This month's issue focuses on ventilation. 

ClarkDietrich is adding two new components to its E-Screen entangled-mesh rainscreen rolls, providing a complete exterior cladding moisture management system that is compliant with ASTM performance criteria.

Gaithersburg, MD — “In many buildings, ventilation is often misunderstood or infrequently assessed,” says the National Institute of Standards and Technology, which has created an online tool designed to help determine indoor air quality.

New York — Ventilation and air filtration recommendations are part of a new workplace policy guide on reducing COVID-19 transmission, published by the New York Committee for Occupational Safety and Health, a worker advocacy group.

Washington — Employers can help prevent the spread of common respiratory viruses indoors by ensuring proper workplace ventilation and limiting the use of small, shared spaces, the Environmental Protection Agency says.

Washington — Citing the increased circulation of airborne viruses when temperatures drop, “indoor air quality in the workplace during cold weather is especially critical,” OSHA says in a new alert.

Boston — Improved air quality in offices can boost worker focus, response times and overall cognitive ability, researchers from the Harvard T.H. Chan School of Public Health claim.

As residential building codes and energy conservation standards continue to evolve, many are requiring proof of high quality air sealing.

The overall objective was to create a complete HVAC system, rather than just a heating + cooling system. The system would provide space heating, cooling, domestic hot water, and fresh air ventilation.

Silica is released into the air during the construction process and breathing it in can lead to cancer. Use this guide to learn how to work safely with silica in every setting.

Here’s an answer for contractors wondering, “How do I effectively sell air movement and ventilation efficiency, and why should I?”

Airflow takes the path of least resistance through buildings, often leaving much of the air stagnant and unaffected. A new IAQ strategy is needed.

This product features multicolored Chroma LEDs that allow users to choose from 24 hues with the included wall control.

HVLS fans offer an affordable and effective solution for large-scale ventilation, as well as demonstrating success in smaller applications.

Residential air movement and ventilation can be a challenge that requires multiple callbacks. There is a way to fix that, though.

Many homeowners may underestimate the importance of proper ventilation, which a lack of could cause discomfort and higher energy bills.

Atlas General Contractors in Illinois turned to Atlas Roofing products to help reroof and improve ventilation for a century-old church.

Spending millions to guard against COVID-19 spread, district leaders also must convince parents school buildings are safe.

Extract

We read with great interest the review article by Randerath et al. [1] recently published in the European Respiratory Review. We would like to congratulate the authors on this clearly structured review, which emphasises the urgent need for an increasingly differentiated view of central sleep apnoea (CSA) in the context of precision medicine.

BACKGROUD:Lung volume measurements are important for monitoring functional aeration and recruitment and may help guide adjustments in ventilator settings. The expiratory phase of airway pressure release ventilation (APRV) may provide physiologic information about lung volume based on the expiratory flow-time slope, angle, and time to approach a no-flow state (expiratory time [TE]). We hypothesized that expiratory flow would correlate with estimated lung volume (ELV) as measured using a modified nitrogen washout/washin technique in a large-animal lung injury model.METHODS:Eight pigs (35.2 ± 1.0 kg) were mechanically ventilated using an Engström Carescape R860 on the APRV mode. All settings were held constant except the expiratory duration, which was adjusted based on the expiratory flow curve. Abdominal pressure was increased to 15 mm Hg in normal and injured lungs to replicate a combination of pulmonary and extrapulmonary lung injury. ELV was estimated using the Carescape FRC INview tool. The expiratory flow-time slope and TE were measured from the expiratory flow profile.RESULTS:Lung elastance increased with induced lung injury from 29.3 ± 7.3 cm H2O/L to 39.9 ± 15.1cm H2O/L, and chest wall elastance increased with increasing intra-abdominal pressures (IAPs) from 15.3 ± 4.1 cm H2O/L to 25.7 ± 10.0 cm H2O/L in the normal lung and 15.8 ± 6.0 cm H2O/L to 33.0 ± 6.2 cm H2O/L in the injured lung (P = .39). ELV decreased from 1.90 ± 0.83 L in the injured lung to 0.67 ± 0.10 L by increasing IAP to 15 mm Hg. This had a significant correlation with a TE decrease from 2.3 ± 0.8 s to 1.0 ± 0.1 s in the injured group with increasing insufflation pressures (ρ = 0.95) and with the expiratory flow-time slope, which increased from 0.29 ± 0.06 L/s2 to 0.63 ± 0.05 L/s2 (ρ = 0.78).CONCLUSIONS:Changes in ELV over time, and the TE and flow-time slope, could be used to demonstrate evolving lung injury during APRV. Using the slope to infer changes in functional lung volume represents a unique, reproducible, real-time, bedside technique that does not interrupt ventilation and may be used for clinical interpretation.

BACKGROUND:This study sought to estimate the overall cumulative incidence and odds of Hospital-acquired venous thromboembolism (VTE) among critically ill children with and without exposure to invasive ventilation. In doing so, we also aimed to describe the temporal relationship between invasive ventilation and hospital-acquired VTE development.METHODS:We performed a retrospective cohort study using Virtual Pediatric Systems (VPS) data from 142 North American pediatric ICUs among children < 18 y of age from January 1, 2016–December 31, 2022. After exclusion criteria were applied, cohorts were identified by presence of invasive ventilation exposure. The primary outcome was cumulative incidence of hospital-acquired VTE, defined as limb/neck deep venous thrombosis or pulmonary embolism. Multivariate logistic regression was used to determine whether invasive ventilation was an independent risk factor for hospital-acquired VTE development.RESULTS:Of 691,118 children studied, 86,922 (12.4%) underwent invasive ventilation. The cumulative incidence of hospital-acquired VTE for those who received invasive ventilation was 1.9% and 0.12% for those who did not (P < .001). The median time to hospital-acquired VTE after endotracheal intubation was 6 (interquartile range 3–14) d. In multivariate models, invasive ventilation exposure and duration were each independently associated with development of hospital-acquired VTE (adjusted odds ratio 1.64 [95% CI 1.42–1.86], P < .001; and adjusted odds ratio 1.03 [95% CI 1.02–1.03], P < .001, respectively).CONCLUSIONS:In this multi-center retrospective review from the VPS registry, invasive ventilation exposure and duration were independent risk factors for hospital-acquired VTE among critically ill children. Children undergoing invasive ventilation represent an important target population for risk-stratified thromboprophylaxis trials.

BACKGROUND:Training in mechanical ventilation is a key goal in critical care fellowship education. Web-based simulators offer a cost-effective and readily available alternative to traditional on-site simulators. However, it is unclear how effective they are as teaching tools. In this study, we evaluated the test scores of fellows who underwent mechanical ventilation training by using a web-based simulator compared with fellows who used an on-site simulator during a mechanical ventilation course.METHODS:This was a nonrandomized controlled trial conducted as part of a mechanical ventilation course that involved 70 first-year critical care fellows. The course was identical except for the simulation technology used. One group of instructors used a traditional on-site simulator, the ASL 5000 Lung Solution (n = 39). The second group was instructed in using a web-based simulator, VentSim (n = 31). Each fellow completed a pre-course test and a post-course test by using a validated, case-based ventilator waveform examination that consisted of 5 questions with a total possible score of 100. The primary outcome was a comparison of the mean scores on the posttest between the 2 groups. The study was designed as a non-inferiority trial with a predetermined margin of 10 points.RESULTS:There was no significant difference in the mean ± SD pretest scores between the web-based and the on-site groups (21.1 ± 12.6 and 26.9 ± 13.6 respectively; P = .11). The mean ± SD posttest scores were 45.6 ± 25.0 for the web-based simulator and 43.4 ± 16.5 for on-site simulator (mean difference 2.2; one-sided 95% CI –7.0 to ∞; Pnon-inferiority = .02 [non-inferiority confirmed]). Changes in mean ± SD scores (posttest – pretest) were 25.9 ± 20.9 for the web-based simulator and 16.5 ± 15.9 for the on-site simulator (mean difference 9.4, one-sided 95% CI 0.9 to ∞; Pnon-inferiority < .001 [non-inferiority confirmed]).CONCLUSIONS:In the education of first-year critical care fellows on mechanical ventilation waveform analysis, a web-based mechanical ventilation simulator was non-inferior to a traditional on-site mechanical ventilation simulator.

Introduction

Exacerbation of COPD complicated by respiratory acidaemia is the commonest indication for noninvasive ventilation (NIV). The NIV outcomes (NIVO) score offers the best estimate of survival for those ventilated. Unfortunately, two-thirds of cases of COPD are unrecognised, and patients may present without COPD having been confirmed by spirometry.

Non-invasive ventilation (NIV) is the mainstay to treat patients who need augmentation of ventilation for acute and chronic forms of respiratory failure. The last several decades have witnessed an extension of the indications for NIV to a variety of acute and chronic lung diseases. Evolving advancements in technology and personalised approaches to patient care make it feasible to prioritise patient-centred care models that deliver home-based management using telemonitoring and telemedicine systems support. These trends may improve patient outcomes, reduce healthcare costs and improve the quality of life for patients who suffer from chronic diseases that precipitate respiratory failure.

The Respiratory Intensive Care Assembly of the European Respiratory Society gathered in Berlin to organise the third Respiratory Failure and Mechanical Ventilation Conference in February 2024. The conference covered key points of acute and chronic respiratory failure in adults. During the 3-day conference ventilatory strategies, patient selection, diagnostic approaches, treatment and health-related quality of life topics were addressed by a panel of international experts. In this article, lectures delivered during the event have been summarised by early career members of the Assembly and take-home messages highlighted.

Unprotected workers exposed to airborne nanoparticles face a potential health risk from carbon black and titanium dioxide nanoparticles, according to a recent study. Reducing airborne nanoparticle contamination to acceptable levels can be achieved by using a workplace filter ventilation system and personal respirators.

Underground trains are among the most widely used public transport systems in cities worldwide. A study investigating the chemical composition and source of particles in Barcelona subway stations found that a new station design, with sliding doors that separate the platform from the tunnel and good ventilation, reduced the concentration of fine particulate matter (PM2.5) by over 50% compared with older station designs.

Kitchen exhaust turns out to be a very complicated issue where there is no real consensus.

Ravi Thiagarajan, MD, MBBS, MPH, discusses his article published in the January Pediatric Critical Care Medicine.

Margaret Parker, MD, FCCM, speaks with Carl O. Eriksson, MD, MPH, lead author on an article published in the November Pediatric Critical Care Medicine

Margaret Parker, MD, MCCM, speaks with Andrea Wolfler, MD

DALLAS, April 3, 2020 — With the COVID-19 pandemic, more patients are having difficulty breathing and requiring ventilators to help them breathe. As hospital and intensive care unit (ICU) volumes increase with COVID-19 patients, health care ...

An automatic programmed ventilation control system for operating a fan includes a fan drive circuit; a duty, cycle control circuit including means for selecting a duty cycle and means for setting the selected duty cycle; a timing circuit including means for selecting the time of day and means for setting the selected time of day; a fan speed control circuit including means for selecting a fan speed and means for setting the selected fan speed; and a manual override switch circuit for overriding the set duty cycle and fan speed for operating the fan at a predetermined speed for a preselected period of time.

This application relates to ventilation systems, more particularly to roof ventilation systems that help to protect buildings against fires. The roof vent has an ember impedance structure that impedes the entry of flames and embers or other floating burning materials while still permitting sufficient air flow to adequately ventilate a building. Several configurations of vents employing baffle members and fire-resistant mesh material are described, which can substantially prevent the ingress of floating embers and flames.

A ventilated roof features an elongated vent having a vent opening and an elongated vent shingle supporting surface. The vent opening is in fluid communication with a slot defined by the top surface of a roof deck and communicating through the roof deck. An end cap has an end cap shingle supporting surface and is located adjacent to an end of the elongated vent. The vent and the end cap adjacent to the vent are supported in an equivalent spaced-apart relation to the top surface of the roof deck. The elongated vent shingle supporting surface, the end cap shingle supporting surface and the top surface of the roof deck provide a substantially continuous support to a shingle overlapping any two of those elements.

In a ventilation fan of inner rotor type in which a shaft is fixed to a motor supporting portion, the shaft is held by a shaft holding portion preferably provided by, for example, a metal member. The shaft holding portion includes a cylindrical portion which is fixed to a resin of the motor supporting portion preferably by being embedded through insert molding and into which the shaft is inserted, and a shaft holding flange portion extending outwards in the radial direction from either one of an upper end or a lower end of the cylindrical portion.

Disclosed is a system and method for decreasing airflow and improving ventilation within a tunnel, such as a railroad tunnel, including a path for movement of a vehicle (e.g., train) therethrough. The system has a plurality of air baffles mounted within the tunnel, each device comprising a body and a mounting device. Each mounting device positions each body inside and along the length of the tunnel between the entrance and the exit. The air baffles are configured to restrict airflow at least in part in a longitudinal direction of the tunnel, thereby increasing a relative difference between a vehicle speed and air speed in a tunnel annulus when the vehicle passes through the tunnel. The restriction (e.g., decrease) of airflow in the tunnel reduces the piston effect resulting from the vehicle or train passing through, thus reducing emissions and heat generated by the locomotives in the tunnel.

A shoe (1) is disclosed comprising: an insole (1) fixed to the upper (T) and comprising a slot (10) in the heel area and a plurality of holes (11) in the plantar surface area. A ventilation system (2) comprises: a pump (4) disposed in the slot (10) of the insole, a membrane (3) fixed in the lower surface of the insole (1) under the holes (11), a connection pipe (20) connecting the chamber (40) of the pump with the spaces (32) of the membrane and an outlet conduit (21) connecting the chamber of the pump (40) with the outside to exhaust air. An outsole (9) obtained by directly injecting expandable material in a mold covers the ventilation system, insole and lower part of the upper (T). A mold (S) for performing said direct injection is also disclosed.

A gas ventilation mask includes an anesthesia nasal mask and a mouth mask defining respectively a nasal chamber and an oral chamber, detachably connected to one another so that the nasal mask and the mouth mask may be used either separately as a nasal mask or as a mouth mask, or as a combination nasal-mouth mask. Also provided is a mask anchor for holding a face mask on a patient, includes a head support for engaging a back of a patient's head, a posterior head strap that originates from behind the patient's head, in contact with the patient's head and attaches either directly or indirectly to the mask when the mask is on the patient's face, wherein the strap can be tightened to create a seal to allow for positive pressure ventilation or left loose and for providing supplement oxygen. Also provided is an anesthesia mask strap system having a first expandable strap portion having the ability to extend; second and third non-expandable strap sections fixed to ends of the first expandable strap section; and an adhesion section for fixing a length of the strap system when the second and third non-expandable strap sections are pulled to tension the expandable strap section.

Disclosed is a nasal ventilation mask having separate ports to monitor end-tidal CO2 expulsion integrated into the mask in order to monitor end-tidal CO2 expelled nasally or orally. Also disclosed is a CPR mask for nose-to-mouth and/or mouth-to-mouth resuscitation, having a body shaped to cover the nose and/or mouth of a victim, said mask including a CO2 absorber for eliminating at least in part rescuer's exhaled CO2 delivered to the victim.

A system and method for concurrently and uniformly removing thermal energy from clustered specimen samples.

The present invention provides for a system for calibrating operation of a compressor unit in a heating, ventilation, and air conditioning (HVAC) system. A measuring device measures an operating parameter of the HVAC system at a position where the measuring device is mounted on a refrigerant line of the HVAC system. The measuring device switches states when the value of the measured operating parameter reaches a switching value. A controller estimates a value of the first operating parameter at the position where the first measuring device is mounted on the refrigerant line, and the controller determines whether the estimated first operating parameter is within a threshold percentage of the switching value.

The separate insole 2 with the, ventilation system is separately insertable in the shoe and the separate insole 2 has longitudinal grooves I downwards, which extend from the space of the heel to the space of the toe through bottom surface an elastic foam layer of the separate insole 2. The rear ends of the longitudinal grooves 1 have an air inlet in the space of the heel and the front ends of the longitudinal grooves 1 have an air outlet in the space of the toe. During step, the longitudinal grooves 1 are gradually compressed from the heel to the toe and air is forced from the longitudinal grooves 1 to the inner toe space of the shoe.

Objectives: The study compared the diagnostic performance of Planar Ventilation/perfusion (V/Q) and V/Q Single-photon computed tomography (SPECT), and determined whether combining perfusion scanning with low-dose computed tomography (Q-LDCT) may be equally effective in a prospective study of patients with chronic thromboembolic pulmonary hypertension (CTEPH) patients. Background: V/Q scanning is recommended for excluding CTEPH during the diagnosis of pulmonary hypertension (PH). However, Planar V/Q and V/Q SPECT techniques have yet to be compared in patients with CTEPH. Methods: Patients with suspected PH were eligible for the study. PH attributable to left heart disease or lung disease was excluded, and patients whose PH was confirmed by right heart catheterization and who completed Planar V/Q, V/Q-SPECT, Q-LDCT, and pulmonary angiography were included. V/Q images were interpreted and patients were diagnosed as instructed by the 2009 EANM guidelines, and pulmonary angiography analyses were used as a reference standard. Results: A total of 208 patients completed the study, including 69 with CTEPH confirmed by pulmonary angiography. Planar V/Q, V/Q-SPECT, and Q-LDCT were all highly effective for diagnosing CTEPH, with no significant differences in sensitivity or specificity observed among the three techniques (Planar V/Q [sensitivity/specificity]: 94.20%/92.81%; V/Q-SPECT: 97.10%/91.37%, Q-LCDT: 95.65%/90.65%). However, V/Q-SPECT was significantly more sensitive (V/Q-SPECT: 79.21%; Planar V/Q: 75.84%, P = 0.012; Q-LDCT: 74.91%, p<0.001), and Planar V/Q was significantly more specific (Planar V/Q: 54.14%; V/Q-SPECT 46.05%, p<0.001; Q-LDCT: 46.05%, P = 0.001) than the other two techniques for identifying perfusion defects in individual lung segments. Conclusion: Both Planar V/Q and V/Q-SPECT were highly effective for diagnosing CTEPH, and Q-LDCT may be a reliable alternative method for patients who are unsuitable for ventilation imaging.