 3% with NAVA. A large variability was observed for Edi in all modes, which was transmitted into Pvent during NAVA (coefficient of variation: 24 ± 8%) and not in PCV (coefficient of variation 2 ± 1%) or PSV (2 ± 2%). NAVA improves patient-ventilator interaction and delivers adequate ventilation with variable pressure in infants.

  15. Energy diagnosis of industrial ventilation systems; Diagnostic energetique des installations de ventilation industrielle

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2003-11-01

    Industrial ventilation systems are numerous and represent an important source of potential energy saving. This book shades light on the principles of ventilation systems used in companies and on the investigation methods to be implemented for an energy diagnosis of these systems. It proposes some solutions for the improvement of existing ventilation systems and some suggestions for the formulation and presentation of recommendations. (J.S.)

  16. Assessment of Indoor Air Quality Benefits and Energy Costs of Mechanical Ventilation

    Energy Technology Data Exchange (ETDEWEB)

    Logue, J.M.; Price, P.N.; Sherman, M.H.; Singer, B.C.

    2011-07-01

    Intake of chemical air pollutants in residences represents an important and substantial health hazard. Sealing homes to reduce air infiltration can save space conditioning energy, but can also increase indoor pollutant concentrations. Mechanical ventilation ensures a minimum amount of outdoor airflow that helps reduce concentrations of indoor emitted pollutants while requiring some energy for fan(s) and thermal conditioning of the added airflow. This work demonstrates a physics based, data driven modeling framework for comparing the costs and benefits of whole-house mechanical ventilation and applied the framework to new California homes. The results indicate that, on a population basis, the health benefits from reduced exposure to indoor pollutants in New California homes are worth the energy costs of adding mechanical ventilation as specified by ASHRAE Standard 62.2.This study determines the health burden for a subset of pollutants in indoor air and the costs and benefits of ASHRAE's mechanical ventilation standard (62.2) for new California homes. Results indicate that, on a population basis, the health benefits of new home mechanical ventilation justify the energy costs.

  17. Worsening respiratory function in mechanically ventilated intensive care patients: feasibility and value of xenon-enhanced dual energy CT.

    Science.gov (United States)

    Hoegl, Sandra; Meinel, Felix G; Thieme, Sven F; Johnson, Thorsten R C; Eickelberg, Oliver; Zwissler, Bernhard; Nikolaou, Konstantin

    2013-03-01

    To evaluate the feasibility and incremental diagnostic value of xenon-enhanced dual-energy CT in mechanically ventilated intensive care patients with worsening respiratory function. The study was performed in 13 mechanically ventilated patients with severe pulmonary conditions (acute respiratory distress syndrome (ARDS), n=5; status post lung transplantation, n=5; other, n=3) and declining respiratory function. CT scans were performed using a dual-source CT scanner at an expiratory xenon concentration of 30%. Both ventilation images (Xe-DECT) and standard CT images were reconstructed from a single CT scan. Findings were recorded for Xe-DECT and standard CT images separately. Ventilation defects on xenon images were matched to morphological findings on standard CT images and incremental diagnostic information of xenon ventilation images was recorded if present. Mean xenon consumption was 2.95 l per patient. No adverse events occurred under xenon inhalation. In the visual CT analysis, the Xe-DECT ventilation defects matched with pathologic changes in lung parenchyma seen in the standard CT images in all patients. Xe-DECT provided additional diagnostic findings in 4/13 patients. These included preserved ventilation despite early pneumonia (n=1), more confident discrimination between a large bulla and pneumothorax (n=1), detection of an airway-to-pneumothorax fistula (n=1) and exclusion of a suspected airway-to-mediastinum fistula (n=1). In all 4 patients, the additional findings had a substantial impact on patients' management. Xenon-enhanced DECT is safely feasible and can add relevant diagnostic information in mechanically ventilated intensive care patients with worsening respiratory function. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  18. 7 CFR 47.5 - Scope and applicability of rules of practice.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Scope and applicability of rules of practice. 47.5... Scope and applicability of rules of practice. Sections 47.6 through 47.25 shall be applicable to the... (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE MARKETING OF PERISHABLE AGRICULTURAL...

  19. 7 CFR 50.1 - Scope and applicability of rules of practice.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Scope and applicability of rules of practice. 50.1... (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE MARKETING OF PERISHABLE AGRICULTURAL COMMODITIES RULES OF PRACTICE GOVERNING WITHDRAWAL OF INSPECTION AND GRADING SERVICES General § 50.1 Scope and...

  20. 29 CFR 780.104 - How modern specialization affects the scope of agriculture.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false How modern specialization affects the scope of agriculture... EXEMPTIONS APPLICABLE TO AGRICULTURE, PROCESSING OF AGRICULTURAL COMMODITIES, AND RELATED SUBJECTS UNDER THE FAIR LABOR STANDARDS ACT General Scope of Agriculture Introductory § 780.104 How modern specialization...

  1. Comfort parameters - Ventilation of a subway wagon

    Science.gov (United States)

    Petr, Pavlíček; Ladislav, Tříska

    2017-09-01

    Research and development of a ventilation system is being carried out as a part of project TA04030774 of the Technology Agency of the Czech Republic. Name of the project is "Research and Development of Mass-optimized Components for Rail Vehicles". Problems being solved are development and testing of a new concept for ventilation systems for public transport vehicles. The main improvements should be a reduction of the mass of the whole system, easy installation and reduction of the noise of the ventilation system. This article is focused on the comfort parameters in a subway wagon (measurement and evaluation carried out on a function sample in accordance with the regulations). The input to the project is a ventilator hybrid casing for a subway wagon, which was manufactured and tested during the Ministry of Industry and Trade project TIP FR-TI3/449.

  2. Adaptive Intelligent Ventilation Noise Control Project

    Data.gov (United States)

    National Aeronautics and Space Administration — To address NASA needs for quiet crew volumes in a space habitat, Physical Optics Corporation (POC) proposes to develop a new Adaptive Intelligent Ventilation Noise...

  3. Adaptive Intelligent Ventilation Noise Control Project

    Data.gov (United States)

    National Aeronautics and Space Administration — To address the NASA need for quiet on-orbit crew quarters (CQ), Physical Optics Corporation (POC) proposes to develop a new Adaptive Intelligent Ventilation Noise...

  4. Design of Natural and Hybrid Ventilation

    DEFF Research Database (Denmark)

    Heiselberg, Per

    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, since the building itself and its components are the elements that can reduce or increase air movement...... as well as influence the air content (dust, pollution etc.). Architects and engineers need to acquire qualitative and quantitative information about the interactions between building characteristics and natural ventilation in order to design buildings and systems consistent with a passive low...

  5. Process control migration towards LHC ventilation functionality

    CERN Document Server

    Blanc, D

    2003-01-01

    The adaptation of the ventilation systems as well as the integration of equipment to fit with the new LHC ventilation requirements lead us to consider a global re-engineering of the existing control system. This, decade old process control structure is composed of elements which are mixed between industrial and home made devices. The proposed modifications are made in order to upgrade the present control system and to provide efficient and well adapted control architecture to integrate the LHC ventilation equipment of the injection tunnels. Moreover, we need a plan for the next fifteen years of the LHC life cycle. The document is to present the situation of the present control system of the LEP ventilation process and to propose a plan for the migration of the control architecture. This is done considering the fact that elements of the present control infrastructure could no longer be supported from 2003 and major components must be removed from the CERN communication infrastructure.

  6. Modelling of Natural and Hybrid Ventilation

    DEFF Research Database (Denmark)

    Heiselberg, Per

    as well as influence the air content (dust, pollution etc.). Architects and engineers need to acquire qualitative and quantitative information about the interactions between building characteristics and natural ventilation in order to design buildings and systems consistent with a passive low......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, since the building itself and its components are the elements that can reduce or increase air movement...

  7. Mechanical ventilation strategies for the surgical patient

    NARCIS (Netherlands)

    Schultz, Marcus J.; Abreu, Marcelo Gama de; Pelosi, Paolo

    2015-01-01

    Purpose of review To summarize clinical evidence for intraoperative ventilation settings, which could protect against postoperative pulmonary complications (PPCs) in surgical patients with uninjured lungs. Recent findings There is convincing evidence for protection against PPCs by low tidal volumes:

  8. 46 CFR 111.15-10 - Ventilation.

    Science.gov (United States)

    2010-10-01

    .... (3) Each blower must have a non-sparking fan. (4) The power ventilation system must be interlocked... vertical; and (iv) That has no appliances, such as flame arresters, that impede free passage of air or gas...

  9. Comparison of Airway Pressure Release Ventilation to Conventional Mechanical Ventilation in the Early Management of Smoke Inhalation Injury in Swine

    Science.gov (United States)

    2011-01-01

    Comparison of airway pressure release ventilation to conventional mechanical ventilation in the early management of smoke inhalation injury in swine...Acute respiratory distress syndrome (ARDS) is a complication of smoke inha- lation injury, with an incidence as high as 54% in mechanically ventilated ... mechanical ventilation on oxygenation in a porcine model of acute respiratory distress syndrome induced by wood smoke inhalation. Design: Prospective

  10. Evaluating Ventilation Systems for Existing Homes

    Energy Technology Data Exchange (ETDEWEB)

    Aldrich, Robb [Consortium for Advanced Residential Buildings (CARB), Norwalk, CT (United States); Arena, Lois [Consortium for Advanced Residential Buildings (CARB), Norwalk, CT (United States)

    2013-02-01

    In an effort to improve housing options near Las Vegas, Nevada, the Clark County Community Resources Division (CCCRD) performs substantial renovations to foreclosed homes. After dramatic energy, aesthetic, and health and safety improvements are made, homes are rented or sold to qualified residents. This report describes the evaluation and selection of ventilation systems for these homes, including key considerations when selecting an ideal system. The report then describes CCCRD’s decision process with respect to ventilation.

  11. Computational Fluid Dynamics in Ventilation Design

    DEFF Research Database (Denmark)

    Nielsen, Peter V.

    2008-01-01

    . The guidebook has, for example, chapters that are very important for CFD quality control in general, and for the quality control of ventilation related problems in particular. A large number of CFD predictions are made nowadays, and it is often difficult to judge the quality level of these predictions....... The guidebook introduces rules for good quality prediction work, and it is the purpose of the guidebook to improve the technical level of CFD work in ventilation....

  12. 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.

  13. Solar ventilation for vehicles. Solarstandentlueftung fuer Kraftfahrzeuge

    Energy Technology Data Exchange (ETDEWEB)

    Watzlawick, R. (Webasto Karosseriesysteme GmbH, Stockdorf (Germany)); Ganz, T. (Webasto Karosseriesysteme GmbH, Stockdorf (Germany)); Adelmann, P. (STECA GmbH, Memmingen (Germany))

    1993-01-01

    Considerable improvement in comfort and further price reductions by a simple process for including the solar cells in a sliding roof and the solar module itself make solar ventilation an attractive component in vehicle air conditioning. With regard to increasing shortages of raw materials and the trend towards engines with optimized consumption, solar ventilation can make a considerable contribution to environmentally-friendly air conditioning in the vehicles. (orig.)

  14. Efficacy of Conventional and High-Frequency Ventilation at Altitude

    Science.gov (United States)

    1988-12-01

    evacuation; Mechanical ventilation ;--andL If.’jJI t’ 06 I 12 i ~High-Frequency ventilation ’& ~.~.- 19 ABSTRACT (Continue on reverse If neesry and identify by...The inspired gas and the subsequent rate of appearance of these gases in arterial blood were monitored. With conventional mechanical ventilation (CMV...AND HIGH-FREQUENCY VENTILATION AT ALTITUDE INTRODUCTION The logistics of aeromedical evacuation of patients requiring mechanical ventilation is

  15. Evaluation of local exhaust ventilation system performance for control of Fe2O3 dust at an iron making unit

    Directory of Open Access Journals (Sweden)

    Mahdi Jamshidi Rastani

    2016-06-01

    Full Text Available Introduction: Adherence to the design values and ventilation standards (VS after installing and also maintaining continuous work of ventilation system with maximum performance throughout its life are amongst the reasons of ventilation systems monitoring. Therefore, the aim of this study was to evaluate performance of local exhaust ventilation system for control of dust by measuring the operating parameters and also to compare it with ventilation standards (VS and design values. Material and Method: The present research is a descriptive and cross-sectional study, conducted in three sections of measuring, monitoring and evaluating the operating parameters on hoods, channels and fan of ventilation system based on the current status of the system, documentation (design, and recommended standards (VS. Static pressure, velocity pressure, surface area, and flow rate were measured based on the recommendations of various sources and ACGIH industrial ventilation manual, and the data were compared with the design and recommended values, using the SPSS software version 16.   Result: The results of paired sample t-test between flow rate and velocities of design and current status, showed significant differences in various parts. Accordingly, the results revealed a reduction of more than 50% in the design duct velocity compared to the current duct velocity, while design duct velocity is 1.3 more than the standard duct velocity of current status, and current duct velocity is about 65% of standard duct velocity. Conclusion: The reduction and nonconformity of the results of measurements of operating parameters (after a minimum of two decades with design and standard values are corroborant and sufficient reason for obstructions, abrasions, leaks, imbalance of system ducts and their inefficiency in some branches. Since there is no base line measurements for system (supposing that the system worked with maximum amounts of setup time, one of the reasons for these

  16. Electrical impedance tomography for assessing ventilation/perfusion mismatch for pulmonary embolism detection without interruptions in respiration.

    Science.gov (United States)

    Nguyen, Doan Trang; Thiagalingam, Aravinda; Bhaskaran, Abhishek; Barry, Michael A; Pouliopoulos, Jim; Jin, Craig; McEwan, Alistair L

    2014-01-01

    Recent studies have shown high correlation between pulmonary perfusion mapping with impedance contrast enhanced Electrical Impedance Tomography (EIT) and standard perfusion imaging methods such as Computed Tomography (CT) and Single Photon Emission Computerized Tomography (SPECT). EIT has many advantages over standard imaging methods as it is highly portable and non-invasive. Contrast enhanced EIT uses hypertonic saline bolus instead of nephrotoxic contrast medium that are utilized by CT and nuclear Ventilation/Perfusion (V/Q) scans. However, current implementation of contrast enhanced EIT requires induction of an apnea period for perfusion measurement, rendering it disadvantageous compared with current gold standard imaging modalities. In the present paper, we propose the use of a wavelet denoising algorithm to separate perfusion signal from ventilation signal such that no interruption in patient's ventilation would be required. Furthermore, right lung to left lung perfusion ratio and ventilation ratio are proposed to assess the mismatch between ventilation and perfusion for detection of Pulmonary Embolism (PE). The proposed methodology was validated on an ovine model (n=3, 83.7±7.7 kg) with artificially induced PE in the right lung. The results showed a difference in right lung to left lung perfusion ratio between baseline and diseased states in all cases with all paired t-tests between baseline and PE yielding p lung to left lung ventilation ratio remained unchanged in two out of three experiments. Statistics were pooled from multiple repetitions of measurements per experiment.

  17. Effectiveness of mask and helmet interfaces to deliver noninvasive ventilation in a human model of resistive breathing.

    Science.gov (United States)

    Racca, Fabrizio; Appendini, Lorenzo; Gregoretti, Cesare; Stra, Elisa; Patessio, Antonio; Donner, Claudio F; Ranieri, V Marco

    2005-10-01

    The helmet, a transparent latex-free polyvinyl chloride cylinder linked by a metallic ring to a soft collar that seals the helmet around the neck, has been recently proposed as an effective alternative to conventional face mask to deliver pressure support ventilation (PSV) during noninvasive ventilation in patients with acute respiratory failure. We tested the hypothesis that mechanical characteristics of the helmet (large internal volume and high compliance) might impair patient-ventilator interactions compared with standard face mask. Breathing pattern, CO(2) clearance, indexes of inspiratory muscle effort and patient-ventilator asynchrony, and dyspnea were measured at different levels of PSV delivered by face mask and helmet in six healthy volunteers before (load-off) and after (load-on) application of a linear resistor. During load-off, no differences in breathing pattern and inspiratory muscle effort were found. During load-on, the use of helmet to deliver pressure support increased inspiratory muscle effort and patient-ventilator asynchrony, worsened CO(2) clearance, and increased dyspnea compared with standard face mask. Autocycled breaths accounted for 12 and 25% of the total minute ventilation and for 10 and 23% of the total inspiratory muscle effort during mask and helmet PSV, respectively. We conclude that PSV delivered by helmet interface is less effective in unloading inspiratory muscles compared with PSV delivered by standard face mask. Other ventilatory assist modes should be tested to exploit to the most the potential benefits offered by the helmet.

  18. Academy of Nutrition and Dietetics: Scope of Practice for the Dietetic Technician, Registered.

    Science.gov (United States)

    2013-06-01

    The Scope of Practice for the Dietetic Technician, Registered provides standards and tools to guide competence in performing nutrition and dietetics practice. Composed of statutory and individual components, the DTR's scope of practice is determined by state statute and the DTR's education, training, credentialing, and demonstrated and documented competence in practice. The Scope of Practice for the Dietetic Technician, Registered reflects the Academy's position on the DTR scope of practice and the essential technical assistance role of the DTR in providing safe timely person-centered care for the delivery of quality food and nutrition services.

  19. Non-invasive ventilation for cystic fibrosis.

    Science.gov (United States)

    Moran, Fidelma; Bradley, Judy M; Piper, Amanda J

    2017-02-20

    Non-invasive ventilation may be a means to temporarily reverse or slow the progression of respiratory failure in cystic fibrosis by providing ventilatory support and avoiding tracheal intubation. Using non-invasive ventilation, in the appropriate situation or individuals, can improve lung mechanics through increasing airflow and gas exchange and decreasing the work of breathing. Non-invasive ventilation thus acts as an external respiratory muscle. This is an update of a previously published review. To compare the effect of non-invasive ventilation versus no non-invasive ventilation in people with cystic fibrosis for airway clearance, during sleep and during exercise. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register comprising references identified from comprehensive electronic database searches, handsearching relevant journals and abstract books of conference proceedings. We searched the reference lists of each trial for additional publications possibly containing other trials.Most recent search: 08 August 2016. Randomised controlled trials comparing a form of pressure preset or volume preset non-invasive ventilation to no non-invasive ventilation used for airway clearance or during sleep or exercise in people with acute or chronic respiratory failure in cystic fibrosis. Three reviewers independently assessed trials for inclusion criteria and methodological quality, and extracted data. Ten trials met the inclusion criteria with a total of 191 participants. Seven trials evaluated single treatment sessions, one evaluated a two-week intervention, one evaluated a six-week intervention and one a three-month intervention. It is only possible to blind trials of airway clearance and overnight ventilatory support to the outcome assessors. In most of the trials we judged there was an unclear risk of bias with regards to blinding due to inadequate descriptions. The six-week trial was the only one judged to have a low risk of bias for all

  20. Networked Microgrids Scoping Study

    Energy Technology Data Exchange (ETDEWEB)

    Backhaus, Scott N. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Dobriansky, Larisa [General MicroGrids, San Diego, CA (United States); Glover, Steve [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Liu, Chen-Ching [Washington State Univ., Pullman, WA (United States); Looney, Patrick [Brookhaven National Lab. (BNL), Upton, NY (United States); Mashayekh, Salman [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Pratt, Annabelle [National Renewable Energy Lab. (NREL), Golden, CO (United States); Schneider, Kevin [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Stadler, Michael [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Starke, Michael [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Wang, Jianhui [Argonne National Lab. (ANL), Argonne, IL (United States); Yue, Meng [Brookhaven National Lab. (BNL), Upton, NY (United States)

    2016-12-05

    Much like individual microgrids, the range of opportunities and potential architectures of networked microgrids is very diverse. The goals of this scoping study are to provide an early assessment of research and development needs by examining the benefits of, risks created by, and risks to networked microgrids. At this time there are very few, if any, examples of deployed microgrid networks. In addition, there are very few tools to simulate or otherwise analyze the behavior of networked microgrids. In this setting, it is very difficult to evaluate networked microgrids systematically or quantitatively. At this early stage, this study is relying on inputs, estimations, and literature reviews by subject matter experts who are engaged in individual microgrid research and development projects, i.e., the authors of this study The initial step of the study gathered input about the potential opportunities provided by networked microgrids from these subject matter experts. These opportunities were divided between the subject matter experts for further review. Part 2 of this study is comprised of these reviews. Part 1 of this study is a summary of the benefits and risks identified in the reviews in Part 2 and synthesis of the research needs required to enable networked microgrids.

  1. 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

  2. 40 CFR 160.1 - Scope and applicability.

    Science.gov (United States)

    2010-07-01

    ... LABORATORY PRACTICE STANDARDS General Provisions § 160.1 Scope and applicability. (a) This part prescribes... for research or marketing permits for pesticide products regulated by the EPA. This part is intended... Federal Food, Drug and Cosmetic Act. (b) This part applies to any study described by paragraph (a) of this...

  3. 28 CFR 544.80 - Purpose and scope.

    Science.gov (United States)

    2010-07-01

    ... opportunity to improve their knowledge and skills through academic, occupation and leisure-time activities... Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT EDUCATION Education, Training and Leisure-Time Program Standards § 544.80 Purpose and scope. In consideration of...

  4. 41 CFR 50-204.1 - Scope and application.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Scope and application. 50-204.1 Section 50-204.1 Public Contracts and Property Management Other Provisions Relating to Public Contracts PUBLIC CONTRACTS, DEPARTMENT OF LABOR 204-SAFETY AND HEALTH STANDARDS FOR FEDERAL SUPPLY CONTRACTS...

  5. A General Scope of Practice for Professional School Counselors.

    Science.gov (United States)

    McCurdy, Kenneth G.

    The roles that school counselors play in schools can vary from school to school, from school district to district, and from state to state. To be effective in their positions as highly trained counseling and human development specialists, school counselors must be clear about their scope of practice. National standards for school counseling…

  6. 10 CFR 51.28 - Scoping-participants.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Scoping-participants. 51.28 Section 51.28 Energy NUCLEAR... environmental impact involved or which is authorized to develop and enforce relevant environmental standards; (4... environmental impact statement does not entitle the participant to become a party to the proceeding to which the...

  7. 28 CFR 549.50 - Purpose and scope.

    Science.gov (United States)

    2010-07-01

    ... Plastic Surgery § 549.50 Purpose and scope. The Bureau of Prisons does not ordinarily perform plastic surgery on inmates to correct preexisting disfigurements (including tattoos) on any part of the body. In circumstances where plastic surgery is a component of a presently medically necessary standard of treatment (for...

  8. 16 CFR 1750.3 - Scope and application.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Scope and application. 1750.3 Section 1750.3... application. This standard shall apply to devices furnished with household refrigerators manufactured and...) are directly accessible when the exterior hinged door(s) is (are) opened, and (c) have a minimum...

  9. 29 CFR 1956.1 - Purpose and scope.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Purpose and scope. 1956.1 Section 1956.1 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) STATE PLANS FOR THE DEVELOPMENT AND ENFORCEMENT OF STATE STANDARDS APPLICABLE TO STATE AND LOCAL...

  10. 29 CFR 1902.30 - Purpose and scope.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 5 2010-07-01 2010-07-01 false Purpose and scope. 1902.30 Section 1902.30 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR STATE PLANS FOR THE DEVELOPMENT AND ENFORCEMENT OF STATE STANDARDS Procedures for Determinations Under...

  11. Daily Goals Formulation and Enhanced Visualization of Mechanical Ventilation Variance Improves Mechanical Ventilation Score.

    Science.gov (United States)

    Walsh, Brian K; Smallwood, Craig; Rettig, Jordan; Kacmarek, Robert M; Thompson, John; Arnold, John H

    2017-03-01

    The systematic implementation of evidence-based practice through the use of guidelines, checklists, and protocols mitigates the risks associated with mechanical ventilation, yet variation in practice remains prevalent. Recent advances in software and hardware have allowed for the development and deployment of an enhanced visualization tool that identifies mechanical ventilation goal variance. Our aim was to assess the utility of daily goal establishment and a computer-aided visualization of variance. This study was composed of 3 phases: a retrospective observational phase (baseline) followed by 2 prospective sequential interventions. Phase I intervention comprised daily goal establishment of mechanical ventilation. Phase II intervention was the setting and monitoring of daily goals of mechanical ventilation with a web-based data visualization system (T3). A single score of mechanical ventilation was developed to evaluate the outcome. The baseline phase evaluated 130 subjects, phase I enrolled 31 subjects, and phase II enrolled 36 subjects. There were no differences in demographic characteristics between cohorts. A total of 171 verbalizations of goals of mechanical ventilation were completed in phase I. The use of T3 increased by 87% from phase I. Mechanical ventilation score improved by 8.4% in phase I and 11.3% in phase II from baseline ( P = .032). The largest effect was in the low risk V T category, with a 40.3% improvement from baseline in phase I, which was maintained at 39% improvement from baseline in phase II ( P = .01). mechanical ventilation score was 9% higher on average in those who survived. Daily goal formation and computer-enhanced visualization of mechanical ventilation variance were associated with an improvement in goal attainment by evidence of an improved mechanical ventilation score. Further research is needed to determine whether improvements in mechanical ventilation score through a targeted, process-oriented intervention will lead to

  12. Radar Plan Position Indicator Scope

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Radar Plan Position Indicator Scope is the collection of weather radar imagery for the period prior to the beginning of the Next Generation Radar (NEXRAD) system...

  13. Analysis of Air Flow in the Ventilated Insulating Air Layer of the External Wall

    Directory of Open Access Journals (Sweden)

    Katunská Jana

    2016-12-01

    Full Text Available The paper deals with problems of impact of air flow in ventilated insulating air layer of the external wall on behaviour of thermal-technical parameters of the proposed external structure (according principles of STN 73 0549, which is not valid now, by comparing them in the calculation according to the valid STN standards, where air flow in the ventilated air layer is not taken into account, as well as by comparing them with behavior of thermal-technical parameters in the proposal of sandwich external wall with the contact heat insulation system without air cavity.

  14. Research on Heat-Mechanical Coupling of Ventilated Disc Brakes under the Condition of Emergency Braking

    Science.gov (United States)

    Tan, Xuelong; Zhang, Jian; Tang, Wenxian; Zhang, Yang

    Taking the ventilated disc brake in some company as research object, and using UG to build 3D models of brake disc and pad, and making use of ABAQUS/Standard to set up two parts' finite element model, via the decelerated motion of actual simulation brake disc, which gets ventilated disc brake in the case of emergency breaking in time and space distribution of conditions of temperature and stress field, summarizes the distribution of temperature field and stress field, proves complex coupling between temperature, stress, and supplies the direct basis for brake's fatigue life analysis.

  15. The integration of engineering and architecture: A perspective on natural ventilation for the new San Francisco Federal Building

    Energy Technology Data Exchange (ETDEWEB)

    McConahey, Erin; Haves, Philip; Christ, Tim

    2002-05-31

    A description of the in-progress design of a new Federal Office Building for San Francisco is used to illustrate a number of issues arising in the design of large, naturally ventilated office buildings. These issues include the need for an integrated approach to design involving the architects, mechanical and structural engineers, lighting designers and specialist simulation modelers. In particular, the use of natural ventilation, and the avoidance of air-conditioning, depends on the high degree of exposed thermal mass made possible by the structural scheme and by the minimization of solar heat gains while maintaining the good daylighting that results from optimization of the fagade. Another issue was the need for a radical change in interior space planning in order to enhance the natural ventilation; all the individual enclosed offices are located along the central spine of each floorplate rather than at the perimeter. The role of integration in deterring the undermining of the design through value engineering is discussed. The comfort criteria for the building were established based on the recent extension to the ASHRAE comfort standard based on the adaptive model for naturally ventilated buildings. The building energy simulation program EnergyPlus was used to compare the performance of different natural ventilation strategies. The results indicate that, in the San Francisco climate, wind-driven ventilation provides sufficient nocturnal cooling to maintain comfortable conditions and that external chimneys do not provide significant additional ventilation at times when it when it would be beneficial.

  16. Oral topical decontamination for preventing ventilator-associated pneumonia: a systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Li, J; Xie, D; Li, A; Yue, J

    2013-08-01

    Oral decontamination is proposed to be an effective prevention of ventilator-associated pneumonia (VAP). The objective of this paper was to evaluate the effectiveness of oral decontamination in adult patients undergoing ventilation for more than 48h. We included all randomized controlled trials that used oral topical decontamination in adult patients from any population requiring mechanical ventilation for more than 48h, versus placebo, normal saline, or standard oral care. Sixteen trials involving 2399 participants were included. Meta-analysis showed that oral topical antiseptics significantly reduced the incidence of VAP [risk ratio (RR): 0.66; 95% confidence interval (CI): 0.49-0.88]. There was a significant reduction of VAP in studies which investigated decontamination with antibiotic agents other than iseganan (RR: 0.27; 95% CI: 0.18-0.42). Neither antiseptics nor antibiotics affected all-cause mortality, duration of ventilation, or duration of intensive care unit (ICU) stay. Oral decontamination reduced the incidence of VAP in adults undergoing ventilation, but did not affect all-cause mortality, duration of ventilation, or duration of ICU stay in ventilated patients. Further evidence from higher quality trials is necessary. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  17. ACQUIRING SCOPE: A LONGITUDINAL STUDY

    Directory of Open Access Journals (Sweden)

    Miao-Ling Hsieh

    2008-06-01

    Full Text Available Based on the spontaneous data of a Chinese-speaking child collected from 1 year old up to 4+ years old, this study focuses on the development of his scope by examining the scope interaction between negation and quantified NPs that occur in preverbal positions. It is found that the child is sensitive to scope at 3;2, an age much earlier than the age reported in other studies (e.g., age of 6 in Lee 1991. Further evidence shows that the child has mastered scope of negation and scope in general at the age of 4. First, starting from age 4;3, the child has managed to mark universal quantifiers and wh-phrases as well as duration phrases occurring in the preverbal position with scope markers such as dou ‘all’ and you ‘have’. Second, by the age of 4;5, the child has placed duration phrases in target positions in relation to negation.

  18. 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

  19. Comparative performance assessment of a non-ventilated and ventilated BIPV rooftop configurations in the Netherlands

    NARCIS (Netherlands)

    Ritzen, M.J.; Vroon, Z.A.E.P.; Rovers, R.; Geurts, C.P.W.

    2017-01-01

    Backside ventilation is one of the most common passive cooling methods of PV modules in the built environment, but might be under constraint when integrating PV in the building envelope. To investigate the short and long term effect of backside ventilation on Building Integrated PV (BIPV)

  20. Mechanical ventilation in emergency departments: Non invasive or invasive mechanical ventilation. Where is the answer?

    OpenAIRE

    Esquinas Rodriguez Antonio M; Cosentini Roberto; Papadakos Peter J

    2012-01-01

    The Emergency Department length of stay for patients requiring mechanical ventilation paper in this issue is very illustrative of many variables that still confound the way we treat patients that may not require endotracheal intubation (ETI) but may benefit from non-invasive mechanical ventilation (NIV) [1].

  1. Recovery Ventilation and Oxygen Debt-A Mathematical Model for the Prediction of Recovery Ventilation

    OpenAIRE

    G. P. Dimri; Arora, B. S.

    1982-01-01

    A Mathematical model has been evolved for the estimation of recovery ventilation following an exercise. The model has been used to estimate recovery ventilation in moderate to heavy exercise for a period of 32 minutes. The model gives satisfactory predictions for persons of different age groups and under different environment conditions thus establishing its universal applicability.

  2. 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.

  3. Analysis of trials comparing High Frequency Ventilation with Conventional Mechanical Ventilation : Clinical Epidemiology in Intensive Care

    NARCIS (Netherlands)

    Bollen, C.W.

    2006-01-01

    An abundance of experimental and clinical evidence indicates that mechanical ventilation can cause ventilator induced lung damage (VILI). Primary mechanisms leading to VILI are volutrauma, i.e. use of large tidal volumes resulting in over-distension, and atelectotrauma, i.e. repetitive closing and

  4. 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

  5. Computational Analysis of Natural Ventilation Flows in Geodesic Dome Building in Hot Climates

    Directory of Open Access Journals (Sweden)

    Zohreh Soleimani

    2016-08-01

    Full Text Available For centuries, dome roofs were used in traditional houses in hot regions such as the Middle East and Mediterranean basin due to its thermal advantages, structural benefits and availability of construction materials. This article presents the computational modelling of the wind- and buoyancy-induced ventilation in a geodesic dome building in a hot climate. The airflow and temperature distributions and ventilation flow rates were predicted using Computational Fluid Dynamics (CFD. The three-dimensional Reynolds-Averaged Navier-Stokes (RANS equations were solved using the CFD tool ANSYS FLUENT15. The standard k-epsilon was used as turbulence model. The modelling was verified using grid sensitivity and flux balance analysis. In order to validate the modelling method used in the current study, additional simulation of a similar domed-roof building was conducted for comparison. For wind-induced ventilation, the dome building was modelled with upper roof vents. For buoyancy-induced ventilation, the geometry was modelled with roof vents and also with two windows open in the lower level. The results showed that using the upper roof openings as a natural ventilation strategy during winter periods is advantageous and could reduce the indoor temperature and also introduce fresh air. The results also revealed that natural ventilation using roof vents cannot satisfy thermal requirements during hot summer periods and complementary cooling solutions should be considered. The analysis showed that buoyancy-induced ventilation model can still generate air movement inside the building during periods with no or very low wind.

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

    Science.gov (United States)

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

    2017-05-15

    After nearly twenty years of rapid modernization and urbanization in China, huge achievements have transformed the daily lives of the Chinese people. However, unprecedented environmental consequences in both indoor and outdoor environments have accompanied this progress and have triggered public awareness and demands for improved living standards, especially in residential environments. Indoor pollution data measured for >7000 dwellings (approximately 1/3 were newly decorated and were tested for volatile organic compound (VOC) measurements, while the rest were tested for particles, phthalates and other semi-volatile organic compounds (SVOCs), moisture/mold, inorganic gases and radon) in China within the last ten years were reviewed, summarized and compared with indoor concentration recommendations based on sensory or health end-points. Ubiquitous pollutants that exceed the concentration recommendations, including particulate matter, formaldehyde, benzene and other VOCs, moisture/mold, inorganic gases and radon, were found, indicating a common indoor air quality (IAQ) issue in Chinese dwellings. With very little prevention, oral, inhalation and dermal exposure to those pollutants at unhealthy concentration levels is almost inevitable. CO2, VOCs, humidity and radon can serve as ventilation determinants, each with different ventilation demands and strategies, at typical occupant densities in China; and particle reduction should be a prerequisite for determining ventilation requirements. Two directional ventilation modes would have profound impacts on improving IAQ for Chinese residences are: 1) natural (or window) ventilation with an air cleaner and 2) mechanical ventilation with an air filtration unit, these two modes were reviewed and compared for their applicability and advantages and disadvantages for reducing human exposure to indoor air pollutants. In general, mode 2 can more reliably ensure good IAQ for occupants; while mode 1 is more applicable due to its low

  7. Comparison of pressure and volume-controlled ventilation in laparoscopic cholecystectomy operations.

    Science.gov (United States)

    Aydın, Venera; Kabukcu, Hanife Karakaya; Sahin, Nursel; Mesci, Ayhan; Arici, Ayse Gulbin; Kahveci, Gulsum; Ozmete, Ozgen

    2016-05-01

    Laparoscopic cholecystectomy has many advantages such as shorter hospital stay of patients, minimal postoperative pain, rapid recovery after the operation; however, systemic disadvantages because intra-abdominal pressure, position and general anaesthesia may also appear. In this study, pressure-controlled ventilation (PCV) and volume-controlled ventilation (VCV) modes during laparoscopic cholecystectomy operations were compared in terms of their effects on haemodynamic, respiratory and blood gas parameters. Patients were randomly assigned to two groups according to the modes of mechanical ventilation, either to the PCV group, group P (35 patients) or to the VCV group, group V (35 patients). A standard electrocardiogram, pulse oximetry, non-invasive blood pressure, end-tidal CO2 , BIS and TOF monitoring were performed. Anaesthesia was induced with propofol, fentanyl and rocuronium. Anaesthesia was maintained with 50% O2  + 50% N2 O, propofol infusion and fentanyl. Haemodynamic data, respiratory parameters, arterial blood gases of the patients were measured. Dynamic compliance of the respiratory system, oxygenation index, alveolar-arterial oxygen gradient and dead space ventilation to tidal volume ratio were calculated. No difference was detected between the groups in terms of descriptive data, operation, anaesthesia, pneumoperitoneum and recovery period (P > 0.05). Haemodynamic data and blood gas values were compared between the two groups, and no significant difference was found (P  0.05). Tidal volume increased 10 min and 20 min after insufflation in the Group V (P ventilation to tidal volume ratio before pneumoperitoneum and alveolar-arterial oxygen gradient after pneumoperitoneum were significantly higher in the Group P compared to the Group V (P controlled ventilation anaesthesia in laparoscopic cholecystectomy, higher tidal volume and lower alveolar-arterial oxygen gradient were achieved after pneumoperitoneum. These findings indicated that

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

    Science.gov (United States)

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

    2014-10-01

    Acute respiratory distress syndrome (ARDS) is common following aneurysmal subarachnoid hemorrhage (SAH), but the influence of mechanical ventilator settings on its development is unclear. We sought to determine adherence to lung protective thresholds in ventilated patients with SAH and describe the association between ventilator settings and subsequent development of ARDS. We conducted a retrospective cohort study of consecutive patients receiving mechanical ventilation within 72 h of SAH at a single academic center. Ventilator settings and blood gas data were collected twice daily for the first 7 days of ventilation along with ICU and hospital outcomes. Lung protective ventilation was defined as follows: tidal volume ≤8 mL/kg of predicted body weight, positive end-expiratory pressure (PEEP) ≥5 cm H(2)O, and peak or plateau pressure ≤30 cm H(2)O. The development of ARDS was ascertained retrospectively by PaO(2)/FiO(2) ≤300 with new bilateral lung opacities on chest X-ray within one day of hypoxemia. We identified 62 patients who underwent early mechanical ventilation following SAH. PS and Continuous Positive Airway Pressure were common ventilator modes with a median tidal volume of 7.8 mL/kg [interquartile range 6.8-8.8], median peak pressure of 14 cm H(2)O [IQR 12-17], and median PEEP of 5 cm H(2)O [IQR 5-6]. Adherence to tidal volumes ≤8 mL/kg was seen in 64 % of all observations and peak pressures lung protective criteria were seen in 58 % of all observations. Thirty-one patients (50 %) were determined to have ARDS. ARDS patients were more frequently ventilated with a peak pressure >30 cm H(2)O (11.3 % of ARDS ventilation days vs. 0 % of non-ARDS ventilation days; p ventilation frequently breathe spontaneously, generating tidal volumes above usual protective thresholds regardless of meeting ARDS criteria. In patients with SAH, the presence of an additional ARDS risk factor should prompt close screening for the development of ARDS and consideration of

  9. VOC level control by ventilation improvement of Flexography printing room using CFD modeling

    Directory of Open Access Journals (Sweden)

    Kamal Hadad

    2017-08-01

    Full Text Available Using Computational Fluid Dynamics (CFD technique, the dispersion contours and the exposure rate of Flexographic printing workers to VOCs in a printing department is evaluated. Firstly, VOCs distribution is determined in the printing room due to the existing ventilation system. Through next steps, 4 scenarios for lowering VOCs concentration and its exposure rate to workers are analyzed. Concentration distributions of ethylene glycol (MEG as a representative of VOCs are determined for 4 scenarios. The results show that, regarding the existing ventilation, the concentration of MEG at the breathing height is 1×10-5 mg/m3 and it is higher than the standard permissible level. Finally, the findings of this study lead to lowered VOCs concentrations to 13.87×10-9 mg/m3 via changing the ventilation system for the Flexography Printing Room.

  10. Energy Impacts of Envelope Tightening and Mechanical Ventilation for the U.S. Residential Sector

    Energy Technology Data Exchange (ETDEWEB)

    Logue, J. M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sherman, M. H. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Walker, I. S. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Singer, B. C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2013-01-01

    Effective residential envelope air sealing reduces infiltration and associated energy costs for thermal conditioning, yet often creates a need for mechanical ventilation to protect indoor air quality. This study estimated the potential energy savings of implementing airtightness improvements or absolute standards along with mechanical ventilation throughout the U.S. housing stock. We used a physics-based modeling framework to simulate the impact of envelope tightening, providing mechanical ventilation as needed. There are 113 million homes in the US. We calculated the change in energy demand for each home in a nationally representative sample of 50,000 virtual homes developed from the 2009 Residential Energy Consumption Survey. Ventilation was provided as required by 2010 and proposed 2013 versions of ASHRAE Standard 62.2. Ensuring that all current homes comply with 62.2-2010 would increase residential site energy demand by 0.07 quads (0.07 exajoules (EJ)) annually. Improving airtightness of all homes at current average retrofit performance levels would decrease demand by 0.7 quads (0.74 EJ) annually and upgrading all homes to be as airtight as the top 10% of similar homes would double the savings, leading to roughly $22 billion in annual savings in energy bills. We also analyzed the potential benefits of bringing the entire stock to airtightness specifications of IECC 2012, Canada's R2000, and Passive House standards.

  11. Setting individualized positive end-expiratory pressure level with a positive end-expiratory pressure decrement trial after a recruitment maneuver improves oxygenation and lung mechanics during one-lung ventilation.

    Science.gov (United States)

    Ferrando, Carlos; Mugarra, Ana; Gutierrez, Andrea; Carbonell, Jose Antonio; García, Marisa; Soro, Marina; Tusman, Gerardo; Belda, Francisco Javier

    2014-03-01

    We investigated whether individualized positive end-expiratory pressure (PEEP) improves oxygenation, ventilation, and lung mechanics during one-lung ventilation compared with standardized PEEP. Thirty patients undergoing thoracic surgery were randomly allocated to the study or control group. Both groups received an alveolar recruitment maneuver at the beginning and end of one-lung ventilation. After the alveolar recruitment maneuver, the control group had their lungs ventilated with a 5 cm·H2O PEEP, while the study group had their lungs ventilated with an individualized PEEP level determined by a PEEP decrement trial. Arterial blood samples, lung mechanics, and volumetric capnography were recorded at multiple timepoints throughout the procedure. The individualized PEEP values in study group were higher than the standardized PEEP values (10 ± 2 vs 5 cm·H2O; P ventilation was switched to one-lung ventilation and increased after the alveolar recruitment maneuver. During one-lung ventilation, oxygenation was maintained in the study group but decreased in the control group. After one-lung ventilation, arterial oxygenation was significantly higher in the study group (306 vs 231 mm·Hg, P = 0.007). Static compliance decreased in both groups when bilateral-lung ventilation was switched to one-lung ventilation. Static compliance increased significantly only in the study group (P ventilation, the improvements in oxygenation and lung mechanics after an alveolar recruitment maneuver were better preserved by ventilation by using individualized PEEP with a PEEP decrement trial than with a standardized 5 cm·H2O of PEEP.

  12. Ventilator versus manual hyperinflation in clearing sputum in ventilated intensive care unit patients.

    Science.gov (United States)

    Dennis, Diane; Jacob, Wendy; Budgeon, Charley

    2012-01-01

    The aim of hyperinflation in the ventilated intensive care unit patient is to increase oxygenation, reverse lung collapse and clear sputum. The efficacy and consistency of manual hyperventilation is well supported in the literature, but there is limited published evidence supporting hyperventilation utilising a ventilator. Despite this, a recent survey established that almost 40% of Australian tertiary intensive care units utilise ventilator hyperinflation. The aim of this non-inferiority cross-over study was to determine whether ventilator hyperinflation was as effective as manual hyperinflation in clearing sputum from patients receiving mechanical ventilation using a prescriptive ventilator hyperinflation protocol. Forty-six patients received two randomly ordered physiotherapy treatments on the same day by the same physiotherapist. The efficacy of the hyperinflation modes was measured by sputum wet weight. Secondary measures included compliance, tidal volume, airway pressure and PaO2/FiO2 ratio. There was no difference in wet weight of sputum cleared using ventilator hyperinflation or manual hyperinflation (mean 3.2 g, P=0.989). Further, no difference in compliance (P=0.823), tidal volume (P=0.219), heart rate (P=0.579), respiratory rate (P=0.929) or mean arterial pressure (P=0.593) was detected. A statistically significant difference was seen in mean airway pressure (P=0.002) between techniques. The effect of techniques on the PaO2/FiO2 response ratio was dependent on time (interaction P=0.024). Physiotherapy using ventilator hyperinflation cleared a comparable amount of sputum and was as safe as manual hyperinflation. This research describes a ventilator hyperinflation protocol that will serve as a platform for continued discussion, research and development of its application in ventilated patients.

  13. The Impact of Ventilator-Associated Events in Critically Ill Subjects With Prolonged Mechanical Ventilation.

    Science.gov (United States)

    Kobayashi, Hidetsugu; Uchino, Shigehiko; Takinami, Masanori; Uezono, Shoichi

    2017-11-01

    The Centers for Disease Control and Prevention recently released a surveillance definition for respiratory complications in ventilated patients, ventilator-associated events (VAEs), to replace ventilator-associated pneumonia (VAP). VAEs consist of ventilator-associated conditions (VAC), infection-related ventilator-associated complications (IVAC), and possible VAP. A duration of mechanical ventilation of at least 4 d is required to diagnose VAE. However, the observed duration of mechanical ventilation was mechanical ventilation for ≥ 4 d. This single-center retrospective cohort study was conducted in the general ICU of an academic hospital. We included 407 adult subjects who were admitted to the ICU and required mechanical ventilation for at least 4 d. VAC and IVAC were identified from the electronic medical records. VAP was defined according to the Centers for Disease Control and Prevention 2008 criteria and was identified from the surveillance data of the infection control team of our hospital. Clinical outcomes were studied in the VAC, IVAC, and VAP groups. Possible VAP was not investigated. Higher mortality was seen in VAC and IVAC subjects, but not in VAP subjects, compared with those without VAEs and VAP. By multivariable hazard analysis for hospital mortality, IVAC was independently associated with hospital mortality (hazard ratio 2.42, 95% CI 1.39-4.20, P = .002). VAC also tended to show a similar association with hospital mortality (hazard ratio 1.45, 95% CI 0.97-2.18, P = .07). On the other hand, VAP did not increase a hazard of hospital death (hazard ratio 1.08, 95% CI 0.44-2.66, P = .87). We found that a VAE was related to hospital mortality in critically ill subjects with prolonged mechanical ventilation, and that VAP was not. Copyright © 2017 by Daedalus Enterprises.

  14. Image-based monitoring of one-lung ventilation.

    Science.gov (United States)

    Jean, S; Cinel, I; Gratz, I; Tay, C; Lotano, V; Deal, E; Parrillo, J E; Dellinger, R P

    2008-12-01

    With the increasing demand for one-lung ventilation in both thoracic surgery and other procedures, identifying the correct placement becomes increasingly important. Currently, endobronchial intubation is suspected based on a combination of auscultation and physiological findings. We investigated the ability of the visual display of airflow-induced vibrations to detect single-lung ventilation with a double-lumen endotracheal tube. Double-lumen tubes were placed prior to surgery. Tracheal and endobronchial lumens were alternately clamped to produce unilateral lung ventilation of right and left lung. Vibration response imaging, which detects vibrations transmitted to the surface of the thorax, was performed during both right- and left-lung ventilation. Geographical area of vibration response image as well as amount and distribution of lung sounds were assessed. During single-lung ventilation, the image and video obtained from the vibration response imaging identifies the ventilated lung with a larger and darker image on the ventilated side. During single-lung ventilation, 87.2 +/- 5.7% of the measured vibrations was detected over the ventilated lung and 12.8 +/- 5.7% over the non-ventilated lung (P single-lung ventilation, the vibration distribution in the non-ventilated lung had a majority of vibration detected by the medial sensors closest to the midline (P lung is ventilated. During single-lung ventilation, vibration response imaging clearly showed increased vibration in the lung that is being ventilated. Distribution of residual vibration differed in the non-ventilated lung in a manner that suggests transmission of vibrations across the mediastinum from the ventilated lung. The lung image and video obtained from vibration response imaging may provide useful and immediate information to help one-lung ventilation assessment.

  15. Light and Ventilation Analysis for Infrastructure in an Urban Region - A Case Study

    Directory of Open Access Journals (Sweden)

    Awkash Kumar

    2017-07-01

    Full Text Available Pressure on infrastructure due to over population has deteriorated the indoor environment causing various health issues. It has also contributed to the sick building syndrome making huge monetary burden to economy. Public health department of the country has taken many actions to mitigate these issues however; design of the building was not taken into consideration. Optimum quantities of light and proper ventilation express the quality of indoor environment. Also, the use of natural light and ventilation is definitely an advantage with the raising concerns regarding the cost and environmental impact of energy use. Natural light and ventilation can reduce building construction and operation costs and reduce the energy consumption. Moreover it would also ensure safe, healthy and comfortable living conditions. Therefore, it is very important to assess indoor environment before implementing new construction or building. This provides theoretical guidelines and basic calculations for understanding a green infrastructures and the factors related to it. In this paper, a building has been studied in an urban city of India where the percentage area of light and ventilation were analyzed Analysis showed the percentage of light is thrice and ventilation is twice the prescribed limits by Indian Green Building Council (IGBC. It has been found that building under study fulfills the given criteria by IGBC. This analysis can be useful while constructing a new infrastructure to improve the standard of living as 90% time is spent indoors.

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

    Science.gov (United States)

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

    2006-12-01

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

  17. Low resource ventilation unit; Ressourcebesparende ventilationsenhed

    Energy Technology Data Exchange (ETDEWEB)

    Drivsholm, C.

    2012-03-15

    In the project a resource-saving ventilation device was developed which is based on the use of a regenerator and a reversible air flow. The regenerator is placed in the building envelope, and the concept works in the way that the heat in the air during ventilation is stored in the regenerator and brought back into the building by a reversible air change. The heated air is blown from inside the building out through the regenerator. In this way the regenerator accumulates the heat in the air. Over a period of 30-120 seconds, the regenerator capacity is utilized. When the regenerator cannot be further heated, the air flow is reversed and there is now blown cold air through the regenerator. Thereby the heat from the regenerator is released to the cold fresh air. Thus, the fresh air brings heat back into the building, whereby the air is replaced with a limited heat loss. Ventilation with a regenerator is described as micro-ventilation. The developed micro-ventilation unit was tested by the Danish Technological Institute. The test results shows that the unit performs according to expectations: 1) The heat recovery is 85%; 2) The flow through the unit is 80m3 per hour in a 5 section unit; 3) The noise level is 30 db(A) in a representative room; 4) The energy consumption is <300 J/m3. The unit is introduced into the market, and the first plants have been sold. (LN)

  18. Intelligent decision support systems for mechanical ventilation.

    Science.gov (United States)

    Tehrani, Fleur T; Roum, James H

    2008-11-01

    An overview of different methodologies used in various intelligent decision support systems (IDSSs) for mechanical ventilation is provided. The applications of the techniques are compared in view of today's intensive care unit (ICU) requirements. Information available in the literature is utilized to provide a methodological review of different systems. Comparisons are made of different systems developed for specific ventilation modes as well as those intended for use in wider applications. The inputs and the optimized parameters of different systems are discussed and rule-based systems are compared to model-based techniques. The knowledge-based systems used for closed-loop control of weaning from mechanical ventilation are also described. Finally, in view of increasing trend towards automation of mechanical ventilation, the potential utility of intelligent advisory systems for this purpose is discussed. IDSSs for mechanical ventilation can be quite helpful to clinicians in today's ICU settings. To be useful, such systems should be designed to be effective, safe, and easy to use at patient's bedside. In particular, these systems must be capable of noise removal, artifact detection and effective validation of data. Systems that can also be adapted for closed-loop control/weaning of patients at the discretion of the clinician, may have a higher potential for use in the future.

  19. Scoping report on various salt mines in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Jacoby, C.H.

    1977-07-01

    One of the most important factors in isolating the demonstration waste storage site is an adequate number of shafts to insure proper ventilation. Proper ventilation will require that the air exhausted from the storage area pass directly to the upcast air shaft. Those mines reported by this scoping contract generally conform with the two shafts per mine requirement of MESA. Three of the mines reported on have more than two shafts. Several of the mines can have additional shafts drilled in time to meet ERDA's schedule. Rough drilling costs have been cited in the report. From an economic standpoint, it is probable that the larger the mine, the greater the economic impact with regard to any dislocation of production that may be required. In some cases, such as the Retsof Mine and the Cayuga Mine, multiple shafts eliminate the probability of dislocation. Those small tonnage mines such as the Kleer at Grand Saline, Texas; the Hockley Mine near Houston and the Lyons Mine of the American Salt Company might be leased or purchased in their entirety.

  20. Parameter estimation of an artificial respiratory system under mechanical ventilation following a noisy regime

    Directory of Open Access Journals (Sweden)

    Marcus Henrique Victor Júnior

    Full Text Available Abstract Introduction: This work concerns the assessment of a novel system for mechanical ventilation and a parameter estimation method in a bench test. The tested system was based on a commercial mechanical ventilator and a personal computer. A computational routine was developed do drive the mechanical ventilator and a parameter estimation method was utilized to estimate positive end-expiratory pressure, resistance and compliance of the artificial respiratory system. Methods The computational routine was responsible for establishing connections between devices and controlling them. Parameters such as tidal volume, respiratory rate and others can be set for standard and noisy ventilation regimes. Ventilation tests were performed directly varying parameters in the system. Readings from a calibrated measuring device were the basis for analysis. Adopting a first-order linear model, the parameters could be estimated and the outcomes statistically analysed. Results Data acquisition was effective in terms of sample frequency and low noise content. After filtering, cycle detection and estimation took place. Statistics of median, mean and standard deviation were calculated, showing consistent matching with adjusted values. Changes in positive end-expiratory pressure statistically imply changes in compliance, but not the opposite. Conclusion The developed system was satisfactory in terms of clinical parameters. Statistics exhibited consistent relations between adjusted and estimated values, besides precision of the measurements. The system is expected to be used in animals, with a view to better understand the benefits of noisy ventilation, by evaluating the estimated parameters and performing cross relations among blood gas, ultrasonography and electrical impedance tomography.

  1. Ventilation, temperature, and HVAC characteristics in small and medium commercial buildings in California.

    Science.gov (United States)

    Bennett, D H; Fisk, W; Apte, M G; Wu, X; Trout, A; Faulkner, D; Sullivan, D

    2012-08-01

    This field study of 37 small and medium commercial buildings throughout California obtained information on ventilation rate, temperature, and heating, ventilating, and air-conditioning (HVAC) system characteristics. The study included seven retail establishments; five restaurants; eight offices; two each of gas stations, hair salons, healthcare facilities, grocery stores, dental offices, and fitness centers; and five other buildings. Fourteen (38%) of the buildings either could not or did not provide outdoor air through the HVAC system. The air exchange rate averaged 1.6 (s.d. = 1.7) exchanges per hour and was similar between buildings with and without outdoor air supplied through the HVAC system, indicating that some buildings have significant leakage or ventilation through open windows and doors. Not all buildings had sufficient air exchange to meet ASHRAE 62.1 Standards, including buildings used for fitness centers, hair salons, offices, and retail establishments. The majority of the time, buildings were within the ASHRAE temperature comfort range. Offices were frequently overcooled in the summer. All of the buildings had filters, but over half the buildings had a filter with a minimum efficiency reporting value rating of 4 or lower, which are not very effective for removing fine particles. Most U.S. commercial buildings (96%) are small- to medium-sized, using nearly 18% of the country's energy, and sheltering a large population daily. Little is known about the ventilation systems in these buildings. This study found a wide variety of ventilation conditions, with many buildings failing to meet relevant ventilation standards. Regulators may want to consider implementing more complete building inspections at commissioning and point of sale. © 2012 John Wiley & Sons A/S.

  2. Noninvasive ventilation for acute exacerbations of asthma: A systematic review of the literature.

    Science.gov (United States)

    Green, Elyce; Jain, Paras; Bernoth, Maree

    2017-11-01

    Asthma is a chronic disease characterised by reversible airway obstruction caused by bronchospasm, mucous and oedema. People with asthma commonly experience acute exacerbations of their disease requiring hospitalisation and subsequent utilisation of economic and healthcare resources. Noninvasive ventilation has been suggested as a treatment for acute exacerbations of asthma due to its ability to provide airway stenting, optimal oxygen delivery and decreased work of breathing. This paper is a systematic review of the available published research focused on the use of noninvasive ventilation for the treatment of acute exacerbations of asthma to determine if this treatment provides better outcomes for patients compared to standard medical therapy. Database searches were conducted using EBSCOhost, MEDLINE and PubMed. Search terms used were combinations of 'noninvasive ventilation', 'BiPAP', 'CPAP', 'wheez*' and 'asthma'. Articles were included if they were research papers focused on adult patients with asthma and a treatment of noninvasive ventilation, and were published in full text in English. Included articles were reviewed using the National Health and Medical Research Council (Australia) evidence hierarchy and quality appraisal tools. There were 492 articles identified from the database searches. After application of inclusion/exclusion criteria 13 articles were included in the systematic review. Studies varied significantly in design, endpoints and outcomes. There was a trend in better outcomes for patients with acute asthma who were treated with noninvasive ventilation compared to standard medical therapy, however, the variability of the studies meant that no conclusive recommendations could be made. More research is required before noninvasive ventilation can be conclusively recommended for the treatment of acute exacerbations of asthma. Copyright © 2017 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

  3. CO2 MONITORING FOR DEMAND CONTROLLED VENTILATION IN COMMERCIAL BUILDINGS

    Energy Technology Data Exchange (ETDEWEB)

    Fisk, William J.; Sullivan, Douglas P.; Faulkner, David; Eliseeva, Ekaterina

    2010-03-17

    Carbon dioxide (CO{sub 2}) sensors are often deployed in commercial buildings to obtain CO{sub 2} data that are used, in a process called demand-controlled ventilation, to automatically modulate rates of outdoor air ventilation. The objective is to keep ventilation rates at or above design specifications and code requirements and also to save energy by avoiding excessive ventilation rates. Demand controlled ventilation is most often used in spaces with highly variable and sometime dense occupancy. Reasonably accurate CO{sub 2} measurements are needed for successful demand controlled ventilation; however, prior research has suggested substantial measurement errors. Accordingly, this study evaluated: (a) the accuracy of 208 CO{sub 2} single-location sensors located in 34 commercial buildings, (b) the accuracy of four multi-location CO{sub 2} measurement systems that utilize tubing, valves, and pumps to measure at multiple locations with single CO{sub 2} sensors, and (c) the spatial variability of CO{sub 2} concentrations within meeting rooms. The field studies of the accuracy of single-location CO{sub 2} sensors included multi-concentration calibration checks of 90 sensors in which sensor accuracy was checked at multiple CO{sub 2} concentrations using primary standard calibration gases. From these evaluations, average errors were small, -26 ppm and -9 ppm at 760 and 1010 ppm, respectively; however, the averages of the absolute values of error were 118 ppm (16%) and 138 ppm (14%), at concentrations of 760 and 1010 ppm, respectively. The calibration data are generally well fit by a straight line as indicated by high values of R{sup 2}. The Title 24 standard specifies that sensor error must be certified as no greater than 75 ppm for a period of five years after sensor installation. At 1010 ppm, 40% of sensors had errors greater than {+-}75 ppm and 31% of sensors has errors greater than {+-}100 ppm. At 760 ppm, 47% of sensors had errors greater than {+-}75 ppm and 37% of

  4. Influence of ambient oxygenation and temperature on metabolic scope and scope for heart rate in the common sole Solea solea

    OpenAIRE

    Lefrancois, Christelle; Claireaux, Guy

    2003-01-01

    The objective of this study was to quantify the constraints exerted by temperature and oxygenation on both metabolic scope and scope for heart rate of the common sole Solea solea. We exposed sole to a large range of temperature and oxygenation conditions and a modelling procedure was implemented to describe metabolic and cardiac responses. Standard metabolic rate (SMR) rose exponentially from 4 to 24degreesC, whereas active metabolic rate (AMR) increased from 55.4 to 159.2 mgO(2) kg(-1) h(-1)...

  5. 30 CFR 57.22201 - Mechanical ventilation (I-A, I-B, I-C, II-A, II-B, III, IV, V-A, and V-B mines).

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Mechanical ventilation (I-A, I-B, I-C, II-A, II...-UNDERGROUND METAL AND NONMETAL MINES Safety Standards for Methane in Metal and Nonmetal Mines Ventilation § 57.22201 Mechanical ventilation (I-A, I-B, I-C, II-A, II-B, III, IV, V-A, and V-B mines). All mines shall...

  6. Assessing Thermal Comfort Due to a Ventilated Double Window

    Science.gov (United States)

    Carlos, Jorge S.; Corvacho, Helena

    2017-10-01

    Building design and its components are the result of a complex process, which should provide pleasant conditions to its inhabitants. Therefore, indoor acceptable comfort is influenced by the architectural design. ISO and ASHRAE standards define thermal comfort as the condition of mind that expresses satisfaction with the thermal environment. The energy demand for heating, beside the building’s physical properties, also depend on human behaviour, like opening or closing windows. Generally, windows are the weakest façade element concerning to thermal performance. A lower thermal resistance allows higher thermal conduction through it. When a window is very hot or cold, and the occupant is very close to it, it may result in thermal discomfort. The functionality of a ventilated double window introduces new physical considerations to a traditional window. In consequence, it is necessary to study the local effect on human comfort in function of the boundary conditions. Wind, solar availability, air temperature and therefore heating and indoor air quality conditions will affect the relationship between this passive system and the indoor environment. In the present paper, the influence of thermal performance and ventilation on human comfort resulting from the construction and geometry solutions is shown, helping to choose the best solution. The presented approach shows that in order to save energy it is possible to reduce the air changes of a room to the minimum, without compromising air quality, enhancing simultaneously local thermal performance and comfort. The results of the study on the effect of two parallel windows with a ventilated channel in the same fenestration on comfort conditions for several different room dimensions, are also presented. As the room dimensions’ rate changes so does the window to floor rate; therefore, under the same climatic conditions and same construction solution, different results are obtained.

  7. Comparing 3 ventilation modalities by measuring several respiratory parameters using the ProSeal laryngeal mask airway in children.

    Science.gov (United States)

    Templeton, T Wesley; Hoke, Lauren K; Yaung, Jill; Aschenbrenner, Carol A; Rose, Danielle M; Templeton, Leah B; Bryan, Yvon F

    2016-11-01

    To determine quantitative differences in several routinely measured ventilation parameters using a standardized anesthetic technique and 3 different ventilation modalities in pediatric patients with a ProSeal laryngeal mask airway (PLMA). Randomized prospective study. Pediatric hospital of a tertiary care academic medical center. Thirty-three, American Society of Anesthesiologists classification 1-2, pediatric patients (12 months to 5 years). Three different ventilation strategies: spontaneous ventilation (SV), pressure support ventilation (PSV), and pressure-controlled ventilation (PCV) were randomly applied to patients who underwent a standardized mask induction with sevoflurane/oxygen and propofol 3 mg/kg and morphine 0.05 mg/kg administered intravenously followed by PLMA insertion. Patients were maintained on sevoflurane and N2O. We measured the differences in end-tidal CO2 (Etco2), tidal volume, and respiratory rate over time between SV, PSV, and PCV. These data were recorded at 5-minute intervals. Etco2 (mm Hg) was significantly higher in the SV vs PSV (P=.016) and vs PCV (P<.001). Tidal volume (mL/kg) was significantly lower in SV vs PSV (P<.001) and vs PCV (P<.001). Respiratory rate (breaths/min) was significantly higher in SV vs PSV (P<.001) and vs PCV (P=.005). All 3 modes of ventilation using a PLMA were safely used. Our SV group was noted to have a significantly higher Etco2 when compared with PSV and PCV with a mean Etco2 over time in excess of 55 mm Hg. PSV and PCV were found to be more appropriate ventilation strategies to more optimally control Etco2 over time in these patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Improving comfort and health with personalized ventilation

    DEFF Research Database (Denmark)

    Melikov, Arsen Krikor

    2004-01-01

    The thermal environment and air quality in buildings affects occupants¿ health, comfort and performance. The heating, ventilating and air-conditioning (HVAC) of buildings today is designed to provide a uniform room environment. However, large individual differences exist between occupants in regard...... 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 fulfil 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 analysed and its impact on thermal comfort and inhaled air quality is discussed together with control strategies and the application of PV in practice...

  9. Personal Exposure in Displacement Ventilated Rooms

    DEFF Research Database (Denmark)

    Brohus, Henrik; Nielsen, Peter Vilhelm

    1996-01-01

    in the lower part of the room close to the occupant. A personal exposure model for displacement ventilated rooms is proposed. The model takes the influence of gradients and the human thermal boundary layer into account. Two new quantities describing the interaction between a person and the ventilation......Personal exposure in a displacement ventilated room is examined. The stratified flow and the considerable concentration gradients necessitate an improvement of the widely used fully mixing compartmental approach. The exposure of a seated and a standing person in proportion to the stratification...... height is examined by means of full-scale measurements. A breathing thermal manikin is used to simulate a person. It is found that the flow in the boundary layer around a person is able to a great extent to entrain and transport air from below the breathing zone. In the case of non-passive, heated...

  10. Home Mechanical Ventilation in South Korea

    Science.gov (United States)

    Kim, Dong Hyun; Choi, Won Ah

    2014-01-01

    Purpose To survey the use of invasive and noninvasive home mechanical ventilation (HMV) methods in South Korea from the perspective of physical medicine and rehabilitation (PM&R). Materials and Methods For 413 users of HMV, retrospective reviews of PM&R interventions and survey of HMV methods employed from Mar 2000 to Dec 2009. Results Of the 413 users, the majority of whom with progressive neuromuscular disorders (NMDs) (n=358), 284 patients initially used noninvasive mechanical ventilation (NIV), while 63 others who were using tracheostomy mechanical ventilation switched to NIV as part of their rehabilitation. The NMD patients began HMV at an earlier age (34.9±20.3 yrs), and used for longer (14.7±7.5) hours than patients with non-neuromuscular causes of respiratory impairment. Conclusion Noninvasive management was preferred over invasive ones, and transition to the former was a result of PM&R interventions. PMID:25323913

  11. Energy Analysis of the Ductless Personalized Ventilation

    DEFF Research Database (Denmark)

    Lelong, Cyril; Dalewski, Mariusz; Melikov, Arsen Krikor

    2013-01-01

    This study explores the impact of different occupancy profiles on the potential energy savings due to using ductless personalized ventilation (DPV) combined with displacement ventilation. Energy simulations were performed with the dynamic simulation software IDA-ICE in order to investigate optimal...... energy efficient strategies for implantation of DPV in practice. The impact of using DPV on annual energy use has been studied for different occupancy profiles in cold climates. The results suggest that using DPV combined with displacement ventilation may significantly reduce building energy use while...... providing good air quality and thermal comfort for the occupants. Matching DPV use with occupants’ presence at their workplaces may allow reducing the energy use of DPV significantly....

  12. Performance of displacement ventilation in practice

    DEFF Research Database (Denmark)

    Naidenov, K.; Pitchurov, G.; Langkilde, Gunnar

    2002-01-01

    This paper presents results of a field study in offices with displacement ventilation. It comprises detailed physical measurements of the thermal environment and collection of occupants´ response at 227 workplaces. The results, both physical measurements and human response, identified draught...... as the major local discomfort in the rooms with displacement ventilation. Twenty-three percent of the occupants were daily bothered by draught. In some buildings the maintenance personnel tried to improve occupants´ thermal comfort by raising the supply air temperature or office workers themselves blocked...... the diffusers by rearranging the furniture. Half of the surveyed occupants were not satisfied with the indoor air quality. The main conclusion is that displacement ventilation needs careful design and room furnishing in order to ensure a comfortable environment. Occupants must understand the underlying...

  13. 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.

  14. Ventilator gas flow rates affect inspiratory time and ventilator efficiency index in term lambs.

    Science.gov (United States)

    Bach, Katinka P; Kuschel, Carl A; Oliver, Mark H; Bloomfield, Frank H

    2009-01-01

    Despite increasing survival in the smallest preterm infants, the incidence of chronic lung disease has not decreased. Research into ventilatory strategies has concentrated on minimising barotrauma, volutrauma and atelectotrauma, but little attention has been paid to the role of bias gas flow rates and the potential for rheotrauma or shear stress injury. Ventilated preterm infants frequently receive relatively high gas flow rates. We hypothesised that altering bias gas flow rates would change the efficiency of ventilation and thereby affect ventilatory parameters. We tested this hypothesis using an artificial lung followed by ventilation of 8 term lambs. Between flows of 2 and 15 l/min, inflation time (Ti) in the artificial lung was inversely related to the bias gas flow rate. In the ventilated lambs, Ti was inversely related to flow rates up to 10 l/min, with no statistically significant effect at flow rates >10 l/min. There were no adverse effects on gas exchange or cardiovascular parameters until a flow rate of 3 l/min was used, when inadequate gas exchange occurred. Ti is inversely associated with the bias gas flow rate. Flow rates much lower than those used in many neonatal units seem to provide adequate ventilation. We suggest that the role of ventilator gas flow rates, which may potentially influence shear stress in ventilator-induced lung injury, merits further investigation. Copyright 2009 S. Karger AG, Basel.

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

    Science.gov (United States)

    Veneroni, Chiara; Farre’, Ramon

    2017-01-01

    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. Educational aims 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. PMID:28620428

  16. Thermoregulation and ventilation of termite mounds

    Science.gov (United States)

    Korb, Judith

    2003-05-01

    Some of the most sophisticated of all animal-built structures are the mounds of African termites of the subfamily Macrotermitinae, the fungus-growing termites. They have long been studied as fascinating textbook examples of thermoregulation or ventilation of animal buildings. However, little research has been designed to provide critical tests of these paradigms, derived from a very small number of original papers. Here I review results from recent studies on Macrotermes bellicosus that considered the interdependence of ambient temperature, thermoregulation, ventilation and mound architecture, and that question some of the fundamental paradigms of termite mounds. M. bellicosus achieves thermal homeostasis within the mound, but ambient temperature has an influence too. In colonies in comparably cool habitats, mound architecture is adapted to reduce the loss of metabolically produced heat to the environment. While this has no negative consequences in small colonies, it produces a trade-off with gas exchange in large colonies, resulting in suboptimally low nest temperatures and increased CO2 concentrations. Along with the alteration in mound architecture, the gas exchange/ventilation mechanism also changes. While mounds in the thermally appropriate savannah have a very efficient circular ventilation during the day, the ventilation in the cooler forest is a less efficient upward movement of air, with gas exchange restricted by reduced surface exchange area. These results, together with other recent findings, question entrenched ideas such as the thermosiphon-ventilation mechanism or the assumption that mounds function to dissipate internally produced heat. Models trying to explain the proximate mechanisms of mound building, or building elements, are discussed.

  17. Advanced design of local ventilation systems

    Energy Technology Data Exchange (ETDEWEB)

    Kulmala, I. [VTT Manufacturing Technology, Espoo (Finland). Safety Technology

    1997-12-31

    Local ventilation is widely used in industry for controlling airborne contaminants. However, the present design practices of local ventilation systems are mainly based on empirical equations and do not take quantitatively into account the various factors affecting the performance of these systems. The aim of this study was to determine the applicability and limitations of more advanced fluid mechanical methods to the design and development of local ventilation systems. The most important factors affecting the performance of local ventilation systems were determined and their effect was studied in a systematic manner. The numerical calculations were made with the FLUENT computer code and they were verified by laboratory experiments, previous measurements or analytical solutions. The results proved that the numerical calculations can provide a realistic simulation of exhaust openings, effects of ambient air flows and wake regions. The experiences with the low-velocity local supply air showed that these systems can also be modelled fairly well. The results were used to improve the efficiency and thermal comfort of a local ventilation unit and to increase the effective control range of exhaust hoods. In the simulation of the interaction of a hot buoyant source and local exhaust, the predicted capture efficiencies were clearly higher than those observed experimentally. The deviations between measurements and non-isothermal flow calculations may have partly been caused by the inability to achieve grid independent solutions. CFD simulations is an advanced and flexible tool for designing and developing local ventilation. The simulations can provide insight into the time-averaged flow field which may assist us in understanding the observed phenomena and to explain experimental results. However, for successful calculations the applicability and limitations of the models must be known. (orig.) 78 refs.

  18. A randomised controlled trial and cost-effectiveness analysis of high-frequency oscillatory ventilation against conventional artificial ventilation for adults with acute respiratory distress syndrome. The OSCAR (OSCillation in ARDS) study.

    Science.gov (United States)

    Lall, Ranjit; Hamilton, Patrick; Young, Duncan; Hulme, Claire; Hall, Peter; Shah, Sanjoy; MacKenzie, Iain; Tunnicliffe, William; Rowan, Kathy; Cuthbertson, Brian; McCabe, Chris; Lamb, Sallie

    2015-03-01

    Patients with the acute respiratory distress syndrome (ARDS) require artificial ventilation but this treatment may produce secondary lung damage. High-frequency oscillatory ventilation (HFOV) may reduce this damage. To determine the clinical benefit and cost-effectiveness of HFOV in patients with ARDS compared with standard mechanical ventilation. A parallel, randomised, unblinded clinical trial. UK intensive care units. Mechanically ventilated patients with a partial pressure of oxygen in arterial blood/fractional concentration of inspired oxygen (P : F) ratio of 26.7 kPa (200 mmHg) or less and an expected duration of ventilation of at least 2 days at recruitment. Treatment arm HFOV using a Novalung R100(®) ventilator (Metran Co. Ltd, Saitama, Japan) ventilator until the start of weaning. Control arm Conventional mechanical ventilation using the devices available in the participating centres. The primary clinical outcome was all-cause mortality at 30 days after randomisation. The primary health economic outcome was the cost per quality-adjusted life-year (QALY) gained. One hundred and sixty-six of 398 patients (41.7%) randomised to the HFOV group and 163 of 397 patients (41.1%) randomised to the conventional mechanical ventilation group died within 30 days of randomisation (p = 0.85), for an absolute difference of 0.6% [95% confidence interval (CI) -6.1% to 7.5%]. After adjustment for study centre, sex, Acute Physiology and Chronic Health Evaluation II score, and the initial P : F ratio, the odds ratio for survival in the conventional ventilation group was 1.03 (95% CI 0.75 to 1.40; p = 0.87 logistic regression). Survival analysis showed no difference in the probability of survival up to 12 months after randomisation. The average QALY at 1 year in the HFOV group was 0.302 compared to 0.246. This gives an incremental cost-effectiveness ratio (ICER) for the cost to society per QALY of £88,790 and an ICER for the cost to the NHS per QALY of £ 78,260. The use

  19. Determinants of Receiving Palliative Care and Ventilator Withdrawal Among Patients With Prolonged Mechanical Ventilation.

    Science.gov (United States)

    Chen, Yang-Ching; Fan, Hsien-Yu; Curtis, J Randall; Lee, Oscar Kuang-Sheng; Liu, Chih-Kuang; Huang, Sheng-Jean

    2017-10-01

    Increasing numbers of patients with prolonged mechanical ventilation generates a tremendous strain on healthcare systems. Patients with prolonged mechanical ventilation suffer from long-term poor quality of life. However, no study has ever explored the willingness to receive palliative care or terminal withdrawal and the factors influencing willingness. Cross-sectional study. Five different hospitals of Taipei City Hospital system. Adult patients with ventilatory support for more than 60 days. None. We identified the family members of 145 consecutive patients with prolonged mechanical ventilation in five hospitals of Taipei City Hospital system and enrolled family members for 106 patients (73.1%). We collected information from patient families' regarding concepts (knowledge, attitude, and experiences) of palliative care, caregiver burden, family function, patient quality of life, and physician-family communications. From the medical record, we obtained duration of hospitalization, consciousness level, disease severity, medical cost, and the presence of do-not-resuscitate orders. The vast majority of family members agreed with the concept of palliative care (90.4%) with 17.3% of the family members agreeing to ventilator withdrawal currently and 67.5% terminally in anticipation of death. Approximately half of the family members regretted having chosen prolonged mechanical ventilation (56.7%). Reduced patient quality of life and increased family understanding of palliative care significantly associated with increased caregiver willingness to endorse palliative care and withdraw life-sustaining agents in anticipation of death. Longer duration of ventilator usage and hospitalization was associated with increased feelings of regret about choosing prolonged mechanical ventilation. During prolonged mechanical ventilation, physicians should thoroughly discuss its benefits and burdens. Families should be given the opportunity to discuss the circumstances under which they

  20. Preoperational test report, recirculation ventilation systems

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, F.T.

    1997-11-11

    This represents a preoperational test report for Recirculation Ventilation Systems, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system provides vapor space cooling of tanks AY1O1, AY102, AZ1O1, AZ102 and supports the ability to exhaust air from each tank. Each system consists of a valved piping loop, a fan, condenser, and moisture separator; equipment is located inside each respective tank farm in its own hardened building. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.