Prototype Vent Gas Heat Exchanger for Exploration EVA - Performance and Manufacturing Characteristics

NASA Technical Reports Server (NTRS)

Jennings, Mallory; Quinn, Gregory; Strange, Jeremy

2012-01-01

NASA is developing new portable life support system (PLSS) technologies, which it is demonstrating in an unmanned ground based prototype unit called PLSS 2.0. One set of technologies within the PLSS provides suitable ventilation to an astronaut while on an EVA. A new component within the ventilation gas loop is a liquid-to-gas heat exchanger to transfer excess heat from the gas to the thermal control system's liquid coolant loop. A unique bench top prototype heat exchanger was built and tested for use in PLSS 2.0. The heat exchanger was designed as a counter-flow, compact plate fin type using stainless steel. Its design was based on previous compact heat exchangers manufactured by United Technologies Aerospace Systems, but was half the size of any previous heat exchanger model and one third the size of previous liquid-to-gas heat exchangers. The prototype heat exchanger was less than 40 cubic inches and weighed 2.6 lb. The water side and gas side pressure drops were 0.8 psid and 0.5 inches of water, respectively. Performance of the heat exchanger at the nominal pressure of 4.1 psia was measured at 94%, while a gas inlet pressure of 25 psia resulted in an effectiveness of 84%. These results compared well with the model, which was scaled for the small size. Modeling of certain phenomena that affect performance, such as flow distribution in the headers was particularly difficult due to the small size of the heat exchanger. Data from the tests has confirmed the correction factors that were used in these parts of the model.

Results of the Trace Contaminant Control Needs Evaluation and Sizing Study for Space Suit Life Support Development

NASA Technical Reports Server (NTRS)

Paul, Heather L.; Jennings, Mallory A.

2009-01-01

The Trace Contaminant Control System (TCCS), located within the ventilation loop of the Portable Life Support System (PLSS) of the Constellation Space Suit Element (CSSE), is responsible for removing hazardous trace contaminants from the space suit ventilation flow. This paper summarizes the results of a trade study that evaluated if trace contaminant control could be accomplished without a TCCS, relying on suit leakage, ullage loss from the carbon dioxide and humidity control system, and other factors. Trace contaminant generation rates were revisited to verify that values reflect the latest designs for CSSE pressure garment materials and PLSS hardware. Additionally, TCCS sizing calculations were performed and a literature survey was conducted to review the latest developments in trace contaminant technologies.

Regenerative Blower for EVA Suit Ventilation Fan

NASA Technical Reports Server (NTRS)

Izenson, Michael G.; Chen, Weibo; Paul, Heather L.

2010-01-01

Portable life support systems in future space suits will include a ventilation subsystem driven by a dedicated fan. This ventilation fan must meet challenging requirements for pressure rise, flow rate, efficiency, size, safety, and reliability. This paper describes research and development that showed the feasibility of a regenerative blower that is uniquely suited to meet these requirements. We proved feasibility through component tests, blower tests, and design analysis. Based on the requirements for the Constellation Space Suit Element (CSSE) Portable Life Support System (PLSS) ventilation fan, we designed the critical elements of the blower. We measured the effects of key design parameters on blower performance using separate effects tests, and used the results of these tests to design a regenerative blower that will meet the ventilation fan requirements. We assembled a proof-of-concept blower and measured its performance at sub-atmospheric pressures that simulate a PLSS ventilation loop environment. Head/flow performance and maximum efficiency point data were used to specify the design and operating conditions for the ventilation fan. We identified materials for the blower that will enhance safety for operation in a lunar environment, and produced a solid model that illustrates the final design. The proof-of-concept blower produced the flow rate and pressure rise needed for the CSSE ventilation subsystem while running at 5400 rpm, consuming only 9 W of electric power using a non-optimized, commercial motor and controller and inefficient bearings. Scaling the test results to a complete design shows that a lightweight, compact, reliable, and low power regenerative blower can meet the performance requirements for future space suit life support systems.

Ventilation Transport Trade Study for Future Space Suit Life Support Systems

NASA Technical Reports Server (NTRS)

Kempf, Robert; Vogel, Matthew; Paul, Heather L.

2008-01-01

A new and advanced portable life support system (PLSS) for space suit surface exploration will require a durable, compact, and energy efficient system to transport the ventilation stream through the space suit. Current space suits used by NASA circulate the ventilation stream via a ball-bearing supported centrifugal fan. As NASA enters the design phase for the next generation PLSS, it is necessary to evaluate available technologies to determine what improvements can be made in mass, volume, power, and reliability for a ventilation transport system. Several air movement devices already designed for commercial, military, and space applications are optimized in these areas and could be adapted for EVA use. This paper summarizes the efforts to identify and compare the latest fan and bearing technologies to determine candidates for the next generation PLSS.

Modified ACES Portable Life Support Integration, Design, and Testing for Exploration Missions

NASA Technical Reports Server (NTRS)

Kelly, Cody

2014-01-01

NASA's next generation of exploration missions provide a unique challenge to designers of EVA life support equipment, especially in a fiscally-constrained environment. In order to take the next steps of manned space exploration, NASA is currently evaluating the use of the Modified ACES (MACES) suit in conjunction with the Advanced Portable Life Support System (PLSS) currently under development. This paper will detail the analysis and integration of the PLSS thermal and ventilation subsystems into the MACES pressure garment, design of prototype hardware, and hardware-in-the-loop testing during the spring 2014 timeframe. Prototype hardware was designed with a minimal impact philosophy in order to mitigate design constraints becoming levied on either the advanced PLSS or MACES subsystems. Among challenges faced by engineers were incorporation of life support thermal water systems into the pressure garment cavity, operational concept definition between vehicle/portable life support system hardware, and structural attachment mechanisms while still enabling maximum EVA efficiency from a crew member's perspective. Analysis was completed in late summer 2013 to 'bound' hardware development, with iterative analysis cycles throughout the hardware development process. The design effort will cumulate in the first ever manned integration of NASA's advanced PLSS system with a pressure garment originally intended primarily for use in a contingency survival scenario.

Proposed Schematics for an Advanced Development Lunar Portable Life Support System

NASA Technical Reports Server (NTRS)

Conger, Bruce; Chullen, Cinda; Barnes, Bruce; Leavitt, Greg

2010-01-01

The latest development of the NASA space suit is an integrated assembly made up of primarily a Pressure Garment System (PGS) and a Portable Life Support System (PLSS). The PLSS is further composed of an oxygen (O2) subsystem, a ventilation subsystem, and a thermal subsystem. This paper baselines a detailed schematic of the PLSS to provide a basis for current and future PLSS development efforts. Both context diagrams and detailed schematics describe the hardware components and overall functions for all three of the PLSS subsystems. The various modes of operations for the PLSS are also presented. A comparison of the proposed PLSS to the Apollo and Shuttle PLSS designs is presented, highlighting several anticipated improvements over the historical PLSS architectures.

Packing the PLSS

NASA Technical Reports Server (NTRS)

Jennings, Mallory

2011-01-01

NASA Engineers design spacesuits for ultimate protection and functionality in the extreme environment of space. The spacesuit is often referred to as a "personal spacecraft" because it provides the astronaut with everything he or she needs to survive and work in space outside of the vehicle or habitat. The systems within the spacesuit include the pressure garment system (PGS), the Portable Life Support System (PLSS), and the power, avionics, and software (PAS) system. These elements are necessary to protect crewmembers and allow them to work effectively in the pressure and temperature extremes of space environments. Development of the spacesuit system is necessary to support future human extravehicular exploration activities to Lunar, Martian, microgravity, and possibly other space destinations. Although all the systems that makeup the space suit are important, the PLSS is one of the most complex. The PLSS provides the life support needed by the astronaut and consists of the oxygen (O2) subsystem, ventilation subsystem, and thermal control subsystem. Within each subsystem, there are many different components, a few of which are explained as follows. The oxygen tanks hold the oxygen that the crewmember uses to breath and pressurizes the suit. The primary oxygen tank is responsible during normal operations and the secondary oxygen tank kicks on in the case of an emergency. The Rapid Cycle Amine (RCA) canister is used to remove the carbon dioxide (CO2) and extra humidity in the crewmember's ventilation/breathing gas. The fan moves the oxygen around the suit. Suit Water Membrane Evaporator (SWME) is used within the thermal control loop to cool the water that is used to maintain a comfortable temperature for both the crew member and the other equipment inside the suit. Another component is the battery, which supplies the power needed to operate all these and the many other pieces. The battery is one of the biggest and heavies components within the PLSS. These are just a few of the components that encompass the PLSS. Each component has a weight and a certain volume that the NASA Engineers must take into account when building the PLSS, because the weight and volumes affect the crewmembers center of gravity (CG). [See the Notes Section for the link to an Apollo video that demonstrates the issues some of the crewmembers had picking up tools and dealing with center of gravity/tools on the surface of the Moon.] In this activity, students will simulate engineering design techniques that NASA Engineers and Designers are currently implementing to configuring the components within the PLSS. Through testing, students will consider the comfort, mobility, and center of gravity for their test subjects and how that changes after adjusting the placement of their simulated PLSS components.

Space Suit Portable Life Support System Test Bed (PLSS 1.0) Development and Testing

NASA Technical Reports Server (NTRS)

Watts, Carly; Campbell, Colin; Vogel, Matthew; Conger, Bruce

2012-01-01

A multi-year effort has been carried out at NASA-JSC to develop an advanced extra-vehicular activity Portable Life Support System (PLSS) design intended to further the current state of the art by increasing operational flexibility, reducing consumables, and increasing robustness. Previous efforts have focused on modeling and analyzing the advanced PLSS architecture, as well as developing key enabling technologies. Like the current International Space Station Extra-vehicular Mobility Unit PLSS, the advanced PLSS comprises three subsystems required to sustain the crew during extra-vehicular activity including the Thermal, Ventilation, and Oxygen Subsystems. This multi-year effort has culminated in the construction and operation of PLSS 1.0, a test bed that simulates full functionality of the advanced PLSS design. PLSS 1.0 integrates commercial off the shelf hardware with prototype technology development components, including the primary and secondary oxygen regulators, Ventilation Subsystem fan, Rapid Cycle Amine swingbed carbon dioxide and water vapor removal device, and Spacesuit Water Membrane Evaporator heat rejection device. The overall PLSS 1.0 test objective was to demonstrate the capability of the Advanced PLSS to provide key life support functions including suit pressure regulation, carbon dioxide and water vapor removal, thermal control and contingency purge operations. Supplying oxygen was not one of the specific life support functions because the PLSS 1.0 test was not oxygen rated. Nitrogen was used for the working gas. Additional test objectives were to confirm PLSS technology development components performance within an integrated test bed, identify unexpected system level interactions, and map the PLSS 1.0 performance with respect to key variables such as crewmember metabolic rate and suit pressure. Successful PLSS 1.0 testing completed 168 test points over 44 days of testing and produced a large database of test results that characterize system level and component performance. With the exception of several minor anomalies, the PLSS 1.0 test rig performed as expected; furthermore, many system responses trended in accordance with pre-test predictions.

Introduction to the Portable Life Support Schematic and Technology Development Components

NASA Technical Reports Server (NTRS)

Conger, Bruce

2008-01-01

Conger presented the operations and functions of the baseline Constellation Program (CxP) Portable Life Support System (PLSS) schematic and key development technologies. He explained the functional descriptions of the schematic components in the fluid systems of the PLSS for multiple operational scenarios. PLSS subsystems include the oxygen subsystem, the ventilation subsystem, and the thermal subsystem. He also presented the operational PLSS modes: Nominal EVA mode, Umbilical - no recharge mode, Umbilical - with recharge mode, BENDS mode, BUDDY mode, Secondary oxygen mode, and the PLSS-removed umbilical mode.

Interfacing with an EVA Suit

NASA Technical Reports Server (NTRS)

Ross, Amy

2011-01-01

A NASA spacesuit under the EVA Technology Domain consists of a suit system; a PLSS; and a Power, Avionics, and Software (PAS) system. Ross described the basic functions, components, and interfaces of the PLSS, which consists of oxygen, ventilation, and thermal control subsystems; electronics; and interfaces. Design challenges were reviewed from a packaging perspective. Ross also discussed the development of the PLSS over the last two decades.

Performance and Life Tests of a Regenerative Blower for EVA Suit Ventilation

NASA Technical Reports Server (NTRS)

Izenson, Mike; Chen, Weibo; Paul, Heather L.; Jennings, Mallory A.

2011-01-01

Ventilation fans for future space suits must meet demanding performance specifications, satisfy stringent safety requirements for operation in an oxygen atmosphere, and be able to increase output to operate in buddy mode. A regenerative blower is an attractive choice due to its ability to meet these requirements at low operating speed. This paper describes progress in the development and testing of a regenerative blower designed to meet requirements for ventilation subsystems in a future space suit Portable Life Support Systems (PLSS). The blower assembly includes a custom-designed motor that has significantly improved in efficiency during this development effort. The blower was tested at both nominal and buddy mode operating points and head/flow performance and power consumption were measured. The blower was operated for over 1000 hours to demonstrate safe operation in an oxygen test loop at prototypical pressures. In addition, the blower demonstrated operation with the introduction of simulated lunar dust.

Characterization of metal oxide absorbents for regenerative carbon dioxide and water vapor removal for advanced portable life support systems

NASA Technical Reports Server (NTRS)

Kast, Timothy P.; Nacheff-Benedict, Maurena S.; Chang, Craig H.; Cusick, Robert J.

1990-01-01

Characterization of the performance of a silver-oxide-based absorbent in terms of its ability to remove both gaseous CO2 and water vapor in an astronaut portable life support systems (PLSS) is discussed. Attention is focused on regeneration of the absorbent from the carbonite state of the oxide state, preconditioning of the absorbent using a humidified gas stream, and absorption breakthrough testing. Based on the results of bench-scale experiments, a test plan is carried out to further characterize the silver-oxide-based absorbent on a larger scale; it calls for examination of the absorbent in both an adiabatic packed bed and a near-isothermal cooled bed configuration. It is demonstrated that the tested absorbent can be utilized in a way that removes substantial amounts of CO2 and water vapor during an 8-hour extravehicular activity mission, and that applying the absorbent to PLSS applications can simplify the ventilation loop.

Investigation of Condensing Ice Heat Exchangers for MTSA Technology Development

NASA Technical Reports Server (NTRS)

Padilla, Sebastian; Powers, Aaron; Ball, Tyler; Iacomini, Christie; Paul, Heather, L.

2008-01-01

Metabolic heat regenerated Temperature Swing Adsorption (MTSA) technology is being developed for thermal, carbon dioxide (CO2) and humidity control for a Portable Life Support Subsystem (PLSS). Metabolically-produced CO2 present in the ventilation gas of a PLSS is collected using a CO2selective adsorbent via temperature swing adsorption. The temperature swing is initiated through cooling to well below metabolic temperatures. Cooling is achieved with a sublimation heat exchanger using water or liquid carbon dioxide (LCO2) expanded below sublimation temperature when exposed to low pressure or vacuum. Subsequent super heated vapor, as well as additional coolant, is used to further cool the astronaut. The temperature swing on the adsorbent is then completed by warming the adsorbent with a separate condensing ice heat exchanger (CIHX) using metabolic heat from moist ventilation gas. The condensed humidity in the ventilation gas is recycled at the habitat. The water condensation from the ventilation gas is a significant heat transfer mechanism for the warming of the adsorbent bed because it represents as much as half of the energy potential in the moist ventilation gas. Designing a heat exchanger to efficiently transfer this energy to the adsorbent bed and allow the collection of the water is a challenge since the CIHX will operate in a temperature range from 210K to 280K. The ventilation gas moisture will first freeze and then thaw, sometimes existing in three phases simultaneously. A NASA Small Business Innovative Research (SBIR) Phase 1 contract was performed to investigate condensing and icing as applied to MTSA to enable higher fidelity modeling and assess the impact of geometry variables on CIHX performance for future CIHX design optimization. Specifically, a design tool was created using analytical relations to explore the complex, interdependent design space of a condensing ice heat exchanger. Numerous variables were identified as having nontrivial contributions to performance such as hydraulic diameter, heat exchanger effectiveness, ventilation gas mass flow rate and surface roughness. Using this tool, four test articles were designed and manufactured to map to a full MTSA subassembly (the adsorbent bed, the sublimation heat exchanger for cooling and the condensing ice heat exchanger for warming). The design mapping considered impacts due to CIHX geometry as well as subassembly impacts such as thermal mass and thermal resistance through the adsorbent bed. The test articles were tested at simulated PLSS ventilation loop temperature, moisture content and subambient pressure. Ice accumulation and melting were observed. Data and test observations were analyzed to identify drivers of the condensing ice heat exchanger performance. This paper will discuss the analytical models, the test article designs, and testing procedures. Testing issues will be discussed to better describe data and share lessons learned. Data analysis and subsequent conclusions will be presented.

Metal hydride heat pump engineering demonstration and evaluation model

NASA Technical Reports Server (NTRS)

Lynch, Franklin E.

1993-01-01

Future generations of portable life support systems (PLSS's) for space suites (extravehicular mobility units or EMU's) may require regenerable nonventing thermal sinks (RNTS's). For purposes of mobility, a PLSS must be as light and compact as possible. Previous venting PLSS's have employed water sublimators to reject metabolic and equipment heat from EMU's. It is desirable for long-duration future space missions to minimize the use of water and other consumables that need to be periodically resupplied. The emission of water vapor also interferes with some types of instrumentation that might be used in future space exploration. The test article is a type of RNTS based on a metal hydride heat pump (MHHP). The task of reservicing EMU's after use must be made less demanding in terms of time, procedures, and equipment. The capability for quick turnaround post-EVA servicing (30 minutes) is a challenging requirement for many of the RNTS options. The MHHP is a very simple option that can be regenerated in the airlock within the 30 minute limit by the application of a heating source and a cooling sink. In addition, advanced PLSS's must provide a greater degree of automatic control, relieving astronauts of the need to manually adjust temperatures in their liquid cooled ventilation garments (LCVG's). The MHHP includes automatic coolant controls with the ability to follow thermal load swings from minimum to maximum in seconds. The MHHP includes a coolant loop subsystem with pump and controls, regeneration equipment for post-EVA servicing, and a PC-based data acquisition and control system (DACS).

Heat Exchanger/Humidifier Trade Study and Conceptual Design for the Constellation Space Suit Portable Life Support System Ventilation Subsystem

NASA Technical Reports Server (NTRS)

Paul, Heather L.; Sompayrac, Robert; Conger, Bruce; Chamberlain, Mateo

2009-01-01

As development of the Constellation Space Suit Element progresses, designing the most effective and efficient life support systems is critical. The baseline schematic analysis for the Portable Life Support System (PLSS) indicates that the ventilation loop will need some method of heat exchange and humidification prior to entering the helmet. A trade study was initiated to identify the challenges associated with conditioning the spacesuit breathing gas stream for temperature and water vapor control, to survey technological literature and resources on heat exchanger and humidifiers to provide solutions to the problems of conditioning the spacesuit breathing gas stream, and to propose potential candidate technologies to perform the heat exchanger and humidifier functions. This paper summarizes the results of this trade study and also describes the conceptual designs that NASA developed to address these issues.

Heat Exchanger/Humidifier Trade Study and Conceptual Design for the Constellation Space Suit Portable Life Support System Ventilation Subsystem

NASA Technical Reports Server (NTRS)

Paul, Heather L.; Conger, Bruce; Sompyrac, Robert; Chamberlain, Mateo

2008-01-01

As development of the Constellation Space Suit Element progresses, designing the most effective and efficient life support systems is critical. The baseline schematic analysis for the Portable Life Support System (PLSS) indicates that the ventilation loop will need some method of heat exchange and humidification prior to entering the helmet. A trade study was initiated to identify the challenges associated with conditioning the spacesuit breathing gas stream for temperature and water vapor control, to survey technological literature and resources on heat exchanger and humidifiers to provide solutions to the problems of conditioning the spacesuit breathing gas stream, and to propose potential candidate technologies to perform the heat exchanger and humidifier functions. This paper summarizes the results of this trade study and also describes the conceptual designs that NASA developed to address these issues.

Advanced Space Suit PLSS 2.0 Cooling Loop Evaluation and PLSS 2.5 Recommendations

NASA Technical Reports Server (NTRS)

Steele, John; Quinn, Greg; Campbell, Colin; Makinen, Janice; Watts, Carly; Westheimer, David

2016-01-01

From 2012 to 2015 The NASA/JSC AdvSS (Advanced Space Suit) PLSS (Portable Life Support Subsystem) team, with support from UTC Aerospace Systems, performed the build-up, packaging and testing of PLSS 2.0. One aspect of that testing was the evaluation of the long-term health of the water cooling circuit and the interfacing components. Periodic and end-of-test water, residue and hardware analyses provided valuable information on the status of the water cooling circuit, and the approaches that would be necessary to enhance water cooling circuit health in the future. The evaluated data has been consolidated, interpreted and woven into an action plan for the maintenance of water cooling circuit health for the planned FY (fiscal year) 2016 through FY 2018 PLSS 2.5 testing. This paper provides an overview of the PLSS 2.0 water cooling circuit findings and the associated steps to be taken in that regard for the PLSS 2.5.

Advanced Space Suit PLSS 2.0 Cooling Loop Evaluation and PLSS 2.5 Recommendations

NASA Technical Reports Server (NTRS)

Steele, John; Quinn, Greg; Campbell, Colin; Makinen, Janice; Watts, Carly; Westheimer, Dave

2016-01-01

From 2012 to 2015 The NASA/JSC AdvSS (Advanced Space Suit) PLSS (Primary Life Support Subsystem) team, with support from UTC Aerospace Systems, performed the build-up, packaging and testing of PLSS 2.0. A key aspect of that testing was the evaluation of the long-term health of the water cooling circuit and the interfacing components. Intermittent and end-of-test water, residue and hardware analyses provided valuable information on the status of the water cooling circuit, and the approaches that would be necessary to enhance water cooling circuit health in the future. The evaluated data has been consolidated, interpreted and woven into an action plan for the maintenance of water cooling circuit health for the planned FY (fiscal year) 2016 through FY 2018 PLSS 2.5 testing. This paper provides an overview of the PLSS 2.0 water cooling circuit findings and the associated steps to be taken in that regard for the PLSS 2.5 testing.

Rapid Cycling CO2 and H2O Removal System for EMU

NASA Technical Reports Server (NTRS)

Alptekin, Gokhan; Cates, Matthew; Dubovik, Margarita; Gershanovich, Yevgenia; Paul, Heather; Thomas, Gretchen

2006-01-01

NASA's planned future missions set stringent demands on the design of the Portable Life Support Systems (PLSS), requiring dramatic reductions in weight, decreased reliance on supplies and greater flexibility on the types of missions. Use of regenerable systems that reduce weight and volume of the EMU is of critical importance to NASA, both for low orbit operations and for long duration manned missions. The CO2 and humidity control unit in the existing PLSS design is relatively large, since it has to remove 8 hours worth of CO2. If the sorbent regeneration can be carried out during the extravehicular activity (EVA) with a relatively high regeneration frequency, the size of the sorbent canister and weight can be significantly reduced. TDA Research, Inc. (TDA) is developing a compact, regenerable sorbent-based system to control CO2 and humidity in the space suit ventilation loop. The sorbent can be regenerated using space vacuum during the EVA, eliminating all duration-limiting elements in the life support system. This paper summarizes the results of the sorbent development and testing, and evaluation efforts. The results of a preliminary system analysis are also included, showing the size and volume reductions provided by the new system.

Development of a Rapid Cycling CO(sub 2) and H(sub 2)O Removal Sorbent

NASA Technical Reports Server (NTRS)

Paul, Heather; Alptekin, Goekhan; Cates, Matthew; Bernal, Casey; Dubovik, Margarita; Gershanovich, Yevgenia

2007-01-01

The National Aeronautics and Space Administration (NASA) planned future missions set stringent demands on the design of the Portable Life Support System (PLSS), requiring dramatic reductions in weight, decreased reliance on supplies and greater flexibility on the types of missions. Use of regenerable systems that reduce weight and volume of the Extravehicular Mobility Unit (EMU) is of critical importance to NASA, both for low orbit operations and for long duration manned missions. The carbon dioxide and humidity control unit in the existing PLSS design is relatively large, since it has to remove and store 8 hours worth of CO2. If the sorbent regeneration can be carried out during the extravehicular activity (EVA) with a relatively high regeneration frequency, the size of the sorbent canister and weight can be significantly reduced. The progress of regenerable CO2 and humidity control is leading us towards the use of a rapid cycling amine system. TDA Research, Inc. is developing compact, regenerable sorbent materials to control CO2 and humidity in the space suit ventilation loop. The sorbent can be regenerated using space vacuum during the EVA, eliminating all carbon dioxide and humidity duration-limiting elements in the life support system. The material also has applications in other areas of space exploration such as the Orion spacecraft and other longer duration exploration missions requiring regenerable technologies. This paper summarizes the results of the sorbent development, testing, and evaluation efforts to date. The results of a preliminary system analysis are also included, showing the size and volume reductions for PLSS provided by the new system.

Space Suit Portable Life Support System (PLSS) 2.0 Unmanned Vacuum Environment Testing

NASA Technical Reports Server (NTRS)

Watts, Carly; Vogel, Matthew

2016-01-01

For the first time in more than 30 years, an advanced space suit Portable Life Support System (PLSS) design was operated inside a vacuum chamber representative of the flight operating environment. The test article, PLSS 2.0, was the second system-level integrated prototype of the advanced PLSS design, following the PLSS 1.0 Breadboard that was developed and tested throughout 2011. Whereas PLSS 1.0 included five technology development components with the balance the system simulated using commercial-off-the-shelf items, PLSS 2.0 featured first generation or later prototypes for all components less instrumentation, tubing and fittings. Developed throughout 2012, PLSS 2.0 was the first attempt to package the system into a flight-like representative volume. PLSS 2.0 testing included an extensive functional evaluation known as Pre-Installation Acceptance (PIA) testing, Human-in-the-Loop testing in which the PLSS 2.0 prototype was integrated via umbilicals to a manned prototype space suit for 19 two-hour simulated EVAs, and unmanned vacuum environment testing. Unmanned vacuum environment testing took place from 1/9/15-7/9/15 with PLSS 2.0 located inside a vacuum chamber. Test sequences included performance mapping of several components, carbon dioxide removal evaluations at simulated intravehicular activity (IVA) conditions, a regulator pressure schedule assessment, and culminated with 25 simulated extravehicular activities (EVAs). During the unmanned vacuum environment test series, PLSS 2.0 accumulated 378 hours of integrated testing including 291 hours of operation in a vacuum environment and 199 hours of simulated EVA time. The PLSS prototype performed nominally throughout the test series, with two notable exceptions including a pump failure and a Spacesuit Water Membrane Evaporator (SWME) leak, for which post-test failure investigations were performed. In addition to generating an extensive database of PLSS 2.0 performance data, achievements included requirements and operational concepts verification, as well as demonstration of vehicular interfaces, consumables sizing and recharge, and water quality control.

Next-Generation Evaporative Cooling Systems for the Advanced Extravehicular Mobility Unit Portable Life Support System

NASA Technical Reports Server (NTRS)

Makinen, Janice V.; Anchondo, Ian; Bue, Grant C.; Campbell, Colin; Colunga, Aaron

2012-01-01

The development of the Advanced Extravehicular Mobility Unit (AEMU) Portable Life Support System (PLSS) is currently underway at NASA Johnson Space Center. The AEMU PLSS features two new evaporative cooling systems, the Reduced Volume Prototype Spacesuit Water Membrane Evaporator (RVP SWME), and the Auxiliary Cooling Loop (ACL). The RVP SWME is the third generation of hollow fiber SWME hardware, and like its predecessors, RVP SWME provides nominal crewmember and electronics cooling by flowing water through porous hollow fibers. Water vapor escapes through the hollow fiber pores, thereby cooling the liquid water that remains inside of the fibers. This cooled water is then recirculated to remove heat from the crewmember and PLSS electronics. Major design improvements, including a 36% reduction in volume, reduced weight, and more flight like back-pressure valve, facilitate the packaging of RVP SWME in the AEMU PLSS envelope. In addition to the RVP SWME, the Auxiliary Cooling Loop (ACL), was developed for contingency crewmember cooling. The ACL is a completely redundant, independent cooling system that consists of a small evaporative cooler--the Mini Membrane Evaporator (Mini-ME), independent pump, independent feed-water assembly and independent Liquid Cooling Garment (LCG). The Mini-ME utilizes the same hollow fiber technology featured in the RVP SWME, but is only 25% of the size of RVP SWME, providing only the necessary crewmember cooling in a contingency situation. The ACL provides a number of benefits when compared with the current EMU PLSS contingency cooling technology; contingency crewmember cooling can be provided for a longer period of time, more contingency situations can be accounted for, no reliance on a Secondary Oxygen Vessel (SOV) for contingency cooling--thereby allowing a SOV reduction in size and pressure, and the ACL can be recharged-allowing the AEMU PLSS to be reused, even after a contingency event. The development of these evaporative cooling systems will contribute to a more robust and comprehensive AEMU PLSS.

Maintaining Adequate CO2 Washout for an Advanced EMU via a New Rapid Cycle Amine Technology

NASA Technical Reports Server (NTRS)

Chullen, Cinda; Conger, Bruce

2012-01-01

Over the past several years, NASA has realized tremendous progress in Extravehicular Activity (EVA) technology development. This has been evidenced by the progressive development of a new Rapid Cycle Amine (RCA) system for the Advanced Extravehicular Mobility Unit (AEMU) Portable Life Support Subsystem (PLSS). The PLSS is responsible for the life support of the crew member in the spacesuit. The RCA technology is responsible for carbon dioxide (CO2) and humidity control. Another aspect of the RCA is that it is on-back vacuum-regenerable, efficient, and reliable. The RCA also simplifies the PLSS schematic by eliminating the need for a condensing heat exchanger for humidity control in the current EMU. As development progresses on the RCA, it is important that the sizing be optimized so that the demand on the PLSS battery is minimized. As well, maintaining the CO2 washout at adequate levels during an EVA is an absolute requirement of the RCA and associated ventilation system. Testing has been underway in-house at NASA Johnson Space Center and analysis has been initiated to evaluate whether the technology provides exemplary performance in ensuring that the CO2 is removed sufficiently and the ventilation flow is adequate for maintaining CO2 washout in the AEMU spacesuit helmet of the crew member during an EVA. This paper will review the recent developments of the RCA unit, testing planned in-house with a spacesuit simulator, and the associated analytical work along with insights from the medical aspect on the testing. 1

Metabolic Heat Regenerated Temperature Swing Adsorption for CO(sub 2) and Heat Removal/Rejection in a Martian PLSS

NASA Technical Reports Server (NTRS)

Iacomini, Christine; Powers, Aaron; Bowers, Chad; Straub-Lopez, Katie; Anderson, Grant; MacCallum, Taber; Paul, Heather

2007-01-01

Two of the fundamental problems facing the development of a Portable Life Support System (PLSS) for use on Mars, are (i) heat rejection (because traditional technologies use sublimation of water, which wastes a scarce resource and contaminates the premises), and (ii) rejection of CO2 in an environment with a ppCO2 of 0.4-0.9 kPa. Patent-pending Metabolic heat regenerated Temperature Swing Adsorption (MTSA) technology is being developed to address both these challenges. The technology utilizes an adsorbent that when cooled with liquid CO2 to near sublimation temperatures (195K) removes metabolically-produced CO2 in the vent loop. Once fully loaded, the adsorbent is then warmed externally by the vent loop (approx. 300K), rejecting the captured CO2 to Mars ambient. Two beds are used to effect a continuous cycle of CO2 removal/rejection as well as facilitate heat exchange out of the vent loop. Any cryogenic fluid can be used in the application; however, since CO2 is readily available at Mars and can be easily produced and stored on the Martian surface, the solution is rather elegant and less complicated when employing liquid CO2. As some metabolic heat will need to be rejected anyway, finding a practical use for metabolic heat is also an overall benefit to the PLSS. To investigate the feasibility of the technology, a series of experiments was conducted which lead to the selection and partial characterization of an appropriate adsorbent. The adsorbent NaX successfully removed CO2 from a simulated vent loop at the prescribed temperature swing anticipated during PLSS operating conditions on Mars using a cryogenic fluid. Thermal conductivity of the adsorbent was also measured to eventually aid in a demonstrator design of the technology. These results provide no show stoppers to the development of MTSA technology and allow its development to focus on other design challenges as listed in the conclusions.

Investigation of Condensing Ice Heat Exchangers for MTSA Technology Development

NASA Technical Reports Server (NTRS)

Padilla, Sebastian; Powers, Aaron; Ball, Tyler; Lacomini, Christie; Paul, Heather L.

2009-01-01

Metabolic heat regenerated Temperature Swing Adsorption (MTSA) technology is being developed for thermal, carbon dioxide (CO2) and humidity control for a Portable Life Support Subsystem (PLSS). Metabolically-produced CO2 present in the ventilation gas of a PLSS is collected using a CO2-selective adsorbent via temperature swing adsorption. The temperature swing is initiated through cooling to well below metabolic temperatures. Cooling is achieved with a sublimation heat exchanger using water or liquid carbon dioxide (L CO2) expanded below sublimation temperature when exposed to low pressure or vacuum. Subsequent super heated vapor, as well as additional coolant, is used to further cool the astronaut. The temperature swing on the adsorbent is then completed by warming the adsorbent with a separate condensing ice heat exchanger (CIHX) using metabolic heat from moist ventilation gas. The condensed humidity in the ventilation gas is recycled at the habitat. The water condensation from the ventilation gas represents a significant source of potential energy for the warming of the adsorbent bed as it represents as much as half of the energy potential in the moist ventilation gas. Designing a heat exchanger to efficiently transfer this energy to the adsorbent bed and allow the collection of the water is a challenge since the CIHX will operate in a temperature range from 210K to 280K. The ventilation gas moisture will first freeze and then thaw, sometimes existing in three phases simultaneously.

Development of a Rapid Cycling CO2 and H2O Removal Sorbent

NASA Technical Reports Server (NTRS)

Alptekin, Gokhan; Cates, Matthew; Bernal, Casey; Dubovik, Margarita; Paul, Heather L.

2007-01-01

The National Aeronautics and Space Administration (NASA) planned future missions set stringent demands on the design of the Portable Life Support System (PLSS), requiring dramatic reductions in weight, decreased reliance on supplies and greater flexibility on the types of missions. Use of regenerable systems that reduce weight and volume of the Extravehicular Mobility Unit (EMU) is of critical importance to NASA, both for low orbit operations and for long duration manned missions. The carbon dioxide and humidity control unit in the existing PLSS design is relatively large, since it has to remove and store eight hours worth of carbon dioxide (CO2). If the sorbent regeneration can be carried out during the Extravehicular Activity (EVA) with a relatively high regeneration frequency, the size of the sorbent canister and weight can be significantly reduced. TDA Research, Inc. is developing compact, regenerable sorbent materials to control CO2 and humidity in the space suit ventilation loop. The sorbent can be regenerated using space vacuum during the EVA, eliminating all CO2 and humidity duration-limiting elements in the life support system. The material also has applications in other areas of space exploration including long duration exploration missions requiring regenerable technologies and possibly the Crew Exploration Vehicle (CEV) spacecraft. This paper summarizes the results of the sorbent development, testing, and evaluation efforts to date.

Simulated Lunar Testing of Metabolic Heat Regenerated Temperature Swing Adsorption

NASA Technical Reports Server (NTRS)

Padilla, Sebastian A.; Bower, Chad E.; Iacomini, Christie S.; Paul, Heather L.

2012-01-01

Metabolic heat regenerated Temperature Swing Adsorption (MTSA) technology is being developed for thermal and carbon dioxide (CO2) control for a Portable Life Support System (PLSS), as well as water recycling. An Engineering Development Unit (EDU) of the MTSA Subassembly (MTSAS) was designed and assembled for optimized Martian operations, but also meets system requirements for lunar operations. For lunar operations the MTSA sorption cycle is driven via a vacuum swing between suit ventilation loop pressure and lunar vacuum. The focus of this effort was testing in a simulated lunar environment. This environment was simulated in Paragon's EHF vacuum chamber. The objective of the testing was to evaluate the full cycle performance of the MTSA Subassembly EDU, and to assess CO2 loading and pressure drop of the wash coated aluminum reticulated foam sorbent bed. Lunar environment testing proved out the feasibility of pure vacuum swing operation, making MTSA a technology that can be tested and used on the Moon prior to going to Mars. Testing demonstrated better than expected CO2 Nomenclature loading on the sorbent and nearly replicates the equilibrium data from the sorbent manufacturer. This exceeded any of the previous sorbent loading tests performed by Paragon. Subsequently, the increased performance of the sorbent bed design indicates future designs will require less mass and volume than the current EDU rendering MTSA as very competitive for Martian PLSS applications.

Simulated Lunar Testing of Metabolic Heat Regenerated Temperature Swing Adsorption Technology

NASA Technical Reports Server (NTRS)

Padilla, Sebastian A.; Bower, Chad; Iacomini, Christie S.; Paul, H.

2011-01-01

Metabolic heat regenerated Temperature Swing Adsorption (MTSA) technology is being developed for thermal and carbon dioxide (CO2) control for a Portable Life Support System (PLSS), as well as water recycling. An Engineering Development Unit (EDU) of the MTSA subassembly was designed and assembled for optimized Martian operations, but also meets system requirements for lunar operations. For lunar operations the MTSA sorption cycle is driven via a vacuum swing between suit ventilation loop pressure and lunar vacuum. The focus of this effort is operations and testing in a simulated lunar environment. This environment was simulated in Paragon s EHF vacuum chamber. The objective of this testing was to evaluate the full cycle performance of the MTSA Subassembly EDU, and to assess CO2 loading and pressure drop of the wash coated aluminum reticulated foam sorbent bed. The lunar testing proved out the feasibility of pure vacuum swing operation, making MTSA a technology that can be tested and used on the Moon prior to going to Mars. Testing demonstrated better than expected CO2 loading on the sorbent and nearly replicates the equilibrium data from the sorbent manufacturer. This had not been achieved in any of the previous sorbent loading tests performed by Paragon. Subsequently, the increased performance of the sorbent bed design indicates future designs will require less mass and volume than the current EDU rendering MTSA as very competitive for Martian PLSS applications.

Optical Breath Gas Sensor for Extravehicular Activity Application

NASA Technical Reports Server (NTRS)

Wood, William R.; Casias, Miguel E.; Vakhtin, Andrei B.; Pilgrim, Jeffrey S.; Chullen, Cinda; Falconi, Eric A.; McMillin, Summer

2013-01-01

The function of the infrared gas transducer used during extravehicular activity in the current space suit is to measure and report the concentration of carbon dioxide (CO2) in the ventilation loop. The next generation portable life support system (PLSS) requires next generation CO2 sensing technology with performance beyond that presently in use on the Space Shuttle/International Space Station extravehicular mobility unit (EMU). Accommodation within space suits demands that optical sensors meet stringent size, weight, and power requirements. A laser diode spectrometer based on wavelength modulation spectroscopy is being developed for this purpose by Vista Photonics, Inc. Two prototype devices were delivered to NASA Johnson Space Center (JSC) in September 2011. The sensors incorporate a laser diode-based CO2 channel that also includes an incidental water vapor (humidity) measurement and a separate oxygen channel using a vertical cavity surface emitting laser. Both prototypes are controlled digitally with a field-programmable gate array/microcontroller architecture. The present development extends and upgrades the earlier hardware to the Advanced PLSS 2.0 test article being constructed and tested at JSC. Various improvements to the electronics and gas sampling are being advanced by this project. The combination of low power electronics with the performance of a long wavelength laser spectrometer enables multi-gas sensors with significantly increased performance over that presently offered in the EMU.

Experimentally Determined Overall Heat Transfer Coefficients for Spacesuit Liquid Cooled Garments

NASA Technical Reports Server (NTRS)

Bue, Grant; Rhodes, Richard; Anchondo, Ian; Westheimer, David; Campbell, Colin; Vogel, Matt; Vonaue, Walt; Conger, Bruce; Stein, James

2015-01-01

A Human-In-The-Loop (HITL) Portable Life Support System 2.0 (PLSS 2.0) test has been conducted at NASA Johnson Space Center in the PLSS Development Laboratory from October 27, 2014 to December 19, 2014. These closed-loop tests of the PLSS 2.0 system integrated with human subjects in the Mark III Suit at 3.7 psi to 4.3 psi above ambient pressure performing treadmill exercise at various metabolic rates from standing rest to 3000 BTU/hr (880 W). The bulk of the PLSS 2.0 was at ambient pressure but effluent water vapor from the Spacesuit Water Membrane Evaporator (SWME) and the Auxiliary Membrane Evaporator (Mini-ME), and effluent carbon dioxide from the Rapid Cycle Amine (RCA) were ported to vacuum to test performance of these components in flight-like conditions. One of the objectives of this test was to determine the overall heat transfer coefficient (UA) of the Liquid Cooling Garment (LCG). The UA, an important factor for modeling the heat rejection of an LCG, was determined in a variety of conditions by varying inlet water temperature, flow rate, and metabolic rate. Three LCG configurations were tested: the Extravehicular Mobility Unit (EMU) LCG, the Oceaneering Space Systems (OSS) LCG, and the OSS auxiliary LCG. Other factors influencing accurate UA determination, such as overall heat balance, LCG fit, and the skin temperature measurement, will also be discussed.

Experimentally Determined Heat Transfer Coefficients for Spacesuit Liquid Cooled Garments

NASA Technical Reports Server (NTRS)

Bue, Grant; Watts, Carly; Rhodes, Richard; Anchondo, Ian; Westheimer, David; Campbell, Colin; Vonau, Walt; Vogel, Matt; Conger, Bruce

2015-01-01

A Human-In-The-Loop (HITL) Portable Life Support System 2.0 (PLSS 2.0) test has been conducted at NASA Johnson Space Center in the PLSS Development Laboratory from October 27, 2014 to December 19, 2014. These closed-loop tests of the PLSS 2.0 system integrated with human subjects in the Mark III Suit at 3.7 psi to 4.3 psi above ambient pressure performing treadmill exercise at various metabolic rates from standing rest to 3000 BTU/hr (880 W). The bulk of the PLSS 2.0 was at ambient pressure but effluent water vapor from the Spacesuit Water Membrane Evaporator (SWME) and the Auxiliary Membrane Evaporator (Mini-ME), and effluent carbon dioxide from the Rapid Cycle Amine (RCA) were ported to vacuum to test performance of these components in flight-like conditions. One of the objectives of this test was to determine the heat transfer coefficient (UA) of the Liquid Cooling Garment (LCG). The UA, an important factor for modeling the heat rejection of an LCG, was determined in a variety of conditions by varying inlet water temperature, flowrate, and metabolic rate. Three LCG configurations were tested: the Extravehicular Mobility Unit (EMU) LCG, the Oceaneering Space Systems (OSS) LCG, and the OSS auxiliary LCG. Other factors influencing accurate UA determination, such as overall heat balance, LCG fit, and the skin temperature measurement, will also be discussed.

Continuously Regenerable Freeze-Out CO2 Control Technology

NASA Technical Reports Server (NTRS)

Fricker, John; Dyer, Chris; Myers, Jeff; Patten, Rich; Paul, Heather

2007-01-01

Carbon dioxide (CO2) removal technology development for portable life support systems (PLSS) has traditionally concentrated in the areas of solid and liquid chemical sorbents and semi-permeable membranes. Most of these systems are too heavy in gravity environments, require prohibitive amounts of consumables for operation on long term planetary missions, or are inoperable on the surface of Mars due to the presence of a CO2 atmosphere. This paper describes the effort performed to mature an innovative CO2 removal technology that meets NASA s planetary mission needs while adhering to the important guiding principles of simplicity, reliability, and operability. A breadboard cryogenic carbon dioxide scrubber (Cryo Scrubber) for a closed loop cryogenic PLSS was developed, designed, and tested, and a conceptual design suitable for a PLSS was developed based on the results of the breadboard testing. The Cryo Scrubber freezes CO2 and other trace contaminants out of expired vent loop gas using cooling available from a liquid oxygen (LOX) based PLSS. The device is continuously regenerable, with solid CO2 being removed from the cold freeze-out surfaces, sublimated, and vented overboard. Duration is limited only by the supply of LOX stored in the PLSS. Simplicity, reliability, and operability are universally important criteria for critical hardware on long duration Lunar or Mars missions. The Cryo Scrubber has no moving parts, requires no additional consumables, and uses no electrical power, contributing to its simplicity and reliability. It is easy to use; no operator action is required to prepare, use, or shut down the Cryo Scrubber, and it does not require charging or regeneration. The versatility of the concept allows for operation on earth, the moon, and Mars, and in microgravity.

Maintaining Adequate CO2 Washout for an Advanced EMU via a New Rapid Cycle Amine Technology

NASA Technical Reports Server (NTRS)

Chullen, Cinda

2011-01-01

Over the past several years, NASA has realized tremendous progress in Extravehicular Activity (EVA) technology development. This has been evidenced by the progressive development of a new Rapic Cycle Amine (RCA) system for the Advanced Extravehicular Mobility Unit (AEMU) Portable Life Support Subsystem (PLSS). The PLSS is responsible for the life support of the crew member in the spacesuit. The RCA technology is responsible for carbon dioxide (CO2) and humidity control. Another aspect of the RCA is that it is on-back vacuum-regenerable, efficient, and reliable. The RCA also simplifies the PLSS schematic by eliminating the need for a condensing heat exchanger for humidity control in the current EMU. As development progresses on the RCA, it is important that the sizing be optimized so that the demand on the PLSS battery is minimized. As well, maintaining the CO2 washout at adequate levels during an EVA is an absolute requirement of the RCA and associated ventilation system. Testing has been underway in-house at NASA Johnson Space Center and analysis has been initiated to evaluate whether the technology provides exemplary performance in ensuring that the CO2 is removed sufficiently enough and the ventilation flow is adequate enough to maintain CO2 1 Project Engineer, Space Suit and Crew Survival Systems Branch, Crew and Thermal Systems Division, 2101 NASA Parkway, Houston, TX 77058/EC5. washout in the AEMU spacesuit helmet of the crew member during an EVA. This paper will review the recent developments of the RCA unit, the testing results performed in-house with a spacesuit simulator, and the associated analytical work along with insights from the medical aspect on the testing.

Helmet Exhalation Capture System (HECS) Sizing Evaluation for an Advanced Space Suit Portable Life Support System

NASA Technical Reports Server (NTRS)

Paul, Heather L.; Waguespack, Glenn M.; Paul, Thomas H.; Conger, Bruce C.

2008-01-01

As part of NASA s initiative to develop an advanced portable life support system (PLSS), a baseline schematic has been chosen that includes gaseous oxygen in a closed circuit ventilation configuration. Supply oxygen enters the suit at the back of the helmet and return gases pass over the astronaut s body to be extracted at the astronaut s wrists and ankles through the liquid cooling and ventilation garment (LCVG). The extracted gases are then treated using a rapid cycling amine (RCA) system for carbon dioxide and water removal and activated carbon for trace gas removal before being mixed with makeup oxygen and reintroduced into the helmet. Thermal control is provided by a suit water membrane evaporator (SWME). As an extension of the original schematic development, NASA evaluated several Helmet Exhalation Capture System (HECS) configurations as alternatives to the baseline. The HECS configurations incorporate the use of full contact masks or non-contact masks to reduce flow requirements within the PLSS ventilation subsystem. The primary scope of this study was to compare the alternatives based on mass and volume considerations; however other design issues were also briefly investigated. This paper summarizes the results of this sizing analysis task.

Development Specification for the Portable Life Support System (PLSS) Thermal Loop Pump

NASA Technical Reports Server (NTRS)

Anchondo, Ian; Campbell, Colin

2017-01-01

The AEMU Thermal Loop Pump Development Specification establishes the requirements for design, performance, and testing of the Water Pump as part of the Thermal System of the Advanced Portable Life Support System (PLSS). It is envisioned that the Thermal Loop Pump is a positive displacement pump that provides a repeatable volume of flow against a given range of back-pressures provided by the various applications. The intention is to operate the pump at a fixed speed for the given application. The primary system is made up of two identical and redundant pumps of which only one is in operation at given time. The Auxiliary Loop Pump is an identical pump design to the primary pumps but is operated at half the flow rate. Inlet positive pressure to the pumps is provided by the upstream Flexible Supply Assembly (FSA-431 and FSA-531) which are physically located inside the suit volume and pressurized by suit pressure. An integrated relief valve, placed in parallel to the pump's inlet and outlet protects the pump and loop from over-pressurization. An integrated course filter is placed upstream of the pump's inlet to provide filtration and prevent potential debris from damaging the pump.

Optical Breath Gas Sensor for Extravehicular Activity Application

NASA Technical Reports Server (NTRS)

Wood, William R.; Casias, Miguel E.; Vakhtin, Andrei B.; Pilgrim, Jeffrey S> ; Chullen, Cinda; Falconi, Eric A.

2012-01-01

The function of the infrared gas transducer used during extravehicular activity (EVA) in the current space suit is to measure and report the concentration of carbon dioxide (CO2) in the ventilation loop. The next generation Portable Life Support System (PLSS) requires next generation CO2 sensing technology with performance beyond that presently in use on the Shuttle/International Space Station extravehicular mobility unit (EMU). Accommodation within space suits demands that optical sensors meet stringent size, weight, and power requirements. A laser diode (LD) spectrometer based on wavelength modulation spectroscopy (WMS) is being developed for this purpose by Vista Photonics, Inc. Two prototype devices were delivered to NASA Johnson Space Center (JSC) in September 2011. The sensors incorporate a laser diode based CO2 channel that also includes an incidental water vapor (humidity) measurement and a separate oxygen (O2) channel using a vertical cavity surface emitting laser (VCSEL). Both prototypes are controlled digitally with a field-programmable gate array (FPGA)/microcontroller architecture. Based on the results of the initial instrument development, further prototype development and testing of instruments leveraging the lessons learned were desired. The present development extends and upgrades the earlier hardware to the Advanced PLSS 2.0 test article being constructed and tested at JSC. Various improvements to the electronics and gas sampling are being advanced by this project. The combination of low power electronics with the performance of a long wavelength laser spectrometer enables multi-gas sensors with significantly increased performance over that presently offered in the EMU. .

Mini-Membrane Evaporator for Contingency Spacesuit Cooling

NASA Technical Reports Server (NTRS)

Makinen, Janice V.; Bue, Grant C.; Campbell, Colin; Petty, Brian; Craft, Jesse; Lynch, William; Wilkes, Robert; Vogel, Matthew

2015-01-01

The next-generation Advanced Extravehicular Mobility Unit (AEMU) Portable Life Support System (PLSS) is integrating a number of new technologies to improve reliability and functionality. One of these improvements is the development of the Auxiliary Cooling Loop (ACL) for contingency crewmember cooling. The ACL is a completely redundant, independent cooling system that consists of a small evaporative cooler--the Mini Membrane Evaporator (Mini-ME), independent pump, independent feedwater assembly and independent Liquid Cooling Garment (LCG). The Mini-ME utilizes the same hollow fiber technology featured in the full-sized AEMU PLSS cooling device, the Spacesuit Water Membrane Evaporator (SWME), but Mini-ME occupies only approximately 25% of the volume of SWME, thereby providing only the necessary crewmember cooling in a contingency situation. The ACL provides a number of benefits when compared with the current EMU PLSS contingency cooling technology, which relies upon a Secondary Oxygen Vessel; contingency crewmember cooling can be provided for a longer period of time, more contingency situations can be accounted for, no reliance on a Secondary Oxygen Vessel (SOV) for contingency cooling--thereby allowing a reduction in SOV size and pressure, and the ACL can be recharged-allowing the AEMU PLSS to be reused, even after a contingency event. The first iteration of Mini-ME was developed and tested in-house. Mini-ME is currently packaged in AEMU PLSS 2.0, where it is being tested in environments and situations that are representative of potential future Extravehicular Activities (EVA's). The second iteration of Mini-ME, known as Mini-ME2, is currently being developed to offer more heat rejection capability. The development of this contingency evaporative cooling system will contribute to a more robust and comprehensive AEMU PLSS.

Mini-Membrane Evaporator for Contingency Spacesuit Cooling

NASA Technical Reports Server (NTRS)

Makinen, Janice V.; Bue, Grant C.; Campbell, Colin; Craft, Jesse; Lynch, William; Wilkes, Robert; Vogel, Matthew

2014-01-01

The next-generation Advanced Extravehicular Mobility Unit (AEMU) Portable Life Support System (PLSS) is integrating a number of new technologies to improve reliability and functionality. One of these improvements is the development of the Auxiliary Cooling Loop (ACL) for contingency crewmember cooling. The ACL is a completely redundant, independent cooling system that consists of a small evaporative cooler--the Mini Membrane Evaporator (Mini-ME), independent pump, independent feedwater assembly and independent Liquid Cooling Garment (LCG). The Mini-ME utilizes the same hollow fiber technology featured in the full-sized AEMU PLSS cooling device, the Spacesuit Water Membrane Evaporator (SWME), but Mini-ME occupies only 25% of the volume of SWME, thereby providing only the necessary crewmember cooling in a contingency situation. The ACL provides a number of benefits when compared with the current EMU PLSS contingency cooling technology, which relies upon a Secondary Oxygen Vessel; contingency crewmember cooling can be provided for a longer period of time, more contingency situations can be accounted for, no reliance on a Secondary Oxygen Vessel (SOV) for contingency cooling--thereby allowing a reduction in SOV size and pressure, and the ACL can be recharged-allowing the AEMU PLSS to be reused, even after a contingency event. The first iteration of Mini-ME was developed and tested in-house. Mini-ME is currently packaged in AEMU PLSS 2.0, where it is being tested in environments and situations that are representative of potential future Extravehicular Activities (EVA's). The second iteration of Mini-ME, known as Mini- ME2, is currently being developed to offer more heat rejection capability. The development of this contingency evaporative cooling system will contribute to a more robust and comprehensive AEMU PLSS.

Modeling Of Metabolic Heat Regenerated Temperature Swing Adsorption (MTSA) Subassembly For Prototype Design

NASA Technical Reports Server (NTRS)

Bower, Chad E.; Padilla, Sebastian A.; Iacomini, Christie S.; Paul, Heather L.

2010-01-01

This paper describes modeling methods for the three core components of a Metabolic heat regenerated Temperature Swing Adsorption (MTSA) subassembly: a sorbent bed, a sublimation (cooling) heat exchanger (SHX), and a condensing icing (warming) heat exchanger (CIHX). The primary function of the MTSA, removing carbon dioxide from a space suit Portable Life Support System (PLSS) ventilation loop, is performed via the sorbent bed. The CIHX is used to heat the sorbent bed for desorption and to remove moisture from the ventilation loop while the SHX is alternately employed to cool the sorbent bed via sublimation of a spray of water at low pressure to prepare the reconditioned bed for the next cycle. This paper describes subsystem heat a mass transfer modeling methodologies relevant to the description of the MTSA subassembly in Thermal Desktop and SINDA/FLUINT. Several areas of particular modeling interest are discussed. In the sorbent bed, capture of the translating carbon dioxide (CO2) front and associated local energy and mass balance in both adsorbing and desorbing modes is covered. The CIHX poses particular challenges for modeling in SINDA/FLUINT as accounting for solids states in fluid submodels are not a native capability. Methods for capturing phase change and latent heat of ice as well as the transport properties across a layer of low density accreted frost are developed. This extended modeling capacity is applicable to temperatures greater than 258 K. To extend applicability to the minimum device temperature of 235 K, a method for a mapped transformation of temperatures from below the limit temperatures to some value above is given along with descriptions for associated material property transformations and the resulting impacts to total heat and mass transfer. Similar considerations are given for the SHX along with functional relationships for areal sublimation rates as limited by flow mechanics in t1he outlet duct.

Optical Breath Gas Extravehicular Activity Sensor for the Advanced Portable Life Support System

NASA Technical Reports Server (NTRS)

Wood, William R.; Casias, Miguel E.; Pilgrim, Jeffrey S.; Chullen, Cinda; Campbell, Colin

2016-01-01

The function of the infrared gas transducer used during extravehicular activity (EVA) in the current space suit is to measure and report the concentration of carbon dioxide (CO2) in the ventilation loop. The next generation portable life support system (PLSS) requires highly accurate CO2 sensing technology with performance beyond that presently in use on the International Space Station extravehicular mobility unit (EMU). Further, that accuracy needs to be provided over the full operating pressure range of the suit (3 to 25 psia). Accommodation within space suits demands that optical sensors meet stringent size, weight, and power requirements. A laser diode (LD) sensor based on infrared absorption spectroscopy is being developed for this purpose by Vista Photonics, Inc. Version 1.0 prototype devices were delivered to NASA Johnson Space Center (JSC) in September 2011. The prototypes were upgraded with more sophisticated communications and faster response times to version 2.0 and delivered to JSC in July 2012. The sensors incorporate a laser diode based CO2 channel that also includes an incidental water vapor (humidity) measurement. The prototypes are controlled digitally with an field-programmable gate array microcontroller architecture. Based on the results of the iterative instrument development, further prototype development and testing of instruments were performed leveraging the lessons learned where feasible. The present development extends and upgrades the earlier hardware for the advanced PLSS 2.5 prototypes for testing at JSC. The prototypes provide significantly enhanced accuracy for water vapor measurement and eliminate wavelength drift affecting the earlier versions. Various improvements to the electronics and gas sampling are currently being advanced including the companion development of engineering development units that will ultimately be capable of radiation tolerance. The combination of low power electronics with the performance of a long wavelength laser spectrometer enables multi-gas sensors with significantly increased performance over that presently offered in the EMU.

Demonstration of Metabolic Heat Regenerated Temperature Swing Adsorption Technology

NASA Technical Reports Server (NTRS)

Paul, Heather; Iacomini, Christine; Powers, Aaron; Dunham, Jonah; Straub-Lopez, Katie; Anerson, Grant; MacCallum, Taber

2007-01-01

Patent-pending Metabolic heat regenerated Temperature Swing Adsorption (MTSA) technology is currently being investigated for removal and rejection of CO2 and heat from a Portable Life Support System (PLSS) to a Martian environment. The metabolically-produced CO2 present in the vent loop gas is collected using a CO2 selective adsorbent that has been cooled via a heat exchanger to near CO2 sublimation temperatures (approx.195K) with liquid CO2 obtained from Martian resources. Once the adsorbent is fully loaded, fresh warm, moist vent loop (approx.300K) is used to heat the adsorbent via another heat exchanger. The adsorbent will then reject the collected CO2 to the Martian ambient. Two beds are used to achieve continuous CO2 removal by cycling between the cold and warm conditions for adsorbent loading and regeneration, respectively. Small experiments have already been completed to show that an adsorbent can be cycled between these PLSS operating conditions to provide adequate conditions for CO2 removal from a simulated vent loop. One of the remaining technical challenges is extracting enough heat from the vent loop to warm the adsorbent in an appreciable time frame to meet the required adsorb/desorb cycle. The other key technical aspect of the technology is employing liquid CO2 to achieve the appropriate cooling. A technology demonstrator has been designed, built and tested to investigate the feasibility of 1) warming the adsorbent using the moist vent loop, 2) cooling the adsorbent using liquid CO2, and 3) using these two methods in conjunction to successfully remove CO2 from a vent loop and reject it to Mars ambient. Both analytical and numerical methods were used to perform design calculations and trades. The demonstrator was built and tested. The design analysis and testing results are presented along with recommendations for future development required to increase the maturity of the technology.

Reexamination of METMAN, Recommendations on Enhancement of LCVG, and Development of New Concepts for EMU Heat Sink

NASA Technical Reports Server (NTRS)

Karimi, Amir

1990-01-01

METMAN is a 41-node transient metabolic computer code developed in 1970 and revised in 1989 by Lockheed Engineering and Sciences, Inc. This program relies on a mathematical model to predict the transient temperature distribution in a body influenced by metabolic heat generation and thermal interaction with the environment. A more complex 315-node model is also available that not only simulates the thermal response of a body exposed to a warm environment, but is also capable of describing the thermal response resulting from exposure to a cold environment. It is important to compare the two models for the prediction of the body's thermal response to metabolic heat generation and exposure to various environmental conditions. Discrepancies between the twi models may warrant an investigation of METMAN to ensure its validity for describing the body's thermal response in space environment. The Liquid Cooling and Ventilation Garment is a subsystem of the Extravehicular Mobility Unit (EMU). This garment, worn under the pressure suit, contains the liquid cooling tubing and gas ventilation manifolds; its purpose is to alleviate or reduce thermal stress resulting from metabolic heat generation. There is renewed interest in modifying this garment through identification of the locus of maximum heat transfer at body-liquid cooled tubing interface. The sublimator is a vital component of the Primary Life Support System (PLSS) in the EMU. It acts as a heat sink to remove heat and humidity from the gas ventilating circuit and the liquid cooling loop of the LCVG. The deficiency of the sublimator is that the ice, used as the heat sink, sublimates into space. There is an effort to minimize water losses in the feedwater circuit of the EMU. This requires developing new concepts to design an alternative heat sink system. Efforts are directed to review and verify the heat transfer formulation of the analytical model employed by METMAN. A conceptual investigation of regenerative non-venting heat-sink subsystem for the EMU is recommended.

Testing and Oxygen Assessment Results for a Next Generation Extravehicular Activity Portable Life Support System Fan

NASA Technical Reports Server (NTRS)

Paul, Heather L.; Jennings, Mallory A.; Rivera, Fatonia L.; Martin, Devin

2011-01-01

NASA is designing a next generation Extravehicular Activity (EVA) Portable Life Support System (PLSS) for use in future surface exploration endeavors. To meet the new requirements for ventilation flow at nominal and buddy modes, a fan has been developed and tested. This paper summarizes the results of the performance and life cycle testing efforts conducted at the NASA Johnson Space Center. Additionally, oxygen compatibility assessment results from an evaluation conducted at White Sands Test Facility (WSTF) are provided, and lessons learned and future recommendations are outlined.

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

PubMed

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

2018-06-01

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.

Optical Breath Gas Extravehicular Activity Sensor for the Advanced Portable Life Support System

NASA Technical Reports Server (NTRS)

Wood, William R.; Casias, Miguel E.; Pilgrim, Jeffrey S.; Chullen, Cinda; Campbell, Colin

2016-01-01

The infrared gas transducer used during extravehicular activity (EVA) in the extravehicular mobility unit (EMU) measures and reports the concentration of carbon dioxide (CO2) in the ventilation loop. It is nearing its end of life and there are a limited number remaining. Meanwhile, the next generation advanced portable life support system (PLSS) now being developed requires CO2 sensing technology with performance beyond that presently in use. A laser diode (LD) spectrometer based on wavelength modulation spectroscopy (WMS) is being developed to address both applications by Vista Photonics, Inc. Accommodation within space suits demands that optical sensors meet stringent size, weight, and power requirements. Version 1.0 devices were delivered to NASA Johnson Space Center (JSC) in 2011. The sensors incorporate a laser diode based CO2 channel that also includes an incidental water vapor (humidity) measurement. The prototypes are controlled digitally with a field-programmable gate array (FPGA)/microcontroller architecture. Version 2.0 devices with improved electronics and significantly reduced wetted volumes were delivered to JSC in 2012. A version 2.5 upgrade recently implemented wavelength stabilized operation, better humidity measurement, and much faster data analysis/reporting. A wholly reconfigured version 3.0 will maintain the demonstrated performance of earlier versions while being backwards compatible with the EMU and offering a radiation tolerant architecture.

Space Suit Portable Life Support System (PLSS) 2.0 Pre-Installation Acceptance (PIA) Testing

NASA Technical Reports Server (NTRS)

Anchondo, Ian; Cox, Marlon; Meginnis, Carly; Westheimer, David; Vogel, Matt R.

2016-01-01

Following successful completion of the space suit Portable Life Support System (PLSS) 1.0 development and testing in 2011, the second system-level prototype, PLSS 2.0, was developed in 2012 to continue the maturation of the advanced PLSS design. This advanced PLSS is intended to reduce consumables, improve reliability and robustness, and incorporate additional sensing and functional capabilities over the current Space Shuttle/International Space Station Extravehicular Mobility Unit (EMU) PLSS. PLSS 2.0 represents the first attempt at a packaged design comprising first generation or later component prototypes and medium fidelity interfaces within a flight-like representative volume. Pre-Installation Acceptance (PIA) is carryover terminology from the Space Shuttle Program referring to the series of test sequences used to verify functionality of the EMU PLSS prior to installation into the Space Shuttle airlock for launch. As applied to the PLSS 2.0 development and testing effort, PIA testing designated the series of 27 independent test sequences devised to verify component and subsystem functionality, perform in situ instrument calibrations, generate mapping data, define set-points, evaluate control algorithms, evaluate hardware performance against advanced PLSS design requirements, and provide quantitative and qualitative feedback on evolving design requirements and performance specifications. PLSS 2.0 PIA testing was carried out in 2013 and 2014 using a variety of test configurations to perform test sequences that ranged from stand-alone component testing to system-level testing, with evaluations becoming increasingly integrated as the test series progressed. Each of the 27 test sequences was vetted independently, with verification of basic functionality required before completion. Because PLSS 2.0 design requirements were evolving concurrently with PLSS 2.0 PIA testing, the requirements were used as guidelines to assess performance during the tests; after the completion of PIA testing, test data served to improve the fidelity and maturity of design requirements as well as plans for future advanced PLSS functional testing.

Space Suit Portable Life Support System (PLSS) 2.0 Pre-Installation Acceptance (PIA) Testing

NASA Technical Reports Server (NTRS)

Watts, Carly; Vogel, Matthew

2016-01-01

Following successful completion of the space suit Portable Life Support System (PLSS) 1.0 development and testing in 2011, the second system-level prototype, PLSS 2.0, was developed in 2012 to continue the maturation of the advanced PLSS design which is intended to reduce consumables, improve reliability and robustness, and incorporate additional sensing and functional capabilities over the current Space Shuttle/International Space Station Extravehicular Mobility Unit (EMU) PLSS. PLSS 2.0 represents the first attempt at a packaged design comprising first generation or later component prototypes and medium fidelity interfaces within a flight-like representative volume. Pre-Installation Acceptance (PIA) is carryover terminology from the Space Shuttle Program referring to the series of test sequences used to verify functionality of the EMU PLSS prior to installation into the Space Shuttle airlock for launch. As applied to the PLSS 2.0 development and testing effort, PIA testing designated the series of 27 independent test sequences devised to verify component and subsystem functionality, perform in situ instrument calibrations, generate mapping data to define set-points for control algorithms, evaluate hardware performance against advanced PLSS design requirements, and provide quantitative and qualitative feedback on evolving design requirements and performance specifications. PLSS 2.0 PIA testing was carried out from 3/20/13 - 3/15/14 using a variety of test configurations to perform test sequences that ranged from stand-alone component testing to system-level testing, with evaluations becoming increasingly integrated as the test series progressed. Each of the 27 test sequences was vetted independently, with verification of basic functionality required before completion. Because PLSS 2.0 design requirements were evolving concurrently with PLSS 2.0 PIA testing, the requirements were used as guidelines to assess performance during the tests; after the completion of PIA testing, test data served to improve the fidelity and maturity of design requirements as well as plans for future advanced PLSS functional testing.

Advanced Space Suit Portable Life Support Subsystem Packaging Design

NASA Technical Reports Server (NTRS)

Howe, Robert; Diep, Chuong; Barnett, Bob; Thomas, Gretchen; Rouen, Michael; Kobus, Jack

2006-01-01

This paper discusses the Portable Life Support Subsystem (PLSS) packaging design work done by the NASA and Hamilton Sundstrand in support of the 3 future space missions; Lunar, Mars and zero-g. The goal is to seek ways to reduce the weight of PLSS packaging, and at the same time, develop a packaging scheme that would make PLSS technology changes less costly than the current packaging methods. This study builds on the results of NASA s in-house 1998 study, which resulted in the "Flex PLSS" concept. For this study the present EMU schematic (low earth orbit) was used so that the work team could concentrate on the packaging. The Flex PLSS packaging is required to: protect, connect, and hold the PLSS and its components together internally and externally while providing access to PLSS components internally for maintenance and for technology change without extensive redesign impact. The goal of this study was two fold: 1. Bring the advanced space suit integrated Flex PLSS concept from its current state of development to a preliminary design level and build a proof of concept mockup of the proposed design, and; 2. "Design" a Design Process, which accommodates both the initial Flex PLSS design and the package modifications, required to accommodate new technology.

Spacesuit Water Membrane Evaporator; An Enhanced Evaporative Cooling System for the Advanced Extravehicular Mobility Unit Portable Life Support System

NASA Technical Reports Server (NTRS)

Bue, Grant C.; Makinen, Janice V.; Miller, Sean; Campbell, Colin; Lynch, Bill; Vogel, Matt; Craft, Jesse; Wilkes, Robert; Kuehnel, Eric

2014-01-01

Development of the Advanced Extravehicular Mobility Unit (AEMU) portable life support subsystem (PLSS) is currently under way at NASA Johnson Space Center. The AEMU PLSS features a new evaporative cooling system, the Generation 4 Spacesuit Water Membrane Evaporator (Gen4 SWME). The SWME offers several advantages when compared with prior crewmember cooling technologies, including the ability to reject heat at increased atmospheric pressures, reduced loop infrastructure, and higher tolerance to fouling. Like its predecessors, Gen4 SWME provides nominal crew member and electronics cooling by flowing water through porous hollow fibers. Water vapor escapes through the hollow fiber pores, thereby cooling the liquid water that remains inside of the fibers. This cooled water is then recirculated to remove heat from the crew member and PLSS electronics. Test results from the backup cooling system which is based on a similar design and the subject of a companion paper, suggested that further volume reductions could be achieved through fiber density optimization. Testing was performed with four fiber bundle configurations ranging from 35,850 fibers to 41,180 fibers. The optimal configuration reduced the Gen4 SWME envelope volume by 15% from that of Gen3 while dramatically increasing the performance margin of the system. A rectangular block design was chosen over the Gen3 cylindrical design, for packaging configurations within the AEMU PLSS envelope. Several important innovations were made in the redesign of the backpressure valve which is used to control evaporation. A twin-port pivot concept was selected from among three low profile valve designs for superior robustness, control and packaging. The backpressure valve motor, the thermal control valve, delta pressure sensors and temperature sensors were incorporated into the manifold endcaps, also for packaging considerations. Flight-like materials including a titanium housing were used for all components. Performance testing of the Gen4 SWME is underway.

Testing and Results of Vacuum Swing Adsorption Units for Spacesuit Carbon Dioxide and Humidity Control

NASA Technical Reports Server (NTRS)

McMillin, Summer D.; Broerman, Craig D.; Swickrath, Michael; Anderson, Molly

2011-01-01

A principal concern for extravehicular activity (EVA) spacesuits is the capability to control carbon dioxide (CO2) and humidity (H2O) for the crewmember. The release of CO2 in a confined or unventilated area is dangerous for human health and leads to asphyxiation; therefore, CO2 and H2O control become leading factors in the design and development of the spacesuit. An amine-based CO2 and H2O vapor sorbent for use in pressure-swing regenerable beds has been developed by Hamilton Sundstrand. The application of solidamine materials with vacuum swing adsorption technology has shown the capacity to concurrently manage CO2 and H2O levels through a fully regenerative cycle eliminating mission constraints imposed with nonregenerative technologies. Two prototype solid amine-based systems, known as rapid cycle amine (RCA), were designed to continuously remove CO2 and H2O vapor from a flowing ventilation stream through the use of a two-bed amine based, vacuum-swing adsorption system. The Engineering and Science Contract Group (ESCG) RCA implements radial flow paths, whereas the Hamilton Sundstrand RCA was designed with linear flow paths. Testing was performed in a sea-level pressure environment and a reduced-pressure environment with simulated human metabolic loads in a closed-loop configuration. This paper presents the experimental results of laboratory testing for a full-size and a sub-scale test article. The testing described here characterized and evaluated the performance of each RCA unit at the required Portable Life Support Subsystem (PLSS) operating conditions. The test points simulated a range of crewmember metabolic rates. The experimental results demonstrated the ability of each RCA unit to sufficiently remove CO2 and H2O from a closed loop ambient or sub-ambient atmosphere.

Portable Life Support Subsystem Thermal Hydraulic Performance Analysis

NASA Technical Reports Server (NTRS)

Barnes, Bruce; Pinckney, John; Conger, Bruce

2010-01-01

This paper presents the current state of the thermal hydraulic modeling efforts being conducted for the Constellation Space Suit Element (CSSE) Portable Life Support Subsystem (PLSS). The goal of these efforts is to provide realistic simulations of the PLSS under various modes of operation. The PLSS thermal hydraulic model simulates the thermal, pressure, flow characteristics, and human thermal comfort related to the PLSS performance. This paper presents modeling approaches and assumptions as well as component model descriptions. Results from the models are presented that show PLSS operations at steady-state and transient conditions. Finally, conclusions and recommendations are offered that summarize results, identify PLSS design weaknesses uncovered during review of the analysis results, and propose areas for improvement to increase model fidelity and accuracy.

Spinal Anesthesia with Isobaric Tetracaine in Patients with Previous Lumbar Spinal Surgery

PubMed Central

Kim, Soo Hwan; Jeon, Dong-Hyuk; Chang, Chul Ho; Lee, Sung-Jin

2009-01-01

Purpose Previous lumbar spinal surgery (PLSS) is not currently considered as a contraindication for regional anesthesia. However, there are still problems that make spinal anesthesia more difficult with a possibility of worsening the patient's back pain. Spinal anesthesia using combined spinal-epidural anesthesia (CSEA) in elderly patients with or without PLSS was investigated and the anesthetic characteristics, success rates, and possible complications were evaluated. Materials and Methods Fifty patients without PLSS (Control group) and 45 patients with PLSS (PLSS group) who were scheduled for total knee arthroplasty were studied prospectively. A CSEA was performed with patients in the left lateral position, and 10 mg of 0.5% isobaric tetracaine was injected through a 27 G spinal needle. An epidural catheter was then inserted for patient controlled analgesia. Successful spinal anesthesia was defined as adequate sensory block level more than T12. The number of skin punctures and the onset time were recorded, and maximal sensory block level (MSBL), time to 2-segment regression, success rate and complications were observed. Results The success rate of CSEA in Control group and PLSS group was 98.0%, and 93.3%, respectively. The median MSBL in PLSS group was higher than Control group [T4 (T2-L1) vs. T6 (T3-T12)] (p < 0.001). There was a significant difference in the number of patients who required ephedrine for the treatment of hypotension in PLSS group (p = 0.028). Conclusion The success rate of CSEA in patients with PLSS was 93.3%, and patients experienced no significant neurological complications. The MSBL can be higher in PLSS group than Control group. PMID:19430559

Advancement of Miniature Optic Gas Sensor (MOGS) Probe Technology

NASA Technical Reports Server (NTRS)

Chullen, Cinda

2015-01-01

Advancement of Miniature Optic Gas Sensor (MOGS) Probe Technology" project will investigate newly developed optic gas sensors delivered from a Small Business Innovative Research (SBIR) Phase II effort. A ventilation test rig will be designed and fabricated to test the sensors while integrated with a Suited Manikin Test Apparatus (SMTA). Once the sensors are integrated, a series of test points will be completed to verify that the sensors can withstand Advanced Suit Portable Life Support System (PLSS) environments and associated human metabolic profiles for changes in pressure and levels of Oxygen (ppO2), carbon dioxide (ppCO2), and humidity (ppH2O).

Structure, Antimicrobial Activities and Mode of Interaction with Membranes of Bovel Phylloseptins from the Painted-Belly Leaf Frog, Phyllomedusa sauvagii

PubMed Central

Raja, Zahid; André, Sonia; Piesse, Christophe; Sereno, Denis; Nicolas, Pierre; Foulon, Thierry

2013-01-01

Transcriptomic and peptidomic analysis of skin secretions from the Painted-belly leaf frog Phyllomedusa sauvagii led to the identification of 5 novel phylloseptins (PLS-S2 to -S6) and also of phylloseptin-1 (PSN-1, here renamed PLS-S1), the only member of this family previously isolated in this frog. Synthesis and characterization of these phylloseptins revealed differences in their antimicrobial activities. PLS-S1, -S2, and -S4 (79–95% amino acid sequence identity; net charge  = +2) were highly potent and cidal against Gram-positive bacteria, including multidrug resistant S. aureus strains, and killed the promastigote stage of Leishmania infantum, L. braziliensis and L. major. By contrast, PLS-S3 (95% amino acid identity with PLS-S2; net charge  = +1) and -S5 (net charge  = +2) were found to be almost inactive against bacteria and protozoa. PLS-S6 was not studied as this peptide was closely related to PLS-S1. Differential scanning calorimetry on anionic and zwitterionic multilamellar vesicles combined with circular dichroism spectroscopy and membrane permeabilization assays on bacterial cells indicated that PLS-S1, -S2, and -S4 are structured in an amphipathic α-helix that disrupts the acyl chain packing of anionic lipid bilayers. As a result, regions of two coexisting phases could be formed, one phase rich in peptide and the other lipid-rich. After reaching a threshold peptide concentration, the disruption of lipid packing within the bilayer may lead to local cracks and disintegration of the microbial membrane. Differences in the net charge, α-helical folding propensity, and/or degree of amphipathicity between PLS-S1, -S2 and -S4, and between PLS-S3 and -S5 appear to be responsible for their marked differences in their antimicrobial activities. In addition to the detailed characterization of novel phylloseptins from P. sauvagii, our study provides additional data on the previously isolated PLS-S1 and on the mechanism of action of phylloseptins. PMID:23967105

Adaptive support ventilation: State of the art review

PubMed Central

Fernández, Jaime; Miguelena, Dayra; Mulett, Hernando; Godoy, Javier; Martinón-Torres, Federico

2013-01-01

Mechanical ventilation is one of the most commonly applied interventions in intensive care units. Despite its life-saving role, it can be a risky procedure for the patient if not applied appropriately. To decrease risks, new ventilator modes continue to be developed in an attempt to improve patient outcomes. Advances in ventilator modes include closed-loop systems that facilitate ventilator manipulation of variables based on measured respiratory parameters. Adaptive support ventilation (ASV) is a positive pressure mode of mechanical ventilation that is closed-loop controlled, and automatically adjust based on the patient's requirements. In order to deliver safe and appropriate patient care, clinicians need to achieve a thorough understanding of this mode, including its effects on underlying respiratory mechanics. This article will discuss ASV while emphasizing appropriate ventilator settings, their advantages and disadvantages, their particular effects on oxygenation and ventilation, and the monitoring priorities for clinicians. PMID:23833471

Apollo Portable Life Support System

NASA Image and Video Library

1968-06-11

S68-34580 (1968) --- With its exterior removed, the Apollo portable life support system (PLSS) can be easily studied. The PLSS is worn as a backpack over the Extravehicular Mobility Unit (EMU), a multi-layered spacesuit used for outside-the-spacecraft activity. JSC photographic frame no. S68-34582 is a close-up view of the working parts of the PLSS.

Apollo Portable Life Support System

NASA Image and Video Library

1968-06-11

S68-34582 (1968) --- With its exterior removed, the Apollo portable life support system (PLSS) can be easily studied. The PLSS is worn as a backpack over the Extravehicular Mobility Unit (EMU) a multi-layered spacesuit used for outside-the-spacecraft activity. JSC photographic frame no. S68-34582 is a wider view of the exposed interior working parts of the PLSS and its removed cover.

Flexible Foam Protection Materials for Portable Life Support System Packaging Study

NASA Technical Reports Server (NTRS)

Tang,Henry H.; Dillon, Paul A.; Thomas, Gretchen A.

2009-01-01

This paper discusses the phase I effort in evaluating and selecting a light weight impact protection material for the Constellation Space Suit Element (CSSE) Portable Life Support System (PLSS) conceptual packaging study. A light weight material capable of holding and protecting the components inside the PLSS is required to demonstrate the viability of the flexible PLSS packaging concept. The material needs to distribute, dissipate, and absorb the impact energy of the PLSS falling on the lunar surface. It must also be robust to consistently perform over several Extravehicular Activity (EVA) missions in the extreme lunar thermal vacuum environment. This paper documents the performance requirements for selecting a foam protection material, and the methodologies for evaluating some commercial off-the-shelf (COTS) foam material candidates. It also presents the mechanical properties and impact drop tests results of the foam material candidates. The results of this study suggest that a foam based flexible protection system is a viable solution for PLSS packaging. However, additional works are needed to optimize COTS foam or to develop a composite foam system that will meet all the performance requirements for the CSSE PLSS flexible packaging.

Flexible Foam Protection Materials for Constellation Space Suit Element Portable Life Support Subsystem Packaging Study

NASA Technical Reports Server (NTRS)

Tang, Henry H.; Orndoff, Evelyne S.; Thomas, Gretchen A.

2009-01-01

This paper discusses the effort in evaluating and selecting a light weight impact protection material for the Constellation Space Suit Element (CSSE) Portable Life Support Subsystem (PLSS) conceptual packaging study. A light weight material capable of holding and protecting the components inside the PLSS is required to demonstrate the viability of the flexible PLSS packaging concept. The material needs to distribute, dissipate, and absorb the impact energy of the PLSS falling on the lunar surface. It must also be very robust and function in the extreme lunar thermal vacuum environment for up to one hundred Extravehicular Activity (EVA) missions. This paper documents the performance requirements for selecting a foam protection material, and the methodologies for evaluating commercial off-the-shelf (COTS) foam protection materials. It also presents the materials properties test results and impact drop test results of the various foam materials evaluated in the study. The findings from this study suggest that a foam based flexible protection system is a viable solution for PLSS packaging. However, additional works are needed to optimize COTS foam properties or to develop a composite foam system that will meet all the performance requirements for the CSSE PLSS flexible packaging.

Testing and Results of Vacuum Swing Adsorption Units for Spacesuit Carbon Dioxide and Humidity Control

NASA Technical Reports Server (NTRS)

McMillin, Summer; Broerman, Craig; Swickrath, Mike; Anderson, Molly

2010-01-01

A principal concern for extravehicular activity (EVA) space suits is the capability to control carbon dioxide (CO2) and humidity (H2O) for the crewmember. The release of CO2 in a confined or unventilated area is dangerous for human health and leads to asphyxiation; therefore, CO2 and H2O become leading factors in the design and development of the spacesuit. An amine-based CO2 and H2O vapor sorbent for use in pressure-swing re-generable beds has been developed by Hamilton Sundstrand. The application of solid-amine materials with vacuum swing adsorption technology has shown the capacity to concurrently manage CO2 and H2O levels through a fully regenerative cycle eliminating mission constraints imposed with non-regenerative technologies. Two prototype solid amine-based systems, known as rapid cycle amine (RCA), were designed to continuously remove CO2 and H2O vapor from a flowing ventilation stream through the use of a two-bed amine based, vacuum-swing adsorption system. The Engineering and Science Contract Group (ESCG) RCA is the first RCA unit implementing radial flow paths, whereas the Hamilton Sundstrand RCA was designed with linear flow paths. Testing was performed in a sea-level pressure environment and a reduced-pressure environment with simulated human metabolic loads in a closed-loop configuration. This paper presents the experimental results of laboratory testing for a full-size and a sub-scale test article. The testing described here characterized and evaluated the performance of each RCA unit at the required Portable Life Support Subsystem (PLSS) operating conditions. The test points simulated a range of crewmember metabolic rates. The experimental results demonstrate the ability of each RCA unit to sufficiently remove CO2 and H2O from a closed loop ambient or subambient atmosphere.

Reduced Volume Prototype Spacesuit Water Membrane Evaporator; A Next-Generation Evaporative Cooling System for the Advanced Extravehicular Mobility Unit Portable Life Support System

NASA Technical Reports Server (NTRS)

Makinen, Janice V.; Anchondo, Ian; Bue, Grant C.; Campbell, Colin; Colunga, Aaron

2013-01-01

Development of the Advanced Extravehicular Mobility Unit (AEMU) portable life support subsystem (PLSS) is currently under way at NASA Johnson Space Center. The AEMU PLSS features a new evaporative cooling system, the reduced volume prototype (RVP) spacesuit water membrane evaporator (SWME). The RVP SWME is the third generation of hollow fiber SWME hardware. Like its predecessors, RVP SWME provides nominal crew member and electronics cooling by flowing water through porous hollow fibers. Water vapor escapes through the hollow fiber pores, thereby cooling the liquid water that remains inside of the fibers. This cooled water is then recirculated to remove heat from the crew member and PLSS electronics. Major design improvements, including a 36% reduction in volume, reduced weight, and a more flight-like backpressure valve, facilitate the packaging of RVP SWME in the AEMU PLSS envelope. The development of these evaporative cooling systems will contribute to a more robust and comprehensive AEMU PLSS.

Walking in simulated Martian gravity: influence of the portable life support system's design on dynamic stability.

PubMed

Scott-Pandorf, Melissa M; O'Connor, Daniel P; Layne, Charles S; Josić, Kresimir; Kurz, Max J

2009-09-01

With human exploration of the moon and Mars on the horizon, research considerations for space suit redesign have surfaced. The portable life support system (PLSS) used in conjunction with the space suit during the Apollo missions may have influenced the dynamic balance of the gait pattern. This investigation explored potential issues with the PLSS design that may arise during the Mars exploration. A better understanding of how the location of the PLSS load influences the dynamic stability of the gait pattern may provide insight, such that space missions may have more productive missions with a smaller risk of injury and damaging equipment while falling. We explored the influence the PLSS load position had on the dynamic stability of the walking pattern. While walking, participants wore a device built to simulate possible PLSS load configurations. Floquet and Lyapunov analysis techniques were used to quantify the dynamic stability of the gait pattern. The dynamic stability of the gait pattern was influenced by the position of load. PLSS loads that are placed high and forward on the torso resulted in less dynamically stable walking patterns than loads placed evenly and low on the torso. Furthermore, the kinematic results demonstrated that all joints of the lower extremity may be important for adjusting to different load placements and maintaining dynamic stability. Space scientists and engineers may want to consider PLSS designs that distribute loads evenly and low, and space suit designs that will not limit the sagittal plane range of motion at the lower extremity joints.

Closed loop ventilation mode in Intensive Care Unit: a randomized controlled clinical trial comparing the numbers of manual ventilator setting changes.

PubMed

Arnal, Jean-Michel; Garnero, Aude; Novotni, Dominik; Corno, Gaëlle; Donati, Stéphane-Yannis; Demory, Didier; Quintana, Gabrielle; Ducros, Laurent; Laubscher, Thomas; Durand-Gasselin, Jacques

2018-01-01

There is an equipoise regarding closed-loop ventilation modes and the ability to reduce workload for providers. On one hand some settings are managed by the ventilator but on another hand the automatic mode introduces new settings for the user. This randomized controlled trial compared the number of manual ventilator setting changes between a full closed loop ventilation and oxygenation mode (INTELLiVENT-ASV®) and conventional ventilation modes (volume assist control and pressure support) in Intensive Care Unit (ICU) patients. The secondary endpoints were to compare the number of arterial blood gas analysis, the sedation dose and the user acceptance. Sixty subjects with an expected duration of mechanical ventilation of at least 48 hours were randomized to be ventilated using INTELLiVENT-ASV® or conventional modes with a protocolized weaning. All manual ventilator setting changes were recorded continuously from inclusion to successful extubation or death. Arterial blood gases were performed upon decision of the clinician in charge. User acceptance score was assessed for nurses and physicians once daily using a Likert Scale. The number of manual ventilator setting changes per 24 h-period per subject was lower in INTELLiVENT-ASV® as compared to conventional ventilation group (5 [4-7] versus 10 [7-17]) manuals settings per subject per day [P<0.001]). The number of arterial blood gas analysis and the sedation doses were not significantly different between the groups. Nurses and physicians reported that INTELLiVENT-ASV® was significantly easier to use as compared to conventional ventilation (P<0.001 for nurses and P<0.01 for physicians). For mechanically ventilated ICU patients, INTELLiVENT-ASV® significantly reduces the number of manual ventilator setting changes with the same number of arterial blood gas analysis and sedation dose, and is easier to use for the caregivers as compared to conventional ventilation modes.

Asteroid Redirect Crewed Mission Space Suit and EVA System Architecture Trade Study

NASA Technical Reports Server (NTRS)

Blanco, Raul A.; Bowie, Jonathan T.; Watson, Richard D.; Sipila, Stephanie A.

2014-01-01

The Asteroid Redirect Crewed Mission (ARCM) requires a Launch/Entry/Abort (LEA) suit capability and short duration Extra Vehicular Activity (EVA) capability for Orion. The EVAs will involve a two-person crew for approximately four hours. Currently, two EVAs are planned with one contingency EVA in reserve. Providing this EVA capability is very challenging due to system level constraints and a new and unknown environment. The goal of the EVA architecture for ARCM is one that builds upon previously developed technologies and lessons learned, and that accomplishes the ARCM mission while providing a stepping stone to future missions and destinations. The primary system level constraints are to 1) minimize system mass and volume and 2) minimize the interfacing impacts to the baseline Orion design. In order to minimize the interfacing impacts and to not perturb the baseline Orion schedule, the concept of adding "kits" to the baseline system is proposed. These kits consist of: an EVA kit (converts LEA suit to EVA suit), EVA Servicing and Recharge Kit (provides suit consumables), the EVA Tools, Translation Aids & Sample Container Kit (the tools and mobility aids to complete the tasks), the EVA Communications Kit (interface between the EVA radio and the MPCV), and the Cabin Repress Kit (represses the MPCV between EVAs). This paper will focus on the trade space, analysis, and testing regarding the space suit (pressure garment and life support system). Historical approaches and lessons learned from all past EVA operations were researched. Previous and current, successfully operated EVA hardware and high technology readiness level (TRL) hardware were evaluated, and a trade study was conducted for all possible pressure garment and life support options. Testing and analysis was conducted and a recommended EVA system architecture was proposed. Pressure garment options that were considered for this mission include the currently in-use ISS EVA Mobility Unit (EMU), all variations of the Advanced Crew Escape Suit (ACES), and the Exploration Z-suit. For this mission, the pressure garment that was selected is the Modified ACES (MACES) with EVA enhancements. Life support options that were considered included short closed-loop umbilicals, long open-loop umbilicals, the currently in-use ISS EMU Portable Life Support System (PLSS), and the currently in development Exploration PLSS. For this mission, the life support option that was selected is the Exploration PLSS. The greatest risk in the proposed architecture is viewed to be the comfort and mobility of the baseline MACES and the delicate balance between adding more mobility features while not compromising landing safety. Feasibility testing was accomplished in low fidelity analogs and in the JSC Neutral Buoyancy Laboratory (NBL) to validate the concept before a final recommendation on the architecture was made. The proposed architecture was found to meet the mission constraints, but much more work is required to determine the details of the required suit upgrades, the integration with the PLSS, and the rest of the tools and equipment required to accomplish the mission. This work and further definition of the remaining kits will be conducted in government fiscal year 14.

Development Requirements for the Exploration PLSS (xPLSS) Carbon Dioxide and Humidity Control Unit (CDHCU)

NASA Technical Reports Server (NTRS)

Chullen, Cinda

2017-01-01

Functional Requirements for the Carbon Dioxide and Humidity Control Unit (CDHCU): The CDHCU is a component of the Exploration Portable Life Support System (xPLSS) to provide carbon dioxide (CO2) and humidity control within the spacesuit for a crewmember to perform extravehicular activities (EVA) in vacuum (micro-g), lunar, and Mars environments for up to 8 hours continuous, and during EVA preparation in airlocks or support vehicles for an additional 2 hours (TBR) continuous.

A dual closed-loop control system for mechanical ventilation.

PubMed

Tehrani, Fleur; Rogers, Mark; Lo, Takkin; Malinowski, Thomas; Afuwape, Samuel; Lum, Michael; Grundl, Brett; Terry, Michael

2004-04-01

Closed-loop mechanical ventilation has the potential to provide more effective ventilatory support to patients with less complexity than conventional ventilation. The purpose of this study was to investigate the effectiveness of an automatic technique for mechanical ventilation. Two closed-loop control systems for mechanical ventilation are combined in this study. In one of the control systems several physiological data are used to automatically adjust the frequency and tidal volume of breaths of a patient. This method, which is patented under US Patent number 4986268, uses the criterion of minimal respiratory work rate to provide the patient with a natural pattern of breathing. The inputs to the system include data representing CO2 and O2 levels of the patient as well as respiratory compliance and airway resistance. The I:E ratio is adjusted on the basis of the respiratory time constant to allow for effective emptying of the lungs in expiration and to avoid intrinsic positive end expiratory pressure (PEEP). This system is combined with another closed-loop control system for automatic adjustment of the inspired fraction of oxygen of the patient. This controller uses the feedback of arterial oxygen saturation of the patient and combines a rapid stepwise control procedure with a proportional-integral-derivative (PID) control algorithm to automatically adjust the oxygen concentration in the patient's inspired gas. The dual closed-loop control system has been examined by using mechanical lung studies, computer simulations and animal experiments. In the mechanical lung studies, the ventilation controller adjusted the breathing frequency and tidal volume in a clinically appropriate manner in response to changes in respiratory mechanics. The results of computer simulations and animal studies under induced disturbances showed that blood gases were returned to the normal physiologic range in less than 25 s by the control system. In the animal experiments understeady-state conditions, the maximum standard deviations of arterial oxygen saturation and the end-tidal partial pressure of CO2 were +/- 1.76% and +/- 1.78 mmHg, respectively. The controller maintained the arterial blood gases within normal limits under steady-state conditions and the transient response of the system was robust under various disturbances. The results of the study have showed that the proposed dual closed-loop technique has effectively controlled mechanical ventilation under different test conditions.

Continued Development of the Rapid Cycle Amine (RCA) System for Advanced Extravehicular Activity Systems

NASA Technical Reports Server (NTRS)

Papale, William; Chullen, Cinda; Campbell, Colin; Conger, Bruce; McMillin, Summer; Jeng, Frank

2014-01-01

Development activities related to the Rapid Cycle Amine (RCA) Carbon Dioxide (CO2) and Humidity control system have progressed to the point of integrating the RCA into an advanced Primary Life Support System (PLSS 2.0) to evaluate the interaction of the RCA among other PLSS components in a ground test environment. The RCA 2.0 assembly (integrated into PLSS 2.0) consists of a valve assembly with commercial actuator motor, a sorbent canister, and a field-programmable gate array (FPGA)-based process node controller. Continued design and development activities for RCA 3.0 have been aimed at optimizing the canister size and incorporating greater fidelity in the valve actuator motor and valve position feedback design. Further, the RCA process node controller is envisioned to incorporate a higher degree of functionality to support a distributed PLSS control architecture. This paper will describe the progression of technology readiness levels of RCA 1.0, 2.0 and 3.0 along with a review of the design and manufacturing successes and challenges for 2.0 and 3.0 units. The anticipated interfaces and interactions with the PLSS 2.0/2.5/3.0 assemblies will also be discussed.

Evolution of Space Station EMU PLSS technology recommendations

NASA Technical Reports Server (NTRS)

Wilde, Richard C.

1990-01-01

Viewgraphs on extravehicular mobility unit (EMU) portable life support system (PLSS) technology recommendations are presented. Topics covered include: oxygen supply storage; oxygen supply regulators; carbon dioxide control; prime movers; crew comfort; heat rejection; power sources; controls; display devices; and sensor technology.

Efforts and Programs of the Department of Defense Relating to the Prevention, Mitigation, and Treatment of Blast Injuries

DTIC Science & Technology

2007-01-01

Combat Critical Care Engineering: Evaluation of Closed Loop Control of Ventilation and Oxygen Flow During Resuscitation in the Compensatory and...Decompensatory Phases of Hemorrhagic Shock: This effort evaluated closed loop control of ventilation and oxygen flow during resuscitation in the...Cerebral Injury Volume, Cerebral Edema, Cerebral Blood Flow and Reactivity, and Histopathology in a Rat Model of Traumatic Brain Injury and Hemorrhagic

The Personal Living Space Cue Inventory: An Analysis and Evaluation

ERIC Educational Resources Information Center

Gosling, Samuel D.; Craik, Kenneth H.; Martin, Nicholas R.; Pryor, Michelle R.

2005-01-01

The authors introduce the Personal Living Space Cue Inventory (PLSCI), designed to document comprehensively features of personal living spaces (PLSs); common examples of PLSs include rooms in family households, dormitories, or residential centers. The article describes the PLSCI's development and provides evidence for its reliability and…

Shuttle/ISS EMU Failure History and the Impact on Advanced EMU Portable Life Support System (PLSS) Design

NASA Technical Reports Server (NTRS)

Campbell, Colin

2015-01-01

As the Shuttle/ISS EMU Program exceeds 35 years in duration and is still supporting the needs of the International Space Station (ISS), a critical benefit of such a long running program with thorough documentation of system and component failures is the ability to study and learn from those failures when considering the design of the next generation space suit. Study of the subject failure history leads to changes in the Advanced EMU Portable Life Support System (PLSS) schematic, selected component technologies, as well as the planned manner of ground testing. This paper reviews the Shuttle/ISS EMU failure history and discusses the implications to the AEMU PLSS.

Shuttle/ISS EMU Failure History and the Impact on Advanced EMU PLSS Design

NASA Technical Reports Server (NTRS)

Campbell, Colin

2011-01-01

As the Shuttle/ISS EMU Program exceeds 30 years in duration and is still successfully supporting the needs of the International Space Station (ISS), a critical benefit of such a long running program with thorough documentation of system and component failures is the ability to study and learn from those failures when considering the design of the next generation space suit. Study of the subject failure history leads to changes in the Advanced EMU Portable Life Support System (PLSS) schematic, selected component technologies, as well as the planned manner of ground testing. This paper reviews the Shuttle/ISS EMU failure history and discusses the implications to the AEMU PLSS.

Shuttle/ISS EMU Failure History and the Impact on Advanced EMU PLSS Design

NASA Technical Reports Server (NTRS)

Campbell, Colin

2015-01-01

As the Shuttle/ISS EMU Program exceeds 30 years in duration and is still supporting the needs of the International Space Station (ISS), a critical benefit of such a long running program with thorough documentation of system and component failures is the ability to study and learn from those failures when considering the design of the next generation space suit. Study of the subject failure history leads to changes in the Advanced EMU Portable Life Support System (PLSS) schematic, selected component technologies, as well as the planned manner of ground testing. This paper reviews the Shuttle/ISS EMU failure history and discusses the implications to the AEMU PLSS.

Advanced Prototype Fan Operating Experience, Post Test Evaluation, and Refurbishment for PLSS 2.0 Test Use

NASA Technical Reports Server (NTRS)

Hodgson, Edward; Oehler, William; Dionne, Steve; Converse, David; Jennings, Mallory A.

2012-01-01

NASA s plans for Extravehicular Activity (EVA) portable life support systems for future exploration missions result in different design requirements than those which led to the combined fan / pump / separator in the current ISS Extravehicular Mobility Unit (EMU). To meet these new requirements, NASA contracted with Hamilton Sundstrand to provide two new prototype fans designed to meet anticipated future system requirements. Based on design trade studies, a high speed fan with mechanical bearing support of the rotating elements and a novel non-metallic barrier canned motor design was developed and implemented in the deliverable prototypes. The prototypes, which used two different bearing lubricants, have been extensively tested in both stand-alone and integrated system tests in NASA laboratories and proven to meet the anticipated performance requirements. Subsequently, they have been subjected to post test inspection and analysis in Hamilton Sundstrand laboratories to assess the effects of integrated operation and resultant exposure to vent loop contaminants. Results have confirmed expectations that one of the lubricants would be superior in this application and the prototype fans have been reassembled with new bearings with the superior lubricant. They have now been returned to the Johnson Space Center for further testing and maturation as part of NASA s PLSS 2.0 integrated test effort. This paper will discuss the test history of these units, resulting test data, the results of post test evaluation, and plans for further testing in the near future.

Design and calibration of a high-frequency oscillatory ventilator.

PubMed

Simon, B A; Mitzner, W

1991-02-01

High-frequency ventilation (HFV) is a modality of mechanical ventilation which presents difficult technical demands to the clinical or laboratory investigator. The essential features of an ideal HFV system are described, including wide frequency range, control of tidal volume and mean airway pressure, minimal dead space, and high effective internal impedance. The design and performance of a high-frequency oscillatory ventilation system is described which approaches these requirements. The ventilator utilizes a linear motor regulated by a closed loop controller and driving a novel frictionless double-diaphragm piston pump. Finally, the ventilator performance is tested using the impedance model of Venegas [1].

Astronaut Edwin Aldrin in EMU verifies fit of Portable Life Support System

NASA Image and Video Library

1969-06-25

Astronaut Edwin E. Aldrin Jr., wearing an Extravehicular Mobility Unit (EMU), verifies fit of the Portable Life Support System (PLSS) strap length during lunar surface training at the Kennedy Space Center. Aldrin is the prime crew lunar module pilot of the Apollo 11 lunar landing mission. Aldrin's PLSS backpack is attached to a lunar weight simulator.

Development of a Compact Efficient Cooling Pump for Space Suit Life Support Systems

NASA Technical Reports Server (NTRS)

vanBoeyen, Roger W.; Reeh, Jonathan A.; Trevino, Luis

2008-01-01

With the increasing demands placed on extravehicular activity (EVA) for the International Space Station (ISS) assembly and maintenance, along with planned lunar and Martian missions, the need for increased human productivity and capability becomes ever more critical. This is most readily achieved by reduction in space suit weight and volume, and increased hardware reliability, durability, and operating lifetime. Considerable progress has been made with each successive generation of space suit design; from the Apollo A7L suit, to the current Shuttle Extravehicular Mobile Unit (EMU) suit, and the next generation Constellation Space Suit Element (CSSE). However, one area of space suit design which has continued to lag is the fluid pump used to drive the water cooling loop of the Primary Life Support System (PLSS). The two main types of fluid pumps typically used in space applications are rotodynamic pumps (pumping is achieved through a rotary vaned impeller) and displacement pumps (which includes rotary and diaphragm pumps). The rotating and moving parts found in the pumps and electric motor add significantly to the susceptibility to wear and friction, thermal mismatch, and complexity of the pumps. Electric motor-driven pumps capable of achieving high operational reliability are necessarily large, heavy, and energy inefficient. This report describes a development effort conducted for NASA by Lynntech, Inc., who recently demonstrated the feasibility of an electrochemically-driven fluid cooling pump. With no electric motor and minimal lightweight components, an electrochemically-driven pump is expected to be significantly smaller, lighter and achieve a longer life time than conventional rotodynamic and displacement pumps. By employing sulfonated polystyrene-based proton exchange membranes, rather than conventional Nafion membranes, a significant reduction in the actuator power consumption was demonstrated. It was also demonstrated that these membranes possess the necessary mechanical strength, durability, and temperature range for long life space operation. The preliminary design for a Phase II prototype pump compares very favorably to the fluid cooling pumps currently used in space suit portable life support systems (PLSS). Characteristics of the electrochemically-driven pump are described and the benefits of the technology as a replacement for electric motor pumps in mechanically pumped single-phase fluid loops (MPFLs) is discussed.

Advanced Hybrid Spacesuit Concept Featuring Integrated Open Loop and Closed Loop Ventilation Systems

NASA Technical Reports Server (NTRS)

Daniel, Brian A.; Fitzpatrick, Garret R.; Gohmert, Dustin M.; Ybarra, Rick M.; Dub, Mark O.

2013-01-01

A document discusses the design and prototype of an advanced spacesuit concept that integrates the capability to function seamlessly with multiple ventilation system approaches. Traditionally, spacesuits are designed to operate both dependently and independently of a host vehicle environment control and life support system (ECLSS). Spacesuits that operate independent of vehicle-provided ECLSS services must do so with equipment selfcontained within or on the spacesuit. Suits that are dependent on vehicle-provided consumables must remain physically connected to and integrated with the vehicle to operate properly. This innovation is the design and prototype of a hybrid spacesuit approach that configures the spacesuit to seamlessly interface and integrate with either type of vehicular systems, while still maintaining the ability to function completely independent of the vehicle. An existing Advanced Crew Escape Suit (ACES) was utilized as the platform from which to develop the innovation. The ACES was retrofitted with selected components and one-off items to achieve the objective. The ventilation system concept was developed and prototyped/retrofitted to an existing ACES. Components were selected to provide suit connectors, hoses/umbilicals, internal breathing system ducting/ conduits, etc. The concept utilizes a lowpressure- drop, high-flow ventilation system that serves as a conduit from the vehicle supply into the suit, up through a neck seal, into the breathing helmet cavity, back down through the neck seal, out of the suit, and returned to the vehicle. The concept also utilizes a modified demand-based breathing system configured to function seamlessly with the low-pressure-drop closed-loop ventilation system.

Accidental entrapment of an endo-bronchial blocker tip by a surgical stapler during selective ventilation for lung lobectomy in a dog.

PubMed

Levionnois, Olivier L; Bergadano, Alessandra; Schatzmann, Urs

2006-01-01

To describe the use of an endobronchial blocker (EBB) and to perform selective ventilation during pulmonary lobe resection via thoracotomy in a dog and report its accidental stapling in the resection site. Clinical case report. One female dog with a suspected abscess or neoplasia of the right caudal pulmonary lobe. One-lung ventilation was performed using a wire-guided EBB to seal the contaminated parenchyma and facilitate surgical access. The affected lung parenchyma was resected and the resection site was closed with staples. Lobar resection was performed successfully, but the loop of the EBB guide wire was inadvertently entrapped in the staple line of the lobectomy. Staples were removed to release the wire loop, and the resulting air leak caused loss of ventilation control until the parenchyma was re-sealed. We recommend removing the wire guide associate with the EBB after successful lung separation to avoid accidents that could have life-threatening consequences if not recognized. One-lung ventilation is useful to isolate healthy parenchyma from diseased parenchyma during lobectomy. Anesthesiologists and surgeons need to be aware of the potential complications associated with use of EBB.

Advanced EMU Portable Life Support System (PLSS) and Shuttle/ISS EMU Schematics, a Comparison

NASA Technical Reports Server (NTRS)

Campbell, Colin

2012-01-01

In order to be able to adapt to differing vehicle interfaces such as suitport and airlock, adjust to varying vehicle pressure schedules, tolerate lower quality working fluids, and adapt to differing suit architectures as dictated by a range of mission architectures, the next generation space suit requires more adaptability and robustness over that of the current Shuttle/ISS Extra-vehicular Mobility Unit (EMU). While some features have been added to facilitate interfaces to differing vehicle and suit architectures, the key performance gains have been made via incorporation of new technologies such as the variable pressure regulators, Rapid Cycle Amine swing-bed, and Suit Water Membrane Evaporator. This paper performs a comparison between the Shuttle/ISS EMU PLSS schematic and the Advanced EMU PLSS schematic complete with a discussion for each difference.

Collaborative Human Engineering Work in Space Exploration Extravehicular Activities (EVA)

NASA Technical Reports Server (NTRS)

DeSantis, Lena; Whitmore, Mihriban

2007-01-01

A viewgraph presentation on extravehicular activities in space exploration in collaboration with other NASA centers, industries, and universities is shown. The topics include: 1) Concept of Operations for Future EVA activities; 2) Desert Research and Technology Studies (RATS); 3) Advanced EVA Walkback Test; 4) Walkback Subjective Results; 5) Integrated Suit Test 1; 6) Portable Life Support Subsystem (PLSS); 7) Flex PLSS Design Process; and 8) EVA Information System; 9)

Asteroid Redirect Crewed Mission Space Suit and EVA System Maturation

NASA Technical Reports Server (NTRS)

Bowie, Jonathan T.; Kelly, Cody; Buffington, Jesse; Watson, Richard D.

2015-01-01

The Asteroid Redirect Crewed Mission (ARCM) requires a Launch/Entry/Abort (LEA) suit capability and short duration Extra Vehicular Activity (EVA) capability from the Orion spacecraft. For this mission, the pressure garment that was selected, for both functions, is the Modified Advanced Crew Escape Suit (MACES) with EVA enhancements and the life support option that was selected is the Exploration Portable Life Support System (PLSS). The proposed architecture was found to meet the mission constraints, but much more work is required to determine the details of the required suit upgrades, the integration with the PLSS, and the rest of the tools and equipment required to accomplish the mission. This work has continued over the last year to better define the operations and hardware maturation of these systems. EVA simulations have been completed in the NBL and interfacing options have been prototyped and analyzed with testing planned for late 2014. For NBL EVA simulations, in 2013, components were procured to allow in-house build up for four new suits with mobility enhancements built into the arms. Boots outfitted with clips that fit into foot restraints have also been added to the suit and analyzed for possible loads. Major suit objectives accomplished this year in testing include: evaluation of mobility enhancements, ingress/egress of foot restraint, use of foot restraint for worksite stability, ingress/egress of Orion hatch with PLSS mockup, and testing with two crew members in the water at one time to evaluate the crew's ability to help one another. Major tool objectives accomplished this year include using various other methods for worksite stability, testing new methods for asteroid geologic sampling and improving the fidelity of the mockups and crew equipment. These tests were completed on a medium fidelity capsule mockup, asteroid vehicle mockup, and asteroid mockups that were more accurate for an asteroid type EVA than previous tests. Another focus was the design and fabrication of the interface between the MACES and the PLSS. The MACES was not designed to interface with a PLSS, hence an interface kit must accommodate the unique design qualities of the MACES and provide the necessary life support function connections to the PLSS. A prototype interface kit for MACES to PLSS has been designed and fabricated. Unmanned and manned testing of the interface will show the usability of the kit while wearing a MACES. The testing shows viability of the kit approach as well as the operations concept. The design will be vetted through suit and PLSS experts and, with the findings from the testing, the best path forward will be determined. As the Asteroid Redirect Mission matures, the suit/life support portion of the mission will mature along with it and EVA Tools & Equipment can be iterated to accommodate the overall mission objectives and compromises inherent in EVA Suit optimization. The goal of the EVA architecture for ARCM is to continue to build on the previously developed technologies and lessons learned, and accomplish the ARCM EVAs while providing a stepping stone to future missions and destinations.

Development of Trace Contaminant Control Prototypes for the Primary Life Support System (PLSS)

NASA Technical Reports Server (NTRS)

Wojtowicz, Marek; Cosgrove, Joseph E.; Serio, Michael E.; Nalette, Tim; Guerrero, Sandra V.; Papale, William; Wilburn, Monique S.

2017-01-01

Results are presented on the development of Trace Contaminant Control (TCC) Prototypes for use in Extravehicular Activities (EVAs), and more specifically in the Primary Life Support System (PLSS). The current TC-control technology involves the use of a packed bed of acid-impregnated granular charcoal, which is non-regenerable, and the carbon-based sorbent under development in this project can be regenerated by exposure to vacuum at room temperature. Data on sorption and desorption of ammonia and formaldehyde, which are major TCs of concern, as well as pressure-drop calculations were used to design and test 1/6-scale and full-scale trace contaminant control system (TCCS) prototypes. Carbon sorbents were fabricated in both the granular and foam-supported forms. Sorbent performance was tested for ammonia sorption and vacuum regeneration in 1/6-scale, and pressure-drop characteristics were measured at flow rates relevant to the PLSS application.

Advanced Spacesuit Portable Life Support System Packaging Concept Mock-Up Design & Development

NASA Technical Reports Server (NTRS)

O''Connell, Mary K.; Slade, Howard G.; Stinson, Richard G.

1998-01-01

A concentrated development effort was begun at NASA Johnson Space Center to create an advanced Portable Life Support System (PLSS) packaging concept. Ease of maintenance, technological flexibility, low weight, and minimal volume are targeted in the design of future micro-gravity and planetary PLSS configurations. Three main design concepts emerged from conceptual design techniques and were carried forth into detailed design, then full scale mock-up creation. "Foam", "Motherboard", and "LEGOtm" packaging design concepts are described in detail. Results of the evaluation process targeted maintenance, robustness, mass properties, and flexibility as key aspects to a new PLSS packaging configuration. The various design tools used to evolve concepts into high fidelity mock ups revealed that no single tool was all encompassing, several combinations were complimentary, the devil is in the details, and, despite efforts, many lessons were learned only after working with hardware.

Design and Development Comparison of Rapid Cycle Amine 1.0, 2.0, and 3.0

NASA Technical Reports Server (NTRS)

Chullen, Cinda; Campbell, Colin; Papale, William; Murray, Sean; Wichowski, Robert; Conger, Bruce; McMillin, Summer

2016-01-01

The development of the Rapid Cycle Amine (RCA) swing-bed technology for carbon dioxide (CO2) removal has been in progress since favorable results were published in 1996. Shortly thereafter, a prototype was designed, developed, and tested successfully and delivered to Johnson Space Center in 1999. An improved prototype (RCA 1.0) was delivered to NASA in 2006 and sized for the extravehicular activity (EVA). The RCA swing-bed technology is a regenerative system which employs two alternating solid-amine sorbent beds to remove CO2 and water. The two-bed design employs a chemisorption process whereby the beds alternate between adsorption and desorption. This process provides for an efficient RCA operation that enables one bed to be in adsorb (uptake) mode, while the other is in the desorb (regeneration) mode. The RCA has progressed through several iterations of technology readiness levels. Test articles have now been designed, developed, and tested for the advanced space suit portable life support system (PLSS) including RCA 1.0, RCA 2.0, and RCA 3.0. The RCA 3.0 was the most recent RCA fabrication and was delivered to NASA-JSC in June 2015. The RCA 1.0 test article was designed with a pneumatically actuated linear motion spool valve. The RCA 2.0 and 3.0 test articles were designed with a valve assembly which allows for switching between uptake and regeneration modes while minimizing gas volume losses to the vacuum source. RCA 2.0 and 3.0 also include an embedded controller design to control RCA operation and provide the capability of interfacing with various sensors and other ventilation loop components. The RCA technology is low power, small, and has fulfilled all test requirements levied upon the technology during development testing thus far. This paper will provide an overview of the design and development of RCA 1.0, 2.0 and 3.0 including detail differences between the design specifications of each. Nomenclature.

Design and Development Comparison of Rapid Cycle Amine 1.0, 2.0, and 3.0

NASA Technical Reports Server (NTRS)

Chullen, Cinda; Campbell, Colin; Papale, William; Murray, Sean; Wichowski, Robert; Conger, Bruce; McMillin, Summer

2016-01-01

The development of the Rapid Cycle Amine (RCA) swing-bed technology for carbon dioxide (CO2) removal has been in progress since favorable results were published in 1996. Shortly thereafter, a prototype was designed, developed, and tested successfully and delivered to Johnson Space Center in 1999. An improved prototype was delivered to NASA in 2006 and was notated as RCA 1.0 and sized for the extravehicular activity (EVA). The new RCA swing-bed technology is a regenerative system which employs two alternating solid-amine sorbent beds to remove CO2 and water. The two- bed design employs a chemisorption process whereby the beds alternate between adsorbtion and desorbsion. This process provides for an efficient operation of the RCA so that while one bed is in adsorb (uptake) mode, the other is in the desorb (regeneration) mode. The RCA has now progressed through several iterations of technology readiness levels. Test articles have now been designed, developed, and tested for the advanced space suit portable life support system (PLSS) including RCA 1.0, RCA 2.0, and RCA 3.0. The RCA 3.0 was the most recent RCA fabrication and was delivered to NASA-JSC in June 2015. The RCA 1.0 test article was designed with a pneumatically actuated linear motion spool valve. The RCA 2.0 and 3.0 test articles were designed with a valve assembly which allows for switching between uptake and regeneration modes while minimizing gas volume losses to the vacuum source. RCA 2.0 and 3.0 also include an embedded controller design to control RCA operation and provide the capability of interfacing with various sensors and other ventilation loop components. The RCA technology is low power, small, and has fulfilled all test requirements levied upon the technology during development testing thus far. This paper will provide an overreview of the design and development of RCA 1.0, 2.0 and 3.0 including detail differences between the design specifications of each.

Water Pump Development for the EVA PLSS

NASA Technical Reports Server (NTRS)

Schuller, Michael; Kurwitz, Cable; Goldman, Jeff; Morris, Kim; Trevino, Luis

2009-01-01

This paper describes the effort by the Texas Engineering Experiment Station (TEES) and Honeywell for NASA to design, fabricate, and test a preflight prototype pump for use in the Extravehicular activity (EVA) portable life support subsystem (PLSS). Major design decisions were driven by the need to reduce the pump s mass, power, and volume compared to the existing PLSS pump. In addition, the pump will accommodate a much wider range of abnormal conditions than the existing pump, including vapor/gas bubbles and increased pressure drop when employed to cool two suits simultaneously. A positive displacement, external gear type pump was selected because it offers the most compact and highest efficiency solution over the required range of flow rates and pressure drops. An additional benefit of selecting a gear pump design is that it is self priming and capable of ingesting noncondensable gas without becoming "air locked." The chosen pump design consists of a 28 V DC, brushless, sealless, permanent magnet motor driven, external gear pump that utilizes a Honeywell development that eliminates the need for magnetic coupling. Although the planned flight unit will use a sensorless motor with custom designed controller, the preflight prototype to be provided for this project incorporates Hall effect sensors, allowing an interface with a readily available commercial motor controller. This design approach reduced the cost of this project and gives NASA more flexibility in future PLSS laboratory testing. The pump design was based on existing Honeywell designs, but incorporated features specifically for the PLSS application, including all of the key features of the flight pump. Testing at TEES will simulate the vacuum environment in which the flight pump will operate. Testing will verify that the pump meets design requirements for range of flow rates, pressure rise, power consumption, working fluid temperature, operating time, and restart capability. Pump testing is currently scheduled for March, 2009, after which the pump will be delivered to NASA for further testing.

Development Specification for the Feedwater Supply Assembly (FSA), FSA-431 with Integrated Auxiliary Feedwater Supply Assembly (AFSA), FSA-531

NASA Technical Reports Server (NTRS)

Anchondo, Ian; Campbell, Colin

2017-01-01

The FSA with Integrated Aux FSA Specification establishes the requirements for design, performance, and testing of the FSA-431/FSA-531 assembly in compliance with CTSD-ADV-780, Development Specification for the Advanced EMU (AEMU) Portable Life Support System (PLSS). This section contains the technical design and performance requirements for the integrated assembly of the Feedwater Supply Assembly and Auxiliary Feedwater Supply Assembly for the Advanced EVA Development Portable Life Support Subsystem (PLSS).

Plasmonic lattice solitons in metallic nanowire materials

DOE Office of Scientific and Technical Information (OSTI.GOV)

Swami, O. P., E-mail: omg1789@gmail.com; Kumar, Vijendra, E-mail: vsmedphysics@gmail.com; Nagar, A. K., E-mail: ajaya.nagar@gmail.com

2016-05-06

In this paper, we demonstrate theoretically that the plasmonic lattice solitons (PLSs) are formed in array of metallic nanowires embedded in Kerr-type material. The strong nonlinearity at metal surface, combined with the tight confinement of the guiding modes of the metallic nanowires, provide the main physical mechanism for balancing the creation of plasmonic lattice solitons and wave diffraction. We show that the PLSs are satisfied in a verity of plasmonic systems, which have important applications in nanophotonics and subwavelength optics.

Oxygen Compatibility and Challenge Testing of the PLSS Variable Oxygen Regulator (VOR) for the Advanced EMU

NASA Technical Reports Server (NTRS)

Campbell, Colin; Cox, Marlon; Meginnis, Carly; Falconi, Eric

2017-01-01

The Variable Oxygen Regulator (VOR), a stepper actuated two-stage mechanical regulator, is being developed for the purpose of serving as the Primary Oxygen Regulator (POR) and Secondary Oxygen Regulator (SOR) within the Advanced EMU PLSS, now referred to as the xEMU and xPLSS. Three prototype designs have been fabricated and tested as part of this development. Building upon the lessons learned from the 35 years of Shuttle/ISS EMU Program operation including the fleet-wide EMU Secondary Oxygen Pack (SOP) contamination failure that occurred in 2000, the VOR is being analyzed, designed, and tested for oxygen compatibility with controlled Non-Volatile Residue (NVR) and a representative worst-case hydro-carbon system contamination event (>100mg/sq ft dodecane). This paper discusses the steps taken in testing of VOR 2.0 with for oxygen compatibility and then discusses follow-on design changes implemented in the VOR 3.0 (3rd prototype) as a result.

Design and Development of a Regenerative Blower for EVA Suit Ventilation

NASA Technical Reports Server (NTRS)

Izenson, Michael G.; Chen, Weibo; Hill, Roger W.; Phillips, Scott D.; Paul, Heather L.

2011-01-01

Ventilation subsystems in future space suits require a dedicated ventilation fan. The unique requirements for the ventilation fan - including stringent safety requirements and the ability to increase output to operate in buddy mode - combine to make a regenerative blower an attractive choice. This paper describes progress in the design, development, and testing of a regenerative blower designed to meet requirements for ventilation subsystems in future space suits. We have developed analysis methods for the blower s complex, internal flows and identified impeller geometries that enable significant improvements in blower efficiency. We verified these predictions by test, measuring aerodynamic efficiencies of 45% at operating conditions that correspond to the ventilation fan s design point. We have developed a compact motor/controller to drive the blower efficiently at low rotating speed (4500 rpm). Finally, we have assembled a low-pressure oxygen test loop to demonstrate the blower s reliability under prototypical conditions.

An innovative exercise method to simulate orbital EVA work - Applications to PLSS automatic controls

NASA Technical Reports Server (NTRS)

Lantz, Renee; Vykukal, H.; Webbon, Bruce

1987-01-01

An exercise method has been proposed which may satisfy the current need for a laboratory simulation representative of muscular, cardiovascular, respiratory, and thermoregulatory responses to work during orbital extravehicular activity (EVA). The simulation incorporates arm crank ergometry with a unique body support mechanism that allows all body position stabilization forces to be reacted at the feet. By instituting this exercise method in laboratory experimentation, an advanced portable life support system (PLSS) thermoregulatory control system can be designed to more accurately reflect the specific work requirements of orbital EVA.

Risk Reduction and Measures of Injury for EVA Associated Upper Extremity Medical Issues: Extended Vent Tube Study

NASA Technical Reports Server (NTRS)

Jones, Jeffrey A.; Hoffman, Ronald B.; Harvey, C. M.; Bowen, C. K.; Hudy, C. E.; Gernhardt, M. L.

2007-01-01

During Neutral Buoyancy Lab (NBL) training sessions, a large amount of moisture accumulates in the EVA gloves. The glove design restricts the extension of the EVA suit s ventilation/cooling system to the hand. Subungual redness and fingernail pain develops for many astronauts following their NBL training sessions with subsequent oncholysis occurring over succeeding weeks. Various attempts have been made to reduce or avoid this problem. The causal role of moisture has yet to be defined. Methods: To determine the contribution that moisture plays in the injury to the fingers and fingernails during EVA training operations in NBL, the current Extravehicular Mobility Unit (EMU), with a Portable Life Support System (PLSS) was configured with a ventilation tube that extended down a single arm of the crewmember during the test and compared with the unventilated contralateral arm; with the ventilated hand serving as the experimental condition (E) and the opposite arm as the control (C). A cross-over design was used with opposite handedness for the vent tube on a subsequent NBL training run. Moisture content measures were conducted at six points on each hand with three types of moisture meters. A questionnaire was administered to determine subjective thermal hand discomfort, skin moisture perception, and hand and nail discomfort. Photographs and video were recorded. Measures were applied to six astronauts pre- and post-run in the NBL. Results: The consistent trends in relative hydration ratios at the dorsum, from 3.34 for C to 2.11 for E, and first ring finger joint locations, from 2.46 for C to 1.96 for E, indicated the extended vent tube promoted skin drying. The experimental treatment appeared to be more effective on the left hand versus the right hand, implying an interaction with hand anthropometry and glove fit. Video analyses differentiated fine and gross motor training tasks during runs and will be discussed. Conclusions: This potential countermeasure was effective in reducing the risks of hand and nail discomfort symptoms from moderate to low in two of six subjects. Improved design in the ventilation pattern of such a countermeasure is expected to improve the countermeasure s efficiency.

Preoperational test report, recirculation ventilation systems

DOE Office of Scientific and Technical Information (OSTI.GOV)

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.

Asteroid Redirect Crewed Mission Space Suit and EVA System Architecture Trade Study

NASA Technical Reports Server (NTRS)

Bowie, Jonathan; Buffington, Jesse; Hood, Drew; Kelly, Cody; Naids, Adam; Watson, Richard; Blanco, Raul; Sipila, Stephanie

2014-01-01

The Asteroid Redirect Crewed Mission (ARCM) requires a Launch/Entry/Abort (LEA) suit capability and short duration Extra Vehicular Activity (EVA) capability from the Orion spacecraft. For this mission, the pressure garment selected for both functions is the Modified Advanced Crew Escape Suit (MACES) with EVA enhancements and the life support option that was selected is the Exploration Portable Life Support System (PLSS) currently under development for Advanced Exploration Systems (AES). The proposed architecture meets the ARCM constraints, but much more work is required to determine the details of the suit upgrades, the integration with the PLSS, and the tools and equipment necessary to accomplish the mission. This work has continued over the last year to better define the operations and hardware maturation of these systems. EVA simulations were completed in the Neutral Buoyancy Lab (NBL) and interfacing options were prototyped and analyzed with testing planned for late 2014. This paper discusses the work done over the last year on the MACES enhancements, the use of tools while using the suit, and the integration of the PLSS with the MACES.

Asteroid Redirect Crewed Mission Space Suit and EVA System Maturation

NASA Technical Reports Server (NTRS)

Bowie, Jonathan; Buffington, Jesse; Hood, Drew; Kelly, Cody; Naids, Adam; Watson, Richard

2015-01-01

The Asteroid Redirect Crewed Mission (ARCM) requires a Launch/Entry/Abort (LEA) suit capability and short duration Extra Vehicular Activity (EVA) capability from the Orion spacecraft. For this mission, the pressure garment selected for both functions is the Modified Advanced Crew Escape Suit (MACES) with EVA enhancements and the life support option that was selected is the Exploration Portable Life Support System (PLSS) currently under development for Advanced Exploration Systems (AES). The proposed architecture meets the ARCM constraints, but much more work is required to determine the details of the suit upgrades, the integration with the PLSS, and the tools and equipment necessary to accomplish the mission. This work has continued over the last year to better define the operations and hardware maturation of these systems. EVA simulations were completed in the Neutral Buoyancy Lab (NBL) and interfacing options were prototyped and analyzed with testing planned for late 2014. This paper discusses the work done over the last year on the MACES enhancements, the use of tools while using the suit, and the integration of the PLSS with the MACES.

Feasibility of quantitative regional ventilation and perfusion mapping with phase-resolved functional lung (PREFUL) MRI in healthy volunteers and COPD, CTEPH, and CF patients.

PubMed

Voskrebenzev, Andreas; Gutberlet, Marcel; Klimeš, Filip; Kaireit, Till F; Schönfeld, Christian; Rotärmel, Alexander; Wacker, Frank; Vogel-Claussen, Jens

2018-04-01

In this feasibility study, a phase-resolved functional lung imaging postprocessing method for extraction of dynamic perfusion (Q) and ventilation (V) parameters using a conventional 1H lung MRI Fourier decomposition acquisition is introduced. Time series of coronal gradient-echo MR images with a temporal resolution of 288 to 324 ms of two healthy volunteers, one patient with chronic thromboembolic hypertension, one patient with cystic fibrosis, and one patient with chronic obstructive pulmonary disease were acquired at 1.5 T. Using a sine model to estimate cardiac and respiratory phases of each image, all images were sorted to reconstruct full cardiac and respiratory cycles. Time to peak (TTP), V/Q maps, and fractional ventilation flow-volume loops were calculated. For the volunteers, homogenous ventilation and perfusion TTP maps (V-TTP, Q-TTP) were obtained. The chronic thromboembolic hypertension patient showed increased perfusion TTP in hypoperfused regions in visual agreement with dynamic contrast-enhanced MRI, which improved postpulmonary endaterectomy surgery. Cystic fibrosis and chronic obstructive pulmonary disease patients showed a pattern of increased V-TTP and Q-TTP in regions of hypoventilation and decreased perfusion. Fractional ventilation flow-volume loops of the chronic obstructive pulmonary disease patient were smaller in comparison with the healthy volunteer, and showed regional differences in visual agreement with functional small airways disease and emphysema on CT. This study shows the feasibility of phase-resolved functional lung imaging to gain quantitative information regarding regional lung perfusion and ventilation without the need for ultrafast imaging, which will be advantageous for future clinical translation. Magn Reson Med 79:2306-2314, 2018. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

New modes of assisted mechanical ventilation.

PubMed

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.

Development of the Self-Powered Extravehicular Mobility Unit Extravehicular Activity Data Recorder

NASA Technical Reports Server (NTRS)

Bernard, Craig; Hill, Terry R.; Murray, Sean; Wichowski, Robert; Rosenbush, David

2012-01-01

The Self-Powered Extravehicular Mobility Unit (EMU) Extravehicular Activity (EVA) Data Recorder (SPEEDR) is a field-programmable gate array (FPGA)-based device designed to collect high-rate EMU Primary Life Support Subsystem (PLSS) data for download at a later time. During EVA, the existing EMU PLSS data downlink capability is one data packet every 2 minutes and is subject to bad packets or loss of signal. Higher-rate PLSS data is generated by the Enhanced Caution and Warning System but is not normally captured or distributed. Access to higher-rate data will increase the capability of EMU anomaly resolution team to pinpoint issues remotely, saving crew time by reducing required call-down Q&A and on-orbit diagnostic activities. With no Space Shuttle flights post Fiscal Year 2011 (FY11), and potentially limited down-mass capability, the ISS crew and ground support personnel will have to be capable of on-orbit operations to maintain, diagnose, repair, and return to service EMU hardware, possibly through 2028. Collecting high-rate EMU PLSS data during both intravehicular activity (IVA) and EVA operations will provide trending analysis for life extension and/or predictive performance. The SPEEDR concept has generated interest as a tool/technology that could be used for other International Space Station subsystems or future exploration-class space suits where hardware reliability/availability is critical and low/variable bandwidth may require store then forward methodology. Preliminary work in FY11 produced a functional prototype consisting of an FPGA evaluation board, custom memory/interface circuit board, and custom software. The SPEEDR concept includes a stand-alone battery that is recharged by a computer Universal Serial Bus (USB) port while data are being downloaded.

Continued Advancement of Supported Liquid Membranes for Carbon Dioxide Control in Extravehicular Activity Applications

NASA Technical Reports Server (NTRS)

Wickham, David T.; Gleason, Kevin J.; Engel, Jeffrey R.; Cowley, Scott W.; Chullen, Cinda

2015-01-01

The development of a new, robust, portable life support system (PLSS) is a high priority for NASA in order to support longer and safer extravehicular activity (EVA) missions. One of the critical PLSS functions is maintaining the carbon dioxide (CO2) concentration in the suit at acceptable levels. Although the Metal Oxide (MetOx) canister has historically performed very well, it has a finite CO2 adsorption capacity. Therefore, the size and weight of the unit would have to be increased to extend EVA times. Consequently, new CO2 control technologies must be developed in order to meet mission objectives without increasing the size of the PLSS. Recent work has centered on sorbents that can be regenerated during the EVA; however, this strategy increases the system complexity and power consumption. A much simpler approach is to employ a membrane that vents CO2 to space and retains oxygen (O2). A membrane has many advantages over current technology: it is a continuous system with no limit on capacity, it requires no consumables, and it does not need any hardware to switch beds between absorption and regeneration. Unfortunately, conventional gas separation membranes do not have the needed selectivity for use in the PLSS. However, the required performance could be obtained with a supported liquid membrane (SLM), which consists of a microporous material filled with a liquid that selectively reacts with CO2 over O2. In a recently completed Phase II SBIR project, Reaction Systems, Inc. achieved the required CO2 permeance and selectivity with an SLM in a flat sheet configuration. This paper describes work to convert the SLM into a more compact form and to scale it up to handle more representative process flow rates.

Development of the ISS EMU SPEEDR

NASA Technical Reports Server (NTRS)

Bernard. Craig; Hill, Terry R.

2011-01-01

The Self Powered EVA EMU Data Recorder (SPEEDR) is an FPGA (Field-programmable gate array) based device designed to collect high-rate EMU (Extravehicular Mobility Unit) PLSS (Primary Life Support Subsystem) data for download at a later time. The existing EMU PLSS data down-link capability during EVA is one data packet every 2 minutes and is subject to bad packets or loss of signal. High-rate PLSS data is generated by the ECWS (Enhanced Caution and Warning System) but is not normally captured or distributed. Access to high-rate data will increase the capability of EMU anomaly resolution team to pinpoint issues remotely, saving crew time by reducing required call-down Q&A and on-orbit diagnostic activities. With no Shuttle flights post FY11, and potentially limited down-mass capability, the ISS crew and ground support personnel will have to be capable of on-orbit operations to maintain, diagnose, repair, and return to service EMU hardware, possibly through 2028. Collecting high-rate EMU PLSS data during both IVA (Intravehicular Activity) and EVA (Extravehicular Activity) operations will provide trending analysis for life extension and/or predictive performance. The SPEEDR concept has generated interest as a tool/technology that could be used for other ISS subsystems or future exploration-class space suits where hardware reliability/availability is critical and low/variable bandwidth may require "store then forward" methodology. Preliminary work in FY11 produced a functional prototype consisting of an FPGA evaluation board, custom memory/interface circuit board, and custom software. The SPEEDR concept includes a stand-alone battery that is recharged by a computer USB (Universal Serial Bus) port while data is being downloaded.

Hardware-in-the-Loop Co-simulation of Distribution Grid for Demand Response

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rotger-Griful, Sergi; Chatzivasileiadis, Spyros; Jacobsen, Rune H.

2016-06-20

In modern power systems, co-simulation is proposed as an enabler for analyzing the interactions between disparate systems. This paper introduces the co-simulation platform Virtual Grid Integration Laboratory (VirGIL) including Hardware-in-the-Loop testing, and demonstrates its potential to assess demand response strategies. VirGIL is based on a modular architecture using the Functional Mock-up Interface industrial standard to integrate new simulators. VirGIL combines state-of-the-art simulators in power systems, communications, buildings, and control. In this work, VirGIL is extended with a Hardware-in-the-Loop component to control the ventilation system of a real 12-story building in Denmark. VirGIL capabilities are illustrated in three scenarios: load following,more » primary reserves and load following aggregation. Experimental results show that the system can track one minute changing signals and it can provide primary reserves for up-regulation. Furthermore, the potential of aggregating several ventilation systems is evaluated considering the impact at distribution grid level and the communications protocol effect.« less

Bio-Inspired Controller on an FPGA Applied to Closed-Loop Diaphragmatic Stimulation

PubMed Central

Zbrzeski, Adeline; Bornat, Yannick; Hillen, Brian; Siu, Ricardo; Abbas, James; Jung, Ranu; Renaud, Sylvie

2016-01-01

Cervical spinal cord injury can disrupt connections between the brain respiratory network and the respiratory muscles which can lead to partial or complete loss of ventilatory control and require ventilatory assistance. Unlike current open-loop technology, a closed-loop diaphragmatic pacing system could overcome the drawbacks of manual titration as well as respond to changing ventilation requirements. We present an original bio-inspired assistive technology for real-time ventilation assistance, implemented in a digital configurable Field Programmable Gate Array (FPGA). The bio-inspired controller, which is a spiking neural network (SNN) inspired by the medullary respiratory network, is as robust as a classic controller while having a flexible, low-power and low-cost hardware design. The system was simulated in MATLAB with FPGA-specific constraints and tested with a computational model of rat breathing; the model reproduced experimentally collected respiratory data in eupneic animals. The open-loop version of the bio-inspired controller was implemented on the FPGA. Electrical test bench characterizations confirmed the system functionality. Open and closed-loop paradigm simulations were simulated to test the FPGA system real-time behavior using the rat computational model. The closed-loop system monitors breathing and changes in respiratory demands to drive diaphragmatic stimulation. The simulated results inform future acute animal experiments and constitute the first step toward the development of a neuromorphic, adaptive, compact, low-power, implantable device. The bio-inspired hardware design optimizes the FPGA resource and time costs while harnessing the computational power of spike-based neuromorphic hardware. Its real-time feature makes it suitable for in vivo applications. PMID:27378844

Crew Survivability After a Rapid Cabin Depressurization Event

NASA Technical Reports Server (NTRS)

Sargusingh, Miriam J.

2012-01-01

Anecdotal evidence acquired through historic failure investigations involving rapid cabin decompression (e.g. Challenger, Columbia and Soyuz 11) show that full evacuation of the cabin atmosphere may occur within seconds. During such an event, the delta-pressure between the sealed suit ventilation system and the cabin will rise at the rate of the cabin depressurization; potentially at a rate exceeding the capability of the suit relief valve. It is possible that permanent damage to the suit pressure enclosure and ventilation loop components may occur as the integrated system may be subjected to delta pressures in excess of the design-to pressures. Additionally, as the total pressure of the suit ventilation system decreases, so does the oxygen available to the crew. The crew may be subjected to a temporarily incapacitating, but non-lethal, hypoxic environment. It is expected that the suit will maintain a survivable atmosphere on the crew until the vehicle pressure control system recovers or the cabin has otherwise attained a habitable environment. A common finding from the aforementioned reports indicates that the crew would have had a better chance at surviving the event had they been in a protective configuration, that is, in a survival suit. Making use of these lessons learned, the Constellation Program implemented a suit loop in the spacecraft design and required that the crew be in a protective configuration, that is suited with gloves on and visors down, during dynamic phases of flight that pose the greatest risk for a rapid and uncontrolled cabin depressurization event: ascent, entry, and docking. This paper details the evaluation performed to derive suit pressure garment and ventilation system performance parameters that would lead to the highest probability of crew survivability after an uncontrolled crew cabin depressurization event while remaining in the realm of practicality for suit design. This evaluation involved: (1) assessment of stakeholder expectations to validate the functionality being imposed; (2) review/refinement of concept of operations to establish the potential triggers for such an event and define the response of the spacecraft and suit ventilation loop pressure control systems; and (3) assessment of system capabilities with respect to structural capability and pressure control.

Requirements and Sizing Investigation for the Constellation Space Suit Portable Life Support System Trace Contaminant Control

NASA Technical Reports Server (NTRS)

Jennings, Mallory A.; Paul, Heather L.; Waguespack, Glenn M.

2010-01-01

This presentation summarized the results of a trade study that evaluated whether trace contaminant control within the Constellation Spacesuit PLSS could be achieved without a Trace Contaminant Control System (TCCS) by relying on suit leakage, ullage loss from the carbon dioxide and humidity control system, and other factors. Mallory Jennings and Dr. Glenn Waguespack studied trace contaminant generation rates to verify that values reflected the latest designs for Constellation spacesuit system pressure garment materials and PLSS hardware. They also calculated TCCS sizing and conducted a literature survey to review the latest developments in trace contaminant technologies.

Reversible Ammonia Sorption for the Primary Life Support System (PLSS)

NASA Technical Reports Server (NTRS)

Wojtowicz, Marek A.; Cosgrove, Joseph E.; Serio, Michael A.; Jennings, Mallory A.

2012-01-01

Results are presented on the development of regenerable trace-contaminant (TC) sorbent for use in Extravehicular Activities (EVAs), and more specifically in the Primary Life Support System (PLSS). Since ammonia is the most important TC to be captured, data presented in this paper are limited to ammonia sorption, with results relevant to other TCs to be reported at a later time. The currently available TC-control technology involves the use of a packed bed of acid-impregnated granular charcoal. The sorbent is non-regenerable, and its use is associated with appreciable pressure drop, i.e. power consumption. The objective of this work is to demonstrate the feasibility of using vacuum-regenerable sorbents for PLSS application. In this study, several carbon sorbent monoliths were fabricated and tested. Multiple adsorption/vacuum-regeneration cycles were demonstrated at room temperature, as well as carbon surface conditioning that enhances ammonia sorption without impairing sorbent regeneration. Depending on sorbent monolith geometry, the reduction in pressure drop with respect to granular sorbent was found to be between 50% and two orders of magnitude. Resistive heating of the carbon sorbent monolith was demonstrated by applying voltage to the opposite ends of the monolith.

Drawing of the Buddy Secondary Life Support System

NASA Image and Video Library

1970-12-22

S70-56965 (December 1970) --- Drawing of the newly developed Buddy Secondary Life Support System (BSLSS). The life-sustaining system will be provided for the first time on the Apollo 14 lunar landing mission. The two flexible hoses, to be used on the second Apollo 14 extravehicular activity (EVA), will be among the paraphernalia on the Modular Equipment Transporter (MET) or two-wheeled workshop, and readily accessible in an emergency. During EVAs the Portable Life Support System (PLSS) supplies the astronaut with breathing and suit-pressurizing oxygen and water flow for the liquid-cooling garment -- a suit of knitted long underwear with thin tubing woven in the torso and limbs. The tubes carry water from a reservoir in the PLSS, and the circulating water serves to carry the astronaut's metabolic heat to a heat exchanger in the PLSS. Before the BSLSS was devised, the emergency tank was required to furnish not only suit pressure and breathing oxygen, but also cooling through a high oxygen flow rate. The BSLSS, by sharing the water supply between the two crewmen, stretches the time of the emergency oxygen from about 40 minutes to 60 to 75 minutes.

Performance of a Multifunctional Space Evaporator- Absorber-Radiator (SEAR)

NASA Technical Reports Server (NTRS)

Izenson, Michael G.; Chen, Weibo; Bue, Grant; Quinn, Gregory

2013-01-01

The Space Evaporator-Absorber-Radiator (SEAR) is a nonventing thermal control subsystem that combines a Space Water Membrane Evaporator (SWME) with a Lithium Chloride Absorber Radiator (LCAR). The LCAR is a heat pump radiator that absorbs water vapor produced in the SWME. Because of the very low water vapor pressure at equilibrium with lithium chloride solution, the LCAR can absorb water vapor at a temperature considerably higher than the SWME, enabling heat rejection by thermal radiation from a relatively small area radiator. Prior SEAR prototypes used a flexible LCAR that was designed to be installed on the outer surface of a portable life support system (PLSS) backpack. This paper describes a SEAR subsystem that incorporates a very compact LCAR. The compact, multifunctional LCAR is built in the form of thin panels that can also serve as the PLSS structural shell. We designed and assembled a 2 sq ft prototype LCAR based on this design and measured its performance in thermal vacuum tests when supplied with water vapor by a SWME. These tests validated our models for SEAR performance and showed that there is enough area available on the PLSS backpack shell to enable heat rejection from the LCAR.

Increased ventilatory variability and complexity in patients with hyperventilation disorder.

PubMed

Bokov, Plamen; Fiamma, Marie-Noëlle; Chevalier-Bidaud, Brigitte; Chenivesse, Cécile; Straus, Christian; Similowski, Thomas; Delclaux, Christophe

2016-05-15

It has been hypothesized that hyperventilation disorders could be characterized by an abnormal ventilatory control leading to enhanced variability of resting ventilation. The variability of tidal volume (VT) often depicts a nonnormal distribution that can be described by the negative slope characterizing augmented breaths formed by the relationship between the probability density distribution of VT and VT on a log-log scale. The objectives of this study were to describe the variability of resting ventilation [coefficient of variation (CV) of VT and slope], the stability in respiratory control (loop, controller and plant gains characterizing ventilatory-chemoresponsiveness interactions) and the chaotic-like dynamics (embedding dimension, Kappa values characterizing complexity) of resting ventilation in patients with a well-defined dysfunctional breathing pattern characterized by air hunger and constantly decreased PaCO2 during a cardiopulmonary exercise test. Compared with 14 healthy subjects with similar anthropometrics, 23 patients with hyperventilation were characterized by increased variability of resting tidal ventilation (CV of VT median [interquartile]: 26% [19-35] vs. 36% [28-48], P = 0.020; slope: -6.63 [-7.65; -5.36] vs. -3.88 [-5.91; -2.66], P = 0.004) that was not related to increased chemical drive (loop gain: 0.051 [0.039-0.221] vs. 0.044 [0.012-0.087], P = 0.149) but that was related to an increased ventilatory complexity (Kappa values, P < 0.05). Plant gain was decreased in patients and correlated with complexity (with Kappa 5 - degree 5: Rho = -0.48, P = 0.006). In conclusion, well-defined patients suffering from hyperventilation disorder are characterized by increased variability of their resting ventilation due to increased ventilatory complexity with stable ventilatory-chemoresponsiveness interactions. Copyright © 2016 the American Physiological Society.

A Multi-Purpose Modular Electronics Integration Node for Exploration Extravehicular Activity

NASA Technical Reports Server (NTRS)

Hodgson, Edward; Papale, William; Wichowski, Robert; Rosenbush, David; Hawes, Kevin; Stankiewicz, Tom

2013-01-01

As NASA works to develop an effective integrated portable life support system design for exploration Extravehicular activity (EVA), alternatives to the current system s electrical power and control architecture are needed to support new requirements for flexibility, maintainability, reliability, and reduced mass and volume. Experience with the current Extravehicular Mobility Unit (EMU) has demonstrated that the current architecture, based in a central power supply, monitoring and control unit, with dedicated analog wiring harness connections to active components in the system has a significant impact on system packaging and seriously constrains design flexibility in adapting to component obsolescence and changing system needs over time. An alternative architecture based in the use of a digital data bus offers possible wiring harness and system power savings, but risks significant penalties in component complexity and cost. A hybrid architecture that relies on a set of electronic and power interface nodes serving functional models within the Portable Life Support System (PLSS) is proposed to minimize both packaging and component level penalties. A common interface node hardware design can further reduce penalties by reducing the nonrecurring development costs, making miniaturization more practical, maximizing opportunities for maturation and reliability growth, providing enhanced fault tolerance, and providing stable design interfaces for system components and a central control. Adaptation to varying specific module requirements can be achieved with modest changes in firmware code within the module. A preliminary design effort has developed a common set of hardware interface requirements and functional capabilities for such a node based on anticipated modules comprising an exploration PLSS, and a prototype node has been designed assembled, programmed, and tested. One instance of such a node has been adapted to support testing the swingbed carbon dioxide and humidity control element in NASA s advanced PLSS 2.0 test article. This paper will describe the common interface node design concept, results of the prototype development and test effort, and plans for use in NASA PLSS 2.0 integrated tests.

Custom Unit Pump Development for the EVA PLSS

NASA Technical Reports Server (NTRS)

Schuller, Michael; Kurwitz, Cable; Little, Frank; Oinuma, Ryoji; Larsen, Ben; Goldman, Jeff; Reinis, Filip; Trevino, Luis

2010-01-01

This paper describes the effort by the Texas Engineering Experiment Station (TEES) and Honeywell for NASA to design and test a pre-flight prototype pump for use in the Extra-vehicular activity (EVA) portable life support subsystem (PLSS). Major design decisions were driven by the need to reduce the pump s mass, power, and volume compared to the existing PLSS pump. In addition, the pump must accommodate a much wider range of abnormal conditions than the existing pump, including vapor/gas bubbles and increased pressure drop when employed to cool two suits simultaneously. A positive displacement, external gear type pump was selected because it offers the most compact and highest efficiency solution over the required range of flow rates and pressure drops. An additional benefit of selecting a gear pump design is that it is self priming and capable of ingesting non-condensable gas without becoming air locked. The chosen pump design consists of a 28 V DC, brushless, seal-less, permanent magnet motor driven, external gear pump that utilizes a Honeywell development that eliminates the need for magnetic coupling. The pump design was based on existing Honeywell designs, but incorporated features specifically for the PLSS application, including all of the key features of the flight pump. Testing at TEES verified that the pump meets the design requirements for range of flow rates, pressure drop, power consumption, working fluid temperature, operating time, gas ingestion, and restart capability under both ambient and vacuum conditions. The pump operated at 40 to 240 lbm/hr flow rate, 35 to 100 oF pump temperature, and 5 to 10 psid pressure rise. Power consumption of the pump controller at the nominal operating point in both ambient and vacuum conditions was 9.5 W, which was less than the 12 W predicted. Gas ingestion capabilities were tested by injecting 100 cc of air into the fluid line; the pump operated normally throughout this test.

Advanced Supported Liquid Membranes for CO2 Control in Extravehicular Activity Applications

NASA Technical Reports Server (NTRS)

Wickham, David T.; Gleason, Kevin J.; Engel, Jeffrey R.; Cowley, Scott W.; Chullen, Cinda

2014-01-01

Developing a new, robust, portable life support system (PLSS) is currently a high priority for NASA in order to support longer and safer extravehicular activity (EVA) missions. One of the critical PLSS functions is maintaining the carbon dioxide (CO2) concentration in the suit at acceptable levels. Although the Metal Oxide (MetOx) canister has worked well, it has a finite CO2 adsorption capacity. Consequently, the unit would have to be larger and heavier to extend EVA times. Therefore, new CO2 control technologies must be developed to meet mission objectives without increasing the size of the PLSS. Although recent work has centered on sorbents that can be regenerated during the EVA, this strategy increases the system complexity and power consumption. A simpler approach is to use a membrane that selectively vents CO2 to space. A membrane has many advantages over current technology: it is a continuous system with no theoretical capacity limit, it requires no consumables, and it requires no hardware for switching beds between absorption and regeneration. Unfortunately, conventional gas separation membranes do not have adequate selectivity for use in the PLSS. However, the required performance could be obtained with a supported liquid membrane (SLM), which consists of a micro porous material filled with a liquid that selectively reacts with CO2 over oxygen (O2). In a current Phase II SBIR project, Reaction Systems has developed a new reactive liquid, which has effectively zero vapor pressure making it an ideal candidate for use in an SLM. The SLM function has been demonstrated with representative pressures of CO2, O2, and water (H2O). In addition to being effective for CO2 control, the SLM also vents moisture to space. Therefore, this project has demonstrated the feasibility of using an SLM to control CO2 in an EVA application.

Advanced Supported Liquid Membranes for CO2 Control in Extravehicular Activity Applications

NASA Technical Reports Server (NTRS)

Wickham, David T.; Gleason, Kevin J.; Engel, Jeffrey R.; Cowley, Scott W.; Chullen, Cinda

2014-01-01

Developing a new, robust, portable life support system (PLSS) is currently a high priority for NASA in order to support longer and safer extravehicular activity (EVA) missions. One of the critical PLSS functions is maintaining the carbon dioxide (CO2) concentration in the suit at acceptable levels. Although the Metal Oxide (MetOx) canister has worked well, it has a finite CO2 adsorption capacity. Consequently, the unit would have to be larger and heavier to extend EVA times. Therefore, new CO2 control technologies must be developed to meet mission objectives without increasing the size of the PLSS. Although recent work has centered on sorbents that can be regenerated during the EVA, this strategy increases the system complexity and power consumption. A simpler approach is to use a membrane that selectively vents CO2 to space. A membrane has many advantages over current technology: it is a continuous system with no theoretical capacity limit, it requires no consumables, and it requires no hardware for switching beds between absorption and regeneration. Unfortunately, conventional gas separation membranes do not have adequate selectivity for use in the PLSS. However, the required performance could be obtained with a supported liquid membrane (SLM), which consists of a micro porous material filled with a liquid that selectively reacts with CO2 over oxygen (O2). In a current Phase II SBIR project, Reaction Systems has developed a new reactive liquid, which has effectively zero vapor pressure making it an ideal candidate for use in an SLM. The SLM function has been demonstrated with representative pressures of CO2, O2, and water (H2O). In addition to being effective for CO2 control, the SLM also vents moisture to space. Therefore, this project has demonstrated the feasibility of using an SLM to control CO2 in an EVA application. 1 President

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

PubMed

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).

The embodiment design of the heat rejection system for the portable life support system

NASA Technical Reports Server (NTRS)

Stuckwisch, Sue; Francois, Jason; Laughlin, Julia; Phillips, Lee; Carrion, Carlos A.

1994-01-01

The Portable Life Support System (PLSS) provides a suitable environment for the astronaut in the Extravehicular Mobility Unit (EMU), and the heat rejection system controls the thermal conditions in the space suit. The current PLSS sublimates water to the space environment; therefore, the system loses mass. Since additional supplies of fluid must be available on the Space Shuttle, NASA desires a closed heat rejecting system. This document presents the embodiment design for a radiative plate heat rejection system without mass transfer to the space environment. This project will transform the concept variant into a design complete with material selection, dimensions of the system, layouts of the heat rejection system, suggestions for manufacturing, and financial viability.

Closed-loop control of propofol anaesthesia.

PubMed

Kenny, G N; Mantzaridis, H

1999-08-01

We describe the use of a closed-loop system to control depth of propofol anaesthesia automatically. We used the auditory evoked potential index (AEPindex) as the input signal of this system to validate it as a true measure of depth of anaesthesia. Auditory evoked potentials were acquired and processed in real time to provide the AEPindex. The AEPindex was used in a proportional integral (PI) controller to determine the target blood concentration of propofol required to induce and maintain general anaesthesia automatically. We studied 100 spontaneously breathing patients. The mean AEPindex before induction of anaesthesia was 73.5 (SD 17.6), during surgical anaesthesia 37.8 (4.5) and at recovery of consciousness 89.7 (17.9). Twenty-two patients required assisted ventilation before incision. After incision, ventilation was assisted in four of these 22 patients for more than 5 min. There was no incidence of intraoperative awareness and all patients were prepared to have the same anaesthetic in future. Movement interfering with surgery was minimal. Cardiovascular stability and overall control of anaesthesia were satisfactory.

Performance of a Multifunctional Space Evaporator-Absorber-Radiator (SEAR)

NASA Technical Reports Server (NTRS)

Izenson, Michael G.; Chen, Weibo; Phillips, Scott; Chepko, Ariane; Bue, Grant; Quinn, Gregory

2014-01-01

The Space Evaporator-Absorber-Radiator (SEAR) is a nonventing thermal control subsystem that combines a Space Water Membrane Evaporator (SWME) with a Lithium Chloride Absorber Radiator (LCAR). The LCAR is a heat pump radiator that absorbs water vapor produced in the SWME. Because of the very low water vapor pressure at equilibrium with lithium chloride solution, the LCAR can absorb water vapor at a temperature considerably higher than the SWME, enabling heat rejection sufficient for most EVA activities by thermal radiation from a relatively small area radiator. Prior SEAR prototypes used a flexible LCAR that was designed to be installed on the outer surface of a portable life support system (PLSS) backpack. This paper describes a SEAR subsystem that incorporates a very compact LCAR. The compact, multifunctional LCAR is built in the form of thin panels that can also serve as the PLSS structural shell. We designed and assembled a 2 ft² prototype LCAR based on this design and measured its performance in thermal vacuum tests when supplied with water vapor by a SWME. These tests validated our models for SEAR performance and showed that there is enough area available on the PLSS backpack shell to enable rejection of metabolic heat from the LCAR. We used results of these tests to assess future performance potential and suggest approaches for integrating the SEAR system with future space suits.

Assessment and monitoring of flow limitation and other parameters from flow/volume loops.

PubMed

Dueck, R

2000-01-01

Flow/volume (F/V) spirometry is routinely used for assessing the type and severity of lung disease. Forced vital capacity (FVC) and timed vital capacity (FEV1) provide the best estimates of airflow obstruction in patients with asthma, chronic obstructive pulmonary disease (COPD) and emphysema. Computerized spirometers are now available for early home recognition of asthma exacerbation in high risk patients with severe persistent disease, and for recognition of either infection or rejection in lung transplant patients. Patients with severe COPD may exhibit expiratory flow limitation (EFL) on tidal volume (VT) expiratory F/V (VTF/V) curves, either with or without applying negative expiratory pressure (NEP). EFL results in dynamic hyperinflation and persistently raised alveolar pressure or intrinsic PEEP (PEEPi). Hyperinflation and raised PEEPi greatly enhance dyspnea with exertion through the added work of the threshold load needed to overcome raised pleural pressure. Esophageal (pleural) pressure monitoring may be added to VTF/V loops for assessing the severity of PEEPi: 1) to optimize assisted ventilation by mask or via endotracheal tube with high inspiratory flow rates to lower I:E ratio, and 2) to assess the efficacy of either pressure support ventilation (PSV) or low level extrinsic PEEP in reducing the threshold load of PEEPi. Intraoperative tidal volume F/V loops can also be used to document the efficacy of emphysema lung volume reduction surgery (LVRS) via disappearance of EFL. Finally, the mechanism of ventilatory constraint can be identified with the use of exercise tidal volume F/V loops referenced to maximum F/V loops and static lung volumes. Patients with severe COPD show inspiratory F/V loops approaching 95% of total lung capacity, and flow limitation over the entire expiratory F/V curve during light levels of exercise. Surprisingly, patients with a history of congestive heart failure may lower lung volume towards residual volume during exercise, thereby reducing airway diameter and inducing expiratory flow limitation.

Custom Unit Pump Design and Testing for the EVA PLSS

NASA Technical Reports Server (NTRS)

Schuller, Michael; Kurwitz, Cable; Goldman, Jeff; Morris, Kim; Trevino, Luis

2009-01-01

This paper describes the effort by the Texas Engineering Experiment Station (TEES) and Honeywell for NASA to design and test a pre-flight prototype pump for use in the Extra-vehicular activity (EVA) portable life support subsystem (PLSS). Major design decisions were driven by the need to reduce the pump s mass, power, and volume compared to the existing PLSS pump. In addition, the pump must accommodate a much wider range of abnormal conditions than the existing pump, including vapor/gas bubbles and increased pressure drop when employed to cool two suits simultaneously. A positive displacement, external gear type pump was selected because it offers the most compact and highest efficiency solution over the required range of flow rates and pressure drops. An additional benefit of selecting a gear pump design is that it is self priming and capable of ingesting non-condensable gas without becoming air locked. The chosen pump design consists of a 28 V DC, brushless, sealless, permanent magnet motor driven, external gear pump that utilizes a Honeywell development that eliminates the need for magnetic coupling. Although the planned flight unit will use a sensorless motor with custom designed controller, the pre-flight prototype to be provided for this project incorporates Hall effect sensors, allowing an interface with a readily available commercial motor controller. This design approach reduced the cost of this project and gives NASA more flexibility in future PLSS laboratory testing. The pump design was based on existing Honeywell designs, but incorporated features specifically for the PLSS application, including all of the key features of the flight pump. Testing at TEES verified that the pump meets the design requirements for range of flow rates, pressure drop, power consumption, working fluid temperature, operating time, gas ingestion , and restart capability under both ambient and vacuum conditions. The pump operated between 40 and 240 lbm/hr flowrate, 35 to 100 F pump temperature range, and 5 to 10 psid pressure rise. Power consumption of the pump controller at the nominal operating point in both ambient and vacuum conditions was 9.5 W, which was less than the 12 W predicted. Gas ingestion capabilities were tested by injecting 100 cc of air into the fluid line; the pump operated normally throughout this test. The test results contained a number of anomalies, specifically power increases and a few flow stoppages, that prompted TEES and Honeywell to disassemble and inspect the pump. Inspection indicated contamination in the pump and fit issues may have played roles in the observed anomalies. Testing following reassembly indicated that the performance of the pump 1) matched both the predicted performance values, 2) the performance values measured prior to disassembly, and 3) was free of the anomalies noted in the pre-disassembly testing.

International Space Station USOS Crew Quarters Ventilation and Acoustic Design Implementation

NASA Technical Reports Server (NTRS)

Broyan, James Lee, Jr.

2009-01-01

The International Space Station (ISS) United States Operational Segment (USOS) has four permanent rack sized ISS Crew Quarters (CQ) providing a private crewmember space. The CQ uses Node 2 cabin air for ventilation/thermal cooling, as opposed to conditioned ducted air from the ISS Temperature Humidity Control System or the ISS fluid cooling loop connections. Consequently, CQ can only increase the air flow rate to reduce the temperature delta between the cabin and the CQ interior. However, increasing airflow causes increased acoustic noise so efficient airflow distribution is an important design parameter. The CQ utilized a two fan push-pull configuration to ensure fresh air at the crewmember s head position and reduce acoustic exposure. The CQ interior needs to be below Noise Curve 40 (NC-40). The CQ ventilation ducts are open to the significantly louder Node 2 cabin aisle way which required significantly acoustic mitigation controls. The design implementation of the CQ ventilation system and acoustic mitigation are very inter-related and require consideration of crew comfort balanced with use of interior habitable volume, accommodation of fan failures, and possible crew uses that impact ventilation and acoustic performance. This paper illustrates the types of model analysis, assumptions, vehicle interactions, and trade-offs required for CQ ventilation and acoustics. Additionally, on-orbit ventilation system performance and initial crew feedback is presented. This approach is applicable to any private enclosed space that the crew will occupy.

Regional Lung Ventilation Analysis Using Temporally Resolved Magnetic Resonance Imaging.

PubMed

Kolb, Christoph; Wetscherek, Andreas; Buzan, Maria Teodora; Werner, René; Rank, Christopher M; Kachelrie, Marc; Kreuter, Michael; Dinkel, Julien; Heuel, Claus Peter; Maier-Hein, Klaus

We propose a computer-aided method for regional ventilation analysis and observation of lung diseases in temporally resolved magnetic resonance imaging (4D MRI). A shape model-based segmentation and registration workflow was used to create an atlas-derived reference system in which regional tissue motion can be quantified and multimodal image data can be compared regionally. Model-based temporal registration of the lung surfaces in 4D MRI data was compared with the registration of 4D computed tomography (CT) images. A ventilation analysis was performed on 4D MR images of patients with lung fibrosis; 4D MR ventilation maps were compared with corresponding diagnostic 3D CT images of the patients and 4D CT maps of subjects without impaired lung function (serving as reference). Comparison between the computed patient-specific 4D MR regional ventilation maps and diagnostic CT images shows good correlation in conspicuous regions. Comparison to 4D CT-derived ventilation maps supports the plausibility of the 4D MR maps. Dynamic MRI-based flow-volume loops and spirograms further visualize the free-breathing behavior. The proposed methods allow for 4D MR-based regional analysis of tissue dynamics and ventilation in spontaneous breathing and comparison of patient data. The proposed atlas-based reference coordinate system provides an automated manner of annotating and comparing multimodal lung image data.

"Atypical" Pleomorphic Lipomatous Tumor: A Clinicopathologic, Immunohistochemical and Molecular Study of 21 Cases, Emphasizing its Relationship to Atypical Spindle Cell Lipomatous Tumor and Suggesting a Morphologic Spectrum (Atypical Spindle Cell/Pleomorphic Lipomatous Tumor).

PubMed

Creytens, David; Mentzel, Thomas; Ferdinande, Liesbeth; Lecoutere, Evelyne; van Gorp, Joost; Atanesyan, Lilit; de Groot, Karel; Savola, Suvi; Van Roy, Nadine; Van Dorpe, Jo; Flucke, Uta

2017-11-01

The classification of the until recently poorly explored group of atypical adipocytic neoplasms with spindle cell features, for which recently the term atypical spindle cell lipomatous tumor (ASLT) has been proposed, remains challenging. Recent studies have proposed ASLT as a unique entity with (in at least a significant subset of cases) a specific genetic background, namely deletions/losses of 13q14, including RB1 and its flanking genes RCBTB2, DLEU1, and ITM2B. Similar genetic aberrations have been reported in pleomorphic liposarcomas (PLSs). This prompted us to investigate a series of 21 low-grade adipocytic neoplasms with a pleomorphic lipoma-like appearance, but with atypical morphologic features (including atypical spindle cells, pleomorphic [multinucleated] cells, pleomorphic lipoblasts and poor circumscription), for which we propose the term "atypical" pleomorphic lipomatous tumor (APLT). Five cases of PLS were also included in this study. We used multiplex ligation-dependent probe amplification to evaluate genetic changes of 13q14. In addition, array-based comparative genomic hybridization was performed on 4 APLTs and all PLSs. Multiplex ligation-dependent probe amplification showed consistent loss of RB1 and its flanking gene RCBTB2 in all cases of APLT. This genetic alteration was also present in all PLSs, suggesting genetic overlap, in addition to morphologic overlap, with APLTs. However, array-based comparative genomic hybridization demonstrated more complex genetic alterations with more losses and gains in PLSs compared with APLTs. APLTs arose in the subcutis (67%) more frequently than in the deep (subfascial) soft tissues (33%). With a median follow-up of 42 months, recurrences were documented in 2 of 12 APLTs for which a long follow-up was available. Herein, we also demonstrate that APLTs share obvious overlapping morphologic, immunohistochemical, genetic and clinical characteristics with the recently defined ASLT, suggesting that they are related lesions that form a spectrum (atypical spindle cell/pleomorphic lipomatous tumor).

Modes of mechanical ventilation for the operating room.

PubMed

Ball, Lorenzo; Dameri, Maddalena; Pelosi, Paolo

2015-09-01

Most patients undergoing surgical procedures need to be mechanically ventilated, because of the impact of several drugs administered at induction and during maintenance of general anaesthesia on respiratory function. Optimization of intraoperative mechanical ventilation can reduce the incidence of post-operative pulmonary complications and improve the patient's outcome. Preoxygenation at induction of general anaesthesia prolongs the time window for safe intubation, reducing the risk of hypoxia and overweighs the potential risk of reabsorption atelectasis. Non-invasive positive pressure ventilation delivered through different interfaces should be considered at the induction of anaesthesia morbidly obese patients. Anaesthesia ventilators are becoming increasingly sophisticated, integrating many functions that were once exclusive to intensive care. Modern anaesthesia machines provide high performances in delivering the desired volumes and pressures accurately and precisely, including assisted ventilation modes. Therefore, the physicians should be familiar with the potential and pitfalls of the most commonly used intraoperative ventilation modes: volume-controlled, pressure-controlled, dual-controlled and assisted ventilation. Although there is no clear evidence to support the advantage of any one of these ventilation modes over the others, protective mechanical ventilation with low tidal volume and low levels of positive end-expiratory pressure (PEEP) should be considered in patients undergoing surgery. The target tidal volume should be calculated based on the predicted or ideal body weight rather than on the actual body weight. To optimize ventilation monitoring, anaesthesia machines should include end-inspiratory and end-expiratory pause as well as flow-volume loop curves. The routine administration of high PEEP levels should be avoided, as this may lead to haemodynamic impairment and fluid overload. Higher PEEP might be considered during surgery longer than 3 h, laparoscopy in the Trendelenburg position and in patients with body mass index >35 kg/m(2). Large randomized trials are warranted to identify subgroups of patients and the type of surgery that can potentially benefit from specific ventilation modes or ventilation settings. Copyright © 2015 Elsevier Ltd. All rights reserved.

Closing the loops in biomedical informatics from theory to daily practice.

PubMed

Gaudinat, A

2009-01-01

This article presents the 2009 selection of the best papers in the special section dedicated to biomedical informatics and cybernetics. Synopsis of the articles selected for the IMIA yearbook 2009 Five papers from international peer reviewed journals where selected for this section. Most of the papers have a strong practical orientation in clinical care. And this selection gives a good overview of what is done with "closing loop" approach, particularly during the year 2008. While quite mature for some clinical applications such as mechanical ventilation, it remains a challenge where rules for the decision system could be difficult to identify due to the number of variables. More complex systems with greater Artificial Intelligence approaches will certainly be the next trend for closed-loop applications.

Transient Modeling and Analysis of a Metabolic Heat-Regenerated Temperature Swing Adsorption (MTSA) System for a PLSS

NASA Technical Reports Server (NTRS)

Iacomini, Christie; Powers, Aaron; Speight, Garland; Padilla, Sebastian; Paul, Heather L.

2009-01-01

A Metabolic heat-regenerated Temperature Swing Adsorption (MTSA) system is being developed for carbon dioxide, water and thermal control in a lunar and martian portable life support system (PLSS). A previous system analysis was performed to evaluate the impact of MTSA on PLSS design. That effort was Mars specific and assumed liquid carbon dioxide (LCO2) coolant made from martian resources. Transient effects were not considered but rather average conditions were used throughout the analysis. This effort takes into further consideration the transient effects inherent in the cycling MTSA system as well as assesses the use of water as coolant. Standard heat transfer, thermodynamic, and heat exchanger methods are presented to conduct the analysis. Assumptions and model verification are discussed. The tool was used to perform various system studies. Coolant selection was explored and takes into account different operational scenarios as the minimum bed temperature is driven by the sublimation temperature of the coolant (water being significantly higher than LCO2). From this, coolant mass is sized coupled with sorbent bed mass because MTSA adsorption performance decreases with increasing sublimation temperature. Reduction in heat exchanger performance and even removal of certain heat exchangers, like a recuperative one between the two sorbent beds, is also investigated. Finally, the coolant flow rate is varied over the cycle to determine if there is a more optimal means of cooling the bed from a mass perspective. Results of these studies and subsequent recommendations for system design are presented.

Failure Analysis Results and Corrective Actions Implemented for the Extravehicular Mobility Unit 3011 Water in the Helmet Mishap

NASA Technical Reports Server (NTRS)

Steele, John; Metselaar, Carol; Peyton, Barbara; Rector, Tony; Rossato, Robert; Macias, Brian; Weigel, Dana; Holder, Don

2015-01-01

Water entered the Extravehicular Mobility Unit (EMU) helmet during extravehicular activity (EVA) no. 23 aboard the International Space Station on July 16, 2013, resulting in the termination of the EVA approximately 1 hour after it began. It was estimated that 1.5 liters of water had migrated up the ventilation loop into the helmet, adversely impacting the astronaut's hearing, vision, and verbal communication. Subsequent on-board testing and ground-based test, tear-down, and evaluation of the affected EMU hardware components determined that the proximate cause of the mishap was blockage of all water separator drum holes with a mixture of silica and silicates. The blockages caused a failure of the water separator degassing function, which resulted in EMU cooling water spilling into the ventilation loop, migrating around the circulating fan, and ultimately pushing into the helmet. The root cause of the failure was determined to be ground-processing shortcomings of the Airlock Cooling Loop Recovery (ALCLR) Ion Filter Beds, which led to various levels of contaminants being introduced into the filters before they left the ground. Those contaminants were thereafter introduced into the EMU hardware on-orbit during ALCLR scrubbing operations. This paper summarizes the failure analysis results along with identified process, hardware, and operational corrective actions that were implemented as a result of findings from this investigation.

Failure Analysis Results and Corrective Actions Implemented for the EMU 3011 Water in the Helmet Mishap

NASA Technical Reports Server (NTRS)

Steele, John; Metselaar, Carol; Peyton, Barbara; Rector, Tony; Rossato, Robert; Macias, Brian; Weigel, Dana; Holder, Don

2015-01-01

During EVA (Extravehicular Activity) No. 23 aboard the ISS (International Space Station) on 07/16/2013 water entered the EMU (Extravehicular Mobility Unit) helmet resulting in the termination of the EVA (Extravehicular Activity) approximately 1-hour after it began. It was estimated that 1.5-L of water had migrated up the ventilation loop into the helmet, adversely impacting the astronauts hearing, vision and verbal communication. Subsequent on-board testing and ground-based TT and E (Test, Tear-down and Evaluation) of the affected EMU hardware components led to the determination that the proximate cause of the mishap was blockage of all water separator drum holes with a mixture of silica and silicates. The blockages caused a failure of the water separator function which resulted in EMU cooling water spilling into the ventilation loop, around the circulating fan, and ultimately pushing into the helmet. The root cause of the failure was determined to be ground-processing short-comings of the ALCLR (Airlock Cooling Loop Recovery) Ion Filter Beds which led to various levels of contaminants being introduced into the Filters before they left the ground. Those contaminants were thereafter introduced into the EMU hardware on-orbit during ALCLR scrubbing operations. This paper summarizes the failure analysis results along with identified process, hardware and operational corrective actions that were implemented as a result of findings from this investigation.

Respiratory system loop gain in normal men and women measured with proportional-assist ventilation.

PubMed

Wellman, Andrew; Malhotra, Atul; Fogel, Robert B; Edwards, Jill K; Schory, Karen; White, David P

2003-01-01

We hypothesized that increased chemical control instability (CCI) in men could partially explain the male predominance in obstructive sleep apnea (OSA). CCI was assessed by sequentially increasing respiratory control system loop gain (LG) with proportional-assist ventilation (PAV) in 10 men (age 24-48 yr) and 9 women (age 22-36 yr) until periodic breathing or awakening occurred. Women were studied in both the follicular and luteal phases of the menstrual cycle. The amount by which PAV amplified LG was quantified from the tidal volume amplification factor [(VtAF) assisted tidal volume/unassisted tidal volume]. LG was calculated as the inverse of the VtAF occurring at the assist level immediately preceding the emergence of periodic breathing (when LG x VtAF = 1). Only 1 of 10 men and 2 of 9 women developed periodic breathing with PAV. The rest were resistant to periodic breathing despite moderately high levels of PAV amplification. We conclude that LG is low in the majority of normal men and women and that higher volume amplification factors are needed to determine whether gender differences exist in this low range.

Performance and Life Tests of a Regenerative Blower for EVA Suit Ventilation

NASA Technical Reports Server (NTRS)

Izenson, Michael G.; Chen, Weibo; McCormick, John; Paul, Heather L.; Jennings, Mallory A.

2012-01-01

Ventilation fans for future space suits must meet demanding performance specifications, satisfy stringent safety requirements for operation in an oxygen atmosphere, and be able to increase output to operate in buddy mode. A regenerative blower is an attractive choice due to its ability to meet these requirements at low operating speed. This paper describes progress in the development and testing of a regenerative blower designed to meet requirements for ventilation subsystems in future space suits. The blower includes a custom-designed motor that has significantly improved its efficiency. We have measured the blower s head/flow performance and power consumption under conditions that simulate both the normal and buddy mode operating points. We have operated the blower for TBD hours and demonstrated safe operation in an oxygen test loop at prototypical pressures. We also demonstrated operation with simulated lunar dust.

Characterization of commercial off-the shelf regenerable sorbent to scrub carbon dioxide in a portable life support system

NASA Astrophysics Data System (ADS)

Arai, Tatsuya; Fricker, John

2018-06-01

A resin bead Mitsubishi DIAION™ CR20 was identified and characterized as a first commercial off-the shelf regenerable carbon dioxide (CO2) sorbent candidate for space life support system applications at room temperature. The CO2 adsorption rates and capacities of CR20 at varying CO2 partial pressures were obtained. The data were used to numerically simulate CO2 adsorption by a swingbed, a pair of two sorbent beds that alternately adsorb and desorb CO2 in a space suit portable life support system (PLSS). The result demonstrated that a reasonable volume of CR20 would be able to continuously adsorb CO2 with bed-swing interval of 4 min at 300-W metabolic rate, and that commercial off-the shelf CR20 would have similar performance of CO2 adsorption to the proprietary swingbed sorbent SA9T for PLSS applications.

Results of the Trace Contaminant Control Trade Study for Space Suit Life Support Development

NASA Technical Reports Server (NTRS)

Jennings, Mallory A.; Paul, Heather L.

2008-01-01

As the United States plans to return astronauts to the moon, designing the most effective and efficient life support systems is of extreme importance. The trace contaminant control system (TCCS) will be located within the Portable Life Support System (PLSS) of the Constellation Space Suit Element (CSSE), and is responsible for removing contaminants, which at increased levels can be hazardous to a crewmember s health. These contaminants come from several sources including metabolic production of the crewmember (breathing, sweating, etc.) and offgassing of the space suit material layers. This paper summarizes the results of a trade study that investigated TCC technologies used in NASA space suits and vehicles as well as commercial and academic applications, to identify the best technology options for the CSSE PLSS. The trade study also looked at the feasibility of regeneration of TCC technologies, specifically to determine the viability of vacuum regeneration for on-back, realtime EVA.

Results of the Trace Contaminant Control Trade Study for Space Suit Life Support Development

NASA Technical Reports Server (NTRS)

Paul, Heather L.; Jennings, Mallory A.

2009-01-01

As the United States plans to return astronauts to the moon, designing the most effective and efficient life support systems is of extreme importance. The trace contaminant control system (TCCS) will be located within the Portable Life Support System (PLSS) of the Constellation Space Suit Element (CSSE), and is responsible for removing contaminants, which at increased levels can be hazardous to a crewmember's health. These contaminants come from several sources including metabolic production of the crewmember (breathing, sweating, etc.) and offgassing of the space suit material layers. This paper summarizes the results of a trade study that investigated TCC technologies used in NASA space suits and vehicles as well as commercial and academic applications, to identify the best technology options for the CSSE PLSS. The trade study also looked at the feasibility of regeneration of TCC technologies, specifically to determine the viability of vacuum regeneration for on-back, real-time EVA.

Automated respiratory cycles selection is highly specific and improves respiratory mechanics analysis.

PubMed

Rigo, Vincent; Graas, Estelle; Rigo, Jacques

2012-07-01

Selected optimal respiratory cycles should allow calculation of respiratory mechanic parameters focusing on patient-ventilator interaction. New computer software automatically selecting optimal breaths and respiratory mechanics derived from those cycles are evaluated. Retrospective study. University level III neonatal intensive care unit. Ten mins synchronized intermittent mandatory ventilation and assist/control ventilation recordings from ten newborns. The ventilator provided respiratory mechanic data (ventilator respiratory cycles) every 10 secs. Pressure, flow, and volume waves and pressure-volume, pressure-flow, and volume-flow loops were reconstructed from continuous pressure-volume recordings. Visual assessment determined assisted leak-free optimal respiratory cycles (selected respiratory cycles). New software graded the quality of cycles (automated respiratory cycles). Respiratory mechanic values were derived from both sets of optimal cycles. We evaluated quality selection and compared mean values and their variability according to ventilatory mode and respiratory mechanic provenance. To assess discriminating power, all 45 "t" values obtained from interpatient comparisons were compared for each respiratory mechanic parameter. A total of 11,724 breaths are evaluated. Automated respiratory cycle/selected respiratory cycle selections agreement is high: 88% of maximal κ with linear weighting. Specificity and positive predictive values are 0.98 and 0.96, respectively. Averaged values are similar between automated respiratory cycle and ventilator respiratory cycle. C20/C alone is markedly decreased in automated respiratory cycle (1.27 ± 0.37 vs. 1.81 ± 0.67). Tidal volume apparent similarity disappears in assist/control: automated respiratory cycle tidal volume (4.8 ± 1.0 mL/kg) is significantly lower than for ventilator respiratory cycle (5.6 ± 1.8 mL/kg). Coefficients of variation decrease for all automated respiratory cycle parameters in all infants. "t" values from ventilator respiratory cycle data are two to three times higher than ventilator respiratory cycles. Automated selection is highly specific. Automated respiratory cycle reflects most the interaction of both ventilator and patient. Improving discriminating power of ventilator monitoring will likely help in assessing disease status and following trends. Averaged parameters derived from automated respiratory cycles are more precise and could be displayed by ventilators to improve real-time fine tuning of ventilator settings.

Miniature Sensor Probe for O2, CO2, and H2O Monitoring in Portable Life Support Systems

NASA Technical Reports Server (NTRS)

Delgado, Jesus; Chambers, Antja

2013-01-01

A miniature sensor probe, composed of four sensors which monitor the partial pressure of O2, CO2, H2O, and temperature, designed to operate in the portable life support system (PLSS), has been demonstrated. The probe provides an important advantage over existing technology in that it is able to operate reliably while wet. These luminescence-based fiber optic sensors consist of an indicator chemistry immobilized in a polymeric film, whose emission lifetime undergoes a strong change upon a reversible interaction with the target gas. Each sensor includes chemistry specifically sensitive to one target parameter. All four sensors are based on indicator chemistries that include luminescent dyes from the same chemical family, and therefore exhibit similar photochemical properties, which allow performing measurements of all the sensors by a single, compact, low-power optoelectronic unit remotely connected to the sensors by an electromagnetic interference-proof optical fiber cable. For space systems, using these miniature sensor elements with remote optoelectronics provides unmatched design flexibility for measurements in highly constrained volume systems such as the PLSS. A 10 mm diameter and 15 mm length prototype multiparameter probe was designed, fabricated, tested, and demonstrated over a wide operational range of gas concentration, humidity, and temperature relevant to operation in the PLSS. The sensors were evaluated for measurement range, precision, accuracy, and response time in temperatures ranging from 50 aF-150 aF and relative humidity from dry to 100% RH. Operation of the sensors in water condensation conditions was demonstrated wherein the sensors not only tolerated liquid water but actually operated while wet.

Freeze Tolerant Radiator for an Advanced EMU

NASA Technical Reports Server (NTRS)

Copeland, Robert J.; Elliott, Jeannine; Weislogel, Mark

2004-01-01

During an Extravehicular Activity (EVA), the astronaut s metabolic heat and the heat produced by the Portable Life Support Unit (PLSS) must be rejected. This heat load is currently rejected by a sublimator, which vents up to eight pounds of water each EVA. However, for advanced space missions of the future, water venting to space needs to be minimized because resupply impacts from earth will be prohibitive. If this heat load could be radiated to space from the PLSS, which has enough surface area to radiate most of the heat, the amount of water now vented could be greatly reduced. Unfortunately, a radiator rejects heat at a relatively constant rate, but the astronauts generate a variable heat load depending on how hard they are working. Without a way to vary the heat removal rate, the astronaut would experience cold discomfort or even frostbite. A proven method allowing a radiator to be turned-down is to sequentially allow tubes that carry the heat transfer fluid to the radiator to freeze. A drawback of current freezable radiators using this method is that they are far to heavy for use on a PLSS, because they use heavy construction to prevent the tubes from bursting as they freeze and thaw. This creates the need for a large radiator to reject most of the heat but with a lightweight tube that doesn t burst as it freezes and thaws. The new freezable radiator for the Extravehicular Mobility Unit (EMU) has features to accommodate the expansion of the radiator fluid when it freezes, and still have the high tube to fin conductance needed to minimize the number and weight of the tubes. Radiator fluid candidates are water and a propylene glycol-water mixture. This design maintains all materials within their elastic limits so that large volume changes can be achieved without breaking the tube. This concept couples this elastic expansion with an extremely lightweight, extremely high conductivity carbon fiber fin that can carry the heat needed to thaw a frozen tube. By using most of the exposed surface area of the PLSS as a radiator, the system can reject about 75% of the highest heat load, and reduce the loss of water through sublimation by a factor of four. The proposed radiator and a small water tank can be no heavier than the current system.

[A design of simple ventilator control system based on LabVIEW].

PubMed

Pei, Baoqing; Xu, Shengwei; Li, Hui; Li, Deyu; Pei, Yidong; He, Haixing

2011-01-01

This paper designed a ventilator control system to control proportional valves and motors. It used LabVIEW to control the object mentioned above and design ,validate, evaluate arithmetic, and establish hardware in loop platform. There are two system' s hierarchies. The high layer was used to run non-real time program and the low layer was used to run real time program. The two layers communicated through TCP/IP net. The program can be divided into several modules, which can be expanded and maintained easily. And the harvest in the prototype designing can be seamlessly used to embedded products. From all above, this system was useful in employing OEM products.

International Space Station Crew Quarters Ventilation and Acoustic Design Implementation

NASA Technical Reports Server (NTRS)

Broyan, James L., Jr.; Cady, Scott M; Welsh, David A.

2010-01-01

The International Space Station (ISS) United States Operational Segment has four permanent rack sized ISS Crew Quarters (CQs) providing a private crew member space. The CQs use Node 2 cabin air for ventilation/thermal cooling, as opposed to conditioned ducted air-from the ISS Common Cabin Air Assembly (CCAA) or the ISS fluid cooling loop. Consequently, CQ can only increase the air flow rate to reduce the temperature delta between the cabin and the CQ interior. However, increasing airflow causes increased acoustic noise so efficient airflow distribution is an important design parameter. The CQ utilized a two fan push-pull configuration to ensure fresh air at the crew member's head position and reduce acoustic exposure. The CQ ventilation ducts are conduits to the louder Node 2 cabin aisle way which required significant acoustic mitigation controls. The CQ interior needs to be below noise criteria curve 40 (NC-40). The design implementation of the CQ ventilation system and acoustic mitigation are very inter-related and require consideration of crew comfort balanced with use of interior habitable volume, accommodation of fan failures, and possible crew uses that impact ventilation and acoustic performance. Each CQ required 13% of its total volume and approximately 6% of its total mass to reduce acoustic noise. This paper illustrates the types of model analysis, assumptions, vehicle interactions, and trade-offs required for CQ ventilation and acoustics. Additionally, on-orbit ventilation system performance and initial crew feedback is presented. This approach is applicable to any private enclosed space that the crew will occupy.

System Design Verification for Closed Loop Control of Oxygenation With Concentrator Integration.

PubMed

Gangidine, Matthew M; Blakeman, Thomas C; Branson, Richard D; Johannigman, Jay A

2016-05-01

Addition of an oxygen concentrator into a control loop furthers previous work in autonomous control of oxygenation. Software integrates concentrator and ventilator function from a single control point, ensuring maximum efficiency by placing a pulse of oxygen at the beginning of the breath. We sought to verify this system. In a test lung, fraction of inspired oxygen (FIO2) levels and additional data were monitored. Tests were run across a range of clinically relevant ventilator settings in volume control mode, for both continuous flow and pulse dose flow oxygenation. Results showed the oxygen concentrator could maintain maximum pulse output (192 mL) up to 16 breaths per minute. Functionality was verified across ranges of tidal volumes and respiratory rates, with and without positive end-expiratory pressure, in continuous flow and pulse dose modes. For a representative test at respiratory rate 16 breaths per minute, tidal volume 550 mL, without positive end-expiratory pressure, pulse dose oxygenation delivered peak FIO2 of 76.83 ± 1.41%, and continuous flow 47.81 ± 0.08%; pulse dose flow provided a higher FIO2 at all tested setting combinations compared to continuous flow (p < 0.001). These tests verify a system that provides closed loop control of oxygenation while integrating time-coordinated pulse-doses from an oxygen concentrator. This allows the most efficient use of resources in austere environments. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Carbon Dioxide Control System for a Mars Space Suit Life Support System

NASA Technical Reports Server (NTRS)

Alptekin, Gokhan; Jayaraman, Ambalavanan; Copeland, Robert; Parker, Amanda; Paul, Heather L.

2011-01-01

Carbon dioxide (CO2) control during Extravehicular Activities (EVAs) on Mars will be challenging. Lithium hydroxide (LiOH) canisters have impractical logistics penalties, and regenerable metal oxide (MetOx) canisters weigh too much. Cycling bed systems and permeable membranes that are regenerable in space vacuum cannot vent on Mars due to the high partial pressure of CO2 in the atmosphere. Although sweep gas regeneration is under investigation, the feasibility, logistics penalties, and failure modes associated with this technique have not been fully determined. TDA Research, Inc. is developing a durable, high-capacity regenerable adsorbent that can remove CO2 from the space suit ventilation loop. The system design allows sorbent regeneration at or above 6 torr, eliminating the potential for Martian atmosphere to leak into the regeneration bed and into the ventilation loop. Regeneration during EVA minimizes the amount of consumables to be brought from Earth and makes the mission more affordable, while providing great operational flexibility during EVA. The feasibility of the concept has been demonstrated in a series of bench-scale experiments and a preliminary system analysis. This paper presents the latest results from these sorbent and system development efforts.

Expiratory flow limitation and operating lung volumes during exercise in older and younger adults.

PubMed

Smith, Joshua R; Kurti, Stephanie P; Meskimen, Kayla; Harms, Craig A

2017-06-01

We determined the effect of aging on expiratory flow limitation (EFL) and operating lung volumes when matched for lung size. We hypothesized that older adults will exhibit greater EFL and increases in EELV during exercise compared to younger controls. Ten older (5M/5W; >60years old) and nineteen height-matched young adults (10M/9W) were recruited. Young adults were matched for%predicted forced vital capacity (FVC) (Y-matched%Pred FVC; n=10) and absolute FVC (Y-matched FVC; n=10). Tidal flow-volume loops were recorded during the incremental exercise test with maximal flow-volume loops measured pre- and post-exercise. Compared to younger controls, older adults exhibited more EFL at ventilations of 26, 35, 51, and 80L/min. The older group had higher end-inspiratory lung volume compared to Y-matched%Pred FVC group during submaximal ventilations. The older group increased EELV during exercise, while EELV stayed below resting in the Y-matched%Pred FVC group. These data suggest older adults exhibit more EFL and increase EELV earlier during exercise compared to younger adults. Copyright © 2017 Elsevier B.V. All rights reserved.

51-A V1103 Results

NASA Technical Reports Server (NTRS)

Counts, B.

1984-01-01

The following are test results from the performance sections of the 51-A V1103.03 conducted on October 31,1984. During this checkout, an astronaut commented that the O2 actuator on SEMU 1052 (PLSS 1007) seemed stiffer to operate than the other two units.

High Performance Mars Liquid Cooling and Ventilation Garment Project

NASA Technical Reports Server (NTRS)

Terrier, Douglas; Clayton, Ronald; Whitlock, David; Conger, Bruce

2015-01-01

EVA space suit mobility in micro-gravity is enough of a challenge and in the gravity of Mars, improvements in mobility will enable the suited crew member to efficiently complete EVA objectives. The idea proposed is to improve thermal efficiencies of the liquid cooling and ventilation garment (LCVG) in the torso area in order to free up the arms and legs by removing the liquid tubes currently used in the ISS EVA suit in the limbs. By using shaped water tubes that greatly increase the contact area with the skin in the torso region of the body, the heat transfer efficiency can be increased to provide the entire liquid cooling requirement and increase mobility by freeing up the arms and legs. Additional potential benefits of this approach include reduced LCVG mass, enhanced evaporation cooling, increased comfort during Mars EVA tasks, and easing of the overly dry condition in the helmet associated with the Advanced Extravehicular Mobility Unit (EMU) ventilation loop currently under development.

Advanced life support study

NASA Technical Reports Server (NTRS)

1991-01-01

Summary reports on each of the eight tasks undertaken by this contract are given. Discussed here is an evaluation of a Closed Ecological Life Support System (CELSS), including modeling and analysis of Physical/Chemical Closed Loop Life Support (P/C CLLS); the Environmental Control and Life Support Systems (ECLSS) evolution - Intermodule Ventilation study; advanced technologies interface requirements relative to ECLSS; an ECLSS resupply analysis; the ECLSS module addition relocation systems engineering analysis; an ECLSS cost/benefit analysis to identify rack-level interface requirements of the alternate technologies evaluated in the ventilation study, with a comparison of these with the rack level interface requirements for the baseline technologies; advanced instrumentation - technology database enhancement; and a clean room survey and assessment of various ECLSS evaluation options for different growth scenarios.

Labeled cutaway line drawing of Shuttle Extravehicular Mobility Unit (EMU)

NASA Image and Video Library

1991-05-21

Labeled cutaway line drawing of the Shuttle extravehicular mobility unit (EMU) identifies its various components and equipment. The portable life support system (PLSS) and protective layers of fabric (thermal micrometeoroid garment (TMG)) incorporated in this extravehicular activity (EVA) space suit are shown.

Labeled cutaway line drawing of Shuttle Extravehicular Mobility Unit (EMU)

NASA Technical Reports Server (NTRS)

1991-01-01

Labeled cutaway line drawing of the Shuttle extravehicular mobility unit (EMU) identifies its various components and equipment. The portable life support system (PLSS) and protective layers of fabric (thermal micrometeoroid garment (TMG)) incorporated in this extravehicular activity (EVA) space suit are shown.

Simplifications for hydronic system models in modelica

DOE PAGES

Jorissen, F.; Wetter, M.; Helsen, L.

2018-01-12

Building systems and their heating, ventilation and air conditioning flow networks, are becoming increasingly complex. Some building energy simulation tools simulate these flow networks using pressure drop equations. These flow network models typically generate coupled algebraic nonlinear systems of equations, which become increasingly more difficult to solve as their sizes increase. This leads to longer computation times and can cause the solver to fail. These problems also arise when using the equation-based modelling language Modelica and Annex 60-based libraries. This may limit the applicability of the library to relatively small problems unless problems are restructured. This paper discusses two algebraicmore » loop types and presents an approach that decouples algebraic loops into smaller parts, or removes them completely. The approach is applied to a case study model where an algebraic loop of 86 iteration variables is decoupled into smaller parts with a maximum of five iteration variables.« less

Development of the electrochemically regenerable carbon dioxide absorber for portable life support system application

NASA Technical Reports Server (NTRS)

Woods, R. R.; Heppner, D. B.; Marshall, R. D.; Quattrone, P. D.

1979-01-01

As the length of manned space missions increase, more ambitious extravehicular activities (EVAs) are required. For the projected longer mission the use of expendables in the portable life support system (PLSS) will become prohibited due to high launch weight and volume requirements. Therefore, the development of a regenerable CO2 absorber for the PLSS application is highly desirable. The paper discusses the concept, regeneration mechanism, performance, system design, and absorption/regeneration cycle testing of a most promising concept known as ERCA (Electrochemically Regenerable CO2 Absorber). This concept is based on absorbing CO2 into an alkaline absorbent similar to LiOH. The absorbent is an aqueous solution supported in a porous matrix which can be electrochemically regenerated on board the primary space vehicle. With the metabolic CO2 recovery the ERCA concept results in a totally regenerable CO2 scrubber. The ERCA test hardware has passed 200 absorption/regeneration cycles without performance degradation.

Hollow Fiber Space Suit Water Membrane Evaporator Development for Lunar Missions

NASA Technical Reports Server (NTRS)

Bue, Grant C.; Trevino, Luis A.; Hanford, Anthony J.; Mitchell, Keith

2009-01-01

The Space Suit Water Membrane Evaporator (SWME) is the baseline heat rejection technology selected for development for the Constellation lunar suit. The Hollow Fiber (HoFi) SWME is being considered for service in the Constellation Space Suit Element (CSSE) Portable Life Support Subsystem (PLSS) to provide cooling to the thermal loop through water evaporation to the vacuum of space. Previous work described the test methodology and planning to compare the test performance of three commercially available hollow fiber materials as alternatives to the sheet membrane prototype for SWME: 1) porous hydrophobic polypropylene, 2) porous hydrophobic polysulfone, and 3) ion exchange through nonporous hydrophilic modified Nafion. Contamination tests were performed to probe for sensitivities of the candidate SWME elements to organics and non-volative inorganics expected to be found in the target feedwater source, i.e., potable water provided by the vehicle. The resulting presence of precipitate in the coolant water could plug pores and tube channels and affect the SWME performance. From this prior work, a commercial porous hydrophobic hollow fiber was selected to satisfy both the sensitivity question and the need to provide 800 W of heat rejection. This paper describes the trade studies, the design methodology, and the hollow fiber test data used to design a full

Continued Advancement of Supported Liquid Membranes for Carbon Dioxide Control in Extravehicular Activity Applications

NASA Technical Reports Server (NTRS)

Wickham, David T.; Gleason, Kevin J.; Engel, Jeffrey R.; Cowley, Scott W.; Chullen, Cinda

2015-01-01

The Development of a new, robust, portable life support system (PLSS) is currently a high NASA priority in order to support longer and safer extravehicular activity (EVA) missions that will be necessary as space travel extends to near-Earth asteroids and eventually Mars. One of the critical PLSS functions is maintaining the carbon dioxide (CO2) concentration in the suit at acceptable levels. The Metal Oxide (MetOx) canister has a finite CO2 adsorption capacity and therefore in order to extend mission times, the unit would have to be larger and heavier, which is undesirable; therefore new CO2 control technologies must be developed. While recent work has centered on the use of alternating sorbent beds that can be regenerated during the EVA, this strategy increases the system complexity and power consumption. A simpler approach is to use a membrane that vents CO2 to space but retains oxygen(O2). A membrane has many advantages over current technology: it is a continuous system with no theoretical capacity limit, it requires no consumables, and it requires no hardware for switching beds between absorption and regeneration. Conventional gas separation membranes do not have adequate selectivity for use in the PLSS, but the required performance could be obtained with a supported liquid membrane (SLM), which consists of a microporous film filled with a liquid that selectively reacts with CO2 over oxygen (O2). In a recently completed Phase II Small Business Innovative Research project, Reaction Systems developed a new reactive liquid that has effectively zero vapor pressure, making it an ideal candidate for use in an SLM. Results obtained with the SLM in a flat sheet configuration with representative pressures of CO2, O2, and water (H2O) have shown that the CO2 permeation rate and CO2/O2 selectivity requirements have been met. In addition, the SLM vents moisture to space very effectively. The SLM has also been prepared and tested in a hollow fiber form, which will be necessary to meet size requirements in the PLSS. In initial tests, the required CO2 permeance values have been obtained, while the current CO2/O2 selectivity values are somewhat lower than needed. However, the performance of the SLM is a strong function of the method used to impregnate the sorbent in the hollow fiber walls and rapid progress is being made in that area.

A closed-loop model of the respiratory system: focus on hypercapnia and active expiration.

PubMed

Molkov, Yaroslav I; Shevtsova, Natalia A; Park, Choongseok; Ben-Tal, Alona; Smith, Jeffrey C; Rubin, Jonathan E; Rybak, Ilya A

2014-01-01

Breathing is a vital process providing the exchange of gases between the lungs and atmosphere. During quiet breathing, pumping air from the lungs is mostly performed by contraction of the diaphragm during inspiration, and muscle contraction during expiration does not play a significant role in ventilation. In contrast, during intense exercise or severe hypercapnia forced or active expiration occurs in which the abdominal "expiratory" muscles become actively involved in breathing. The mechanisms of this transition remain unknown. To study these mechanisms, we developed a computational model of the closed-loop respiratory system that describes the brainstem respiratory network controlling the pulmonary subsystem representing lung biomechanics and gas (O2 and CO2) exchange and transport. The lung subsystem provides two types of feedback to the neural subsystem: a mechanical one from pulmonary stretch receptors and a chemical one from central chemoreceptors. The neural component of the model simulates the respiratory network that includes several interacting respiratory neuron types within the Bötzinger and pre-Bötzinger complexes, as well as the retrotrapezoid nucleus/parafacial respiratory group (RTN/pFRG) representing the central chemoreception module targeted by chemical feedback. The RTN/pFRG compartment contains an independent neural generator that is activated at an increased CO2 level and controls the abdominal motor output. The lung volume is controlled by two pumps, a major one driven by the diaphragm and an additional one activated by abdominal muscles and involved in active expiration. The model represents the first attempt to model the transition from quiet breathing to breathing with active expiration. The model suggests that the closed-loop respiratory control system switches to active expiration via a quantal acceleration of expiratory activity, when increases in breathing rate and phrenic amplitude no longer provide sufficient ventilation. The model can be used for simulation of closed-loop control of breathing under different conditions including respiratory disorders.

Automated Control of Endotracheal Tube Cuff Pressure during Simulated Flight

DTIC Science & Technology

2016-06-21

accomplished in the intensive care unit (ICU) with stand-alone devices as well as those integral to a ventilator [13,14]. We hypothesized that closed loop ... Administration approved automatic cuff pressure adjustment devices (Intellicuff, Hamilton Medical , Reno, NV; Pyton, ARM Medical , Bristol, CT; Cuff Sentry, Outcome...711th Human Performance Wing U.S. Air Force School of Aerospace Medicine Int’l Expeditionary Educ & Training Dept Air Force Expeditionary Medical

Controlling 212Bi to 212Pb activity concentration ratio in thoron chambers.

PubMed

He, Zhengzhong; Xiao, Detao; Lv, Lidan; Zhou, Qingzhi; Shan, Jian; Qiu, Shoukang; Wu, Xijun

2017-11-01

It is necessary to establish a reference atmosphere in a thoron chamber containing various ratios of 212 Bi to 212 Pb activity concentrations (C( 212 Bi)/C( 212 Pb)) to simulate typical environmental conditions (e.g., indoor or underground atmospheres). In this study, a novel method was developed for establishing and controlling C( 212 Bi)/C( 212 Pb) in a thoron chamber system based on an aging chamber and air recirculation loops which alter the ventilation rate. The effects of main factors on the C( 212 Bi)/C( 212 Pb) were explored, and a steady-state theoretical model was derived to calculate the ratio. The results show that the C( 212 Bi)/C( 212 Pb) inside the chamber is mainly dependent on ventilation rate. Ratios ranging from 0.33 to 0.83 are available under various ventilation. The stability coefficient of the ratios is better than 7%. The experimental results are close to the theoretical calculated results, which indicates that the model can serve as a guideline for the quantitative control of C( 212 Bi)/C( 212 Pb). Copyright © 2017 Elsevier Ltd. All rights reserved.

Portable Life Support System: PLSS 101

NASA Technical Reports Server (NTRS)

Thomas, Gretchen A.

2011-01-01

This presentation reviewed basic interfaces and considerations necessary for prototype suit hardware integration from an advanced spacesuit engineer perspective during the early design and test phases. The discussion included such topics such as the human interface, suit pass-throughs, keep-out zones, hardware form factors, subjective feedback from suit tests, and electricity in the suit.

Continued Development of Compact Multi-gas Monitor for Life Support Systems Control in Space

NASA Technical Reports Server (NTRS)

Delgado-Alonso, Jesús; Phillips, Straun; Chullen, Cinda; Quinn, Gregory

2016-01-01

Miniature optic gas sensors (MOGS) based on luminescent materials have shown great potential as alternatives to Near-Infrared-based gas sensor systems for the advanced space suit portable life support system (PLSS). The unique capability of MOGS for carbon dioxide and oxygen monitoring under wet conditions has been reported, as has the fast recovery of MOGS humidity sensors after long periods of being wet. Lower volume and power requirements are also potential advantages of MOGS over both traditional and advanced Non-Dispersive Infrared (NDIR) gas sensors, which have shown so far longer life than luminescent sensors. This paper presents the most recent results in the development and analytical validation of a compact multi-gas sensor unit based on luminescent sensors for the PLSS. Results of extensive testing are presented, including studies conducted at Intelligent Optical Systems laboratories, a United Technology Corporation Aerospace Systems (UTAS) laboratory, and a Johnson Space Center laboratory. The potential of this sensor technology for gas monitoring in PLSSs and other life support systems and the advantages and limitations found through detailed sensor validation are discussed.

Continued Development of Compact Multi-Gas Monitor for Life Support Systems Control in Space

NASA Technical Reports Server (NTRS)

Delgado, Jesus; Phillips, Straun; Chullen, Cinda

2015-01-01

Miniature optic gas sensors (MOGS) based on luminescent materials have shown great potential as alternatives to NIR-based gas sensor systems for the Portable Life Support System (PLSS). The unique capability of MOGS for carbon dioxide and oxygen monitoring under wet conditions has been reported, as has the fast recovery of MOGS humidity sensors after long periods of being wet. Lower volume and power requirements are also potential advantages of MOGS over both traditional and advanced Non-Dispersive Infrared (NDIR) gas sensors, which have shown so far longer life than luminescent sensors. In this paper we present the most recent results in the development and analytical validation of a compact multi-gas sensor unit based on luminescent sensors for the PLSS. Results of extensive testing are presented, including studies conducted at Intelligent Optical Systems laboratories, a United Technology Corporation Aerospace Systems (UTAS) laboratory, and a Johnson Space Center laboratory. The potential of this sensor technology for gas monitoring in PLSSs and other life support systems and the advantages and limitations found through detailed sensor validation are discussed.

Continued Development of Compact Multi-Gas Monitor for Life Support Systems Control in Space

NASA Technical Reports Server (NTRS)

Delgado-Alonso, Jesus; Phillips, Straun; Berry, David; DiCarmine, Paul; Chullen, Cinda; Quinn, Gregory

2016-01-01

Miniature optical gas sensors based on luminescent materials have shown great potential as alternatives to NIR-based gas sensor systems for the Portable Life Support System (PLSS). The unique capability of luminescent sensors for carbon dioxide and oxygen monitoring under wet conditions has been reported, as has the fast recovery of humidity sensors after long periods of being wet. Lower volume and power requirements are also potential advantages over both traditional and advanced non-dispersive infrared (NDIR) gas sensors, which have so far shown longer life than luminescent sensors. In this paper we present the most recent results in the development and analytical validation of a compact multi-gas sensor unit based on luminescent sensors for the PLSS. Results of extensive testing are presented, including studies conducted in Intelligent Optical Systems laboratories, a United Technologies Corporation Aerospace Systems (UTC) laboratory, and a Johnson Space Center laboratory. The potential of this sensor technology for gas monitoring in PLSSs and other life support systems, and the advantages and limitations found through detailed sensor validation are discussed.

Speckle tracking evaluation of right ventricular functions in children with sickle cell disease.

PubMed

Tolba, Osama Abd Rab Elrasol; El-Shanshory, Mohamed Ramadan; El-Gamasy, Mohamed Abd Elaziz; El-Shehaby, Walid Ahmed

2017-01-01

Cardiac dysfunction is a risk factor for death in patients with sickle cell disease (SCD). Aim of the work is to evaluate the right ventricular systolic and diastolic functions by tissue Doppler and speckling tracking imaging in children with SCD. Thirty children with SCD and thirty controls were subjected to clinical, laboratory evaluations, and echocardiographic study using GE Vivid 7 (GE Medical System, Horten, Norway with a 3.5-MHz multifrequency transducer) including; Two-dimensional and tissue Doppler echocardiographic study (lateral tricuspid valve annulus peak E' velocity, lateral tricuspid valve annulus peak A' velocity, E'/A' ratio, isovolumetric relaxation time, lateral tricuspid valve annulus S' and septal S' waves and peak longitudinal systolic strain [PLSS] and time to PLSS) were done in six right ventricular segments. There was a significant decrease in right ventricular systolic and diastolic function in patients group when compared to controls. Children with SCD have impaired right ventricular systolic and diastolic functions when compared to healthy children with early evaluation of the systolic dysfunction by speckle tracking imaging technique.

NASA Tech Briefs, December 2013

NASA Technical Reports Server (NTRS)

2013-01-01

Topics include: Microwave Kinetic Inductance Detector With; Selective Polarization Coupling; Flexible Microstrip Circuits for; Superconducting Electronics; CFD Extraction Tool for TecPlot From DPLR Solutions; RECOVIR Software for Identifying Viruses; Enhanced Contact Graph Routing (ECGR) MACHETE Simulation Model; Orbital Debris Engineering Model (ORDEM) v.3; Scatter-Reducing Sounding Filtration Using a Genetic Algorithm and Mean Monthly Standard Deviation; Thermo-Mechanical Methodology for Stabilizing Shape Memory Alloy Response; Hermetic Seal Designs for Sample Return Sample Tubes; Silicon Alignment Pins: An Easy Way To Realize a Wafer-to-Wafer Alignment; Positive-Buoyancy Rover for Under Ice Mobility; Electric Machine With Boosted Inductance to Stabilize Current Control; International Space Station-Based Electromagnetic Launcher for Space Science Payloads; Advanced Hybrid Spacesuit Concept Featuring Integrated Open Loop and Closed Loop Ventilation Systems; Data Quality Screening Service.

Respiratory diagnostic possibilities during closed circuit anesthesia.

PubMed

Verkaaik, A P; Erdmann, W

1990-01-01

An automatic feed back controlled totally closed circuit system (Physioflex) has been developed for quantitative practice of inhalation anesthesia and ventilation. In the circuit system the gas is moved unidirectionally around by a blower at 70 l/min. In the system four membrane chambers are integrated for ventilation. Besides end-expiratory feed back control of inhalation anesthetics, and inspiratory closed loop control of oxygen, the system offers on-line registration of flow, volume and respiratory pressures as well as a capnogram and oxygen consumption. Alveolar ventilation and static compliance can easily be derived. On-line registration of oxygen consumption has proven to be of value for determination of any impairment of tissue oxygen supply when the oxygen delivery has dropped to critical values. Obstruction of the upper or lower airways are immediately detected and differentiated. Disregulations of metabolism, e.g. in malignant hyperthermia, are seen in a pre-crisis phase (increase of oxygen consumption and of CO2 production), and therapy can be started extremely early and before a disastrous condition has developed. Registration of compliance is only one of the continuously available parameters that guarantee a better and adequate control of lung function (e.g. atalectasis is early detected). The newly developed sophisticated anesthesia device enlarges tremendously the monitoring and respiratory diagnostic possibilities of artificial ventilation, gives new insights in the (patho)physiology and detects disturbances of respiratory parameters and metabolism in an early stage.

A Simple “Blood-Saving Bundle” Reduces Diagnostic Blood Loss and the Transfusion Rate in Mechanically Ventilated Patients

PubMed Central

Riessen, Reimer; Behmenburg, Melanie; Blumenstock, Gunnar; Guenon, Doris; Enkel, Sigrid; Schäfer, Richard; Haap, Michael

2015-01-01

Introduction Aim of this study was to reduce blood loss caused by diagnostic blood sampling and to minimize the development of anemia in a high-risk group of mechanically ventilated medical intensive care patients. We therefore implemented a “blood-saving bundle” (BSB) combining a closed-loop arterial blood sampling system, smaller sampling tubes, reduced frequency of blood drawings, and reduced sample numbers. Methods The study included all patients from our medical ICU who were ventilated for more than 72 hours. Exclusion criteria were: acute or chronic anemia on admission, bleeding episode(s) during the ICU stay, or end-of-life therapy. The BSB was introduced in 2009 with training and educational support. Patients treated in 2008, before the introduction of the BSB, served as a control group (n = 41, 617 observation days), and were compared with patients treated in 2010 after the introduction of the BSB (BSB group, n = 50, 559 observation days). Primary endpoints were blood loss per day, and development of anemia. Secondary endpoints were numbers of blood transfusions, number of days on mechanical ventilation, and length of the ICU stay. Results Mean blood loss per ICU day was decreased from 43.3 ml (95% CI: 41.2 to 45.3 ml) in the controls to 15.0 ml (14.3 to 15.7 ml) in the BSB group (P < 0.001). The introduction of a closed-loop arterial blood sampling system was the major contributor to this effect. Mean hemoglobin concentrations showed no significant differences in both groups during the ICU stay. Hemoglobin values <9 g/dl, however, were recorded in 21.2% of observation days in the controls versus 15.4% in the BSB group (P = 0.01). Units of transfused red blood cells per 100 observation days decreased from 7 to 2.3 (P < 0.001). The mean number of ventilation days was 7.1 days (6.1 to 8.3 days) in the controls and 7.5 days (6.6 to 8.5 days) in the BSB group (P = NS). In total, patients in the BSB group stayed in ICU for a mean of 9.9 days (8.6 to 11.3 days), compared to a mean ICU stay of 13.0 days (10.9 to 15.4 days) in the control group (P = 0.014). Due to the longitudinal study design, however, we cannot exclude uncontrolled confounders affecting the transfusion frequency and mean ICU stay. Conclusion Our BSB could be easily implemented and was able to reduce diagnostic blood loss. PMID:26421920

Pathogenesis of Central and Complex Sleep Apnoea

PubMed Central

Orr, Jeremy E.; Malhotra, Atul; Sands, Scott A.

2016-01-01

Central sleep apnoea (CSA)—the temporary absence or diminution of ventilator effort during sleep—is seen in a variety of forms including periodic breathing in infancy and healthy adults at altitude and Cheyne-Stokes respiration in heart failure. In most circumstances, the cyclic absence of effort is paradoxically a consequence of hypersensitive ventilatory chemoreflex responses to oppose changes in airflow, i.e. elevated loop gain, leading to overshoot/undershoot ventilatory oscillations. Considerable evidence illustrates overlap between CSA and obstructive sleep apnoea (OSA), including elevated loop gain in patients with OSA and the presence of pharyngeal narrowing during central apnoeas. Indeed, treatment of OSA, whether via CPAP, tracheostomy, or oral appliances, can reveal CSA, an occurrence referred to as complex sleep apnoea. Factors influencing loop gain include increased chemosensitivity (increased controller gain), reduced damping of blood gas levels (increased plant gain) and increased lung to chemoreceptor circulatory delay. Sleep-wake transitions and pharyngeal dilator muscle responses effectively raise the controller gain and therefore also contribute to total loop gain and overall instability. In some circumstances, for example apnoea of infancy and central congenital hypoventilation syndrome, central apnoeas are the consequence of ventilatory depression and defective ventilatory responses, i.e. low loop gain. The efficacy of available treatments for CSA can be explained in terms of their effects on loop gain, e.g. CPAP improves lung volume (plant gain), stimulants reduce the alveolar-inspired PCO2 difference, supplemental oxygen lowers chemosensitivity. Understanding the magnitude of loop gain and the mechanisms contributing to instability may facilitate personalised interventions for CSA. PMID:27797160

Servo-controlled pneumatic pressure oscillator for respiratory impedance measurements and high-frequency ventilation.

PubMed

Kaczka, David W; Lutchen, Kenneth R

2004-04-01

The ability to provide forced oscillatory excitation of the respiratory system can be useful in mechanical impedance measurements as well as high frequency ventilation (HFV). Experimental systems currently used for generating forced oscillations are limited in their ability to provide high amplitude flows or maintain the respiratory system at a constant mean pressure during excitation. This paper presents the design and implementation of a pneumatic pressure oscillator based on a proportional solenoid valve. The device is capable of providing forced oscillatory excitations to the respiratory system over a bandwidth suitable for mechanical impedance measurements and HVF. It delivers high amplitude flows (> 1.4 l/s) and utilizes a servo-control mechanism to maintain a load at a fixed mean pressure during simultaneous oscillation. Under open-loop conditions, the device exhibited a static hysteresis of approximately 7%, while its dynamic magnitude and phase responses were flat out to 10 Hz. Broad-band measurement of total harmonic distortion was approximately 19%. Under closed-loop conditions, the oscillator was able to maintain a mechanical test load at both positive and negative mean pressures during oscillatory excitations from 0.1 to 10.0 Hz. Impedance of the test load agreed closely with theoretical predictions. We conclude that this servo-controlled oscillator can be a useful tool for respiratory impedance measurements as well as HFV.

Hearing loss among high-risk newborns admitted to a tertiary Neonatal Intensive Care Unit.

PubMed

Khairy, May Ahmed; Abuelhamed, Walaa Alsharany; Ahmed, Radwa Sayed; El Fouly, Hedayet El Sayed; Elhawary, Ismail Mohamed

2018-07-01

The aim of this work is to identify the most significant risk factors for hearing impairment in high risk neonates hospitalized at our Neonatal Intensive Care Unit (NICU) and to assess the sensitivity of hearing screening tests. This study involved 260 neonates admitted to a tertiary NICU; they were classified into two groups; 150 preterm and 110 full terms with risk factors for hearing loss. The hearing screening tests performed were transient evoked otoacoustic emissions (TEOAEs) and the automated auditory brainstem response (AABR). Forty-eight preterm neonates (32%) and 30 full term neonates (27.3%) had pathological AABR. In preterm group, mechanical ventilation more than five days, sepsis, usage of aminoglycosides, loop diuretics, vancomycin alone or in combination with aminoglycosides and prolonged duration of admission were considered risk factors of hearing affection whereas in full term group mechanical ventilation more than five days was the risk factor of hearing affection (p<.05). The prevalence of hearing loss is highest among high risk neonates and TEOAE and AABR were found to be reliable screening tools. Use of ototoxic drugs and mechanical ventilation for more than five days were significant risk factors for hearing loss in our study population.

Evaluation of three automatic oxygen therapy control algorithms on ventilated low birth weight neonates.

PubMed

Morozoff, Edmund P; Smyth, John A

2009-01-01

Neonates with under developed lungs often require oxygen therapy. During the course of oxygen therapy, elevated levels of blood oxygenation, hyperoxemia, must be avoided or the risk of chronic lung disease or retinal damage is increased. Low levels of blood oxygen, hypoxemia, may lead to permanent brain tissue damage and, in some cases, mortality. A closed loop controller that automatically administers oxygen therapy using 3 algorithms - state machine, adaptive model, and proportional integral derivative (PID) - is applied to 7 ventilated low birth weight neonates and compared to manual oxygen therapy. All 3 automatic control algorithms demonstrated their ability to improve manual oxygen therapy by increasing periods of normoxemia and reducing the need for manual FiO(2) adjustments. Of the three control algorithms, the adaptive model showed the best performance with 0.25 manual adjustments per hour and 73% time spent within target +/- 3% SpO(2).

Acquisition of Computer Literacy Skills through Self-Organizing Systems of Learning among Children in Bhutan and India

ERIC Educational Resources Information Center

Mitra, Sugata; Dangwal, Ritu

2017-01-01

This article describes a study under the Reaching the Unreached component of the Chiphen Rigpel project between the governments of Bhutan and India. This initiative is an attempt to provide computer literacy to children of Bhutan through setting up "hole in the wall" (HiWEL) Playground Learning Station(s) (PLSs). The study described here…

SSTAC/ARTS review of the draft Integrated Technology Plan (ITP). Volume 5: Human Support

NASA Technical Reports Server (NTRS)

1991-01-01

Viewgraphs of briefings from the Space Systems and Technology Advisory Committee (SSTAC)/ARTS review of the draft integrated technology plan (ITP) on human support are included. Topics covered include: human support program; human factors; life support technology; fire safety; medical support technology; advanced refrigeration technology; EVA suit system; advanced PLSS technology; and ARC-EVA systems research program.

Lunar Portable Life Support System Heat Rejection Study

NASA Technical Reports Server (NTRS)

Conger, Bruce; Sompayrac,Robert G.; Trevino, Luis A.; Bue, Grant C.

2009-01-01

Performing extravehicular activity (EVA) at various locations of the lunar surface presents thermal challenges that exceed those experienced in space flight to date. The lunar Portable Life Support System (PLSS) cooling unit must maintain thermal conditions within the space suit and reject heat loads generated by the crewmember and the PLSS equipment. The amount of cooling required varies based on the lunar location and terrain due to the heat transferred between the suit and its surroundings. A study has been completed which investigated the resources required to provide cooling under various lunar conditions, assuming three different thermal technology categories: 1. Spacesuit Water Membrane Evaporator (SWME) 2. Subcooled Phase Change Material (SPCM) 3. Radiators with and without heat pumps Results from the study are presented that show mass and power impacts on the cooling system as a function of the location and terrain on the lunar surface. Resources (cooling equipment mass and consumables) are greater at the equator and inside sunlit craters due to the additional heat loads on the cooling system. While radiator and SPCM technologies require minimal consumables, they come with carry-weight penalties and have limitations. A wider investigation is recommended to determine if these penalties and limitations are offset by the savings in consumables.

Assessment of metal pollution based on multivariate statistical modeling of 'hot spot' sediments from the Black Sea.

PubMed

Simeonov, V; Massart, D L; Andreev, G; Tsakovski, S

2000-11-01

The paper deals with application of different statistical methods like cluster and principal components analysis (PCA), partial least squares (PLSs) modeling. These approaches are an efficient tool in achieving better understanding about the contamination of two gulf regions in Black Sea. As objects of the study, a collection of marine sediment samples from Varna and Bourgas "hot spots" gulf areas are used. In the present case the use of cluster and PCA make it possible to separate three zones of the marine environment with different levels of pollution by interpretation of the sediment analysis (Bourgas gulf, Varna gulf and lake buffer zone). Further, the extraction of four latent factors offers a specific interpretation of the possible pollution sources and separates natural from anthropogenic factors, the latter originating from contamination by chemical, oil refinery and steel-work enterprises. Finally, the PLSs modeling gives a better opportunity in predicting contaminant concentration on tracer (or tracers) element as compared to the one-dimensional approach of the baseline models. The results of the study are important not only in local aspect as they allow quick response in finding solutions and decision making but also in broader sense as a useful environmetrical methodology.

Flexible Packaging Concept for a Space Suit Portable Life Support Subsystem

NASA Technical Reports Server (NTRS)

Thomas, Gretchen; Dillon, Paul; Oliver, Joe; Zapata, Felipe

2009-01-01

Neither the Shuttle Extravehicular Mobility Unit (EMU), the space suit currently used for space shuttle and International Space Station (ISS) missions, nor the Apollo EMU, the space suit successfully used on previous lunar missions, will satisfy the requirements for the next generation Constellation Program (CxP) lunar suit. The CxP system or Constellation Space Suit Element (CSSE) must be able to tolerate more severe environmental and use conditions than any previous system. These conditions include missions to the severely cold lunar poles and up to 100 Extravehicular Activity (EVA) excursions without ground maintenance. Much effort is focused on decreasing the mass and volume of the Portable Life Support Subsystem (PLSS) over previous suit designs in order to accommodate the required increase in functionality. This paper documents the progress of a conceptual packaging effort of a flexible backpack for the CSSE PLSS. The flexible backpack concept relies on a foam protection system to absorb, distribute, and dissipate the energy from falls on the lunar surface. Testing and analysis of the foam protection system concept that was conducted during this effort indicates that this method of system packaging is a viable solution.

Next Generation Life Support Project: Development of Advanced Technologies for Human Exploration Missions

NASA Technical Reports Server (NTRS)

Barta, Daniel J.

2012-01-01

Next Generation Life Support (NGLS) is one of several technology development projects sponsored by the National Aeronautics and Space Administration s Game Changing Development Program. NGLS is developing life support technologies (including water recovery, and space suit life support technologies) needed for humans to live and work productively in space. NGLS has three project tasks: Variable Oxygen Regulator (VOR), Rapid Cycle Amine (RCA) swing bed, and Alternative Water Processing. The selected technologies within each of these areas are focused on increasing affordability, reliability, and vehicle self sufficiency while decreasing mass and enabling long duration exploration. The RCA and VOR tasks are directed at key technology needs for the Portable Life Support System (PLSS) for an Exploration Extravehicular Mobility Unit (EMU), with focus on prototyping and integrated testing. The focus of the Rapid Cycle Amine (RCA) swing-bed ventilation task is to provide integrated carbon dioxide removal and humidity control that can be regenerated in real time during an EVA. The Variable Oxygen Regulator technology will significantly increase the number of pressure settings available to the space suit. Current spacesuit pressure regulators are limited to only two settings while the adjustability of the advanced regulator will be nearly continuous. The Alternative Water Processor efforts will result in the development of a system capable of recycling wastewater from sources expected in future exploration missions, including hygiene and laundry water, based on natural biological processes and membrane-based post treatment. The technologies will support a capability-driven architecture for extending human presence beyond low Earth orbit to potential destinations such as the Moon, near Earth asteroids and Mars.

Aerophagia and anesthesia: an unusual cause of ventilatory insufficiency in a neonate.

PubMed

Lalwani, Kirk

2005-10-01

We describe a healthy neonate with abdominal distention, inadequate ventilation, and delayed extubation during anesthesia for minor surgery. Following rectal decompression and successful extubation, extreme abdominal distention recurred postoperatively after ingestion of clear fluids. We elicited a history of frequent and excessive flatus from the parents, and abdominal radiography revealed distended loops of small bowel with small lung volumes suggestive of aerophagia. The differential diagnosis of aerophagia is reviewed, the anesthetic implications discussed, and relevant literature pertaining to this condition summarized.

A Comparative Data-Based Modeling Study on Respiratory CO2 Gas Exchange during Mechanical Ventilation

PubMed Central

Kim, Chang-Sei; Ansermino, J. Mark; Hahn, Jin-Oh

2016-01-01

The goal of this study is to derive a minimally complex but credible model of respiratory CO2 gas exchange that may be used in systematic design and pilot testing of closed-loop end-tidal CO2 controllers in mechanical ventilation. We first derived a candidate model that captures the essential mechanisms involved in the respiratory CO2 gas exchange process. Then, we simplified the candidate model to derive two lower-order candidate models. We compared these candidate models for predictive capability and reliability using experimental data collected from 25 pediatric subjects undergoing dynamically varying mechanical ventilation during surgical procedures. A two-compartment model equipped with transport delay to account for CO2 delivery between the lungs and the tissues showed modest but statistically significant improvement in predictive capability over the same model without transport delay. Aggregating the lungs and the tissues into a single compartment further degraded the predictive fidelity of the model. In addition, the model equipped with transport delay demonstrated superior reliability to the one without transport delay. Further, the respiratory parameters derived from the model equipped with transport delay, but not the one without transport delay, were physiologically plausible. The results suggest that gas transport between the lungs and the tissues must be taken into account to accurately reproduce the respiratory CO2 gas exchange process under conditions of wide-ranging and dynamically varying mechanical ventilation conditions. PMID:26870728

Efforts to Reduce International Space Station Crew Maintenance Time in the Management of the Extravehicular Mobility Unit Transport Loop Water Quality

NASA Technical Reports Server (NTRS)

Etter,David; Rector, Tony; Boyle, robert; Zande, Chris Vande

2012-01-01

The EMU (Extravehicular Mobility Unit) contains a semi-closed-loop re-circulating water circuit (Transport Loop) to absorb heat into a LCVG (Liquid Coolant and Ventilation Garment) worn by the astronaut. A second, single-pass water circuit (Feed-water Loop) provides water to a cooling device (Sublimator) containing porous plates, and that water sublimates through the porous plates to space vacuum. The cooling effect from the sublimation of this water translates to a cooling of the LCVG water that circulates through the Sublimator. The quality of the EMU Transport Loop water is maintained through the use of a water processing kit (ALCLR - Airlock Cooling Loop Remediation) that is used to periodically clean and disinfect the water circuit. Opportunities to reduce crew time associated with ALCLR operations include a detailed review of the historical water quality data for evidence to support an extension to the implementation cycle. Furthermore, an EMU returned after 2-years of use on the ISS (International Space Station) is being used as a test bed to evaluate the results of extended and repeated ALCLR implementation cycles. Finally, design, use and on-orbit location enhancements to the ALCLR kit components are being considered to allow the implementation cycle to occur in parallel with other EMU maintenance and check-out activities, and to extend the life of the ALCLR kit components. These efforts are undertaken to reduce the crew-time and logistics burdens for the EMU, while ensuring the long-term health of the EMU water circuits for a post- Shuttle 6-year service life.

Efforts to Reduce International Space Station Crew Maintenance for the Management of the Extravehicular Mobility Unit Transport Loop Water Quality

NASA Technical Reports Server (NTRS)

Steele, John W.; Etter, David; Rector, Tony; Boyle, Robert; Vandezande, Christopher

2013-01-01

The EMU (Extravehicular Mobility Unit) contains a semi-closed-loop re-circulating water circuit (Transport Loop) to absorb heat into a LCVG (Liquid Coolant and Ventilation Garment) worn by the astronaut. A second, single-pass water circuit (Feed-water Loop) provides water to a cooling device (Sublimator) containing porous plates, and that water sublimates through the porous plates to space vacuum. The cooling effect from the sublimation of this water translates to a cooling of the LCVG water that circulates through the Sublimator. The quality of the EMU Transport Loop water is maintained through the use of a water processing kit (ALCLR Airlock Cooling Loop Remediation) that is used to periodically clean and disinfect the water circuit. Opportunities to reduce crew time associated with on-orbit ALCLR operations include a detailed review of the historical water quality data for evidence to support an extension to the implementation cycle. Furthermore, an EMU returned after 2-years of use on the ISS (International Space Station) is being used as a test bed to evaluate the results of extended and repeated ALCLR implementation cycles. Finally, design, use and on-orbit location enhancements to the ALCLR kit components are being considered to allow the implementation cycle to occur in parallel with other EMU maintenance and check-out activities, and to extend the life of the ALCLR kit components. These efforts are undertaken to reduce the crew-time and logistics burdens for the EMU, while ensuring the long-term health of the EMU water circuits for a post-Shuttle 6-year service life.

Development Specification for RV-346/348 Positive Pressure Relief Valves (PPRV)

NASA Technical Reports Server (NTRS)

Ralston, Russell L.

2017-01-01

This specification establishes the requirements for design, performance, safety, testing, and manufacture of the RV-346 and RV-348, Positive Pressure Relief Valve (PPRV) as part of the Advanced Extravehicular Mobility Unit (EMU)(AEMU) Portable Life Support System (PLSS). The RV-346 serves as the Positive Pressure Relief Valve (PPRV), and the RV-348 serves as the Secondary Positive Pressure Relief Valve (SPPRV).

s70-56415

NASA Image and Video Library

2013-09-11

S70-56415 (December 1970) --- At Kapoho, Hawaii, astronauts David R. Scott (left), commander of the Apollo 15 lunar landing mission, and James B. Irwin, lunar module pilot, train at a designated lunar surface simulation area for their upcoming lunar landing mission. Wearing street clothes, but equipped with a Portable Life Support System (PLSS), the two rehearse for a selenological traverse. Here, they are inspecting a grapefruit-sized rock. Photo credit: NASA

Confocal Light Absorption and Scattering Spectroscopic (CLASS) imaging: From cancer detection to sub-cellular function

NASA Astrophysics Data System (ADS)

Qiu, Le

Light scattering spectroscopy (LSS), an optical technique that relates the spectroscopic properties of light elastically scattered by small particles to their size, refractive index and shape, has been recently successfully employed for sensing morphological and biochemical properties of epithelial tissues and cells in vivo. LSS does not require exogenous markers, is non-invasive, and, due to its multispectral nature, can sense biological structures well beyond the diffraction limit. All that makes LSS be a very good candidate to be used both in clinical medicine for in vivo detection of disease and in cell biology to monitor cell function on the organelle scale. Recently we developed two LSS-based imaging modalities: clinical Polarized LSS (PLSS) Endoscopic Technique for locating early pre-cancerous changes in GI tract and Confocal Light Absorption and Scattering Spectroscopic (CLASS) Microscopy for studying cells in vivo without exogenous markers. One important application of the clinical PLSS endoscopic instrument, a noncontact scanning imaging device compatible with the standard clinical endoscopes and capable of detecting dysplastic changes, is to serve as a guide for biopsy in Barrett's esophagus (BE). The instrument detects parallel and perpendicular components of the polarized light, backscattered from epithelial tissues, and determines characteristics of epithelial nuclei from the residual spectra. It also can find tissue oxygenation, hemoglobin content and other properties from the diffuse light component. By rapidly scanning esophagus the PLSS endoscopic instrument makes sure the entire BE portion is scanned and examined for the presence of dysplasia. CLASS microscopy, on the other hand, combines principles of light scattering spectroscopy (LSS) with confocal microscopy. Its main purpose is to image cells on organelle scale in vivo without the use of exogenous labels which may affect the cell function. The confocal geometry selects specific region and images are obtained by scanning the confocal volume across the sample. The new beam scanning CLASS microscope is a significant improvement over the previous proof-of-principle device. With this new device we have already performed experiments to monitor morphological changes in cells during apoptosis, differentiated fetal from maternal nucleated red blood cells, and detected plasmon scattering spectra of single gold nanorod.

Carbon Dioxide Control System for a Mars Space Suit Life Support System

NASA Technical Reports Server (NTRS)

Alptekin, Gokhan; Jayaraman, Ambalavanan; Copeland, Robert; Parker, amanda; Paul, Heather L.

2010-01-01

Carbon dioxide (CO2) control during Extravehicular Activities (EVAs) on Mars will be challenging. Lithium hydroxide (LiOH) canisters have impractical logistics penalties, and regenerable metal oxide (MetOx) canisters weigh too much. Cycling bed systems and permeable membranes that are regenerable in space vacuum cannot vent on Mars due to the high partial pressure of CO2 in the atmosphere. Although sweep gas regeneration is under investigation, the feasibility, logistics penalties, and failure modes associated with this technique have not been fully determined. TDA Research, Inc. is developing a durable, high-capacity regenerable adsorbent that can remove CO2 from the space suit ventilation loop. The system design allows sorbent regeneration at or above 6 torr, eliminating the potential for Martian atmosphere to leak into the regeneration bed and into the ventilation loop. Regeneration during EVA eliminates the consumable requirement related to the use of LiOH canisters and the mission duration limitations imposed by MetOx system. The concept minimizes the amount of consumable to be brought from Earth and makes the mission more affordable, while providing great operational flexibility during EVA. The feasibility of the concept has been demonstrated in a series of bench-scale experiments and a preliminary system analysis. Results indicate that sorbent regeneration can be accomplished by applying a 14 C temperature swing, while regenerating at 13 torr (well above the Martian atmospheric pressure), withstanding over 1,000 adsorption/regeneration cycles. This paper presents the latest results from these sorbent and system development efforts.

Management of the Post-Shuttle Extravehicular Mobility Unit (EMU) Water Circuits

NASA Technical Reports Server (NTRS)

Steele, John W.; Etter, David; Rector, Tony; Hill, Terry; Wells, Kevin

2011-01-01

The EMU incorporates two separate water circuits for the rejection of metabolic heat from the astronaut and the cooling of electrical components. The first (the Transport Water Loop) circulates in a semi-closed-loop manner and absorbs heat into a Liquid Coolant and Ventilation Garment (LCVG) warn by the astronaut. The second (the Feed Water Loop) provides water to a cooling device (Sublimator) with a porous plate, and that water subsequently sublimates to space vacuum. The cooling effect from the sublimation of this water translates to a cooling of the LCVG water that circulates through the Sublimator. Efforts are underway to streamline the use of a water processing kit (ALCLR) that is being used to periodically clean and disinfect the Transport Loop Water. Those efforts include a fine tuning of the duty cycle based on a review of prior performance data as well as an assessment of a fixed installation of this kit into the EMU backpack or within on-orbit EMU interface hardware. Furthermore, testing is being conducted to ensure compatibility between the International Space Station (ISS) Water Processor Assembly (WPA) effluent and the EMU Sublimator as a prelude to using the WPA effluent as influent to the EMU Feed Water loop. This work is undertaken to reduce the crew-time and logistics burdens for the EMU, while ensuring the long-term health of the EMU water circuits for a post-Shuttle 6-year service life.

Regenerable Sorbent for CO2 Removal

NASA Technical Reports Server (NTRS)

Alptekin, Gokhan; Jayaraman, Ambal

2013-01-01

A durable, high-capacity regenerable sorbent can remove CO2 from the breathing loop under a Martian atmosphere. The system design allows near-ambient temperature operation, needs only a small temperature swing, and sorbent regeneration takes place at or above 8 torr, eliminating the potential for Martian atmosphere to leak into the regeneration bed and into the breathing loop. The physical adsorbent can be used in a metabolic, heat-driven TSA system to remove CO2 from the breathing loop of the astronaut and reject it to the Martian atmosphere. Two (or more) alternating sorbent beds continuously scrub and reject CO2 from the spacesuit ventilation loop. The sorbent beds are cycled, alternately absorbing CO2 from the vent loop and rejecting the adsorbed material into the environment at a high CO2 partial pressure (above 8 torr). The system does not need to run the adsorber at cryogenic temperatures, and uses a much smaller temperature swing. The sorbent removes CO2 via a weak chemical interaction. The interaction is strong enough to enable CO2 adsorption even at 3 to 7.6 torr. However, because the interaction between the surface adsorption sites and the CO2 is relatively weak, the heat input needed to regenerate the sorbent is much lower than that for chemical absorbents. The sorbent developed in this project could potentially find use in a large commercial market in the removal of CO2 emissions from coal-fired power plants, if regulations are put in place to curb carbon emissions from power plants.

Management of the Post-Shuttle Extravehicular Mobility Unit (EMU) Water Circuits

NASA Technical Reports Server (NTRS)

Steele, John W.; Etter, David; Rector, Tony; Hill, Terry; Wells, Kevin

2012-01-01

The EMU incorporates two separate water circuits for the rejection of metabolic heat from the astronaut and the cooling of electrical components. The first (the Transport Water Loop) circulates in a semi-closed-loop manner and absorbs heat into a Liquid Coolant and Ventilation Garment (LCVG) worn by the astronaut. The second (the Feed-water Loop) provides water to a cooling device (Sublimator) with a porous plate, and that water subsequently sublimates to space vacuum. The cooling effect from the sublimation of this water translates to a cooling of the LCVG water that circulates through the Sublimator. Efforts are underway to streamline the use of a water processing kit (ALCLR) that is being used to periodically clean and disinfect the Transport Loop Water. Those efforts include a fine tuning of the duty cycle based on a review of prior performance data as well as an assessment of a fixed installation of this kit into the EMU backpack, within on-orbit EMU interface hardware or as a stand-alone unit. Furthermore, testing is being conducted to ensure compatibility between the International Space Station (ISS) Water Processor Assembly (WPA) effluent and the EMU Sublimator as a prelude to using the WPA effluent as influent to the EMU Feed Water loop. This work is undertaken to reduce the crewtime and logistics burdens for the EMU, while ensuring the long-term health of the EMU water circuits for a 6-year service life.

Next Generation Life Support Project Status

NASA Technical Reports Server (NTRS)

Barta, Daniel J.; Chullen, Cinda; Vega, Leticia; Cox, Marlon R.; Aitchison, Lindsay T.; Lange, Kevin E.; Pensinger, Stuart J.; Meyer, Caitlin E.; Flynn, Michael; Jackson, W. Andrew;

Meeting the Challenge: A 1986 History of the Naval Surface Weapons Center

DTIC Science & Technology

1987-05-29

8217GClK JACK lMUITRIUXER DIG Iot I ---, , SUpFt S COMPUTER ’ HEL DE Osi cOeiTROLPRiOCESSO HIGM SPEED ATA BUS OM SWR AU VAGKTtC BIBS11 Closed-Loop...appear. HVAC designers think it can determine if closures need to be installed on ventilation inlets to prevent the ingress of exhaust gases from...and fuze timing errors. If the fuze could be caused to actuate based on target position rather than a predicted time of flight, these errors could be

Applying Computer Models to Realize Closed-Loop Neonatal Oxygen Therapy.

PubMed

Morozoff, Edmund; Smyth, John A; Saif, Mehrdad

2017-01-01

Within the context of automating neonatal oxygen therapy, this article describes the transformation of an idea verified by a computer model into a device actuated by a computer model. Computer modeling of an entire neonatal oxygen therapy system can facilitate the development of closed-loop control algorithms by providing a verification platform and speeding up algorithm development. In this article, we present a method of mathematically modeling the system's components: the oxygen transport within the patient, the oxygen blender, the controller, and the pulse oximeter. Furthermore, within the constraints of engineering a product, an idealized model of the neonatal oxygen transport component may be integrated effectively into the control algorithm of a device, referred to as the adaptive model. Manual and closed-loop oxygen therapy performance were defined in this article by 3 criteria in the following order of importance: percent duration of SpO2 spent in normoxemia (target SpO2 ± 2.5%), hypoxemia (less than normoxemia), and hyperoxemia (more than normoxemia); number of 60-second periods <85% SpO2 and >95% SpO2; and number of manual adjustments. Results from a clinical evaluation that compared the performance of 3 closed-loop control algorithms (state machine, proportional-integral-differential, and adaptive model) with manual oxygen therapy on 7 low-birth-weight ventilated preterm babies, are presented. Compared with manual therapy, all closed-loop control algorithms significantly increased the patients' duration in normoxemia and reduced hyperoxemia (P < 0.05). The number of manual adjustments was also significantly reduced by all of the closed-loop control algorithms (P < 0.05). Although the performance of the 3 control algorithms was equivalent, it is suggested that the adaptive model, with its ease of use, may have the best utility.

JPRS Report, Soviet Union, Foreign Military Review, No. 2, February 1988

DTIC Science & Technology

1988-08-05

polyurethane foam . The engine and transmission compartment is located in the front part of the hull. The eight-cylinder engine is connected with a...more effective land- based systems including MLRS and in the future the ATACMS missiles (it is planned to launch them from existing and future MLRS... ATACMS missiles, Skeet & TGSM precision-guidance munitions SADARM and TGSM precis ion-guidance munitions PLSS recon- attack system, MLRS, F-4G

Subclinical right ventricle systolic dysfunction in childhood-onset systemic lupus erythematosus: insights from two-dimensional speckle-tracking echocardiography.

PubMed

Leal, G N; Silva, K F; França, C M P; Lianza, A C; Andrade, J L; Campos, L M A; Bonfá, E; Silva, C A

2015-05-01

The objective of this article is to evaluate right ventricle strain imaging by two-dimensional speckle-tracking (2DST) in childhood-onset systemic lupus erythematosus (c-SLE). Thirty-five c-SLE patients with no signs or symptoms of heart failure and 33 healthy volunteers were evaluated by standard echocardiogram and 2DST. Conventional parameters included tricuspid annular plane systolic excursion (TAPSE), RV tissue-Doppler-derived Tei index and systolic pulmonary artery pressure. Global peak longitudinal systolic strain (PLSS) and strain rate (PLSSR) of RV were obtained by 2DST. Demographic/clinical features, SLEDAI-2K/SLICC/ACR-DI and treatment were also assessed. The median current age was similar in patients and controls (14.75 vs. 14.88 years, p = 0.62). RV PLSS was significantly reduced in c-SLE (-24.5 ± 5.09 vs. -27.62 ± 3.02%, p = 0.003). Similar findings were observed after excluding patients with pulmonary hypertension (-24.62 ± 4.87% vs. -27.62 ± 3.02%, p = 0.0041). RV PLSS was positively correlated with TAPSE (r = +0.49, p = 0.0027) and negatively correlated with Tei index (r = -0.34, p = 0.04) in c-SLE. RV PLSSR was not different comparing patients and controls (-0.65 s(-1 )± 0.47 vs. -1.87 ± 0.49 s(-1), p = 0.07). Further analysis of c-SLE patients revealed higher frequencies of neuropsychiatric manifestations (39% vs. 0%, p = 0.007) and antiphospholipid antibodies (55% vs. 18%, p = 0.035) in those with RV PLSS ≤ -23.7% vs >-23.7%. No differences were evidenced in demographic data, disease activity/damage or treatments (p > 0.05). The present study, using a new and more sensitive technique, revealed subclinical RV systolic dysfunction in c-SLE patients that may have future prognostic implications. The novel association of asymptomatic RV dysfunction with neuropsychiatric manifestations and antiphospholipid antibodies may suggest common physiopathological pathways. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Development of a Fan for Future Space Suit Applications

NASA Technical Reports Server (NTRS)

Paul. Heather L.; Converse, David; Dionne, Steven; Moser, Jeff

2010-01-01

NASA's next generation space suit system will place new demands on the fan used to circulate breathing gas through the ventilation loop of the portable life support system. Long duration missions with frequent extravehicular activities (EVAs), the requirement for significant increases in reliability and durability, and a mission profile that imposes strict limits on weight, volume and power create the basis for a set of requirements that demand more performance than is available from existing fan designs. This paper describes the development of a new fan to meet these needs. A centrifugal fan was designed with a normal operating speed of approximately 39,400 rpm to meet the ventilation flow requirements while also meeting the aggressive minimal packaging, weight and power requirements. The prototype fan also operates at 56,000 rpm to satisfy a second operating condition associated with a single fan providing ventilation flow to two spacesuits connected in series. This fan incorporates a novel nonmetallic "can" to keep the oxygen flow separate from the motor electronics, thus eliminating ignition potential. The nonmetallic can enables a small package size and low power consumption. To keep cost and schedule within project bounds a commercial motor controller was used. The fan design has been detailed and implemented using materials and approaches selected to address anticipated mission needs. Test data is presented to show how this fan performs relative to anticipated ventilation requirements for the EVA portable life support system. Additionally, data is presented to show tolerance to anticipated environmental factors such as acoustics, shock, and vibration. Recommendations for forward work to progress the technology readiness level and prepare the fan for the next EVA space suit system are also discussed.

Simulation Speed Analysis and Improvements of Modelica Models for Building Energy Simulation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jorissen, Filip; Wetter, Michael; Helsen, Lieve

This paper presents an approach for speeding up Modelica models. Insight is provided into how Modelica models are solved and what determines the tool’s computational speed. Aspects such as algebraic loops, code efficiency and integrator choice are discussed. This is illustrated using simple building simulation examples and Dymola. The generality of the work is in some cases verified using OpenModelica. Using this approach, a medium sized office building including building envelope, heating ventilation and air conditioning (HVAC) systems and control strategy can be simulated at a speed five hundred times faster than real time.

Chapter 3 innovations in the en route care of combat casualties.

PubMed

Hatzfeld, Jennifer J; Dukes, Susan; Bridges, Elizabeth

2014-01-01

The en route care environment is dynamic and requires constant innovation to ensure appropriate nursing care for combat casualties. Building on experiences in Iraq and Afghanistan, there have been tremendous innovations in the process of transporting patients, including the movement of patients with spinal injuries. Advances have also been made in pain management and noninvasive monitoring, particularly for trauma and surgical patients requiring close monitoring of their hemodynamic and perfusion status. In addition to institutionalizing these innovations, future efforts are needed to eliminate secondary insults to patients with traumatic brain injuries and technologies to provide closed-loop sedation and ventilation.

Multifunctional Space Evaporator-Absorber-Radiator (SEAR)

NASA Technical Reports Server (NTRS)

Bue, Grant C.; Hodgson, Ed; Izenson, Mike; Chen, Weibo

2013-01-01

A system for non-venting thermal control for spacesuits was built by integrating two previously developed technologies, namely NASA's Spacesuit Water Membrane Evaporator (SWME), and Creare's flexible version of the Lithium Chloride Absorber Radiator (LCAR). This SEAR system was tested in relevant thermal vacuum conditions. These tests show that a 1 sq m radiator having about three times as much absorption media as in the test article would be required to support a 7 hour spacewalk. The serial flow arrangement of the LCAR of the flexible version proved to be inefficient for venting non-condensable gas (NCG). A different LCAR packaging arrangement was conceived wherein the Portable Life Support System (PLSS) housing would be made with a high-strength carbon fiber composite honeycomb, the cells of which would be filled with the chemical absorption media. This new packaging reduce the mass and volume impact of the SEAR on the Portable Life Support System (PLSS) compared to the flexible design. A 0.2 sq m panel with flight-like honeycomb geometry is being constructed and will be tested in thermal and thermal vacuum conditions. Design analyses forecast improved system performance and improved NCG control. A flight-like regeneration system also is also being built and tested. Design analyses for the structurally integrated prototype as well as the earlier test data show that SEAR is not only practical for spacesuits but also has useful applications in spacecraft thermal control.

Spacesuit Water Membrane Evaporator Development for Lunar Missions

NASA Technical Reports Server (NTRS)

Vogel, Matt R.; Peterson, Keith; Zapata, Felipe, III; Dillon, Paul; Trevino, Luis A.

2008-01-01

For future lunar extra-vehicular activities (EVA), one method under consideration for rejecting crew and electronics heat involves evaporating water through a hydrophobic, porous Teflon membrane. A Spacesuit Water Membrane Evaporator (SWME) prototype using the Teflon membrane was tested successfully by Ungar and Thomas (2001) with predicted performance matching test data well. The above referenced work laid the foundation for the design of the SWME development unit, which is being considered for service in the Constellation System Spacesuit Element (CSSE) Portable Life Support System (PLSS). Multiple PLSS SWME configurations were considered on the basis of thermal performance, mass, volume, and performance and manufacturing risk. All configurations were a variation of an alternating concentric water and vapor channel configuration or a stack of alternating rectangular water and vapor channels. Supporting thermal performance trades mapped maximum SWME heat rejection as a function of water channel thickness, vapor channel thickness, channel length, number of water channels, porosity of the membrane structural support, and backpressure valve throat area. Preliminary designs of each configuration were developed to determine total mass and volume as well as to understand manufacturing issues. Review of configurations led to the selection of a concentric annulus configuration that meets the requirements of 800 watts (W) of heat rejection. Detailed design of the SWME development unit will be followed by fabrication of a prototype test unit, with thermal testing expected to start in 2008.

Space Evaporator-Absorber-Radiator (SEAR)

NASA Technical Reports Server (NTRS)

Bue, Grant C.; Stephan, Ryan; Hodgson, Ed; Izenson, Mike; Chen, Weibo

2012-01-01

A system for non-venting thermal control for spacesuits was built by integrating two previously developed technologies, namely NASA s Spacesuit Water Membrane Evaporator (SWME), and Creare s flexible version of the Lithium Chloride Absorber Radiator (LCAR). This SEAR system was tested in relevant thermal vacuum conditions. These tests show that a 1 m2 radiator having about three times as much absorption media as in the test article would be required to support a 7 hour spacewalk. The serial flow arrangement of the LCAR of the flexible version proved to be inefficient for venting non-condensable gas (NCG). A different LCAR packaging arrangement was conceived wherein the Portable Life Support System (PLSS) housing would be made with a high-strength carbon fiber composite honeycomb, the cells of which would be filled with the chemical absorption media. This new packaging reduces the mass and volume impact of the SEAR on the Portable Life Support System (PLSS) compared to the flexible design. A 0.2 sq m panel with flight-like honeycomb geometry is being constructed and will be tested in thermal and thermal vacuum conditions. Design analyses forecast improved system performance and improved NCG control. A flight-like regeneration system also is also being built and tested. Design analyses for the structurally integrated prototype as well as the earlier test data show that SEAR is not only practical for spacesuits but also has useful applications in spacecraft thermal control.

New Lithium-ion Polymer Battery for the Extravehicular Mobility Unit Suit

NASA Technical Reports Server (NTRS)

Jeevarajan, J. A.; Darcy, E. C.

2004-01-01

The Extravehicular Mobility Unit (EMU) suit currently has a silver-zinc battery that is 20.5 V and 45 Ah capacity. The EMU's portable life support system (PLSS) will draw power from the battery during the entire period of an EVA. Due to the disadvantages of using the silver-zinc battery in terms of cost and performance, a new high energy density battery is being developed for future use, The new battery (Lithium-ion battery or LIB) will consist of Li-ion polymer cells that will provide power to the EMU suit. The battery design consists of five 8 Ah cells in parallel to form a single module of 40 Ah and five such modules will be placed in series to give a 20.5 V, 40 Ah battery. Charging will be accomplished on the Shuttle or Station using the new LIB charger or the existing ALPS (Air Lock Power Supply) charger. The LIB delivers a maximum of 3.8 A on the average, for seven continuous hours, at voltages ranging from 20.5 V to 16.0 V and it should be capable of supporting transient pulses during start up and once every hour to support PLSS fan and pump operation. Figure 1 shows the placement of the battery in the backpack area of the EMU suit. The battery and cells will undergo testing under different conditions to understand its performance and safety characteristics.

Next Generation Life Support Project Status

NASA Technical Reports Server (NTRS)

Barta, Daniel J.; Chullen, Cinda; Pickering, Karen D.; Cox, Marlon; Towsend, Neil; Campbell, Colin; Flynn, Michael; Wheeler, Raymond

2012-01-01

Next Generation Life Support (NGLS) is one of several technology development projects sponsored by NASA s Game Changing Development Program. The NGLS Project is developing life support technologies (including water recovery and space suit life support technologies) needed for humans to live and work productively in space. NGLS has three project tasks: Variable Oxygen Regulator (VOR), Rapid Cycle Amine (RCA) swing bed, and Alternative Water Processor (AWP). The RCA swing bed and VOR tasks are directed at key technology needs for the Portable Life Support System (PLSS) for an Advanced Extravehicular Mobility Unit, with focus on test article development and integrated testing in an Advanced PLSS in cooperation with the Advanced Extra Vehicular Activity (EVA) Project. An RCA swing-bed provides integrated carbon dioxide removal and humidity control that can be regenerated in real time during an EVA. The VOR technology will significantly increase the number of pressure settings available to the space suit. Current space suit pressure regulators are limited to only two settings whereas the adjustability of the advanced regulator will be nearly continuous. The AWP effort, based on natural biological processes and membrane-based secondary treatment, will result in the development of a system capable of recycling wastewater from sources expected in future exploration missions, including hygiene and laundry water. This paper will provide a status of technology development activities and future plans.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chatterton, Mike

The Recovery Act: Districtwide Geothermal Heating Conversion project performed by the Blaine County School District was part of a larger effort by the District to reduce operating costs, address deferred maintenance items, and to improve the learning environment of the students. This project evaluated three options for the ground source which were Open-Loop Extraction/Re-injection wells, Closed-Loop Vertical Boreholes, and Closed-Loop Horizontal Slinky approaches. In the end the Closed-Loop Horizontal Slinky approach had the lowest total cost of ownership but the majority of the sites associated with this project did not have enough available ground area to install the system somore » the second lowest option was used (Open-Loop). In addition to the ground source, this project looked at ways to retrofit existing HVAC systems with new high efficiency systems. The end result was the installation of distributed waterto- air heat pumps with water-to-water heat pumps installed to act as boilers/chillers for areas with a high ventilation demand such as they gymnasiums. A number of options were evaluated and the lowest total cost of ownership approach was implemented in the majority of the facilities. The facilities where the lowest total cost of ownership approaches was not selected were done to maintain consistency of the systems from facility to facility. This project had a number of other benefits to the Blaine County public. The project utilizes guaranteed energy savings to justify the levy funds expended. The project also developed an educational dashboard that can be used in the classrooms and to educate the community on the project and its performance. In addition, the majority of the installation work was performed by contractors local to Blaine County which acted as an economic stimulus to the area during a period of recession.« less

Oxygen cost of exercise hyperpnoea is greater in women compared with men

PubMed Central

Dominelli, Paolo B; Render, Jacqueline N; Molgat-Seon, Yannick; Foster, Glen E; Romer, Lee M; Sheel, A William

2015-01-01

We compared the oxygen cost of breathing () in healthy men and women over a wide range of exercise ventilations (). Eighteen subjects (nine women) completed 4 days of testing. First, a step-wise maximal cycle exercise test was completed for the assessment of spontaneous breathing patterns. Next, subjects were familiarized with the voluntary hyperpnoea protocol used to estimate . During the final two visits, subjects mimicked multiple times (four to six) the breathing patterns associated with five or six different exercise stages. Each trial lasted 5 min, and on-line pressure–volume and flow–volume loops were superimposed on target loops obtained during exercise to replicate the work of breathing accurately. At ∼55 l min−1 , was significantly greater in women. At maximal ventilation, the absolute was not different (P > 0.05) between the sexes, but represented a significantly greater fraction of whole-body in women (13.8 ± 1.5 vs. 9.4 ± 1.1% ). During heavy exercise at 92 and 100% , the unit cost of was +0.7 and +1.1 ml O2 l−1 greater in women (P < 0.05). At , men and women who developed expiratory flow limitation had a significantly greater than those who did not (435 ± 44 vs. 331 ± 30 ml O2 min−1). In conclusion, women have a greater for a given , and this represents a greater fraction of whole-body . The greater in women may have implications for the integrated physiological response to exercise. PMID:25652549

Astronaut Russell Schweickart photographed during EVA

NASA Technical Reports Server (NTRS)

1969-01-01

Astronaut Russell L. Schweickart, lunar module pilot, operates a 70mm Hasselblad camera during his extravehicular activity on the fourth day of the Apollo 9 earth-orbital mission. The Command/Service Module and the Lunar Module 3 'Spider' are docked. This view was taken form the Command Module 'Gumdrop'. Schweickart, wearing an Extravehicular Mobility Unit (EMU), is standing in 'golden slippers' on the Lunar Module porch. On his back, partially visible, are a Portable Life Support System (PLSS) and an Oxygen Purge System (OPS).

Congestive heart failure and central sleep apnea.

PubMed

Sands, Scott A; Owens, Robert L

2015-07-01

Congestive heart failure (CHF) is among the most common causes of admission to hospitals in the United States, especially in those over age 65. Few data exist regarding the prevalence CHF of Cheyne-Stokes respiration (CSR) owing to congestive heart failure in the intensive care unit (ICU). Nevertheless, CSR is expected to be highly prevalent among those with CHF. Treatment should focus on the underlying mechanisms by which CHF increases loop gain and promotes unstable breathing. Few data are available to determine prevalence of CSR in the ICU, or how CSR might affect clinical management and weaning from mechanical ventilation. Copyright © 2015 Elsevier Inc. All rights reserved.

Congestive Heart Failure and Central Sleep Apnea.

PubMed

Sands, Scott A; Owens, Robert L

2016-03-01

Congestive heart failure (CHF) is among the most common causes of admission to hospitals in the United States, especially in those over age 65. Few data exist regarding the prevalence CHF of Cheyne-Stokes respiration (CSR) owing to congestive heart failure in the intensive care unit (ICU). Nevertheless, CSR is expected to be highly prevalent among those with CHF. Treatment should focus on the underlying mechanisms by which CHF increases loop gain and promotes unstable breathing. Few data are available to determine prevalence of CSR in the ICU, or how CSR might affect clinical management and weaning from mechanical ventilation. Copyright © 2016 Elsevier Inc. All rights reserved.

Systematic reviews on child welfare services: identifying and disseminating the evidence.

PubMed

Kornør, Hege; Bergman, Hanna; Maayan, Nicola; Soares-Weiser, Karla; Bjørndal, Arild

2015-10-01

Evidence-based practice is at an early stage of uptake within child welfare services. To facilitate well-informed decisions, we disseminated evidence from systematic reviews (SR) to local child welfare stakeholders in Norway through plain language summaries on a website (http://www.r-bup.no). We developed and implemented our dissemination strategy through seven steps: (1) systematic literature search; (2) selection of relevant SRs; (3) assembly of an advisory board; (4) selection of child welfare SRs relevant to Norway; (5) prioritization of the included SRs; (6) development of a plain language summary (PLS) after feedback from the advisory board; and (7) implementation of website. A total of 9266 potentially relevant records were screened and 120 SRs were included. The advisory board was assembled from local policymakers, practitioners, researchers, carers and consumers. The advisory board members independently ranked the 120 SRs according to relevance and prioritized 20 SRs that were written up into the PLS. The format of the PLS was tested and agreed with the board members. A website was developed and the PLSs were published starting September 2014. We think that the PLSs will be valuable resources to practitioners and it will be easily accessible to caregivers and consumers. This knowledge will inform research priorities and practice in Norway, leading the way to the use of evidence-based decisions in local child welfare services. © 2015 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

Performance Monitoring of Chilled-Water Distribution Systems Using HVAC-Cx

PubMed Central

Ferretti, Natascha Milesi; Galler, Michael A.; Bushby, Steven T.

2017-01-01

In this research we develop, test, and demonstrate the newest extension of the software HVAC-Cx (NIST and CSTB 2014), an automated commissioning tool for detecting common mechanical faults and control errors in chilled-water distribution systems (loops). The commissioning process can improve occupant comfort, ensure the persistence of correct system operation, and reduce energy consumption. Automated tools support the process by decreasing the time and the skill level required to carry out necessary quality assurance measures, and as a result they enable more thorough testing of building heating, ventilating, and air-conditioning (HVAC) systems. This paper describes the algorithm, developed by National Institute of Standards and Technology (NIST), to analyze chilled-water loops and presents the results of a passive monitoring investigation using field data obtained from BACnet® (ASHRAE 2016) controllers and presents field validation of the findings. The tool was successful in detecting faults in system operation in its first field implementation supporting the investigation phase through performance monitoring. Its findings led to a full energy retrocommissioning of the field site. PMID:29167584

Performance Monitoring of Chilled-Water Distribution Systems Using HVAC-Cx.

PubMed

Ferretti, Natascha Milesi; Galler, Michael A; Bushby, Steven T

2017-01-01

In this research we develop, test, and demonstrate the newest extension of the software HVAC-Cx (NIST and CSTB 2014), an automated commissioning tool for detecting common mechanical faults and control errors in chilled-water distribution systems (loops). The commissioning process can improve occupant comfort, ensure the persistence of correct system operation, and reduce energy consumption. Automated tools support the process by decreasing the time and the skill level required to carry out necessary quality assurance measures, and as a result they enable more thorough testing of building heating, ventilating, and air-conditioning (HVAC) systems. This paper describes the algorithm, developed by National Institute of Standards and Technology (NIST), to analyze chilled-water loops and presents the results of a passive monitoring investigation using field data obtained from BACnet ® (ASHRAE 2016) controllers and presents field validation of the findings. The tool was successful in detecting faults in system operation in its first field implementation supporting the investigation phase through performance monitoring. Its findings led to a full energy retrocommissioning of the field site.

EVA Roadmap: New Space Suit for the 21st Century

NASA Technical Reports Server (NTRS)

Yowell, Robert

1998-01-01

New spacesuit design considerations for the extra vehicular activity (EVA) of a manned Martian exploration mission are discussed. Considerations of the design includes:(1) regenerable CO2 removal, (2) a portable life support system (PLSS) which would include cryogenic oxygen produced from in-situ manufacture, (3) a power supply for the EVA, (4) the thermal control systems, (5) systems engineering, (5) space suit systems (materials, and mobility), (6) human considerations, such as improved biomedical sensors and astronaut comfort, (7) displays and controls, and robotic interfaces, such as rovers, and telerobotic commands.

Extravehicular Activity (EVA) Power, Avionics, and Software (PAS) 101

NASA Technical Reports Server (NTRS)

Irimies, David

2011-01-01

EVA systems consist of a spacesuit or garment, a PLSS, a PAS system, and spacesuit interface hardware. The PAS system is responsible for providing power for the suit, communication of several types of data between the suit and other mission assets, avionics hardware to perform numerous data display and processing functions, and information systems that provide crewmembers data to perform their tasks with more autonomy and efficiency. Irimies discussed how technology development efforts have advanced the state-of-the-art in these areas and shared technology development challenges.

Lithium-ion Battery Demonstration for the 2007 NASA Desert Research and Technology Studies (Desert RATS) Program

NASA Technical Reports Server (NTRS)

Bennett, William; Baldwin, Richard

2007-01-01

The NASA Glenn Research Center (GRC) Electrochemistry Branch designed and produced five lithium-ion battery packs for demonstration in a portable life support system (PLSS) on spacesuit simulators. The experimental batteries incorporated advanced, NASA-developed electrolytes and included internal protection against over-current, over-discharge and over-temperature. The 500-gram batteries were designed to deliver a constant power of 38 watts over 103 minutes of discharge time (130 Wh/kg). Battery design details are described and field and laboratory test results are summarized.

Space Suit Radiator Performance in Lunar and Mars Environments

NASA Technical Reports Server (NTRS)

Paul, Heather; Trevino, Luis; Nabity, James; Mason, Georgia; Copeland, Robert; Libberton, Kerry; Stephan, Ryan

2007-01-01

During an ExtraVehicular Activity (EVA), both the heat generated by the astronaut's metabolism and that produced by the Portable Life Support System (PLSS) must be rejected to space. The heat sources include the heat of adsorption of metabolic CO2, the heat of condensation of water, the heat removed from the body by the liquid cooling garment and the load from the electrical components. Although the sublimator hardware to reject this load weighs only 3.48 lbs, an additional eight pounds of water are loaded into the unit of which about six to eight are sublimated and lost; this is the single largest expendable during an eight-hour EVA. Using a radiator to reject heat from the Astronaut during an EVA, we can significantly reduce the amount of expendable water consumed by the sublimator. Last year we reported on the design and initial operational assessment tests of our novel radiator designated the Radiator And Freeze Tolerant heat eXchanger (RAFT-X). Herein, we report on tests conducted in the NASA Johnson Space Center Chamber E Thermal Vacuum Test Facility. Up to 800 Btu/h of heat were rejected in lunar and Mars environments with temperatures as cold as 150 F. Tilting the radiator did not cause an observable loss in performance. The RAFT-X endured freeze/thaw cycles and in fact, the heat exchanger was completely frozen three times without any apparent damage to the unit. We were also able to operate the heat exchanger in a partially frozen configuration to throttle the heat rejection rate from 530 Btu/h at low water flow rate down to 300 Btu/h. Finally, the deliberate loss of a single loop heat pipe only degraded the heat rejection performance by about 2 to 5%.

Space Suit Radiator Performance in Lunar and Mars Environments

NASA Technical Reports Server (NTRS)

Nabity, James; Mason, Georgia; Copeland, Robert; Libberton, Kerry; Trevino, Luis; Stephan, Ryan; Paul, Heather

2007-01-01

During an ExtraVehicular Activity (EVA), both the heat generated by the astronaut's metabolism and that produced by the Portable Life Support System (PLSS) must be rejected to space. The heat sources include the heat of adsorption of metabolic CO2, the heat of condensation of water, the heat removed from the body by the liquid cooling garment and the load from the electrical components. Although the sublimator hardware to reject this load weighs only 3.48 lbs, an additional eight pounds of water are loaded into the unit of which about six to eight are sublimated and lost; this is the single largest expendable during an eight-hour EVA. Using a radiator to reject heat from the Astronaut during an EVA, we can significantly reduce the amount of expendable water consumed by the sublimator. Last year we reported on the design and initial operational assessment tests of our novel radiator designated the Radiator And Freeze Tolerant heat eXchanger (RAFT-X). Herein, we report on tests conducted in the NASA Johnson Space Center Chamber E Thermal Vacuum Test Facility. Up to 800 Btu/h of heat were rejected in lunar and Mars environments with temperatures as cold as -150 F. Tilting the radiator did not cause an observable loss in performance. The RAFT-X endured freeze / thaw cycles and in fact, the heat exchanger was completely frozen three times without any apparent damage to the unit. We were also able to operate the heat exchanger in a partially frozen configuration to throttle the heat rejection rate from 530 Btu/h at low water flow rate down to 300 Btu/h. Finally, the deliberate loss of a single loop heat pipe only degraded the heat rejection performance by about 2 to 5%.

Alternative approaches to treatment of Central Sleep Apnea.

PubMed

Thomas, Robert Joseph

2014-03-01

Divergent approaches to treatment of hypocapnic central sleep apnea syndromes reflect the difficulties in taming a hyperactive respiratory chemoreflex. As both sleep fragmentation and a narrow CO 2 reserve or increased loop gain drive the disease, sedatives (to induce longer periods of stable non-rapid eye movement (NREM) sleep and reduce the destabilizing effects of arousals in NREM sleep) and CO 2 -based stabilization approaches are logical. Adaptive ventilation reduces mean hyperventilation yet can induce ventilator-patient dyssynchrony, while enhanced expiratory rebreathing space (EERS, dead space during positive pressure therapy) and CO 2 manipulation directly stabilize respiratory control by moving CO 2 above the apnea threshold. Carbonic anhydrase inhibition can provide further adjunctive benefits. Provent and Winx may be less likely to trigger central apneas or periodic breathing in those with a narrow CO 2 reserve. An oral appliance can meaningfully reduce positive pressure requirements and thus enable treatment of complex apnea. Novel pharmacological approaches may target mediators of carotid body glomus cell excitation, such as the balance between gas neurotransmitters. In complex apnea patients, single mode therapy is not always successful, and multi-modality therapy might need to be considered. Phenotyping of sleep apnea beyond conventional scoring approaches is the key to optimal management.

Spool Valve for Switching Air Flows Between Two Beds

NASA Technical Reports Server (NTRS)

Dean, W. Clark

2005-01-01

U.S. Patent 6,142,151 describes a dual-bed ventilation system for a space suit, with emphasis on a multiport spool valve that switches air flows between two chemical beds that adsorb carbon dioxide and water vapor. The valve is used to alternately make the air flow through one bed while exposing the other bed to the outer-space environment to regenerate that bed through vacuum desorption of CO2 and H2O. Oxygen flowing from a supply tank is routed through a pair of periodically switched solenoid valves to drive the spool valve in a reciprocating motion. The spool valve equalizes the pressures of air in the beds and the volumes of air flowing into and out of the beds during the alternations between the adsorption and desorption phases, in such a manner that the volume of air that must be vented to outer space is half of what it would be in the absence of pressure equalization. Oxygen that has been used to actuate the spool valve in its reciprocating motion is released into the ventilation loop to replenish air lost to vacuum during the previous desorption phase of the operating cycle.

Effect of diurnal and seasonal temperature variation on Cussac cave ventilation using co2 assessment

NASA Astrophysics Data System (ADS)

Peyraube, Nicolas; Lastennet, Roland; Villanueva, Jessica Denila; Houillon, Nicolas; Malaurent, Philippe; Denis, Alain

2017-08-01

Cussac cave was investigated to assess the cave air temperature variations and to understand its ventilation regime. This cave is located in an active karst system in the south west part of France. It has a single entrance and is considered as a cold air trap. In this study, air mass exchanges were probed. Measurements of temperature and Pco2 with a 30-min frequency were made in several locations close to the cave entrance. Speed of the air flow was also measured at the door of cave entrance. Results show that cave air Pco2 varies from 0.18 to 3.33 %. This cave appears to be a CO2 source with a net mass of 2319 tons blown in 2009. Carbon-stable isotope of CO2 (13Cco2) ranges from -20.6 ‰ in cold season to -23.8 ‰ in warm season. Cave air is interpreted as a result of a mix between external air and an isotopically depleted air, coming from the rock environment. The isotopic value of the light member varies through time, from -23.9 to -22.5 ‰. Furthermore, this study ascertains that the cave never stops in communicating with the external air. The ventilation regime is identified. (1) In cold season, the cave inhales at night and blows a little at the warmest hours. However, in warm season, (2) cave blows at night, but (3) during the day, a convection loop takes place in the entrance area and prevents the external air from entering the cave, confirming the cold air trap.

Construction of a 2- by 2-foot transonic adaptive-wall test section at the NASA Ames Research Center

NASA Technical Reports Server (NTRS)

Morgan, Daniel G.; Lee, George

1986-01-01

The development of a new production-size, two-dimensional, adaptive-wall test section with ventilated walls at the NASA Ames Research Center is described. The new facility incorporates rapid closed-loop operation, computer/sensor integration, and on-line interference assessment and wall corrections. Air flow through the test section is controlled by a series of plenum compartments and three-way slide vales. A fast-scan laser velocimeter was built to measure velocity boundary conditions for the interference assessment scheme. A 15.2-cm- (6.0-in.-) chord NACA 0012 airfoil model will be used in the first experiments during calibration of the facility.

Co-Adsorption of Ammonia and Formaldehyde on Regenerable Carbon Sorbents for the Primary Life Support System (PLSS)

NASA Technical Reports Server (NTRS)

Wojtowicz, Marek A.; Cosgrove, Joseph E.; Serio, Michael A.; Wilburn, Monique S.

2016-01-01

Results are presented on the development of a reversible carbon sorbent for trace-contaminant (TC) removal for use in Extravehicular Activities (EVAs), and more specifically in the Primary Life Support System (PLSS). The current TC-control technology involves the use of a packed bed of acid-impregnated granular charcoal, which is deemed non-regenerable, while the carbon-based sorbent under development in this project can be regenerated by exposure to vacuum at room temperature. Data on concurrent sorption and desorption of ammonia and formaldehyde, which are major TCs of concern, are presented in this paper. A carbon sorbent was fabricated by dry impregnation of a reticulated carbon-foam support with polyvinylidene chloride, followed by carbonization and thermal oxidation in air. Sorbent performance was tested for ammonia and formaldehyde sorption and vacuum regeneration, with and without water present in the gas stream. It was found that humidity in the gas phase enhanced ammonia-sorption capacity by a factor larger than two. Co-adsorption of ammonia and formaldehyde in the presence of water resulted in strong formaldehyde sorption (to the point that it was difficult to saturate the sorbent on the time scales used in this study). In the absence of humidity, adsorption of formaldehyde on the carbon surface was found to impair ammonia sorption in subsequent runs; in the presence of water, however, both ammonia and formaldehyde could be efficiently removed from the gas phase by the sorbent. The efficiency of vacuum regeneration could be enhanced by gentle heating to temperatures below 60 deg.

Deadzones, Dying Eddies, and the Loop Current: Stability, Ventilation, and Heat Content from Buoyancy Glider Observations in the Northwest Gulf of Mexico in Spring and Summer 2015

NASA Astrophysics Data System (ADS)

DiMarco, S. F.; Knap, A. H.; Wang, Z.; Walpert, J.; Dreger, K.

2016-02-01

The northwestern Gulf of Mexico is host to a myriad of physical and biochemical processes, which govern the exchange and transport of material and volume between the coastal and offshore environments. We report on five G2 Slocum glider deployments in the northwestern Gulf during the spring and summer of 2015. The gliders were deployed in shallow (20 m) and deep (greater than 1000 m) water for a total of about 200 days. During this time, the gliders encountered a variety of environmental conditions that impact the circulation, biology, chemistry of the shelf and slope. The shallow gliders encountered coastal waters influenced by extensive flooding in terrestrial Texas that vertically stratified the water-column and was coincident with sub-pycnocline low dissolved oxygen concentration, at times below the hypoxic threshold of 2 mg/L, and elevated CDOM concentrations. These gliders also reveal high spatial variability with bottom boundary oxygen and biomass scales on the order of a few kilometers. The deep gliders were tasked to investigate shelf/slope exchange at two locations 94W and 91W. The western glider encountered a mature mesoscale circulation eddy that was actively weakening. The eastern glider simultaneously encountered a freshly separated Loop Current eddy. The vertical structure of hydrographic and dissolved oxygen parameters shows significant and distinguishable variability in each feature. The vertical structure of both features show significant departures from that which is expected based on sea surface height determined from satellite altimetry. Additionally, glider observations are compared to operational high-resolution regional numerical model output. These observations emphasize the importance of direct observations over satellite-derived products for applications that include upper ocean heat content for hurricane intensification and vertical mixing and ventilation of the oceanic interior.

System Modeling of Metabolic Heat Regenerated Temperature Swing Adsorption (MTSA) Subassembly for Prototype Design

NASA Technical Reports Server (NTRS)

Bower, Chad; Padilla, Sebastian; Iacomini, Christie; Paul, Heather L.

2009-01-01

This paper describes modeling methods for the three core components of a Metabolic heat regenerated Temperature Swing Adsorption (MTSA) subassembly: the sorbent bed, a sublimation (cooling) heat exchanger (SHX), and a condensing icing (warming) heat exchanger (CIHX). The primary function of the MTSA, removing carbon dioxide from a ventilation loop, is performed via the sorbent bed. The CIHX is used to heat the sorbent bed for desorption and to remove moisture from the ventilation loop while the SHX is alternately employed to cool the sorbent bed via sublimation of a spray of water at low pressure to prepare the reconditioned bed for the next cycle. This paper describes a system level model of the MTSA as developed in Thermal Desktop and SINDA/FLUINT including assumptions on geometry and physical phenomena, modeling methodology and relevant pa ra mete rizatio ns. Several areas of particular modeling interest are discussed. In the sorbent bed, capture of the translating CO2 saturation front and associated local energy and mass balance in both adsorbing and desorbing modes is covered. The CIHX poses particular challenges for modeling in SINDA/FLUINT as accounting for solids states in fluid submodels are not a native capability. Methods for capturing phase change and latent heat of ice as well as the transport properties across a layer of low density accreted frost are developed. This extended modeling capacity is applicable to temperatures greater than 258 K. To extend applicability to the minimum device temperature of 235 K, a method for a mapped transformation of temperatures from below the limit temperatures to some value above is given along with descriptions for associated material property transformations and the resulting impacts to total heat and mass transfer. Similar considerations are shown for the SHX along with assumptions for flow mechanics and resulting model methods for sublimation in a flow.

Mechanisms of Injury and Countermeasures for EVA Associated Upper Extremity Medical Issues: Extended Vent Tube Study

NASA Technical Reports Server (NTRS)

Jones, Jeff; Hoffman, Ron; Harvey, Craig; Bowen, C. K.; Hudy, C. E.; Tuxhorn, Jennifer; Gernhardt, Mike; Scheuring, Richard A.

2007-01-01

The goal of this study is to determine the role that moisture plays in the injury to the fingers and fingernails during EVA training operations in the Neutral Buoyancy Laboratory. Current Extravehicular Mobility Unit (EMU, with a PLSS) as configured in the NBL was used for all testing and a vent tube was extended down a single arm of the crewmember during the test; vent tube was moved between left and right arm to serve as experimental condition being investigated and the other arm served as control condition.

Early sepsis, obstructive jaundice and right-sided diaphragmatic hernia in the newborn.

PubMed

García-Muñoz, F; Santana, C; Reyes, D; Wiehoff, A; López-Pinto, J M; García-Alix, A

2001-01-01

A male newborn was admitted to our Unit because of early sepsis and shock. He required antimicrobial therapy and mechanical ventilation and initially did well, although he exhibited jaundice and cholestasis. During the second week he deteriorated, with radiological opacification of the right hemithorax and pleural effusion, and did poorly in spite of antibiotical therapy and drainage of the effusion. In the third week, the X-ray suggested some bowel loops in the right hemithorax. A right-sided diaphragmatic hernia was confirmed by a CT-scan, and surgery was performed with good outcome. The association of delayed-onset right-sided CDH following early sepsis and obstructive jaundice has not been published before, and illustrates a scarcely known form of presentation of this condition.

Multiscale integral analysis of a HT leakage in a fusion nuclear power plant

NASA Astrophysics Data System (ADS)

Velarde, M.; Fradera, J.; Perlado, J. M.; Zamora, I.; Martínez-Saban, E.; Colomer, C.; Briani, P.

2016-05-01

The present work presents an example of the application of an integral methodology based on a multiscale analysis that covers the whole tritium cycle within a nuclear fusion power plant, from a micro scale, analyzing key components where tritium is leaked through permeation, to a macro scale, considering its atmospheric transport. A leakage from the Nuclear Power Plants, (NPP) primary to the secondary side of a heat exchanger (HEX) is considered for the present example. Both primary and secondary loop coolants are assumed to be He. Leakage is placed inside the HEX, leaking tritium in elementary tritium (HT) form to the secondary loop where it permeates through the piping structural material to the exterior. The Heating Ventilation and Air Conditioning (HVAC) system removes the leaked tritium towards the NPP exhaust. The HEX is modelled with system codes and coupled to Computational Fluid Dynamic (CFD) to account for tritium dispersion inside the nuclear power plants buildings and in site environment. Finally, tritium dispersion is calculated with an atmospheric transport code and a dosimetry analysis is carried out. Results show how the implemented methodology is capable of assessing the impact of tritium from the microscale to the atmospheric scale including the dosimetric aspect.

Energy efficient model based algorithm for control of building HVAC systems.

PubMed

Kirubakaran, V; Sahu, Chinmay; Radhakrishnan, T K; Sivakumaran, N

2015-11-01

Energy efficient designs are receiving increasing attention in various fields of engineering. Heating ventilation and air conditioning (HVAC) control system designs involve improved energy usage with an acceptable relaxation in thermal comfort. In this paper, real time data from a building HVAC system provided by BuildingLAB is considered. A resistor-capacitor (RC) framework for representing thermal dynamics of the building is estimated using particle swarm optimization (PSO) algorithm. With objective costs as thermal comfort (deviation of room temperature from required temperature) and energy measure (Ecm) explicit MPC design for this building model is executed based on its state space representation of the supply water temperature (input)/room temperature (output) dynamics. The controllers are subjected to servo tracking and external disturbance (ambient temperature) is provided from the real time data during closed loop control. The control strategies are ported on a PIC32mx series microcontroller platform. The building model is implemented in MATLAB and hardware in loop (HIL) testing of the strategies is executed over a USB port. Results indicate that compared to traditional proportional integral (PI) controllers, the explicit MPC's improve both energy efficiency and thermal comfort significantly. Copyright © 2015 Elsevier Inc. All rights reserved.

Alternative approaches to treatment of Central Sleep Apnea

PubMed Central

2013-01-01

Synopsis Divergent approaches to treatment of hypocapnic central sleep apnea syndromes reflect the difficulties in taming a hyperactive respiratory chemoreflex. As both sleep fragmentation and a narrow CO2 reserve or increased loop gain drive the disease, sedatives (to induce longer periods of stable non-rapid eye movement (NREM) sleep and reduce the destabilizing effects of arousals in NREM sleep) and CO2-based stabilization approaches are logical. Adaptive ventilation reduces mean hyperventilation yet can induce ventilator-patient dyssynchrony, while enhanced expiratory rebreathing space (EERS, dead space during positive pressure therapy) and CO2 manipulation directly stabilize respiratory control by moving CO2 above the apnea threshold. Carbonic anhydrase inhibition can provide further adjunctive benefits. Provent and Winx may be less likely to trigger central apneas or periodic breathing in those with a narrow CO2 reserve. An oral appliance can meaningfully reduce positive pressure requirements and thus enable treatment of complex apnea. Novel pharmacological approaches may target mediators of carotid body glomus cell excitation, such as the balance between gas neurotransmitters. In complex apnea patients, single mode therapy is not always successful, and multi-modality therapy might need to be considered. Phenotyping of sleep apnea beyond conventional scoring approaches is the key to optimal management. PMID:24772053

Performance Characterization and Simulation of Amine-Based Vacuum Swing Sorption Units for Spacesuit Carbon Dioxide and Humidity Control

NASA Technical Reports Server (NTRS)

Swickrath, Michael J.; Watts, Carly; Anderson, Molly; McMillin, Summer; Broerman, Craig; Colunga, Aaron; Vogel, Matthew

2012-01-01

Controlling carbon dioxide (CO2) and water (H2O) vapor concentrations in a space suit is critical to ensuring an astronauts safety, comfort, and capability to perform extra-vehicular activity (EVA) tasks. Historically, this has been accomplished using lithium hydroxide (LiOH) and metal oxide (MetOx) canisters. Lithium hydroxide is a consumable material that requires priming with water before it becomes effective at removing carbon dioxide. MetOx is regenerable through a power-intensive thermal cycle but is significantly heavier on a volume basis than LiOH. As an alternative, amine-based vacuum swing beds are under aggressive development for EVA applications. The vacuum swing units control atmospheric concentrations of both CO2 and H2O through fully-regenerative process. The current concept, referred to as the rapid cycle amine (RCA), has resulted in numerous laboratory prototypes. Performance of these prototypes have been assessed experimentally and documented in previous reports. To support developmental e orts, a first principles model has also been established for the vacuum swing sorption technology. For the first time in several decades, a major re-design of Portable Life Support System (PLSS) for the extra-vehicular mobility unit (EMU) is underway. NASA at Johnson Space Center built and tested an integrated PLSS test bed of all subsystems under a variety of simulated EVA conditions of which the RCA prototype played a significant role. The efforts documented herein summarize RCA test performance and simulation results for single and variable metabolic rate experiments in an integrated context. In addition, a variety of off-nominal tests were performed to assess the capability of the RCA to function under challenging circumstances. Tests included high water production experiments, degraded vacuum regeneration, and deliberate valve/power failure and recovery.

Investigating Liquid CO2 as a Coolant for a MTSA Heat Exchanger Design

NASA Technical Reports Server (NTRS)

Paul, Heather L.; Padilla, Sebastian; Powers, Aaron; Iacomini, Christie

2009-01-01

Metabolic heat regenerated Temperature Swing Adsorption (MTSA) technology is being developed for thermal and carbon dioxide (CO 2) control for a future Portable Life Support System (PLSS), as well as water recycling. CO 2 removal and rejection is accomplished by driving a sorbent through a temperature swing of approximately 210 K to 280 K . The sorbent is cooled to these sub-freezing temperatures by a Sublimating Heat Exchanger (SHX) with liquid coolant expanded to sublimation temperatures. Water is the baseline coolant available on the moon, and if used, provides a competitive solution to the current baseline PLSS schematic. Liquid CO2 (LCO2) is another non-cryogenic coolant readily available from Martian resources which can be produced and stored using relatively low power and minimal infrastructure. LCO 2 expands from high pressure liquid (5800 kPa) to Mars ambient (0.8 kPa) to produce a gas / solid mixture at temperatures as low as 156 K. Analysis and experimental work are presented to investigate factors that drive the design of a heat exchanger to effectively use this sink. Emphasis is given to enabling efficient use of the CO 2 cooling potential and mitigation of heat exchanger clogging due to solid formation. Minimizing mass and size as well as coolant delivery are also considered. The analysis and experimental work is specifically performed in an MTSA-like application to enable higher fidelity modeling for future optimization of a SHX design. In doing so, the work also demonstrates principles and concepts so that the design can be further optimized later in integrated applications (including Lunar application where water might be a choice of coolant).

Lithium Iron Phosphate Cell Performance Evaluations for Lunar Extravehicular Activities

NASA Technical Reports Server (NTRS)

Reid, Concha

2007-01-01

Lithium-ion battery cells are being evaluated for their ability to provide primary power and energy storage for NASA s future Exploration missions. These missions include the Orion Crew Exploration Vehicle, the Ares Crew Launch Vehicle Upper Stage, Extravehicular Activities (EVA, the advanced space suit), the Lunar Surface Ascent Module (LSAM), and the Lunar Precursor and Robotic Program (LPRP), among others. Each of these missions will have different battery requirements. Some missions may require high specific energy and high energy density, while others may require high specific power, wide operating temperature ranges, or a combination of several of these attributes. EVA is one type of mission that presents particular challenges for today s existing power sources. The Portable Life Support System (PLSS) for the advanced Lunar surface suit will be carried on an astronaut s back during eight hour long sorties, requiring a lightweight power source. Lunar sorties are also expected to occur during varying environmental conditions, requiring a power source that can operate over a wide range of temperatures. Concepts for Lunar EVAs include a primary power source for the PLSS that can recharge rapidly. A power source that can charge quickly could enable a lighter weight system that can be recharged while an astronaut is taking a short break. Preliminary results of Al23 Ml 26650 lithium iron phosphate cell performance evaluations for an advanced Lunar surface space suit application are discussed in this paper. These cells exhibit excellent recharge rate capability, however, their specific energy and energy density is lower than typical lithium-ion cell chemistries. The cells were evaluated for their ability to provide primary power in a lightweight battery system while operating at multiple temperatures.

Arizona Geology Trip - February 25-28, 2008

NASA Technical Reports Server (NTRS)

Thomas, Gretchen A.; Ross, Amy J.

2008-01-01

A variety of hardware developers, crew, mission planners, and headquarters personnel traveled to Gila Bend, Arizona, in February 2008 for a CxP Lunar Surface Systems Team geology experience. Participating in this field trip were the CxP Space Suit System (EC5) leads: Thomas (PLSS) and Ross (PGS), who presented the activities and findings learned from being in the field during this KC. As for the design of a new spacesuit system, this allowed the engineers to understand the demands this type of activity will have on NASA's hardware, systems, and planning efforts. The engineers also experienced the methods and tools required for lunar surface activity.

The Modern Integrated Anaesthesia Workstation

PubMed Central

Patil, Vijaya P; Shetmahajan, Madhavi G; Divatia, Jigeeshu V

2013-01-01

Over the years, the conventional anaesthesia machine has evolved into an advanced carestation. The new machines use advanced electronics, software and technology to offer extensive capabilities for ventilation, monitoring, inhaled agent delivery, low-flow anaesthesia and closed-loop anaesthesia. They offer integrated monitoring and recording facilities and seamless integration with anaesthesia information systems. It is possible to deliver tidal volumes accurately and eliminate several hazards associated with the low pressure system and oxygen flush. Appropriate use can result in enhanced safety and ergonomy of anaesthetic delivery and monitoring. However, these workstations have brought in a new set of limitations and potential drawbacks. There are differences in technology and operational principles amongst the new workstations. Understand the principles of operation of these workstations and have a thorough knowledge of the operating manual of the individual machines. PMID:24249877

ECLSS and Thermal Systems Integration Challenges Across the Constellation Architecture

NASA Technical Reports Server (NTRS)

Carrasquillo, Robyn

2010-01-01

As the Constellation Program completes its initial capability Preliminary Design Review milestone for the Initial Capability phase, systems engineering of the Environmental Control and Life Support (ECLS) and Thermal Systems for the various architecture elements has progressed from the requirements to design phase. As designs have matured for the Ares, Orion, Ground Systems, and Extravehicular (EVA) System, a number of integration challenges have arisen requiring analyses and trades, resulting in changes to the design and/or requirements. This paper will address some of the key integration issues and results, including the Orion-to-Ares shared compartment venting and purging, Orion-to-EVA suit loop integration issues with the suit system, Orion-to-ISS and Orion-to-Altair intermodule ventilation, and Orion and Ground Systems impacts from post-landing environments.

Impacts of an Ammonia Leak on the Cabin Atmosphere of the International Space Station

NASA Technical Reports Server (NTRS)

Duchesne, Stephanie M.; Sweterlitsch, Jeff J.; Son, Chang H.; Perry, Jay L.

2011-01-01

Toxic chemical release into the cabin atmosphere is one of the three major emergency scenarios identified on the International Space Station (ISS). The release of anhydrous ammonia, the coolant used in the U.S. On-orbit Segment (USOS) External Active Thermal Control Subsystem (EATCS), into the ISS cabin atmosphere is one of the most serious toxic chemical release cases identified on board ISS. The USOS Thermal Control System (TCS) includes an Internal Thermal Control Subsystem (ITCS) water loop and an EATCS ammonia loop that transfer heat at the interface heat exchanger (IFHX). Failure modes exist that could cause a breach within the IFHX. This breach would result in high pressure ammonia from the EATCS flowing into the lower pressure ITCS water loop. As the pressure builds in the ITCS loop, it is likely that the gas trap, which has the lowest maximum design pressure within the ITCS, would burst and cause ammonia to enter the ISS atmosphere. It is crucial to first characterize the release of ammonia into the ISS atmosphere in order to develop methods to properly mitigate the environmental risk. This paper will document the methods used to characterize an ammonia leak into the ISS cabin atmosphere. A mathematical model of the leak was first developed in order to define the flow of ammonia into the ISS cabin atmosphere based on a series of IFHX rupture cases. Computational Fluid Dynamics (CFD) methods were then used to model the dispersion of the ammonia throughout the ISS cabin and determine localized effects and ventilation effects on the dispersion of ammonia. Lastly, the capabilities of the current on-orbit systems to remove ammonia were reviewed and scrubbing rates of the ISS systems were defined based on the ammonia release models. With this full characterization of the release of ammonia from the USOS TCS, an appropriate mitigation strategy that includes crew and system emergency response procedures, personal protection equipment use, and atmosphere monitoring and scrubbing hardware can be established.

Impacts of an Ammonia Leak on the Cabin Atmosphere of the International Space Station

NASA Technical Reports Server (NTRS)

Duchesne, Stephanie M.; Sweterlitsch, Jeffrey J.; Son, Chang H.; Perry Jay L.

2012-01-01

Toxic chemical release into the cabin atmosphere is one of the three major emergency scenarios identified on the International Space Station (ISS). The release of anhydrous ammonia, the coolant used in the U.S. On-orbit Segment (USOS) External Active Thermal Control Subsystem (EATCS), into the ISS cabin atmosphere is one of the most serious toxic chemical release cases identified on board ISS. The USOS Thermal Control System (TCS) includes an Internal Thermal Control Subsystem (ITCS) water loop and an EATCS ammonia loop that transfer heat at the interface heat exchanger (IFHX). Failure modes exist that could cause a breach within the IFHX. This breach would result in high pressure ammonia from the EATCS flowing into the lower pressure ITCS water loop. As the pressure builds in the ITCS loop, it is likely that the gas trap, which has the lowest maximum design pressure within the ITCS, would burst and cause ammonia to enter the ISS atmosphere. It is crucial to first characterize the release of ammonia into the ISS atmosphere in order to develop methods to properly mitigate the environmental risk. This paper will document the methods used to characterize an ammonia leak into the ISS cabin atmosphere. A mathematical model of the leak was first developed in order to define the flow of ammonia into the ISS cabin atmosphere based on a series of IFHX rupture cases. Computational Fluid Dynamics (CFD) methods were then used to model the dispersion of the ammonia throughout the ISS cabin and determine localized effects and ventilation effects on the dispersion of ammonia. Lastly, the capabilities of the current on-orbit systems to remove ammonia were reviewed and scrubbing rates of the ISS systems were defined based on the ammonia release models. With this full characterization of the release of ammonia from the USOS TCS, an appropriate mitigation strategy that includes crew and system emergency response procedures, personal protection equipment use, and atmosphere monitoring and scrubbing hardware can be established.

A model for technology assessment as applied to closed loop infusion systems. Technology Assessment Task Force of the Society of Critical Care Medicine.

PubMed

Jastremski, M; Jastremski, C; Shepherd, M; Friedman, V; Porembka, D; Smith, R; Gonzales, E; Swedlow, D; Belzberg, H; Crass, R

1995-10-01

To test a model for the assessment of critical care technology on closed loop infusion control, a technology that is in its early stages of development and testing on human subjects. A computer-assisted search of the English language literature and reviews of the gathered data by experts in the field of closed loop infusion control systems. Studies relating to closed loop infusion control that addressed one or more of the questions contained in our technology assessment template were analyzed. Study design was not a factor in article selection. However, the lack of well-designed clinical outcome studies was an important factor in determining our conclusions. A focus person summarized the data from the selected studies that related to each of the assessment questions. The preliminary data summary developed by the focus person was further analyzed and refined by the task force. Experts in closed loop systems were then added to the group to review the summary provided by the task force. These experts' comments were considered by the task force and this final consensus report was developed. Closed loop system control is a technological concept that may be applicable to several aspects of critical care practice. This is a technology in the early stages of evolution and much more research and data are needed before its introduction into usual clinical practice. Furthermore, each specific application and each device for each application (e.g., nitroprusside infusion, ventilator adjustment), although based on the same technological concept, are sufficiently different in terms of hardware and computer algorithms to require independent validation studies. Closed loop infusion systems may have a role in critical care practice. However, for most applications, further development is required to move this technology from the innovation phase to the point where it can be evaluated so that its role in critical car practice can be defined. Each application of closed loop infusion systems must be independently validated by appropriately designed research studies. Users should be provided with the clinical parameters driving each closed loop system so that they can ensure that it agrees with their opinion of acceptable medical practice. Clinical researchers and leaders in industry should collaborate to perform the scientifically valid, outcome-based research that is necessary to evaluate the effect of this new technology. The original model we developed for technology assessment required the addition of several more questions to produce a complete analysis of an emerging technology. An emerging technology should be systematically assessed (using a model such as the model developed by the Society of Critical Care Medicine), before its introduction into clinical practice in order to provide a focus for human outcome validation trials and to minimize the possibility of widespread use of an unproven technology.

Astronaut Russell Schweickart photographed during EVA

NASA Image and Video Library

1969-03-06

AS09-19-2983 (6 March 1969) --- Astronaut Russell L. Schweickart, lunar module pilot, operates a 70mm Hasselblad camera during his extravehicular activity (EVA) on the fourth day of the Apollo 9 Earth-orbital mission. The Command and Service Modules (CSM) and Lunar Module (LM) "Spider" are docked. This view was taken from the Command Module (CM) "Gumdrop". Schweickart, wearing an Extravehicular Mobility Unit (EMU), is standing in "golden slippers" on the LM porch. On his back, partially visible, are a Portable Life Support System (PLSS) and an Oxygen Purge System (OPS). Astronaut James A. McDivitt, Apollo 9 commander, was inside the "Spider". Astronaut David R. Scott, command module pilot, remained at the controls in the CM.

Apollo 9 Mission image - Astronaut Russell L. Schweickart, lunar module pilot, during EVA

NASA Image and Video Library

1969-03-03

Astronaut Russell L. Schweickart, lunar module pilot, operates a 70mm Hasselblad camera during his extravehicular activity on the fourth day of the Apollo 9 earth-orbital mission. The Command/Service Module and the Lunar Module 3 "Spider" are docked. This view was taken form the Command Module "Gumdrop". Schweickart, wearing an Extravehicular Mobility Unit (EMU), is standing in "golden slippers" on the Lunar Module porch. On his back, partially visible, are a Portable Life Support System (PLSS) and an Oxygen Purge System (OPS). Film magazine was A,film type was SO-368 Ektachrome with 0.460 - 0.710 micrometers film / filter transmittance response and haze filter,80mm lens.

Humanoid Flight Metabolic Simulator Project

NASA Technical Reports Server (NTRS)

Ross, Stuart

2015-01-01

NASA's Evolvable Mars Campaign (EMC) has identified several areas of technology that will require significant improvements in terms of performance, capacity, and efficiency, in order to make a manned mission to Mars possible. These include crew vehicle Environmental Control and Life Support System (ECLSS), EVA suit Portable Life Support System (PLSS) and Information Systems, autonomous environmental monitoring, radiation exposure monitoring and protection, and vehicle thermal control systems (TCS). (MADMACS) in a Suit can be configured to simulate human metabolism, consuming crew resources (oxygen) in the process. In addition to providing support for testing Life Support on unmanned flights, MADMACS will also support testing of suit thermal controls, and monitor radiation exposure, body zone temperatures, moisture, and loads.

Real-time display of flow-pressure-volume loops.

PubMed

Morozoff, P E; Evans, R W

1992-01-01

Graphic display of respiratory waveforms can be valuable for monitoring the progress of ventilated patients. A system has been developed that can display flow-pressure-volume loops as derived from a patient's respiratory circuit in real time. It can also display, store, print, and retrieve ventilatory waveforms. Five loops can be displayed at once: current, previous, reference, "ideal," and previously saved. Two components, the data-display device (DDD) and the data-collection device (DCD), comprise the system. An IBM 286/386 computer with a graphics card (VGA) and bidirectional parallel port is used for the DDD; an eight-bit microprocessor card and an A/D convertor card make up the DCD. A real-time multitasking operating system was written to control the DDD, while the DCD operates from in-line assembly code. The DCD samples the pressure and flow sensors at 100 Hz and looks for a complete flow waveform pattern based on flow slope. These waveforms are then passed to the DDD via the mutual parallel port. Within the DDD a process integrates the flow to create a volume signal and performs a multilinear regression on the pressure, flow, and volume data to calculate the elastance, resistance, pressure offset, and coefficient of determination. Elastance, resistance, and offset are used to calculate Pr and Pc where: Pr[k] = P[k]-offset-(elastance.V[k]) and Pc[k] = P[k]-offset-(resistance.F[k]). Volume vs. Pc and flow vs. Pr can be displayed in real time. Patient data from previous clinical tests were loaded into the device to verify the software calculations. An analog waveform generator was used to simulate flow and pressure waveforms that validated the system.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain versus lung: hierarchy of feedback loops in single-ventricle patients with superior cavopulmonary connection.

PubMed

Fogel, Mark A; Durning, Suzanne; Wernovsky, Gil; Pollock, Avrum N; Gaynor, J William; Nicolson, Susan

2004-09-14

CO2 vasodilates and O2 vasoconstricts the cerebral vascular bed; the opposite is true in the lungs. When the brain and lungs are connected exclusively in series, which feedback loop predominates is unknown. The circulation of the superior cavopulmonary connection (SCPC) provides a unique physiology to answer this question. To determine cerebral and pulmonary blood flow and to establish the hierarchy of cerebral and pulmonary feedback mechanisms, 12 intubated, ventilated, single-ventricle patients in SCPC physiology (age 2.2+/-0.5 years) underwent magnetic resonance imaging velocity mapping of their jugular veins and aorta in room air, hypercarbia, and 100% O2. Flows in these vessels and arterial blood gases were measured. With 22+/-6 torr CO2 (Pco2) increased from 40 to 63 mm Hg, P<0.01), flow to the brain and lungs increased (1.5 to 2.7 L/min per m2, P=0.0003), Po2 improved (48 to 60 mm Hg, P=0.0004), and cardiac index increased (4.3 to 5.4 L/min per m2, P=0.0003). The increased cardiac index accounted for the increased cerebral and pulmonary blood flow (R=0.73, P=0.02) and cerebral O2 transport increased by 80% (P=0.0005) while preserving body O2 delivery. Hyperoxia did not change cerebral and pulmonary blood flow; Po2 increased 94% (P=0.01). The cerebral CO2 feedback loop predominates over the pulmonary one when they directly compete with each other. CO2 has a major impact on flow distribution whereas O2 has little impact. Increased CO2 improves cerebral oxygenation in SCPC patients. This may provide a clue in determining neurological sequelae in SC physiology and may influence timing of Fontan completion.

Continuous infusion or bolus injection of loop diuretics for patients admitted for severe acute heart failure: is one strategy better than the other?

PubMed

Caetano, Francisca; Mota, Paula; Almeida, Inês; Fernandes, Andreia; Botelho, Ana; Leitão Marques, António

2015-02-01

Intravenous loop diuretics are an essential part of acute heart failure management; however, data to guide their use is sparse. Our aim was to compare continuous intravenous infusion of loop diuretics with intravenous bolus administration in terms of efficacy and adverse events in patients admitted with severe acute heart failure. Over a period of three years, 110 patients were admitted to our cardiac intensive care unit with acute heart failure. Clinical, laboratory and prognostic parameters were compared according to the diuretic strategy used and mortality and readmission for acute heart failure during follow-up were analyzed. Previous medical history was similar in the two groups. At admission, the continuous infusion group met criteria for worse prognosis: lower systolic blood pressure (p=0.011), more severe renal injury (p=0.008), lower left ventricular ejection fraction (p=0.016) and higher incidence of restrictive pattern of diastolic dysfunction (p=0.032). They were more often treated with vasopressors (p=0.003), inotropes (p=0.010), renal support therapy (p=0.003) and non-invasive ventilation (p<0.001). They had longer hospitalizations (p=0.014) and a higher incidence of cardiorenal syndrome (p=0.009); however, at discharge, there were no differences in renal function between the groups. In-hospital mortality was similar, and during follow-up there were no differences in mortality or readmission for acute heart failure. Continuous infusion was preferred in patients presenting with worse clinical status, in whom renal dysfunction was transiently worse. However, in-hospital mortality and creatinine at discharge were similar. Continuous infusion thus appears to counteract the initial dire prognosis of more unstable patients. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

An open-loop controlled active lung simulator for preterm infants.

PubMed

Cecchini, Stefano; Schena, Emiliano; Silvestri, Sergio

2011-01-01

We describe the underlying theory, design and experimental evaluation of an electromechanical analogue infant lung to simulate spontaneous breathing patterns of preterm infants. The aim of this work is to test the possibility to obtain breathing patterns of preterm infants by taking into consideration the air compressibility. Respiratory volume function represents the actuation pattern, and pulmonary pressure and flow-rate waveforms are mathematically obtained through the application of the perfect gas and adiabatic laws. The mathematical model reduces the simulation interval into a step shorter than 1 ms, allowing to consider an entire respiratory act as composed of a large number of almost instantaneous adiabatic transformations. The device consists of a spherical chamber where the air is compressed by four cylinder-pistons, moved by stepper motors, and flows through a fluid-dynamic resistance, which also works as flow-rate sensor. Specifically designed software generates the actuators motion, based on the desired ventilation parameters, without controlling the gas pneumatic parameters with a closed-loop. The system is able to simulate tidal volumes from 3 to 8 ml, breathing frequencies from 60 to 120 bpm and functional residual capacities from 25 to 80 ml. The simulated waveforms appear very close to the measured ones. Percentage differences on the tidal volume waveform vary from 7% for the tidal volume of 3 ml, down to 2.2-3.5% for tidal volumes in the range of 4-7 ml, and 1.3% for the tidal volume equal to 8 ml in the whole breathing frequency and functional residual capacity ranges. The open-loop electromechanical simulator shows that gas compressibility can be theoretically assessed in the typical pneumatic variable range of preterm infant respiratory mechanics. Copyright © 2010 IPEM. Published by Elsevier Ltd. All rights reserved.

Respiratory research networks in Europe and beyond: aims, achievements and aspirations for the 21st century

PubMed Central

Zampieri, Fernando; Povoa, Pedro; Ranzani, Otavio; Bos, Lieuwe D.; Aliberti, Stefano; Torres, Antoni

2017-01-01

Healthcare-associated infection, such as intensive care unit (ICU)-related respiratory infections, remain the most frequently encountered morbidity of ICU admission, prolonging hospital stay and increasing mortality rates. The epidemiology of ICU-related respiratory infections, particularly nonventilated ICU-associated pneumonia and ventilator-associated tracheobronchitis, appears to be quite different among different countries. European countries have different prevalence, patterns and mechanism of resistance, as well as different treatments chosen by different attending physicians. The classical clinical research process in respiratory infections consists of the following loop: 1) identification of knowledge gaps; 2) systematic review and search for adequate answers; 3) generation of study hypotheses; 4) design of study protocols; 5) collection clinical data; 6) analysis and interpretation of the results; and 7) implementation of the results in clinical practice. PMID:28894481

Prevalence and test characteristics of national health safety network ventilator-associated events.

PubMed

Lilly, Craig M; Landry, Karen E; Sood, Rahul N; Dunnington, Cheryl H; Ellison, Richard T; Bagley, Peter H; Baker, Stephen P; Cody, Shawn; Irwin, Richard S

2014-09-01

The primary aim of the study was to measure the test characteristics of the National Health Safety Network ventilator-associated event/ventilator-associated condition constructs for detecting ventilator-associated pneumonia. Its secondary aims were to report the clinical features of patients with National Health Safety Network ventilator-associated event/ventilator-associated condition, measure costs of surveillance, and its susceptibility to manipulation. Prospective cohort study. Two inpatient campuses of an academic medical center. Eight thousand four hundred eight mechanically ventilated adults discharged from an ICU. None. The National Health Safety Network ventilator-associated event/ventilator-associated condition constructs detected less than a third of ventilator-associated pneumonia cases with a sensitivity of 0.325 and a positive predictive value of 0.07. Most National Health Safety Network ventilator-associated event/ventilator-associated condition cases (93%) did not have ventilator-associated pneumonia or other hospital-acquired complications; 71% met the definition for acute respiratory distress syndrome. Similarly, most patients with National Health Safety Network probable ventilator-associated pneumonia did not have ventilator-associated pneumonia because radiographic criteria were not met. National Health Safety Network ventilator-associated event/ventilator-associated condition rates were reduced 93% by an unsophisticated manipulation of ventilator management protocols. The National Health Safety Network ventilator-associated event/ventilator-associated condition constructs failed to detect many patients who had ventilator-associated pneumonia, detected many cases that did not have a hospital complication, and were susceptible to manipulation. National Health Safety Network ventilator-associated event/ventilator-associated condition surveillance did not perform as well as ventilator-associated pneumonia surveillance and had several undesirable characteristics.

Anaesthesia ventilators.

PubMed

Jain, Rajnish K; Swaminathan, Srinivasan

2013-09-01

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

Evaluation of ventilators for mouthpiece ventilation in neuromuscular disease.

PubMed

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

2014-09-01

Daytime mouthpiece ventilation is a useful adjunct to nocturnal noninvasive ventilation (NIV) in patients with neuromuscular disease. The aims of the study were to analyze the practice of mouthpiece ventilation and to evaluate the performance of ventilators for mouthpiece ventilation. Practice of mouthpiece ventilation was assessed by a questionnaire, and the performance of 6 home ventilators with mouthpiece ventilation was assessed in a bench test using 24 different conditions per ventilator: 3 mouthpieces, a child and an adult patient profile, and 4 ventilatory modes. Questionnaires were obtained from 30 subjects (mean age 33 ± 11 y) using NIV for 12 ± 7 y. Fifteen subjects used NIV for > 20 h/day, and 11 were totally ventilator-dependent. The subject-reported benefits of mouthpiece ventilation were a reduction in dyspnea (73%) and fatigue (93%) and an improvement in speech (43%) and eating (27%). The bench study showed that none of the ventilators, even those with mouthpiece ventilation software, were able to deliver mouthpiece ventilation without alarms and/or autotriggering in each condition. Alarms and/or ineffective triggering or autotriggering were observed in 135 of the 198 conditions. The occurrence of alarms was more common with a large mouthpiece without a filter compared to a small mouthpiece with a filter (P < .001), but it was not related to the patient profile, the ventilatory mode, or the type of ventilator. Subjects are satisfied with mouthpiece ventilation. Alarms are common with home ventilators, although less common in those with mouthpiece ventilation software. Improvements in home ventilators are needed to facilitate the expansion of mouthpiece ventilation. Copyright © 2014 by Daedalus Enterprises.

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

PubMed

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

2018-01-01

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

A new system for understanding modes of mechanical ventilation.

PubMed

Chatburn, R L; Primiano, F P

2001-06-01

Numerous ventilation modes and ventilation options have become available as new mechanical ventilators have reached the market. Ventilator manufacturers have no standardized terminology for ventilator modes and ventilation options, and ventilator operator's manuals do not help the clinician compare the modes of ventilators from different manufacturers. This article proposes a standardized system for classifying ventilation modes, based on general engineering principles and a small set of explicit definitions. Though there may be resistance by ventilator manufacturers to a standardized system of ventilation terminology, clinicians and health care equipment purchasers should adopt such a system in the interest of clear communication--the lack of which prevents clinicians from fully understanding the therapies they administer and could compromise the quality of patient care.

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

PubMed Central

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

2018-01-01

Background Few studies have investigated the difference in bacterial contamination between conventional reused ventilator systems and disposable closed ventilator-suction systems. The aim of this study was to investigate the bacterial contamination rates of the reused and disposable ventilator systems, and the association between system disconnection and bacterial contamination of ventilator systems. Methods The enrolled intubated and mechanically ventilated patients used a conventional reused ventilator system and a disposable closed ventilator-suction system, respectively, for a week; specimens were then collected from the ventilator circuit systems to evaluate human and environmental bacterial contamination. The sputum specimens from patients were also analyzed in this study. Results The detection rate of bacteria in the conventional reused ventilator system was substantially higher than that in the disposable ventilator system. The inspiratory and expiratory limbs of the disposable closed ventilator-suction system had higher bacterial concentrations than the conventional reused ventilator system. The bacterial concentration in the heated humidifier of the reused ventilator system was significantly higher than that in the disposable ventilator system. Positive associations existed among the bacterial concentrations at different locations in the reused and disposable ventilator systems, respectively. The predominant bacteria identified in the reused and disposable ventilator systems included Acinetobacter spp., Bacillus cereus, Elizabethkingia spp., Pseudomonas spp., and Stenotrophomonas (Xan) maltophilia. Conclusions Both the reused and disposable ventilator systems had high bacterial contamination rates after one week of use. Disconnection of the ventilator systems should be avoided during system operation to decrease the risks of environmental pollution and human exposure, especially for the disposable ventilator system. Trial registration ClinicalTrials.gov PRS / NCT03359148 PMID:29547638

Astronaut Russell Schweickart photographed during EVA

NASA Image and Video Library

1969-03-06

AS09-19-2994 (6 March 1969) --- Astronaut Russell L. Schweickart, lunar module pilot, is photographed from the Command Module (CM) "Gumdrop" during his extravehicular activity (EVA) on the fourth day of the Apollo 9 Earth-orbital mission. He holds, in his right hand, a thermal sample which he is retrieving from the Lunar Module (LM) exterior. The Command and Service Modules (CSM) and LM "Spider" are docked. Schweickart, wearing an Extravehicular Mobility Unit (EMU), is standing in "golden slippers" on the LM porch. Visible on his back are the Portable Life Support System (PLSS) and Oxygen Purge System (OPS). Astronaut James A. McDivitt, Apollo 9 commander, was inside the "Spider". Astronaut David R. Scott, command module pilot, remained at the controls in the CM "Gumdrop".

Extravehicular Activity (EVA) 101: Constellation EVA Systems

NASA Technical Reports Server (NTRS)

Jordan, Nicole C.

2007-01-01

A viewgraph presentation on Extravehicular Activity (EVA) Systems is shown. The topics include: 1) Why do we need space suits? 2) Protection From the Environment; 3) Primary Life Support System (PLSS); 4) Thermal Control; 5) Communications; 6) Helmet and Extravehicular Visor Assy; 7) Hard Upper Torso (HUT) and Arm Assy; 8) Display and Controls Module (DCM); 9) Gloves; 10) Lower Torso Assembly (LTA); 11) What Size Do You Need?; 12) Boot and Sizing Insert; 13) Boot Heel Clip and Foot Restraint; 14) Advanced and Crew Escape Suit; 15) Nominal & Off-Nominal Landing; 16) Gemini Program (mid-1960s); 17) Apollo EVA on Service Module; 18) A Bold Vision for Space Exploration, Authorized by Congress; 19) EVA System Missions; 20) Configurations; 21) Reduced Gravity Program; and 22) Other Opportunities.

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

PubMed

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

2016-08-01

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

High Performance Torso Cooling Garment

NASA Technical Reports Server (NTRS)

Conger, Bruce

2016-01-01

The concept proposed in this paper is to improve thermal efficiencies of the liquid cooling and ventilation garment (LCVG) in the torso area, which could facilitate removal of LCVG tubing from the arms and legs, thereby increasing suited crew member mobility. EVA space suit mobility in micro-gravity is challenging, and it becomes even more challenging in the gravity of Mars. By using shaped water tubes that greatly increase the contact area with the skin in the torso region of the body, the heat transfer efficiency can be increased. This increase in efficiency could provide the required liquid cooling via torso tubing only; no arm or leg LCVG tubing would be required. Benefits of this approach include increased crewmember mobility, reduced LCVG mass, enhanced evaporation cooling, increased comfort during Mars EVA tasks, and easing of the overly dry condition in the helmet associated with the Advanced Extravehicular Mobility Unit (EMU) ventilation loop currently under development. This report describes analysis and test activities performed to evaluate the potential improvements to the thermal performance of the LCVG. Analyses evaluated potential tube shapes for improving the thermal performance of the LCVG. The analysis results fed into the selection of flat flow strips to improve thermal contact with the skin of the suited test subject. Testing of small segments was performed to compare thermal performance of the tubing approach of the current LCVG to the flat flow strips proposed as the new concept. Results of the testing is presented along with recommendations for future development of this new concept.

High Performance Torso Cooling Garment

NASA Technical Reports Server (NTRS)

Conger, Bruce; Makinen, Janice

2016-01-01

The concept proposed in this paper is to improve thermal efficiencies of the liquid cooling and ventilation garment (LCVG) in the torso area, which could facilitate removal of LCVG tubing from the arms and legs, thereby increasing suited crew member mobility. EVA space suit mobility in micro-gravity is challenging, and it becomes even more challenging in the gravity of Mars. By using shaped water tubes that greatly increase the contact area with the skin in the torso region of the body, the heat transfer efficiency can be increased. This increase in efficiency could provide the required liquid cooling via torso tubing only; no arm or leg LCVG tubing would be required. Benefits of this approach include increased crewmember mobility, enhanced evaporation cooling, increased comfort during Mars EVA tasks, and easing of the overly dry condition in the helmet associated with the Advanced Extravehicular Mobility Unit (EMU) ventilation loop currently under development. This report describes analysis and test activities performed to evaluate the potential improvements to the thermal performance of the LCVG. Analyses evaluated potential tube shapes for improving the thermal performance of the LCVG. The analysis results fed into the selection of flat flow strips to improve thermal contact with the skin of the suited test subject. Testing of small segments was performed to compare thermal performance of the tubing approach of the current LCVG to the flat flow strips proposed as the new concept. Results of the testing is presented along with recommendations for future development of this new concept.

Determination of the intersegmental plane using the slip-knot method

PubMed Central

Endoh, Makoto; Kato, Hirohisa; Suzuki, Jun; Watarai, Hikaru; Hamada, Akira; Suzuki, Katsuyuki; Nakahashi, Kenta; Sadahiro, Mitsuaki

2018-01-01

Background Visualization of intersegmental planes in the lung is desirable for precise anatomical lung segmentectomy. We developed the slip-knot method for creating inflation-deflation lines. This study aimed to assess relevant data for thoracoscopic segmentectomy performed using this method. Methods In the slip-knot method, the objective segmental bronchus is looped with a monofilament thread. One end of the thread is then pulled during temporary bilateral ventilation, causing the knot to slip toward the bronchus. Thereafter, bronchial ligation is tightened to block the outflow of segmental air, ensuring that the segment remains expanded while the other reserved segments collapse on resumption of unilateral ventilation. Data from 221 patients who underwent thoracoscopic pulmonary segmentectomy between 2010 and 2016 were analyzed. Results A total of 147 patients (67%) were indicated for the slip-knot method, and 74 cases (33%) were non-adaptive cases. Ninety six percent of 147 cases were well adapted to the slip-knot method, which allowed us to obtain good inflation-deflation line images to determine the intersegmental plane. The mean operative time was 171±51 min (range, 71–367 min). The mean duration of chest tube insertion was 1.5±1.2 days (range, 1–7 days). Three cases (2.0%) had prolonged air-leakage and one (0.7%) case had readmission for late air-leakage. Conclusions Our method enables determination of anatomical intersegmental planes using only one monofilament thread, thus facilitating thoracoscopic pulmonary anatomical segmentectomy. PMID:29785297

Are we fully utilizing the functionalities of modern operating room ventilators?

PubMed

Liu, Shujie; Kacmarek, Robert M; Oto, Jun

2017-12-01

The modern operating room ventilators have become very sophisticated and many of their features are comparable with those of an ICU ventilator. To fully utilize the functionality of modern operating room ventilators, it is important for clinicians to understand in depth the working principle of these ventilators and their functionalities. Piston ventilators have the advantages of delivering accurate tidal volume and certain flow compensation functions. Turbine ventilators have great ability of flow compensation. Ventilation modes are mainly volume-based or pressure-based. Pressure-based ventilation modes provide better leak compensation than volume-based. The integration of advanced flow generation systems and ventilation modes of the modern operating room ventilators enables clinicians to provide both invasive and noninvasive ventilation in perioperative settings. Ventilator waveforms can be used for intraoperative neuromonitoring during cervical spine surgery. The increase in number of new features of modern operating room ventilators clearly creates the opportunity for clinicians to optimize ventilatory care. However, improving the quality of ventilator care relies on a complete understanding and correct use of these new features. VIDEO ABSTRACT: http://links.lww.com/COAN/A47.

A randomised crossover comparison of mouth-to-face-shield ventilation and mouth-to-pocket-mask ventilation by surf lifeguards in a manikin.

PubMed

Adelborg, K; Bjørnshave, K; Mortensen, M B; Espeseth, E; Wolff, A; Løfgren, B

2014-07-01

Thirty surf lifeguards (mean (SD) age: 25.1 (4.8) years; 21 male, 9 female) were randomly assigned to perform 2 × 3 min of cardiopulmonary resuscitation on a manikin using mouth-to-face-shield ventilation (AMBU LifeKey) and mouth-to-pocket-mask ventilation (Laerdal Pocket Mask). Interruptions in chest compressions, effective ventilation (visible chest rise) ratio, tidal volume and inspiratory time were recorded. Interruptions in chest compressions per cycle were increased with mouth-to-face-shield ventilation (mean (SD) 8.6 (1.7) s) compared with mouth-to-pocket-mask ventilation (6.9 (1.2) s, p < 0.0001). The proportion of effective ventilations was less using mouth-to-face-shield ventilation (199/242 (82%)) compared with mouth-to-pocket-mask ventilation (239/240 (100%), p = 0.0002). Tidal volume was lower using mouth-to-face-shield ventilation (mean (SD) 0.36 (0.20) l) compared with mouth-to-pocket-mask ventilation (0.45 (0.20) l, p = 0.006). No differences in inspiratory times were observed between mouth-to-face-shield ventilation and mouth-to-pocket-mask ventilation. In conclusion, mouth-to-face-shield ventilation increases interruptions in chest compressions, reduces the proportion of effective ventilations and decreases delivered tidal volumes compared with mouth-to-pocket-mask ventilation. © 2014 The Association of Anaesthetists of Great Britain and Ireland.

[Neurally adjusted ventilatory assist (NAVA). A new mode of assisted mechanical ventilation].

PubMed

Moerer, O; Barwing, J; Quintel, M

2008-10-01

The aim of mechanical ventilation is to assure gas exchange while efficiently unloading the respiratory muscles and mechanical ventilation is an integral part of the care of patients with acute respiratory failure. Modern lung protective strategies of mechanical ventilation include low-tidal-volume ventilation and the continuation of spontaneous breathing which has been shown to be beneficial in reducing atelectasis and improving oxygenation. Poor patient-ventilator interaction is a major issue during conventional assisted ventilation. Neurally adjusted ventilator assist (NAVA) is a new mode of mechanical ventilation that uses the electrical activity of the diaphragm (EAdi) to control the ventilator. First experimental studies showed an improved patient-ventilator synchrony and an efficient unloading of the respiratory muscles. Future clinical studies will have to show that NAVA is of clinical advantage when compared to conventional modes of assisted mechanical ventilation. This review characterizes NAVA according to current publications on this topic.

Antibiotic therapy in ventilator-associated tracheobronchitis: a literature review.

PubMed

Alves, Abel Eduardo; Pereira, José Manuel

2018-03-01

The concept of ventilator-associated tracheobronchitis is controversial; its definition is not unanimously accepted and often overlaps with ventilator-associated pneumonia. Ventilator-associated tracheobronchitis has an incidence similar to that of ventilator-associated pneumonia, with a high prevalence of isolated multiresistant agents, resulting in an increase in the time of mechanical ventilation and hospitalization but without an impact on mortality. The performance of quantitative cultures may allow better diagnostic definition of tracheobronchitis associated with mechanical ventilation, possibly avoiding the overdiagnosis of this condition. One of the major difficulties in differentiating between ventilator-associated tracheobronchitis and ventilator-associated pneumonia is the exclusion of a pulmonary infiltrate by chest radiography; thoracic computed tomography, thoracic ultrasonography, or invasive specimen collection may also be required. The institution of systemic antibiotic therapy does not improve the clinical impact of ventilator-associated tracheobronchitis, particularly in reducing time of mechanical ventilation, hospitalization or mortality, despite the possible reduced progression to ventilator-associated pneumonia. However, there are doubts regarding the methodology used. Thus, considering the high prevalence of tracheobronchitis associated with mechanical ventilation, routine treatment of this condition would result in high antibiotic usage without clear benefits. However, we suggest the institution of antibiotic therapy in patients with tracheobronchitis associated with mechanical ventilation and septic shock and/or worsening of oxygenation, and other auxiliary diagnostic tests should be simultaneously performed to exclude ventilator-associated pneumonia. This review provides a better understanding of the differentiation between tracheobronchitis associated with mechanical ventilation and pneumonia associated with mechanical ventilation, which can significantly decrease the use of antibiotics in critically ventilated patients.

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

PubMed

Kimura, Fumiharu

2016-04-28

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

Epidemiology of Noninvasive Ventilation in Pediatric Cardiac ICUs.

PubMed

Romans, Ryan A; Schwartz, Steven M; Costello, John M; Chanani, Nikhil K; Prodhan, Parthak; Gazit, Avihu Z; Smith, Andrew H; Cooper, David S; Alten, Jeffrey; Mistry, Kshitij P; Zhang, Wenying; Donohue, Janet E; Gaies, Michael

2017-10-01

To describe the epidemiology of noninvasive ventilation therapy for patients admitted to pediatric cardiac ICUs and to assess practice variation across hospitals. Retrospective cohort study using prospectively collected clinical registry data. Pediatric Cardiac Critical Care Consortium clinical registry. Patients admitted to cardiac ICUs at PC4 hospitals. None. We analyzed all cardiac ICU encounters that included any respiratory support from October 2013 to December 2015. Noninvasive ventilation therapy included high flow nasal cannula and positive airway pressure support. We compared patient and, when relevant, perioperative characteristics of those receiving noninvasive ventilation to all others. Subgroup analysis was performed on neonates and infants undergoing major cardiovascular surgery. To examine duration of respiratory support, we created a casemix-adjustment model and calculated adjusted mean durations of total respiratory support (mechanical ventilation + noninvasive ventilation), mechanical ventilation, and noninvasive ventilation. We compared adjusted duration of support across hospitals. The cohort included 8,940 encounters from 15 hospitals: 3,950 (44%) received noninvasive ventilation and 72% were neonates and infants. Medical encounters were more likely to include noninvasive ventilation than surgical. In surgical neonates and infants, 2,032 (55%) received postoperative noninvasive ventilation. Neonates, extracardiac anomalies, single ventricle, procedure complexity, preoperative respiratory support, mechanical ventilation duration, and postoperative disease severity were associated with noninvasive ventilation therapy (p < 0.001 for all). Across hospitals, noninvasive ventilation use ranged from 32% to 65%, and adjusted mean noninvasive ventilation duration ranged from 1 to 4 days (3-d observed mean). Duration of total adjusted respiratory support was more strongly correlated with duration of mechanical ventilation compared with noninvasive ventilation (Pearson r = 0.93 vs 0.71, respectively). Noninvasive ventilation use is common in cardiac ICUs, especially in patients admitted for medical conditions, infants, and those undergoing high complexity surgery. We observed wide variation in noninvasive ventilation use across hospitals, though the primary driver of total respiratory support time seems to be duration of mechanical ventilation.

Interactive simulation system for artificial ventilation on the internet: virtual ventilator.

PubMed

Takeuchi, Akihiro; Abe, Tadashi; Hirose, Minoru; Kamioka, Koichi; Hamada, Atsushi; Ikeda, Noriaki

2004-12-01

To develop an interactive simulation system "virtual ventilator" that demonstrates the dynamics of pressure and flow in the respiratory system under the combination of spontaneous breathing, ventilation modes, and ventilator options. The simulation system was designed to be used by unexperienced health care professionals as a self-training tool. The system consists of a simulation controller and three modules: respiratory, spontaneous breath, and ventilator. The respiratory module models the respiratory system by three resistances representing the main airway, the right and left lungs, and two compliances also representing the right and left lungs. The spontaneous breath module generates inspiratory negative pressure produced by a patient. The ventilator module generates driving force of pressure or flow according to the combination of the ventilation mode and options. These forces are given to the respiratory module through the simulation controller. The simulation system was developed using HTML, VBScript (3000 lines, 100 kB) and ActiveX control (120 kB), and runs on Internet Explorer (5.5 or higher). The spontaneous breath is defined by a frequency, amplitude and inspiratory patterns in the spontaneous breath module. The user can construct a ventilation mode by setting a control variable, phase variables (trigger, limit, and cycle), and options. Available ventilation modes are: controlled mechanical ventilation (CMV), continuous positive airway pressure, synchronized intermittent mandatory ventilation (SIMV), pressure support ventilation (PSV), SIMV + PSV, pressure-controlled ventilation (PCV), pressure-regulated volume control (PRVC), proportional assisted ventilation, mandatory minute ventilation (MMV), bilevel positive airway pressure (BiPAP). The simulation system demonstrates in a graph and animation the airway pressure, flow, and volume of the respiratory system during mechanical ventilation both with and without spontaneous breathing. We developed a web application that demonstrated the respiratory mechanics and the basic theory of ventilation mode.

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vinogradskiy, Yevgeniy, E-mail: yevgeniy.vinogradskiy@ucdenver.edu; Koo, Phillip J.; Castillo, Richard

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

Impact of Room Ventilation Rates on Mouse Cage Ventilation and Microenvironment.

PubMed

Reeb, Carolyn K.; Jones, Robert B.; Bearg, David W.; Bedigian, Hendrick; Paigen, Beverly

1997-01-01

To assess the impact of room ventilation on animal cage microenvironment, intracage ventilation rate, temperature, humidity, and concentrations of carbon dioxide and ammonia were monitored in nonpressurized, bonnet-topped mouse cages. Cages on the top, middle, and bottom rows of a mouse rack were monitored at room ventilation rates of 0, 5, 10, and 20 air changes/h (ACH). Ventilation inside the animal cage increased somewhat from 12.8 to 18.9 ACH as room ventilation rate in- creased from 0 to 20 ACH, but the differences were not statistically significant, and most of the increase occurred in cages in the top row nearest to the fresh air supply. Cages containing mice had ventilation rate between 10 and 15 ACH even when room ventilation was reduced to 0 ACH; this ventilation is a result of the thermal heat load of the mice. After 6 days of soiled bedding, intracage ammonia concentration was c 3 ppm at all room ventilation rates and was not affected by increasing room ventilation. Temperature inside cages did not change with increasing ventilation. Humidity inside cages significantly decreased with increasing ventilation, from 55% relative humidity at 5 ACH to 36% relative humidity at 20 ACH. Carbon dioxide concentration decreased from 2,500 ppm to 1,900 ppm when ventilation rate increased from 5 ACH to 10 ACH, but no further significant decrease was observed at 20 ACH. In conclusion, increasing the room ventilation rate higher than 5 ACH did not result in significant improvements in the cage microenvironment.

Variable mechanical ventilation

PubMed Central

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

Effects of positive end-expiratory pressure and recruitment maneuvers in a ventilator-induced injury mouse model

PubMed Central

Franzi, Lisa M.; Linderholm, Angela L.; Last, Jerold A.; Adams, Jason Y.; Harper, Richart W.

2017-01-01

Background Positive-pressure mechanical ventilation is an essential therapeutic intervention, yet it causes the clinical syndrome known as ventilator-induced lung injury. Various lung protective mechanical ventilation strategies have attempted to reduce or prevent ventilator-induced lung injury but few modalities have proven effective. A model that isolates the contribution of mechanical ventilation on the development of acute lung injury is needed to better understand biologic mechanisms that lead to ventilator-induced lung injury. Objectives To evaluate the effects of positive end-expiratory pressure and recruitment maneuvers in reducing lung injury in a ventilator-induced lung injury murine model in short- and longer-term ventilation. Methods 5–12 week-old female BALB/c mice (n = 85) were anesthetized, placed on mechanical ventilation for either 2 hrs or 4 hrs with either low tidal volume (8 ml/kg) or high tidal volume (15 ml/kg) with or without positive end-expiratory pressure and recruitment maneuvers. Results Alteration of the alveolar-capillary barrier was noted at 2 hrs of high tidal volume ventilation. Standardized histology scores, influx of bronchoalveolar lavage albumin, proinflammatory cytokines, and absolute neutrophils were significantly higher in the high-tidal volume ventilation group at 4 hours of ventilation. Application of positive end-expiratory pressure resulted in significantly decreased standardized histology scores and bronchoalveolar absolute neutrophil counts at low- and high-tidal volume ventilation, respectively. Recruitment maneuvers were essential to maintain pulmonary compliance at both 2 and 4 hrs of ventilation. Conclusions Signs of ventilator-induced lung injury are evident soon after high tidal volume ventilation (as early as 2 hours) and lung injury worsens with longer-term ventilation (4 hrs). Application of positive end-expiratory pressure and recruitment maneuvers are protective against worsening VILI across all time points. Dynamic compliance can be used guide the frequency of recruitment maneuvers to help ameloriate ventilator-induced lung injury. PMID:29112971

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

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) ELECTRICAL ENGINEERING ELECTRIC SYSTEMS-GENERAL REQUIREMENTS Remote Stopping Systems § 111.103-1 Power ventilation systems except machinery space ventilation systems. Each power ventilation system must... 46 Shipping 4 2010-10-01 2010-10-01 false Power ventilation systems except machinery space...

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

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) ELECTRICAL ENGINEERING ELECTRIC SYSTEMS-GENERAL REQUIREMENTS Remote Stopping Systems § 111.103-1 Power ventilation systems except machinery space ventilation systems. Each power ventilation system must... 46 Shipping 4 2011-10-01 2011-10-01 false Power ventilation systems except machinery space...

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

Code of Federal Regulations, 2014 CFR

2014-10-01

... (CONTINUED) ELECTRICAL ENGINEERING ELECTRIC SYSTEMS-GENERAL REQUIREMENTS Remote Stopping Systems § 111.103-1 Power ventilation systems except machinery space ventilation systems. Each power ventilation system must... 46 Shipping 4 2014-10-01 2014-10-01 false Power ventilation systems except machinery space...

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

Code of Federal Regulations, 2012 CFR

2012-10-01

... (CONTINUED) ELECTRICAL ENGINEERING ELECTRIC SYSTEMS-GENERAL REQUIREMENTS Remote Stopping Systems § 111.103-1 Power ventilation systems except machinery space ventilation systems. Each power ventilation system must... 46 Shipping 4 2012-10-01 2012-10-01 false Power ventilation systems except machinery space...

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

Code of Federal Regulations, 2013 CFR

2013-10-01

... (CONTINUED) ELECTRICAL ENGINEERING ELECTRIC SYSTEMS-GENERAL REQUIREMENTS Remote Stopping Systems § 111.103-1 Power ventilation systems except machinery space ventilation systems. Each power ventilation system must... 46 Shipping 4 2013-10-01 2013-10-01 false Power ventilation systems except machinery space...

A regulator for pressure-controlled total-liquid ventilation.

PubMed

Robert, Raymond; Micheau, Philippe; Avoine, Olivier; Beaudry, Benoit; Beaulieu, Alexandre; Walti, Hervé

2010-09-01

Total-liquid ventilation (TLV) is an innovative experimental method of mechanical-assisted ventilation in which lungs are totally filled and then ventilated with a tidal volume of perfluorochemical liquid by using a dedicated liquid ventilator. Such a novel medical device must resemble other conventional ventilators: it must be able to conduct controlled-pressure ventilation. The objective was to design a robust controller to perform pressure-regulated expiratory flow and to implement it on our latest liquid-ventilator prototype (Inolivent-4). Numerical simulations, in vitro experiments, and in vivo experiments in five healthy term newborn lambs have demonstrated that it was efficient to generate expiratory flows while avoiding collapses. Moreover, the in vivo results have demonstrated that our liquid ventilator can maintain adequate gas exchange, normal acid-base equilibrium, and achieve greater minute ventilation, better oxygenation and CO2 extraction, while nearing flow limits. Hence, it is our suggestion to perform pressure-controlled ventilation during expiration with minute ventilation equal or superior to 140 mL x min(-1) x kg(-1) in order to ensure PaCO2 below 55 mmHg. From a clinician's point of view, pressure-controlled ventilation greatly simplifies the use of the liquid ventilator, which will certainly facilitate its introduction in intensive care units for clinical applications.

[Anesthesia ventilators].

PubMed

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

1997-01-01

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

Ventilation practices in the neonatal intensive care unit: a cross-sectional study.

PubMed

van Kaam, Anton H; Rimensberger, Peter C; Borensztajn, Dorine; De Jaegere, Anne P

2010-11-01

To assess current ventilation practices in newborn infants. We conducted a 2-point cross-sectional study in 173 European neonatal intensive care units, including 535 infants (mean gestational age 28 weeks and birth weight 1024 g). Patient characteristics, ventilator settings, and measurements were collected bedside from endotracheally ventilated infants. A total of 457 (85%) patients were conventionally ventilated. Time cycled pressure-limited ventilation was used in 59% of these patients, most often combined with synchronized intermittent mandatory ventilation (51%). Newer conventional ventilation modes like volume targeted and pressure support ventilation were used in, respectively, 9% and 7% of the patients. The mean tidal volume, measured in 84% of the conventionally ventilated patients, was 5.7 ± 2.3 ml/kg. The mean positive end-expiratory pressure was 4.5 ± 1.1 cmH(2)O and rarely exceeded 7 cmH(2)O. Time cycled pressure-limited ventilation is the most commonly used mode in neonatal ventilation. Tidal volumes are usually targeted between 4 to 7 mL/kg and positive end-expiratory pressure between 4 to 6 cmH(2)O. Newer ventilation modes are only used in a minority of patients. Copyright © 2010 Mosby, Inc. All rights reserved.

Differential lung ventilation via tracheostomy using two endotracheal tubes in an infant: a case report.

PubMed

Demirkol, Demet; Ataman, Yasemin; Gündoğdu, Gökhan

2017-09-08

This case report presents differential lung ventilation in an infant. The aim is to define an alternative technique for performing differential lung ventilation in children. To the best of our knowledge, this is the first report of this kind. A 4.2-kg, 2.5-month-old Asian boy was referred to our facility with refractory hypoxemia and hypercarbia due to asymmetric lung disease with atelectasis of the left lung and hyperinflation of the right lung. He was unresponsive to conventional ventilator strategies; different ventilator settings were required. To perform differential lung ventilation, two separate single-lumen endotracheal tubes were inserted into the main bronchus of each lung by tracheotomy; the tracheal tubes were attached to discrete ventilators. The left lung was ventilated with a lung salvage strategy using high-frequency oscillatory ventilation, and the right lung was ventilated with a lung-protective strategy using pressure-regulated volume control mode. Differential lung ventilation was performed successfully with this technique without complications. Differential lung ventilation may be a lifesaving procedure in select patients who have asymmetric lung disease. Inserting two single-lumen endotracheal tubes via tracheotomy for differential lung ventilation can be an effective and safe alternative method.

Effect of one-lung ventilation on end-tidal carbon dioxide during cardiopulmonary resuscitation in a pig model of cardiac arrest.

PubMed

Ryu, Dong Hyun; Jung, Yong Hun; Jeung, Kyung Woon; Lee, Byung Kook; Jeong, Young Won; Yun, Jong Geun; Lee, Dong Hun; Lee, Sung Min; Heo, Tag; Min, Yong Il

2018-01-01

Unrecognized endobronchial intubation frequently occurs after emergency intubation. However, no study has evaluated the effect of one-lung ventilation on end-tidal carbon dioxide (ETCO2) during cardiopulmonary resuscitation (CPR). We compared the hemodynamic parameters, blood gases, and ETCO2 during one-lung ventilation with those during conventional two-lung ventilation in a pig model of CPR, to determine the effect of the former on ETCO2. A randomized crossover study was conducted in 12 pigs intubated with double-lumen endobronchial tube to achieve lung separation. During CPR, the animals underwent three 5-min ventilation trials based on a randomized crossover design: left-lung, right-lung, or two-lung ventilation. Arterial blood gases were measured at the end of each ventilation trial. Ventilation was provided using the same tidal volume throughout the ventilation trials. Comparison using generalized linear mixed model revealed no significant group effects with respect to aortic pressure, coronary perfusion pressure, and carotid blood flow; however, significant group effect in terms of ETCO2 was found (P < 0.001). In the post hoc analyses, ETCO2 was lower during the right-lung ventilation than during the two-lung (P = 0.006) or left-lung ventilation (P < 0.001). However, no difference in ETCO2 was detected between the left-lung and two-lung ventilations. The partial pressure of arterial carbon dioxide (PaCO2), partial pressure of arterial oxygen (PaO2), and oxygen saturation (SaO2) differed among the three types of ventilation (P = 0.003, P = 0.001, and P = 0.001, respectively). The post hoc analyses revealed a higher PaCO2, lower PaO2, and lower SaO2 during right-lung ventilation than during two-lung or left-lung ventilation. However, the levels of these blood gases did not differ between the left-lung and two-lung ventilations. In a pig model of CPR, ETCO2 was significantly lower during right-lung ventilation than during two-lung ventilation. However, interestingly, ETCO2 during left-lung ventilation was comparable to that during two-lung ventilation.

Protective mechanical ventilation in United Kingdom critical care units: A multicentre audit

PubMed Central

Martin, Matthew J; Richardson, Neil; Bourdeaux, Christopher P

2016-01-01

Lung protective ventilation is becoming increasingly used for all critically ill patients being mechanically ventilated on a mandatory ventilator mode. Compliance with the universal application of this ventilation strategy in intensive care units in the United Kingdom is unknown. This 24-h audit of ventilation practice took place in 16 intensive care units in two regions of the United Kingdom. The mean tidal volume for all patients being ventilated on a mandatory ventilator mode was 7.2(±1.4) ml kg−1 predicted body weight and overall compliance with low tidal volume ventilation (≤6.5 ml kg−1 predicted body weight) was 34%. The mean tidal volume for patients ventilated with volume-controlled ventilation was 7.0(±1.2) ml kg−1 predicted body weight and 7.9(±1.8) ml kg−1 predicted body weight for pressure-controlled ventilation (P < 0.0001). Overall compliance with recommended levels of positive end-expiratory pressure was 72%. Significant variation in practice existed both at a regional and individual unit level. PMID:28979556

Protective mechanical ventilation in United Kingdom critical care units: A multicentre audit.

PubMed

Newell, Christopher P; Martin, Matthew J; Richardson, Neil; Bourdeaux, Christopher P

2017-05-01

Lung protective ventilation is becoming increasingly used for all critically ill patients being mechanically ventilated on a mandatory ventilator mode. Compliance with the universal application of this ventilation strategy in intensive care units in the United Kingdom is unknown. This 24-h audit of ventilation practice took place in 16 intensive care units in two regions of the United Kingdom. The mean tidal volume for all patients being ventilated on a mandatory ventilator mode was 7.2(±1.4) ml kg -1 predicted body weight and overall compliance with low tidal volume ventilation (≤6.5 ml kg -1 predicted body weight) was 34%. The mean tidal volume for patients ventilated with volume-controlled ventilation was 7.0(±1.2) ml kg -1 predicted body weight and 7.9(±1.8) ml kg -1 predicted body weight for pressure-controlled ventilation ( P  < 0.0001). Overall compliance with recommended levels of positive end-expiratory pressure was 72%. Significant variation in practice existed both at a regional and individual unit level.

Clinical challenges in mechanical ventilation.

PubMed

Goligher, Ewan C; Ferguson, Niall D; Brochard, Laurent J

2016-04-30

Mechanical ventilation supports gas exchange and alleviates the work of breathing when the respiratory muscles are overwhelmed by an acute pulmonary or systemic insult. Although mechanical ventilation is not generally considered a treatment for acute respiratory failure per se, ventilator management warrants close attention because inappropriate ventilation can result in injury to the lungs or respiratory muscles and worsen morbidity and mortality. Key clinical challenges include averting intubation in patients with respiratory failure with non-invasive techniques for respiratory support; delivering lung-protective ventilation to prevent ventilator-induced lung injury; maintaining adequate gas exchange in severely hypoxaemic patients; avoiding the development of ventilator-induced diaphragm dysfunction; and diagnosing and treating the many pathophysiological mechanisms that impair liberation from mechanical ventilation. Personalisation of mechanical ventilation based on individual physiological characteristics and responses to therapy can further improve outcomes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Feasibility of Suited 10-km Ambulation "Walkback" on the Moon

NASA Technical Reports Server (NTRS)

Norcross, Jason; Lee, Lesley; DeWitt, John K.; Klein, Jill; Wessell, James; Gernhardt, Michael L.

2008-01-01

This viewgraph presentation reviews a study that examined the feasibility of having astronauts walk about 10 kilometers to the base in the event of a breakdown of the lunar rover. This was done in part to examine the possibility of having a single rover on the lunar exploration missions. Other objectives of the study are to: (1) Understand specific biomedical and human performance limitations of the suit compared to matched shirt-sleeve controls; (2) Collect metabolic and ground-reaction force data to develop an EVA simulator for use on future prebr eathe protocol verification tests (3) Provide data to estimate consum ables usage for input to suit and portable life support system (PLSS) design (4) Assess the cardiovascular and resistance exercise associa ted with partialgravity EVA for planning appropriate exploration exer cise countermeasures

Novel and lost forests in the Upper Midwestern United States, from new estimates of settlement-era composition, stem density, and biomass

USGS Publications Warehouse

Goring, Simon; Mladenoff, David J.; Cogbill, Charles; Record, Sydne; Paciorek, Christopher J.; Dietze, Michael C.; Dawson, Andria; Matthes, Jaclyn; McLachlan, Jason S.; Williams, John W.

2016-01-01

EuroAmerican land-use and its legacies have transformed forest structure and composition across the United States (US). More accurate reconstructions of historical states are critical to understanding the processes governing past, current, and future forest dynamics. Here we present new gridded (8x8km) reconstructions of pre-settlement (1800s) forest composition and structure from the upper Midwestern US (Minnesota, Wisconsin, and most of Michigan), using 19th Century Public Land Survey System (PLSS), with estimates of relative composition, above-ground biomass, stem density, and basal area for 28 tree types. This mapping is more robust than past efforts, using spatially varying correction factors to accommodate sampling design, azimuthal censoring, and biases in tree selection.

Improved oxygenation 24 hours after transition to airway pressure release ventilation or high-frequency oscillatory ventilation accurately discriminates survival in immunocompromised pediatric patients with acute respiratory distress syndrome*.

PubMed

Yehya, Nadir; Topjian, Alexis A; Thomas, Neal J; Friess, Stuart H

2014-05-01

Children with an immunocompromised condition and requiring invasive mechanical ventilation have high risk of death. Such patients are commonly transitioned to rescue modes of nonconventional ventilation, including airway pressure release ventilation and high-frequency oscillatory ventilation, for acute respiratory distress syndrome refractory to conventional ventilation. Our aim was to describe our experience with airway pressure release ventilation and high-frequency oscillatory ventilation in children with an immunocompromised condition and acute respiratory distress syndrome refractory to conventional ventilation and to identify factors associated with survival. Retrospective cohort study. Tertiary care, university-affiliated PICU. Sixty pediatric patients with an immunocompromised condition and acute respiratory distress syndrome refractory to conventional ventilation transitioned to either airway pressure release ventilation or high-frequency oscillatory ventilation. None. Demographic data, ventilator settings, arterial blood gases, oxygenation index, and PaO(2)/FIO(2) were recorded before transition to either mode of nonconventional ventilation and at predetermined intervals after transition for up to 5 days. Mortality in the entire cohort was 63% and did not differ between patients transitioned to airway pressure release ventilation and high-frequency oscillatory ventilation. For both airway pressure release ventilation and high-frequency oscillatory ventilation, improvements in oxygenation index and PaO(2)/FIO(2) at 24 hours expressed as a fraction of pretransition values (oxygenation index(24)/oxygenation index(pre) and PaO(2)/FIO(224)/PaO(2)/FIO(2pre)) reliably discriminated nonsurvivors from survivors, with receiver operating characteristic areas under the curves between 0.89 and 0.95 (p for all curves < 0.001). Sensitivity-specificity analysis suggested that less than 15% reduction in oxygenation index (90% sensitive, 75% specific) or less than 90% increase in PaO(2)/FIO(2) (80% sensitive, 94% specific) 24 hours after transition to airway pressure release ventilation were the optimal cutoffs to identify nonsurvivors. The comparable values 24 hours after transition to high-frequency oscillatory ventilation were less than 5% reduction in oxygenation index (100% sensitive, 83% specific) or less than 80% increase in PaO(2)/FIO(2) (91% sensitive, 89% specific) to identify nonsurvivors. In this single-center retrospective study of pediatric patients with an immunocompromised condition and acute respiratory distress syndrome failing conventional ventilation transitioned to either airway pressure release ventilation or high-frequency oscillatory ventilation, improved oxygenation at 24 hours expressed as PaO(2)/FIO(224)/PaO(2)/FIO(2pre) or oxygenation index(24)/oxygenation indexpre reliably discriminates nonsurvivors from survivors. These findings should be prospectively verified.

GENERAL VIEW SHOWING VENTILATOR NUMBER NINE. THIS VENTILATOR IS SLIGHTLY ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

GENERAL VIEW SHOWING VENTILATOR NUMBER NINE. THIS VENTILATOR IS SLIGHTLY MORE ORNATE THAN WAS GENERALLY USED BECAUSE OF ITS LOCATION - Old Croton Aqueduct, Ventilator Number 9, Spring & Everett Streets, Ossining, Westchester County, NY

Clinical Validation of 4-Dimensional Computed Tomography Ventilation With Pulmonary Function Test Data

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brennan, Douglas; Schubert, Leah; Diot, Quentin

Purpose: A new form of functional imaging has been proposed in the form of 4-dimensional computed tomography (4DCT) ventilation. Because 4DCTs are acquired as part of routine care for lung cancer patients, calculating ventilation maps from 4DCTs provides spatial lung function information without added dosimetric or monetary cost to the patient. Before 4DCT-ventilation is implemented it needs to be clinically validated. Pulmonary function tests (PFTs) provide a clinically established way of evaluating lung function. The purpose of our work was to perform a clinical validation by comparing 4DCT-ventilation metrics with PFT data. Methods and Materials: Ninety-eight lung cancer patients withmore » pretreatment 4DCT and PFT data were included in the study. Pulmonary function test metrics used to diagnose obstructive lung disease were recorded: forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity. Four-dimensional CT data sets and spatial registration were used to compute 4DCT-ventilation images using a density change–based and a Jacobian-based model. The ventilation maps were reduced to single metrics intended to reflect the degree of ventilation obstruction. Specifically, we computed the coefficient of variation (SD/mean), ventilation V20 (volume of lung ≤20% ventilation), and correlated the ventilation metrics with PFT data. Regression analysis was used to determine whether 4DCT ventilation data could predict for normal versus abnormal lung function using PFT thresholds. Results: Correlation coefficients comparing 4DCT-ventilation with PFT data ranged from 0.63 to 0.72, with the best agreement between FEV1 and coefficient of variation. Four-dimensional CT ventilation metrics were able to significantly delineate between clinically normal versus abnormal PFT results. Conclusions: Validation of 4DCT ventilation with clinically relevant metrics is essential. We demonstrate good global agreement between PFTs and 4DCT-ventilation, indicating that 4DCT-ventilation provides a reliable assessment of lung function. Four-dimensional CT ventilation enables exciting opportunities to assess lung function and create functional avoidance radiation therapy plans. The present work provides supporting evidence for the integration of 4DCT-ventilation into clinical trials.« less

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Patton, T; Du, K; Bayouth, J

Purpose: Ventilation change caused by radiation therapy (RT) can be predicted using four-dimensional computed tomography (4DCT) and image registration. This study tested the dependency of predicted post-RT ventilation on effort correction and pre-RT lung function. Methods: Pre-RT and 3 month post-RT 4DCT images were obtained for 13 patients. The 4DCT images were used to create ventilation maps using a deformable image registration based Jacobian expansion calculation. The post-RT ventilation maps were predicted in four different ways using the dose delivered, pre-RT ventilation, and effort correction. The pre-RT ventilation and effort correction were toggled to determine dependency. The four different predictedmore » ventilation maps were compared to the post-RT ventilation map calculated from image registration to establish the best prediction method. Gamma pass rates were used to compare the different maps with the criteria of 2mm distance-to-agreement and 6% ventilation difference. Paired t-tests of gamma pass rates were used to determine significant differences between the maps. Additional gamma pass rates were calculated using only voxels receiving over 20 Gy. Results: The predicted post-RT ventilation maps were in agreement with the actual post-RT maps in the following percentage of voxels averaged over all subjects: 71% with pre-RT ventilation and effort correction, 69% with no pre-RT ventilation and effort correction, 60% with pre-RT ventilation and no effort correction, and 58% with no pre-RT ventilation and no effort correction. When analyzing only voxels receiving over 20 Gy, the gamma pass rates were respectively 74%, 69%, 65%, and 55%. The prediction including both pre- RT ventilation and effort correction was the only prediction with significant improvement over using no prediction (p<0.02). Conclusion: Post-RT ventilation is best predicted using both pre-RT ventilation and effort correction. This is the only prediction that provided a significant improvement on agreement. Research support from NIH grants CA166119 and CA166703, a gift from Roger Koch, and a Pilot Grant from University of Iowa Carver College of Medicine.« less

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

PubMed

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

2011-05-01

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

Analysis of radon reduction and ventilation systems in uranium mines in China.

PubMed

Hu, Peng-hua; Li, Xian-jie

2012-09-01

Mine ventilation is the most important way of reducing radon in uranium mines. At present, the radon and radon progeny levels in Chinese uranium mines where the cut and fill stoping method is used are 3-5 times higher than those in foreign uranium mines, as there is not much difference in the investments for ventilation protection between Chinese uranium mines and international advanced uranium mines with compaction methodology. In this paper, through the analysis of radon reduction and ventilation systems in Chinese uranium mines and the comparison of advantages and disadvantages between a variety of ventilation systems in terms of radon control, the authors try to illustrate the reasons for the higher radon and radon progeny levels in Chinese uranium mines and put forward some problems in three areas, namely the theory of radon control and ventilation systems, radon reduction ventilation measures and ventilation management. For these problems, this paper puts forward some proposals regarding some aspects, such as strengthening scrutiny, verifying and monitoring the practical situation, making clear ventilation plans, strictly following the mining sequence, promoting training of ventilation staff, enhancing ventilation system management, developing radon reduction ventilation technology, purchasing ventilation equipment as soon as possible in the future, and so on.

1. GENERAL VIEW SHOWING VENTILATOR NO. 9. THIS VENTILATOR IS ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

1. GENERAL VIEW SHOWING VENTILATOR NO. 9. THIS VENTILATOR IS SLIGHTLY MORE ORNATE THAN WAS GENERALLY USED BECAUSE OF ITS LOCATION. - Old Croton Aqueduct, Ventilator Number 9, Spring & Everett Streets, Ossining, Westchester County, NY

Optimal ventilation of the anesthetized pediatric patient.

PubMed

Feldman, Jeffrey M

2015-01-01

Mechanical ventilation of the pediatric patient is challenging because small changes in delivered volume can be a significant fraction of the intended tidal volume. Anesthesia ventilators have traditionally been poorly suited to delivering small tidal volumes accurately, and pressure-controlled ventilation has become used commonly when caring for pediatric patients. Modern anesthesia ventilators are designed to deliver small volumes accurately to the patient's airway by compensating for the compliance of the breathing system and delivering tidal volume independent of fresh gas flow. These technology advances provide the opportunity to implement a lung-protective ventilation strategy in the operating room based upon control of tidal volume. This review will describe the capabilities of the modern anesthesia ventilator and the current understanding of lung-protective ventilation. An optimal approach to mechanical ventilation for the pediatric patient is described, emphasizing the importance of using bedside monitors to optimize the ventilation strategy for the individual patient.

46 CFR 32.60-20 - Pumprooms on tank vessels carrying Grade A, B, C, D and/or E liquid cargo-TB/ALL.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... Ventilation from the weather deck shall be provided. Power supply ventilation may be fitted in lieu of natural... not exceed 500 °F. (b) Ventilation for pumprooms on tank vessels the construction or conversion of... with power ventilation. Pumprooms equipped with power ventilation shall have the ventilation outlets...

Effect of flashlight guidance on manual ventilation performance in cardiopulmonary resuscitation: A randomized controlled simulation study.

PubMed

Kim, Ji Hoon; Beom, Jin Ho; You, Je Sung; Cho, Junho; Min, In Kyung; Chung, Hyun Soo

2018-01-01

Several auditory-based feedback devices have been developed to improve the quality of ventilation performance during cardiopulmonary resuscitation (CPR), but their effectiveness has not been proven in actual CPR situations. In the present study, we investigated the effectiveness of visual flashlight guidance in maintaining high-quality ventilation performance. We conducted a simulation-based, randomized, parallel trial including 121 senior medical students. All participants were randomized to perform ventilation during 2 minutes of CPR with or without flashlight guidance. For each participant, we measured mean ventilation rate as a primary outcome and ventilation volume, inspiration velocity, and ventilation interval as secondary outcomes using a computerized device system. Mean ventilation rate did not significantly differ between flashlight guidance and control groups (P = 0.159), but participants in the flashlight guidance group exhibited significantly less variation in ventilation rate than participants in the control group (P<0.001). Ventilation interval was also more regular among participants in the flashlight guidance group. Our results demonstrate that flashlight guidance is effective in maintaining a constant ventilation rate and interval. If confirmed by further studies in clinical practice, flashlight guidance could be expected to improve the quality of ventilation performed during CPR.

Effects of Multiple Ventilation Courses and Duration of Mechanical Ventilation on Respiratory Outcomes in Extremely Low-Birth-Weight Infants.

PubMed

Jensen, Erik A; DeMauro, Sara B; Kornhauser, Michael; Aghai, Zubair H; Greenspan, Jay S; Dysart, Kevin C

2015-11-01

Extubation failure is common in extremely preterm infants. The current paucity of data on the adverse long-term respiratory outcomes associated with reinitiation of mechanical ventilation prevents assessment of the risks and benefits of a trial of extubation in this population. To evaluate whether exposure to multiple courses of mechanical ventilation increases the risk of adverse respiratory outcomes before and after adjustment for the cumulative duration of mechanical ventilation. We performed a retrospective cohort study of extremely low-birth-weight (ELBW; birth weight <1000 g) infants born from January 1, 2006, through December 31, 2012, who were receiving mechanical ventilation. Analysis was conducted between November 2014 and February 2015. Data were obtained from the Alere Neonatal Database. The primary study exposures were the cumulative duration of mechanical ventilation and the number of ventilation courses. The primary outcome was bronchopulmonary dysplasia (BPD) among survivors. Secondary outcomes were death, use of supplemental oxygen at discharge, and tracheostomy. We identified 3343 ELBW infants, of whom 2867 (85.8%) survived to discharge. Among the survivors, 1695 (59.1%) were diagnosed as having BPD, 856 (29.9%) received supplemental oxygen at discharge, and 31 (1.1%) underwent tracheostomy. Exposure to a greater number of mechanical ventilation courses was associated with a progressive increase in the risk of BPD and use of supplemental oxygen at discharge. Compared with a single ventilation course, the adjusted odds ratios for BPD ranged from 1.88 (95% CI, 1.54-2.31) among infants with 2 ventilation courses to 3.81 (95% CI, 2.88-5.04) among those with 4 or more courses. After adjustment for the cumulative duration of mechanical ventilation, the odds of BPD were only increased among infants exposed to 4 or more ventilation courses (adjusted odds ratio, 1.44; 95% CI, 1.04-2.01). The number of ventilation courses was not associated with increased risk of supplemental oxygen use at discharge after adjustment for the length of ventilation. A greater number of ventilation courses did not increase the risk of tracheostomy. Among ELBW infants, a longer cumulative duration of mechanical ventilation largely accounts for the increased risk of chronic respiratory morbidity associated with reinitiation of mechanical ventilation. These results support attempts of extubation in ELBW infants receiving mechanical ventilation on low ventilator settings, even when success is not guaranteed.

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

PubMed

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 < 0.05). Higher endotracheal tube and tracheal deposition was observed during pressure support ventilation (27.4 ± 6.6 vs. 20.7 ± 6.0 %, p < 0.05). A similar penetration index was observed for the right (p = 0.210) and the left lung (p = 0.211) with both 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.

Association Between Noninvasive Ventilation and Mortality Among Older Patients With Pneumonia

PubMed Central

Valley, Thomas S.; Walkey, Allan J.; Lindenauer, Peter K.; Wiener, Renda Soylemez; Cooke, Colin R.

2016-01-01

Objective Despite increasing use, evidence is mixed as to the appropriate use of noninvasive ventilation in patients with pneumonia. We aimed to determine the relationship between receipt of noninvasive ventilation and outcomes for patients with pneumonia in a real-world setting. Design, Setting, Patients We performed a retrospective cohort study of Medicare beneficiaries (aged > 64 yr) admitted to 2,757 acute-care hospitals in the United States with pneumonia, who received mechanical ventilation from 2010 to 2011. Exposures Noninvasive ventilation versus invasive mechanical ventilation. Measurement and Main Results The primary outcome was 30-day mortality with Medicare reimbursement as a secondary outcome. To account for unmeasured confounding associated with noninvasive ventilation use, an instrumental variable was used—the differential distance to a high noninvasive ventilation use hospital. All models were adjusted for patient and hospital characteristics to account for measured differences between groups. Among 65,747 Medicare beneficiaries with pneumonia who required mechanical ventilation, 12,480 (19%) received noninvasive ventilation. Patients receiving noninvasive ventilation were more likely to be older, male, white, rural-dwelling, have fewer comorbidities, and were less likely to be acutely ill as measured by organ failures. Results of the instrumental variable analysis suggested that, among marginal patients, receipt of noninvasive ventilation was not significantly associated with differences in 30-day mortality when compared with invasive mechanical ventilation (54% vs 55%; p = 0.92; 95% CI of absolute difference, –13.8 to 12.4) but was associated with significantly lower Medicare spending ($18,433 vs $27,051; p = 0.02). Conclusions Among Medicare beneficiaries hospitalized with pneumonia who received mechanical ventilation, noninvasive ventilation use was not associated with a real-world mortality benefit. Given the wide CIs, however, substantial harm associated with noninvasive ventilation could not be excluded. The use of noninvasive ventilation for patients with pneumonia should be cautioned, but targeted enrollment of marginal patients with pneumonia could enrich future randomized trials. PMID:27749319

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

PubMed

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

2001-08-01

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

Cardiorespiratory action of opioid/tachykinin agonist peptide hybrid in anaesthetized rats: Transduction pathways.

PubMed

Wojciechowski, Piotr; Szereda-Przestaszewska, Małgorzata; Lipkowski, Andrzej Wojciech

2017-09-05

AWL3106 composed of opioid (dermorphin) and tachykinin (substance P 7-11 ) pharmacophores is a new compound with high analgesic potency and markedly reduced ability to induce tolerance and dependence. The present study aimed to determine the respiratory and cardiovascular responses evoked by this peptide in urethane-chloralose anaesthetized, spontaneously breathing rats in the presence or absence of vagal connection. Intravenous injection of AWL3106 at a dose of 0.3μmol/kg in intact rats resulted in apnoea lasting 5.1 ± 0.7s. Breathing that followed was of diminished frequency (F) and augmented tidal volume (V T ) with no significant impact on minute ventilation. AWL3106-challenge induced biphasic fall in arterial blood pressure with no effect on heart rate. Midcervical and supranodosal sectioning the vagal nerves prevented the occurrence of the apnoea and abrogated the post-AWL3106 reduction in F but failed to eliminate the increase in V T . Hypotensive response appeared to be less profound following supranodose vagotomy. NaloxoneHCl abolished solely the occurrence of apnoea. However additional blockade of tachykinin NK 1 receptors with SR140333 was required to abolish V T increase, deceleration of breathing and to markedly suppress AWL3106-induced hypotension. The present study shows that extravagally controlled stimulation of V T maintains fairly regular ventilation by levelling the bradypnoeic effects. Although the peptide showed no cardiac effects, hypotension occurring beyond the vagal loop may limit future therapeutic benefits of this chimeric compound. Copyright © 2017 Elsevier B.V. All rights reserved.

Bench performance of ventilators during simulated paediatric ventilation.

PubMed

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

2013-05-01

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

Significant Improvements in Pyranometer Nighttime Offsets Using High-Flow DC Ventilation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Michalsky, Joseph J.; Kutchenreiter, Mark; Long, Charles N.

Ventilators are used to keep the domes of pyranometers clean and dry, but they affect the nighttime offset as well. This paper examines different ventilation strategies. For the several commercial single-black-detector pyranometers with ventilators examined here, high flow rate (50 CFM and higher), 12 VDC fans lower the offsets, lower the scatter, and improve the predictability of the offsets during the night compared with lower flow rate 35 CFM, 120 VAC fans operated in the same ventilator housings. Black-and-white pyranometers sometimes show improvement with DC ventilation, but in some cases DC ventilation makes the offsets slightly worse. Since the offsetsmore » for these black-and-white pyranometers are always small, usually no more than 1 Wm -2, whether AC or DC ventilated, changing their ventilation to higher CFM DC ventilation is not imperative. Future work should include all major manufacturers of pyranometers and unventilated, as well as, ventilated pyranometers. Lastly, an important outcome of future research will be to clarify under what circumstances nighttime data can be used to predict daytime offsets.« less

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Turner, William; Walker, Iain

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.more » ASHRAE Standard 62.2-2010 – the United States standard for residential ventilation - is used as the chronic standard, and exposure limits for PM 2.5, formaldehyde and NO 2 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.« less

Significant Improvements in Pyranometer Nighttime Offsets Using High-Flow DC Ventilation

DOE PAGES

Michalsky, Joseph J.; Kutchenreiter, Mark; Long, Charles N.

2017-06-20

Ventilators are used to keep the domes of pyranometers clean and dry, but they affect the nighttime offset as well. This paper examines different ventilation strategies. For the several commercial single-black-detector pyranometers with ventilators examined here, high flow rate (50 CFM and higher), 12 VDC fans lower the offsets, lower the scatter, and improve the predictability of the offsets during the night compared with lower flow rate 35 CFM, 120 VAC fans operated in the same ventilator housings. Black-and-white pyranometers sometimes show improvement with DC ventilation, but in some cases DC ventilation makes the offsets slightly worse. Since the offsetsmore » for these black-and-white pyranometers are always small, usually no more than 1 Wm -2, whether AC or DC ventilated, changing their ventilation to higher CFM DC ventilation is not imperative. Future work should include all major manufacturers of pyranometers and unventilated, as well as, ventilated pyranometers. Lastly, an important outcome of future research will be to clarify under what circumstances nighttime data can be used to predict daytime offsets.« less

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

PubMed

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%, equivalent to a $6500 increase in employee productivity each year. Reduced absenteeism and improved health are also seen with enhanced ventilation. The health benefits associated with enhanced ventilation rates far exceed the per-person energy costs relative to salary costs. Environmental impacts can be mitigated at regional, building, and individual-level scales through the transition to renewable energy sources, adoption of energy efficient systems and ventilation strategies, and promotion of other sustainable policies.

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

PubMed Central

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

2015-01-01

Introduction: 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. Methods: 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. Results: 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%, equivalent to a $6500 increase in employee productivity each year. Reduced absenteeism and improved health are also seen with enhanced ventilation. Conclusions: The health benefits associated with enhanced ventilation rates far exceed the per-person energy costs relative to salary costs. Environmental impacts can be mitigated at regional, building, and individual-level scales through the transition to renewable energy sources, adoption of energy efficient systems and ventilation strategies, and promotion of other sustainable policies. PMID:26593933

Using domiciliary non-invasive ventilator data downloads to inform clinical decision-making to optimise ventilation delivery and patient compliance

PubMed Central

Mansell, Stephanie K; Cutts, Steven; Hackney, Isobel; Wood, Martin J; Hawksworth, Kevin; Creer, Dean D; Kilbride, Cherry; Mandal, Swapna

2018-01-01

Introduction Ventilation parameter data from patients receiving home mechanical ventilation can be collected via secure data cards and modem technology. This can then be reviewed by clinicians and ventilator prescriptions adjusted. Typically available measures include tidal volume (VT), leak, respiratory rate, minute ventilation, patient triggered breaths, achieved pressures and patient compliance. This study aimed to assess the potential impact of ventilator data downloads on management of patients requiring home non-invasive ventilation (NIV). Methods A longitudinal within-group design with repeated measurements was used. Baseline ventilator data were downloaded, reviewed and adjustments made to optimise ventilation. Leak, VT and compliance data were collected for comparison at the first review and 3–7 weeks later. Ventilator data were monitored and amended remotely via a modem by a consultant physiotherapist between the first review and second appointment. Results Analysis of data from 52 patients showed increased patient compliance (% days used >4 hours) from 90% to 96% (p=0.007), increased usage from 6.53 to 6.94 hours (p=0.211) and a change in VT(9.4 vs 8.7 mL/kg/ideal body weight, p=0.022). There was no change in leak following review of NIV prescriptions (mean (SD): 43 (23.4) L/min vs 45 (19.9)L/min, p=0.272). Conclusion Ventilator data downloads, via early remote assessment, can help optimise patient ventilation through identification of modifiable factors, in particular interface leak and ventilator prescriptions. However, a prospective study is required to assess whether using ventilator data downloads provides value in terms of patient outcomes and cost-effectiveness. The presented data will help to inform the design of such a study. PMID:29531743

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

PubMed Central

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

2009-01-01

Objective To compare 13 commercially available, new-generation, intensive-care-unit (ICU) ventilators regarding trigger function, pressurization capacity during pressure-support ventilation (PSV), accuracy of pressure measurements and expiratory resistance. Design and Setting Bench study at a research laboratory in a university hospital. Material Four turbine-based ventilators and nine conventional servo-valve compressed-gas ventilators were tested using a two-compartment lung model. Results Three levels of effort were simulated. Each ventilator was evaluated at four PSV levels (5, 10, 15, and 20 cm H2O), with and without positive end-expiratory pressure (5 cm H2O, Trigger function was assessed as the time from effort onset to detectable pressurization. Pressurization capacity was evaluated using the airway pressure-time product computed as the net area under the pressure-time curve over the first 0.3 s after inspiratory effort onset. Expiratory resistance was evaluated by measuring trapped volume in controlled ventilation. Significant differences were found across the ventilators, with a range of triggering-delay from 42 ms to 88 ms for all conditions averaged (P<.001). Under difficult conditions, the triggering delay was longer than 100 ms and the pressurization was poor with five ventilators at PSV5 and three at PSV10, suggesting an inability to unload patient’s effort. On average, turbine-based ventilators performed better than conventional ventilators, which showed no improvement compared to a 2000 bench comparison. Conclusion Technical performances of trigger function, pressurization capacity and expiratory resistance vary considerably across new-generation ICU ventilators. ICU ventilators seem to have reached a technical ceiling in recent years, and some ventilators still perform inadequately. PMID:19352622

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

PubMed

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

2014-03-01

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

Academic Emergency Medicine Physicians' Knowledge of Mechanical Ventilation.

PubMed

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 ventilation.

Effects of types of ventilation system on indoor particle concentrations in residential buildings.

PubMed

Park, J S; Jee, N-Y; Jeong, J-W

2014-12-01

The objective of this study was to quantify the influence of ventilation systems on indoor particle concentrations in residential buildings. Fifteen occupied, single-family apartments were selected from three sites. The three sites have three different ventilation systems: unbalanced mechanical ventilation, balanced mechanical ventilation, and natural ventilation. Field measurements were conducted between April and June 2012, when outdoor air temperatures were comfortable. Number concentrations of particles, PM2.5 and CO2 , were continuously measured both outdoors and indoors. In the apartments with natural ventilation, I/O ratios of particle number concentrations ranged from 0.56 to 0.72 for submicron particles, and from 0.25 to 0.60 for particles larger than 1.0 μm. The daily average indoor particle concentration decreased to 50% below the outdoor level for submicron particles and 25% below the outdoor level for fine particles, when the apartments were mechanically ventilated. The two mechanical ventilation systems reduced the I/O ratios by 26% for submicron particles and 65% for fine particles compared with the natural ventilation. These results showed that mechanical ventilation can reduce exposure to outdoor particles in residential buildings. Results of this study confirm that mechanical ventilation with filtration can significantly reduce indoor particle levels compared with natural ventilation. The I/O ratios of particles substantially varied at the naturally ventilated apartments because of the influence of variable window opening conditions and unsteadiness of wind flow on the penetration of outdoor air particles. For better prediction of the exposure to outdoor particles in naturally ventilated residential buildings, it is important to understand the penetration of outdoor particles with variable window opening conditions. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

FiO2 delivered by a turbine portable ventilator with an oxygen concentrator in an Austere environment.

PubMed

Bordes, Julien; Erwan d'Aranda; Savoie, Pierre-Henry; Montcriol, Ambroise; Goutorbe, Philippe; Kaiser, Eric

2014-09-01

Management of critically ill patients in austere environments is a logistic challenge. Availability of oxygen cylinders for the mechanically ventilated patient may be difficult in such a context. A solution is to use a ventilator able to function with an oxygen concentrator. We tested the SeQual Integra™ (SeQual, San Diego, CA) 10-OM oxygen concentrator paired with the Pulmonetic System(®) LTV 1000 ventilator (Pulmonetic Systems, Minneapolis, MN) and evaluated the delivered fraction of inspired oxygen (FiO2) across a range of minute volumes and combinations of ventilator settings. Two LTV 1000 ventilators were tested. The ventilators were attached to a test lung and FiO2 was measured by a gas analyzer. Continuous-flow oxygen was generated by the OC from 0.5 L/min to 10 L/min and injected into the oxygen inlet port of the LTV 1000. Several combinations of ventilator settings were evaluated to determine the factors affecting the delivered FiO2. The LTV 1000 ventilator is a turbine ventilator that is able to deliver high FiO2 when functioning with an oxygen concentrator. However, modifications of the ventilator settings such as increase in minute ventilation affect delivered FiO2 even if oxygen flow is constant on the oxygen concentrator. The ability of an oxygen concentrator to deliver high FiO2 when used with a turbine ventilator makes this method of oxygen delivery a viable alternative to cylinders in austere environments when used with a turbine ventilator. However, FiO2 has to be monitored continuously because delivered FiO2 decreases when minute ventilation is increased. Copyright © 2014 Elsevier Inc. All rights reserved.

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

PubMed

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

2009-08-01

To compare 13 commercially available, new-generation, intensive-care-unit (ICU) ventilators in terms of trigger function, pressurization capacity during pressure-support ventilation (PSV), accuracy of pressure measurements, and expiratory resistance. Bench study at a research laboratory in a university hospital. Four turbine-based ventilators and nine conventional servo-valve compressed-gas ventilators were tested using a two-compartment lung model. Three levels of effort were simulated. Each ventilator was evaluated at four PSV levels (5, 10, 15, and 20 cm H2O), with and without positive end-expiratory pressure (5 cm H2O). Trigger function was assessed as the time from effort onset to detectable pressurization. Pressurization capacity was evaluated using the airway pressure-time product computed as the net area under the pressure-time curve over the first 0.3 s after inspiratory effort onset. Expiratory resistance was evaluated by measuring trapped volume in controlled ventilation. Significant differences were found across the ventilators, with a range of triggering delays from 42 to 88 ms for all conditions averaged (P < 0.001). Under difficult conditions, the triggering delay was longer than 100 ms and the pressurization was poor for five ventilators at PSV5 and three at PSV10, suggesting an inability to unload patient's effort. On average, turbine-based ventilators performed better than conventional ventilators, which showed no improvement compared to a bench comparison in 2000. Technical performance of trigger function, pressurization capacity, and expiratory resistance differs considerably across new-generation ICU ventilators. ICU ventilators seem to have reached a technical ceiling in recent years, and some ventilators still perform inadequately.

The comfort of breathing: a study with volunteers assessing the influence of various modes of assisted ventilation.

PubMed

Russell, W C; Greer, J R

2000-11-01

To assess the subjective feeling of comfort of healthy volunteers breathing on various modes of ventilation used in intensive care. A randomized, prospective, double-blinded, crossover trial using volunteers. An intensive care unit (ICU) in a teaching hospital. We compared, by using healthy volunteers, the subjective feeling of comfort of three modes of ventilation used during the weaning phase of critical illness. We used healthy volunteers to avoid other distracting influences of intensive care that may confound the primary feeling of comfort. The modes we compared were synchronized intermittent mandatory ventilation, assisted spontaneous breathing, and biphasic positive airway pressure. The imposed ventilation was comparable with 50% of the volunteers' normal respiratory effort. The volunteers breathed via a mouthpiece through a ventilator circuit, and the modes of ventilation were introduced in a randomized manner. We measured visual analog scores for comfort for the three modes of ventilation and collected a ranking order and open-ended comments. We demonstrated that at the level of support we imposed, assisted spontaneous breathing was the most comfortable mode of ventilation and that synchronized intermittent mandatory ventilation was the most uncomfortable. These results were strongly supported by both the ranking scale and comments of the volunteers. Assisted spontaneous breathing was the most comfortable mode of ventilation because the pattern was primarily determined by the volunteer. Synchronized intermittent mandatory ventilation was the most uncomfortable because the ventilatory pattern was imposed on the volunteers, leading to ventilator-volunteer dyssynchrony. We also conclude there is wide individual variation in the subjective feeling of comfort. Whereas the mode of ventilation in ICUs is based primarily on the physiologic needs of the patient, the feeling of comfort may be considered when choosing an appropriate mode of ventilation during the weaning phase of critical illness.

Oxidative lung injury correlates with one-lung ventilation time during pulmonary lobectomy: a study of exhaled breath condensate and blood.

PubMed

García-de-la-Asunción, José; García-del-Olmo, Eva; Perez-Griera, Jaume; Martí, Francisco; Galan, Genaro; Morcillo, Alfonso; Wins, Richard; Guijarro, Ricardo; Arnau, Antonio; Sarriá, Benjamín; García-Raimundo, Miguel; Belda, Javier

2015-09-01

During lung lobectomy, the operated lung is collapsed and hypoperfused; oxygen deprivation is accompanied by reactive hypoxic pulmonary vasoconstriction. After lung lobectomy, ischaemia present in the collapsed state is followed by expansion-reperfusion and lung injury attributed to the production of reactive oxygen species. The primary objective of this study was to investigate the time course of several markers of oxidative stress simultaneously in exhaled breath condensate and blood and to determine the relationship between oxidative stress and one-lung ventilation time in patients undergoing lung lobectomy. This single-centre, observational, prospective study included 28 patients with non-small-cell lung cancer who underwent lung lobectomy. We measured the levels of hydrogen peroxide, 8-iso-PGF2α, nitrites plus nitrates and pH in exhaled breath condensate (n = 25). The levels of 8-iso-PGF2α and nitrites plus nitrates were also measured in blood (n = 28). Blood samples and exhaled breath condensate samples were collected from all patients at five time points: preoperatively; during one-lung ventilation, immediately before resuming two-lung ventilation; immediately after resuming two-lung ventilation; 60 min after resuming two-lung ventilation and 180 min after resuming two-lung ventilation. Both exhaled breath condensate and blood exhibited significant and simultaneous increases in oxidative-stress markers immediately before two-lung ventilation was resumed. However, all these values underwent larger increases immediately after resuming two-lung ventilation. In both exhaled breath condensate and blood, marker levels significantly and directly correlated with the duration of one-lung ventilation immediately before resuming two-lung ventilation and immediately after resuming two-lung ventilation. Although pH significantly decreased in exhaled breath condensate immediately after resuming two-lung ventilation, these pH values were inversely correlated with the duration of one-lung ventilation. During lung lobectomy, the operated lung is collapsed and oxidative injury occurs, with the levels of markers of oxidative stress increasing simultaneously in exhaled breath condensate and blood during one-lung ventilation. These increases were larger after resuming two-lung ventilation. Increases immediately before resuming two-lung ventilation and immediately after resuming two-lung ventilation were directly correlated with the duration of one-lung ventilation. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

TH-E-BRF-02: 4D-CT Ventilation Image-Based IMRT Plans Are Dosimetrically Comparable to SPECT Ventilation Image-Based Plans

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kida, S; University of Tokyo Hospital, Bunkyo, Tokyo; Bal, M

Purpose: An emerging lung ventilation imaging method based on 4D-CT can be used in radiotherapy to selectively avoid irradiating highly-functional lung regions, which may reduce pulmonary toxicity. Efforts to validate 4DCT ventilation imaging have been focused on comparison with other imaging modalities including SPECT and xenon CT. The purpose of this study was to compare 4D-CT ventilation image-based functional IMRT plans with SPECT ventilation image-based plans as reference. Methods: 4D-CT and SPECT ventilation scans were acquired for five thoracic cancer patients in an IRB-approved prospective clinical trial. The ventilation images were created by quantitative analysis of regional volume changes (amore » surrogate for ventilation) using deformable image registration of the 4D-CT images. A pair of 4D-CT ventilation and SPECT ventilation image-based IMRT plans was created for each patient. Regional ventilation information was incorporated into lung dose-volume objectives for IMRT optimization by assigning different weights on a voxel-by-voxel basis. The objectives and constraints of the other structures in the plan were kept identical. The differences in the dose-volume metrics have been evaluated and tested by a paired t-test. SPECT ventilation was used to calculate the lung functional dose-volume metrics (i.e., mean dose, V20 and effective dose) for both 4D-CT ventilation image-based and SPECT ventilation image-based plans. Results: Overall there were no statistically significant differences in any dose-volume metrics between the 4D-CT and SPECT ventilation imagebased plans. For example, the average functional mean lung dose of the 4D-CT plans was 26.1±9.15 (Gy), which was comparable to 25.2±8.60 (Gy) of the SPECT plans (p = 0.89). For other critical organs and PTV, nonsignificant differences were found as well. Conclusion: This study has demonstrated that 4D-CT ventilation image-based functional IMRT plans are dosimetrically comparable to SPECT ventilation image-based plans, providing evidence to use 4D-CT ventilation imaging for clinical applications. Supported in part by Free to Breathe Young Investigator Research Grant and NIH/NCI R01 CA 093626. The authors thank Philips Radiation Oncology Systems for the Pinnacle3 treatment planning systems.« less

46 CFR 154.1200 - Mechanical ventilation system: General.

Code of Federal Regulations, 2010 CFR

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...

46 CFR 153.312 - Ventilation system standards.

Code of Federal Regulations, 2013 CFR

2013-10-01

... CARRYING BULK LIQUID, LIQUEFIED GAS, OR COMPRESSED GAS HAZARDOUS MATERIALS Design and Equipment Cargo Handling Space Ventilation § 153.312 Ventilation system standards. A cargo handling space ventilation... (approx. 32.8 ft) from openings into or ventilation intakes for, accommodation or service spaces. (b) A...

46 CFR 153.312 - Ventilation system standards.

Code of Federal Regulations, 2012 CFR

2012-10-01

... CARRYING BULK LIQUID, LIQUEFIED GAS, OR COMPRESSED GAS HAZARDOUS MATERIALS Design and Equipment Cargo Handling Space Ventilation § 153.312 Ventilation system standards. A cargo handling space ventilation... (approx. 32.8 ft) from openings into or ventilation intakes for, accommodation or service spaces. (b) A...

46 CFR 153.312 - Ventilation system standards.

Code of Federal Regulations, 2011 CFR

2011-10-01

... CARRYING BULK LIQUID, LIQUEFIED GAS, OR COMPRESSED GAS HAZARDOUS MATERIALS Design and Equipment Cargo Handling Space Ventilation § 153.312 Ventilation system standards. A cargo handling space ventilation... (approx. 32.8 ft) from openings into or ventilation intakes for, accommodation or service spaces. (b) A...

46 CFR 153.312 - Ventilation system standards.

Code of Federal Regulations, 2014 CFR

2014-10-01

... CARRYING BULK LIQUID, LIQUEFIED GAS, OR COMPRESSED GAS HAZARDOUS MATERIALS Design and Equipment Cargo Handling Space Ventilation § 153.312 Ventilation system standards. A cargo handling space ventilation... (approx. 32.8 ft) from openings into or ventilation intakes for, accommodation or service spaces. (b) A...

46 CFR 153.312 - Ventilation system standards.

Code of Federal Regulations, 2010 CFR

2010-10-01

... CARRYING BULK LIQUID, LIQUEFIED GAS, OR COMPRESSED GAS HAZARDOUS MATERIALS Design and Equipment Cargo Handling Space Ventilation § 153.312 Ventilation system standards. A cargo handling space ventilation... (approx. 32.8 ft) from openings into or ventilation intakes for, accommodation or service spaces. (b) A...

30 CFR 75.333 - Ventilation controls.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Ventilation controls. 75.333 Section 75.333... MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Ventilation § 75.333 Ventilation controls. (a) For... ventilation control devices constructed after November 15, 1992, shall be built and maintained— (1) Between...

30 CFR 75.333 - Ventilation controls.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Ventilation controls. 75.333 Section 75.333... MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Ventilation § 75.333 Ventilation controls. (a) For... ventilation control devices constructed after November 15, 1992, shall be built and maintained— (1) Between...

33 CFR 183.620 - Natural ventilation system.

Code of Federal Regulations, 2010 CFR

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...

33 CFR 183.620 - Natural ventilation system.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 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...

Composite materials for the extravehicular mobility unit

NASA Technical Reports Server (NTRS)

Barrera, Enrique V.; Tello, Hector M.

1992-01-01

The extravehicular mobility unit (EMU), commonly known as the astronaut space suit assembly (SSA) and primary life support system (PLSS), has evolved through the years to incorporate new and innovative materials in order to meet the demands of the space environment. The space shuttle program which is seeing an increasing level of extravehicular activity (EVA), also called space walks, along with interest in an EMU for Lunar-Mars missions means even more demanding conditions are being placed on the suit and PLSS. The project for this NASA-ASEE Summer Program was to investigate new materials for these applications. The focus was to emphasize the use of composite materials for every component of the EMU to enhance the properties while reducing the total weight of the EMU. To accomplish this, development of new materials called fullerene reinforced materials (FRM's) was initiated. Fullerenes are carbon molecules which when added to a material significantly reduce the weight of that material. The Faculty Fellow worked directly on the development of the fullerene reinforced materials. A chamber for fullerene production was designed and assembled and first generation samples were processed. He also supervised with the JSC Colleague, a study of composite materials for the EMU conducted by the student participant in the NASA-ASEE Program, Hector Tello a Rice University graduate student, and by a NASA Aerospace Technologist (Materials Engineer) Evelyne Orndoff, in the Systems Engineering Analysis Office (EC7), also a Rice University graduate student. Hector Tello conducted a study on beryllium and Be alloys and initiated a study of carbon and glass reinforced composites for space applications. Evelyne Orndoff compiled an inventory of the materials on the SSA. Ms. Orndoff also reviewed SSA material requirements and cited aspects of the SSA design where composite materials might be further considered. Hector Tello spent part of his time investigating the solar radiation sensitivity of anodic coatings. This project was directed toward the effects of ultra-violet radiation on high emissivity anodic coatings. The work of both Evelyne Orndoff and Hector Tello is of interest to the Engineering Directorate at NASA/JSC and is also directed toward their research as Rice University graduate students.

[Bellows or bag? Testing 10 ventilators and some medical history comments].

PubMed

Kötter, K P; Maleck, W H; Altmannsberger, S; Herchet, J; Petroianu, G A

1998-01-01

We compared a new bellows ventilator (Kendall Cardiovent) with two other bellows (Dräger Resutator 63, Tagg Breathsaver) and seven bag or ball ventilators (Aerodyne Hope, Ambu Mark 3, Ambu Silicon, Dräger Resutator 2000, Laerdal Resu, Mercury CPR, Weinmann Combibag). Tidal volumes were measured with two Laerdal Recording Resusci Annies, one lying on the floor, one in a bed. Twelve participants performed mask ventilation with all ten devices on both manikins for two minutes, trying to achieve tidal volumes of between 0.8 and 1.21 as recommended by the AHA. The last ten ventilations each on the graphic strips were analysed for volume. The participants scored handling of the devices on a 6-point scale (1 = very good, 6 = insufficient). The results of the Cardiovent were compared to those of the other devices by rank sum test (percentage of correct ventilations) and sign test (subjective handling). The Cardiovent provided exact ventilation with 95% of ventilations) on the floor and 78% of ventilations in bed in the recommended range. However, the percentage of correct ventilations with the Cardiovent was not significantly different to the other devices except for a lower percentage of correct ventilations with the Combibag in the in bed setting. Concerning subjective handling, the Cardiovent was significantly superior to several ball ventilators.

Temperature of gas delivered from ventilators.

PubMed

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

2013-01-01

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

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

PubMed

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

2018-02-21

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

Variability in usual care mechanical ventilation for pediatric acute lung injury: the potential benefit of a lung protective computer protocol.

PubMed

Khemani, Robinder G; Sward, Katherine; Morris, Alan; Dean, J Michael; Newth, Christopher J L

2011-11-01

Although pediatric intensivists claim to embrace lung protective ventilation for acute lung injury (ALI), ventilator management is variable. We describe ventilator changes clinicians made for children with hypoxemic respiratory failure, and evaluate the potential acceptability of a pediatric ventilation protocol. This was a retrospective cohort study performed in a tertiary care pediatric intensive care unit (PICU). The study period was from January 2000 to July 2007. We included mechanically ventilated children with PaO(2)/FiO(2) (P/F) ratio less than 300. We assessed variability in ventilator management by evaluating actual changes to ventilator settings after an arterial blood gas (ABG). We evaluated the potential acceptability of a pediatric mechanical ventilation protocol we adapted from National Institutes of Health/National Heart, Lung, and Blood Institute (NIH/NHLBI) Acute Respiratory Distress Syndrome (ARDS) Network protocols by comparing actual practice changes in ventilator settings to changes that would have been recommended by the protocol. A total of 2,719 ABGs from 402 patients were associated with 6,017 ventilator settings. Clinicians infrequently decreased FiO(2), even when the PaO(2) was high (>68 mmHg). The protocol would have recommended more positive end expiratory pressure (PEEP) than was used in actual practice 42% of the time in the mid PaO(2) range (55-68 mmHg) and 67% of the time in the low PaO(2) range (<55 mmHg). Clinicians often made no change to either peak inspiratory pressure (PIP) or ventilator rate (VR) when the protocol would have recommended a change, even when the pH was greater than 7.45 with PIP at least 35 cmH(2)O. There may be lost opportunities to minimize potentially injurious ventilator settings for children with ALI. A reproducible pediatric mechanical ventilation protocol could prompt clinicians to make ventilator changes that are consistent with lung protective ventilation.

46 CFR 154.1205 - Mechanical ventilation system: Standards.

Code of Federal Regulations, 2010 CFR

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...

21 CFR 868.5975 - Ventilator tubing.

Code of Federal Regulations, 2010 CFR

2010-04-01

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

Ventilation and ventilators.

PubMed

Hayes, B

1982-01-01

The history of ventilation is reviewed briefly and recent developments in techniques of ventilation are discussed. Operating features of ventilators have changed in the past few years, partly as the result of clinical progress; yet, technology appears to have outstripped the clinician's ability to harness it most effectively. Clinical discipline and training of medical staff in the use of ventilators could be improved. The future is promising if clinician and designer can work together closely. Ergonomics of ventilators and their controls and the provision of alarms need special attention. Microprocessors are likely to feature prominently in the next generation of designs.

Elective ventilation for organ donation: law, policy and public ethics.

PubMed

Coggon, John

2013-03-01

This paper examines questions concerning elective ventilation, contextualised within English law and policy. It presents the general debate with reference both to the Exeter Protocol on elective ventilation, and the considerable developments in legal principle since the time that that protocol was declared to be unlawful. I distinguish different aspects of what might be labelled elective ventilation policies under the following four headings: 'basic elective ventilation'; 'epistemically complex elective ventilation'; 'practically complex elective ventilation'; and 'epistemically and practically complex elective ventilation'. I give a legal analysis of each. In concluding remarks on their potential practical viability, I emphasise the importance not just of ascertaining the legal and ethical acceptability of these and other forms of elective ventilation, but also of assessing their professional and political acceptability. This importance relates both to the successful implementation of the individual practices, and to guarding against possible harmful effects in the wider efforts to increase the rates of posthumous organ donation.

[The incidence and risk factors of ventilator-associated pneumonia in patients with severe traumatic brain injury].

PubMed

Marjanović, Vesna; Novak, Vesna; Velicković, Ljubinka; Marjanović, Goran

2011-01-01

Patients with severe traumatic brain injury are at a risk of developing ventilator-associated pneumonia. The aim of this study was to describe the incidence, etiology, risk factors for development of ventilator-associated pneumonia and outcome in patients with severe traumatic brain injury. A retrospective study was done in 72 patients with severe traumatic brain injury, who required mechanical ventilation for more than 48 hours. Ventilator-associated pneumonia was found in 31 of 72 (43.06%) patients with severe traumatic brain injury. The risk factors for ventilator-associated pneumonia were: prolonged mechanical ventilation (12.42 vs 4.34 days, p < 0.001), longer stay at intensive care unit (17 vs 5 days, p < 0.001) and chest injury (51.61 vs 19.51%, p < 0.009) compared to patients without ventilator-associated pneumonia. The mortality rate in the patients with ventilator-associated pneumonia was higher (38.71 vs 21.95%, p = 0.12). The development of ventilator-associated pneumonia in patients with severe traumatic brain injury led to the increased morbidity due to the prolonged mechanical ventilation, longer stay at intensive care unit and chest injury, but had no effect on mortality.

A polyurethane cuffed endotracheal tube is associated with decreased rates of ventilator-associated pneumonia.

PubMed

Miller, Melissa A; Arndt, Jennifer L; Konkle, Mark A; Chenoweth, Carol E; Iwashyna, Theodore J; Flaherty, Kevin R; Hyzy, Robert C

2011-06-01

The aim of this study was to determine whether the use of a polyurethane-cuffed endotracheal tube would result in a decrease in ventilator-associated pneumonia rate. We replaced conventional endotracheal tube with a polyurethane-cuff endotracheal tube (Microcuff, Kimberly-Clark Corporation, Rosewell, Ga) in all adult mechanically ventilated patients throughout our large academic hospital from July 2007 to June 2008. We retrospectively compared the rates of ventilator-associated pneumonia before, during, and after the intervention year by interrupted time-series analysis. Ventilator-associated pneumonia rates decreased from 5.3 per 1000 ventilator days before the use of the polyurethane-cuffed endotracheal tube to 2.8 per 1000 ventilator days during the intervention year (P = .0138). During the first 3 months after return to conventional tubes, the rate of ventilator-associated pneumonia was 3.5/1000 ventilator days. Use of the polyurethane-cuffed endotracheal tube was associated with an incidence risk ratio of ventilator-associated pneumonia of 0.572 (95% confidence interval, 0.340-0.963). In statistical regression analysis controlling for other possible alterations in the hospital environment, as measured by rate of tracheostomy-ventilator-associated pneumonia, the incidence risk ratio of ventilator-associated pneumonia in patients intubated with polyurethane-cuffed endotracheal tube was 0.565 (P = .032; 95% confidence interval, 0.335-0.953). Use of a polyurethane-cuffed endotracheal tube was associated with a significant decrease in the rate of ventilator-associated pneumonia in our study. Copyright © 2011 Elsevier Inc. All rights reserved.

Prone versus supine position in mechanically ventilated children: a pilot study.

PubMed

Sawhney, Ashu; Kumar, Nirmal; Sreenivas, Vishnubhatla; Gupta, Sangeeta; Tyagi, Vineet; Puliyel, Jacob M

2005-05-01

It is known that mechanically ventilated patients in the prone position have improved oxygenation compared with those supine. We did a prospective, randomized, controlled trial to evaluate the effect of prone position during mechanical ventilation, on survival in critically ill children. Forty-two children needing mechanical ventilation for various illnesses were randomized to receive initial ventilation for four hours prone or supine by drawing lots. Initial severity of illness and blood gases in all children were noted. In a crossover design, after the initial four hours the children were turned over and ventilated in the alternate posture for an hour. Oxygenation parameters and mean airway pressures were noted at one hour, four hours, and five hours. Mortality, duration of ventilation, and the above parameters were compared in the two groups. Initial PRISM scores were similar in the two groups. Mortality in the prone group was less than in the supine group. The odds ratio of mortality was 0.20 (95% CI 0.05-0.75). Duration of ventilation was similar in the two groups. The oxygenation index was significantly lower in the prone group at one, four, and five hours after onset of ventilation. Prone position in the first few hours of ventilation significantly improves gas exchange and oxygenation, reduces the mean airway pressures required to ventilate children, and may cause significant improvement in survival. Our study protocol allowed ventilator settings to be changed as needed during ventilation.

The effect of electromagnetic interference from mobile communication on the performance of intensive care ventilators.

PubMed

Jones, R P; Conway, D H

2005-08-01

Electromagnetic interference produced by wireless communication can affect medical devices and hospital policies exist to address this risk. During the transfer of ventilated patients, these policies may be compromised by essential communication between base and receiving hospitals. Local wireless networks (e.g. Bluetooth) may reduce the 'spaghetti syndrome' of wires and cables seen on intensive care units, but also generate electromagnetic interference. The aim of this study was to investigate these effects on displayed and actual ventilator performance. Five ventilators were tested: Drager Oxylog 2000, BREAS LTV-1000, Respironics BiPAP VISION, Puritan Bennett 7200 and 840. Electromagnetic interference was generated by three devices: Simoco 8020 radio handset, Nokia 7210 and Nokia 6230 mobile phone, Nokia 6230 communicating via Bluetooth with a Palm Tungsten T Personal Digital Assistant. We followed the American National Standard Recommended Practice for On-Site, Ad Hoc Testing (ANSI C63) for electromagnetic interference. We used a ventilator tester, to simulate healthy adult lungs and measure ventilator performance. The communication device under test was moved in towards each ventilator from a distance of 1 m in six axes. Alarms or error codes on the ventilator were recorded, as was ventilator performance. All ventilators tested, except for the Respironics VISION, showed a display error when subjected to electromagnetic interference from the Nokia phones and Simoco radio. Ventilator performance was only affected by the radio which caused the Puritan Bennett 840 to stop functioning completely. The transfer ventilators' performance were not affected by radio or mobile phone, although the mobile phone did trigger a low-power alarm. Effects on intensive care ventilators included display reset, with the ventilator restoring normal display function within 2 s, and low-power/low-pressure alarms. Bluetooth transmission had no effect on the function of all the ventilators tested. In a clinical setting, high-power-output devices such as a two-way radio may cause significant interference in ventilator function. Medium-power-output devices such as mobile phones may cause minor alarm triggers. Low-power-output devices such as Bluetooth appear to cause no interference with ventilator function.

TU-G-BRA-04: Changes in Regional Lung Function Measured by 4D-CT Ventilation Imaging for Thoracic Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nakajima, Y; Kadoya, N; Kabus, S

Purpose: To test the hypothesis: 4D-CT ventilation imaging can show the known effects of radiotherapy on lung function: (1) radiation-induced ventilation reductions, and (2) ventilation increases caused by tumor regression. Methods: Repeat 4D-CT scans (pre-, mid- and/or post-treatment) were acquired prospectively for 11 thoracic cancer patients in an IRB-approved clinical trial. A ventilation image for each time point was created using deformable image registration and the Hounsfield unit (HU)-based or Jacobian-based metric. The 11 patients were divided into two subgroups based on tumor volume reduction using a threshold of 5 cm{sup 3}. To quantify radiation-induced ventilation reduction, six patients whomore » showed a small tumor volume reduction (<5 cm{sup 3}) were analyzed for dose-response relationships. To investigate ventilation increase caused by tumor regression, two of the other five patients were analyzed to compare ventilation changes in the lung lobes affected and unaffected by the tumor. The remaining three patients were excluded because there were no unaffected lobes. Results: Dose-dependent reductions of HU-based ventilation were observed in a majority of the patient-specific dose-response curves and in the population-based dose-response curve, whereas no clear relationship was seen for Jacobian-based ventilation. The post-treatment population-based dose-response curve of HU-based ventilation demonstrated the average ventilation reductions of 20.9±7.0% at 35–40 Gy (equivalent dose in 2-Gy fractions, EQD2), and 40.6±22.9% at 75–80 Gy EQD2. Remarkable ventilation increases in the affected lobes were observed for the two patients who showed an average tumor volume reduction of 37.1 cm{sup 3} and re-opening airways. The mid-treatment increase in HU-based ventilation of patient 3 was 100.4% in the affected lobes, which was considerably greater than 7.8% in the unaffected lobes. Conclusion: This study has demonstrated that 4D-CT ventilation imaging shows the known effects of radiotherapy on lung function: radiation-induced ventilation reduction and ventilation increase caused by tumor regression, providing validation for 4D-CT ventilation imaging. This study was supported in part by a National Lung Cancer Partnership Young Investigator Research grant.« less

Pilot Intervention Study of Household Ventilation and Fine Particulate Matter Concentrations in a Low-Income Urban Area, Dhaka, Bangladesh.

PubMed

Weaver, Anne M; Parveen, Shahana; Goswami, Doli; Crabtree-Ide, Christina; Rudra, Carole; Yu, Jihnhee; Mu, Lina; Fry, Alicia M; Sharmin, Iffat; Luby, Stephen P; Ram, Pavani K

2017-08-01

Fine particulate matter (PM 2.5 ) is a risk factor for pneumonia; ventilation may be protective. We tested behavioral and structural ventilation interventions on indoor PM 2.5 in Dhaka, Bangladesh. We recruited 59 good ventilation (window or door in ≥ 3 walls) and 29 poor ventilation (no window, one door) homes. We monitored baseline indoor and outdoor PM 2.5 for 48 hours. We asked all participants to increase ventilation behavior, including opening windows and doors, and operating fans. Where permitted, we installed windows in nine poor ventilation homes, then repeated PM 2.5 monitoring. We estimated effects using linear mixed-effects models and conducted qualitative interviews regarding motivators and barriers to ventilation. Compared with poor ventilation homes, good ventilation homes were larger, their residents wealthier and less likely to use biomass fuel. In multivariable linear mixed-effects models, ventilation structures and opening a door or window were inversely associated with the number of hours PM 2.5 concentrations exceeded 100 and 250 μg/m 3 . Outdoor air pollution was positively associated with the number of hours PM 2.5 concentrations exceeded 100 and 250 μg/m 3 . Few homes accepted window installation, due to landlord refusal and fear of theft. Motivators for ventilation behavior included cooling of the home and sunlight; barriers included rain, outdoor odors or noise, theft risk, mosquito entry, and, for fan use, perceptions of wasting electricity or unavailability of electricity. We concluded that ventilation may reduce indoor PM 2.5 concentrations but, there are barriers to increasing ventilation and, in areas with high ambient PM 2.5 concentrations, indoor concentrations may remain above recommended levels.

Duration of Mechanical Ventilation in the Emergency Department.

PubMed

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

2017-08-01

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

Protective ventilation of preterm lambs exposed to acute chorioamnionitis does not reduce ventilation-induced lung or brain injury.

PubMed

Barton, Samantha K; Moss, Timothy J M; Hooper, Stuart B; Crossley, Kelly J; Gill, Andrew W; Kluckow, Martin; Zahra, Valerie; Wong, Flora Y; Pichler, Gerhard; Galinsky, Robert; Miller, Suzanne L; Tolcos, Mary; Polglase, Graeme R

2014-01-01

The onset of mechanical ventilation is a critical time for the initiation of cerebral white matter (WM) injury in preterm neonates, particularly if they are inadvertently exposed to high tidal volumes (VT) in the delivery room. Protective ventilation strategies at birth reduce ventilation-induced lung and brain inflammation and injury, however its efficacy in a compromised newborn is not known. Chorioamnionitis is a common antecedent of preterm birth, and increases the risk and severity of WM injury. We investigated the effects of high VT ventilation, after chorioamnionitis, on preterm lung and WM inflammation and injury, and whether a protective ventilation strategy could mitigate the response. Pregnant ewes (n = 18) received intra-amniotic lipopolysaccharide (LPS) 2 days before delivery, instrumentation and ventilation at 127±1 days gestation. Lambs were either immediately euthanased and used as unventilated controls (LPSUVC; n = 6), or were ventilated using an injurious high VT strategy (LPSINJ; n = 5) or a protective ventilation strategy (LPSPROT; n = 7) for a total of 90 min. Mean arterial pressure, heart rate and cerebral haemodynamics and oxygenation were measured continuously. Lungs and brains underwent molecular and histological assessment of inflammation and injury. LPSINJ lambs had poorer oxygenation than LPSPROT lambs. Ventilation requirements and cardiopulmonary and systemic haemodynamics were not different between ventilation strategies. Compared to unventilated lambs, LPSINJ and LPSPROT lambs had increases in pro-inflammatory cytokine expression within the lungs and brain, and increased astrogliosis (p<0.02) and cell death (p<0.05) in the WM, which were equivalent in magnitude between groups. Ventilation after acute chorioamnionitis, irrespective of strategy used, increases haemodynamic instability and lung and cerebral inflammation and injury. Mechanical ventilation is a potential contributor to WM injury in infants exposed to chorioamnionitis.

Limiting ventilator-induced lung injury through individual electronic medical record surveillance.

PubMed

Herasevich, Vitaly; Tsapenko, Mykola; Kojicic, Marija; Ahmed, Adil; Kashyap, Rachul; Venkata, Chakradhar; Shahjehan, Khurram; Thakur, Sweta J; Pickering, Brian W; Zhang, Jiajie; Hubmayr, Rolf D; Gajic, Ognjen

2011-01-01

To improve the safety of ventilator care and decrease the risk of ventilator-induced lung injury, we designed and tested an electronic algorithm that incorporates patient characteristics and ventilator settings, allowing near-real-time notification of bedside providers about potentially injurious ventilator settings. Electronic medical records of consecutive patients who received invasive ventilation were screened in three Mayo Clinic Rochester intensive care units. The computer system alerted bedside providers via the text paging notification about potentially injurious ventilator settings. Alert criteria included a Pao2/Fio2 ratio of <300 mm Hg, free text search for the words "edema" or "bilateral + infiltrates" on the chest radiograph report, a tidal volume of >8 mL/kg predicted body weight (based on patient gender and height), a plateau pressure of >30 cm H2O, and a peak airway pressure of >35 cm H2O. Respiratory therapists answered a brief online satisfaction survey. Ventilator-induced lung injury risk was compared before and after the introduction of ventilator-induced lung injury alert. The prevalence of acute lung injury was 42% (n = 490) among 1,159 patients receiving >24 hrs of invasive ventilation. The system sent 111 alerts for 80 patients, with a positive predictive value of 59%. The exposure to potentially injurious ventilation decreased after the intervention from 40.6 ± 74.6 hrs to 26.9 ± 77.3 hrs (p = .004). Electronic medical record surveillance of mechanically ventilated patients accurately detects potentially injurious ventilator settings and is able to influence bedside practice at moderate costs. Its implementation is associated with decreased patient exposure to potentially injurious mechanical ventilation settings.

Winter ventilation rates at primary schools: comparison between Portugal and Finland.

PubMed

Canha, N; Almeida, S M; Freitas, M C; Täubel, M; Hänninen, O

2013-01-01

This study focused on examination of ventilation rates in classrooms with two different types of ventilation systems: natural and mechanical. Carbon dioxide (CO2) measurements were conducted in primary schools of Portugal characterized by natural ventilation and compared to Finland where mechanical ventilation is the norm. The winter period was selected since this season exerts a great influence in naturally ventilated classrooms, where opening of windows and doors occurs due to outdoor atmospheric conditions. The ventilation rates were calculated by monitoring CO2 concentrations generated by the occupants (used as a tracer gas) and application of the buildup phase method. A comparison between both countries' results was conducted with respect to ventilation rates and how these levels corresponded to national regulatory standards. Finnish primary schools (n = 2) registered a mean ventilation rate of 13.3 L/s per person, which is higher than the recommended ventilation standards. However, the Finnish classroom that presented the lowest ventilation rate (7.2 L/s per person) displayed short-term CO2 levels above 1200 ppm, which is the threshold limit value (TLV) recommended by national guidelines. The Portuguese classrooms (n = 2) showed low ventilation rates with mean values of 2.4 L/s per person, which is markedly lower than the minimum recommended value of 7 L/s per person as defined by ASHRAE and 20% less than the REHVA minimum of 3 L/s per person. Carbon dioxide levels of 1000 ppm, close to the TLV of 1200 ppm, were also reached in both Portuguese classrooms studied. The situation in Portugal indicates a potentially serious indoor air quality problem and strengthens the need for intervention to improve ventilation rates in naturally ventilated classrooms.

Inhibition of forkhead boxO-specific transcription prevents mechanical ventilation-induced diaphragm dysfunction.

PubMed

Smuder, Ashley J; Sollanek, Kurt J; Min, Kisuk; Nelson, W Bradley; Powers, Scott K

2015-05-01

Mechanical ventilation is a lifesaving measure for patients with respiratory failure. However, prolonged mechanical ventilation results in diaphragm weakness, which contributes to problems in weaning from the ventilator. Therefore, identifying the signaling pathways responsible for mechanical ventilation-induced diaphragm weakness is essential to developing effective countermeasures to combat this important problem. In this regard, the forkhead boxO family of transcription factors is activated in the diaphragm during mechanical ventilation, and forkhead boxO-specific transcription can lead to enhanced proteolysis and muscle protein breakdown. Currently, the role that forkhead boxO activation plays in the development of mechanical ventilation-induced diaphragm weakness remains unknown. This study tested the hypothesis that mechanical ventilation-induced increases in forkhead boxO signaling contribute to ventilator-induced diaphragm weakness. University research laboratory. Young adult female Sprague-Dawley rats. Cause and effect was determined by inhibiting the activation of forkhead boxO in the rat diaphragm through the use of a dominant-negative forkhead boxO adeno-associated virus vector delivered directly to the diaphragm. Our results demonstrate that prolonged (12 hr) mechanical ventilation results in a significant decrease in both diaphragm muscle fiber size and diaphragm-specific force production. However, mechanically ventilated animals treated with dominant-negative forkhead boxO showed a significant attenuation of both diaphragm atrophy and contractile dysfunction. In addition, inhibiting forkhead boxO transcription attenuated the mechanical ventilation-induced activation of the ubiquitin-proteasome system, the autophagy/lysosomal system, and caspase-3. Forkhead boxO is necessary for the activation of key proteolytic systems essential for mechanical ventilation-induced diaphragm atrophy and contractile dysfunction. Collectively, these results suggest that targeting forkhead boxO transcription could be a key therapeutic target to combat ventilator-induced diaphragm dysfunction.

Ventilation of the Subtropical North Atlantic: Locations and Times of Last Ventilation Estimated Using Tracer Constraints From GEOTRACES Section GA03

NASA Astrophysics Data System (ADS)

Holzer, Mark; Smethie, William M.; Ting, Yu-Heng

2018-04-01

The ventilation of the subtropical North Atlantic along GEOTRACES section GA03 is quantified in terms of where and how long ago water was last in the mixed layer. Measurements of T, S, PO4∗, CFC-11, CFC-12, SF6, and estimates of prebomb 14C are deconvolved for the boundary propagator G using a maximum-entropy approach. From G, we calculate the fractions of water last ventilated in specified surface regions Ωw. We estimate that (56 ± 13)% of the water deeper than 1,000 m was ventilated in northern high latitudes, (15 ± 5)% in the Mediterranean, and (27 ± 12)% in the Southern Ocean. Below the thermocline and outside the deep western boundary current, mean ages of Ωw-ventilated water exceed a century. Consequently, memory of where last ventilation occurred tends to get lost and the deep mean-age patterns of Ωw-ventilated water are broadly similar for all Ωw. The mean ventilation ages, averaged over the section with Ωw-fraction weights, are roughly 200 years for all deep water masses except for water last ventilated south of the Antarctic divergence, which is about twice as old. The uncertainties in the section-mean profiles of the Ωw fractions and their mean ages are ˜50% and ˜20%, respectively. The Ωw fractions have vertically diffuse overlapping patterns suggesting significant diapycnal mixing, consistent with century-scale mean ages. We quantify the seasonal cycle of ventilation and find that in both hemispheres peak ventilation occurs during late winter and early spring, but Northern Hemisphere ventilated deep waters have a more pronounced seasonal cycle with nearly zero summertime ventilation.

AT1 receptor blocker losartan protects against mechanical ventilation-induced diaphragmatic dysfunction

PubMed Central

Kwon, Oh Sung; Smuder, Ashley J.; Wiggs, Michael P.; Hall, Stephanie E.; Sollanek, Kurt J.; Morton, Aaron B.; Talbert, Erin E.; Toklu, Hale Z.; Tumer, Nihal

2015-01-01

Mechanical ventilation is a life-saving intervention for patients in respiratory failure. Unfortunately, prolonged ventilator support results in diaphragmatic atrophy and contractile dysfunction leading to diaphragm weakness, which is predicted to contribute to problems in weaning patients from the ventilator. While it is established that ventilator-induced oxidative stress is required for the development of ventilator-induced diaphragm weakness, the signaling pathway(s) that trigger oxidant production remain unknown. However, recent evidence reveals that increased plasma levels of angiotensin II (ANG II) result in oxidative stress and atrophy in limb skeletal muscles. Using a well-established animal model of mechanical ventilation, we tested the hypothesis that increased circulating levels of ANG II are required for both ventilator-induced diaphragmatic oxidative stress and diaphragm weakness. Cause and effect was determined by administering an angiotensin-converting enzyme inhibitor (enalapril) to prevent ventilator-induced increases in plasma ANG II levels, and the ANG II type 1 receptor antagonist (losartan) was provided to prevent the activation of ANG II type 1 receptors. Enalapril prevented the increase in plasma ANG II levels but did not protect against ventilator-induced diaphragmatic oxidative stress or diaphragm weakness. In contrast, losartan attenuated both ventilator-induced oxidative stress and diaphragm weakness. These findings indicate that circulating ANG II is not essential for the development of ventilator-induced diaphragm weakness but that activation of ANG II type 1 receptors appears to be a requirement for ventilator-induced diaphragm weakness. Importantly, these experiments provide the first evidence that the Food and Drug Administration-approved drug losartan may have clinical benefits to protect against ventilator-induced diaphragm weakness in humans. PMID:26359481

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

PubMed

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

2012-06-01

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

Natural ventilation of buildings: opposing wind and buoyancy

NASA Astrophysics Data System (ADS)

Linden, Paul; Hunt, Gary

1998-11-01

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

Night ventilation control strategies in office buildings

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Zhaojun; Yi, Lingli; Gao, Fusheng

2009-10-15

In moderate climates night ventilation is an effective and energy-efficient approach to improve the indoor thermal environment for office buildings during the summer months, especially for heavyweight construction. However, is night ventilation a suitable strategy for office buildings with lightweight construction located in cold climates? In order to answer this question, the whole energy-consumption analysis software EnergyPlus was used to simulate the indoor thermal environment and energy consumption in typical office buildings with night mechanical ventilation in three cities in northern China. The summer outdoor climate data was analyzed, and three typical design days were chosen. The most important factorsmore » influencing night ventilation performance such as ventilation rates, ventilation duration, building mass and climatic conditions were evaluated. When night ventilation operation time is closer to active cooling time, the efficiency of night ventilation is higher. With night ventilation rate of 10 ach, the mean radiant temperature of the indoor surface decreased by up to 3.9 C. The longer the duration of operation, the more efficient the night ventilation strategy becomes. The control strategies for three locations are given in the paper. Based on the optimized strategies, the operation consumption and fees are calculated. The results show that more energy is saved in office buildings cooled by a night ventilation system in northern China than ones that do not employ this strategy. (author)« less

46 CFR 72.15-15 - Ventilation for closed spaces.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 3 2011-10-01 2011-10-01 false Ventilation for closed spaces. 72.15-15 Section 72.15-15... ARRANGEMENT Ventilation § 72.15-15 Ventilation for closed spaces. (a) All enclosed spaces within the vessel... spaces and for closing all doorways, ventilators and annular spaces around funnels and other openings to...

46 CFR 72.15-15 - Ventilation for closed spaces.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 3 2013-10-01 2013-10-01 false Ventilation for closed spaces. 72.15-15 Section 72.15-15... ARRANGEMENT Ventilation § 72.15-15 Ventilation for closed spaces. (a) All enclosed spaces within the vessel... spaces and for closing all doorways, ventilators and annular spaces around funnels and other openings to...

46 CFR 111.103-3 - Machinery space ventilation.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 4 2013-10-01 2013-10-01 false Machinery space ventilation. 111.103-3 Section 111.103-3...-GENERAL REQUIREMENTS Remote Stopping Systems § 111.103-3 Machinery space ventilation. (a) Each machinery space ventilation system must have two controls to stop the ventilation, one of which may be the supply...

46 CFR 111.103-3 - Machinery space ventilation.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 4 2011-10-01 2011-10-01 false Machinery space ventilation. 111.103-3 Section 111.103-3...-GENERAL REQUIREMENTS Remote Stopping Systems § 111.103-3 Machinery space ventilation. (a) Each machinery space ventilation system must have two controls to stop the ventilation, one of which may be the supply...

46 CFR 108.181 - Ventilation for enclosed spaces.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 4 2012-10-01 2012-10-01 false Ventilation for enclosed spaces. 108.181 Section 108.181... AND EQUIPMENT Construction and Arrangement Ventilation § 108.181 Ventilation for enclosed spaces. (a) Each enclosed space must be vented or ventilated. (b) There must be a means to close each vent or...

46 CFR 108.181 - Ventilation for enclosed spaces.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Ventilation for enclosed spaces. 108.181 Section 108.181... AND EQUIPMENT Construction and Arrangement Ventilation § 108.181 Ventilation for enclosed spaces. (a) Each enclosed space must be vented or ventilated. (b) There must be a means to close each vent or...

46 CFR 72.15-15 - Ventilation for closed spaces.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 3 2010-10-01 2010-10-01 false Ventilation for closed spaces. 72.15-15 Section 72.15-15... ARRANGEMENT Ventilation § 72.15-15 Ventilation for closed spaces. (a) All enclosed spaces within the vessel... spaces and for closing all doorways, ventilators and annular spaces around funnels and other openings to...

46 CFR 72.15-15 - Ventilation for closed spaces.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 3 2014-10-01 2014-10-01 false Ventilation for closed spaces. 72.15-15 Section 72.15-15... ARRANGEMENT Ventilation § 72.15-15 Ventilation for closed spaces. (a) All enclosed spaces within the vessel... spaces and for closing all doorways, ventilators and annular spaces around funnels and other openings to...

46 CFR 108.181 - Ventilation for enclosed spaces.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 4 2014-10-01 2014-10-01 false Ventilation for enclosed spaces. 108.181 Section 108.181... AND EQUIPMENT Construction and Arrangement Ventilation § 108.181 Ventilation for enclosed spaces. (a) Each enclosed space must be vented or ventilated. (b) There must be a means to close each vent or...

46 CFR 111.103-3 - Machinery space ventilation.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 4 2012-10-01 2012-10-01 false Machinery space ventilation. 111.103-3 Section 111.103-3...-GENERAL REQUIREMENTS Remote Stopping Systems § 111.103-3 Machinery space ventilation. (a) Each machinery space ventilation system must have two controls to stop the ventilation, one of which may be the supply...

46 CFR 108.181 - Ventilation for enclosed spaces.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 4 2013-10-01 2013-10-01 false Ventilation for enclosed spaces. 108.181 Section 108.181... AND EQUIPMENT Construction and Arrangement Ventilation § 108.181 Ventilation for enclosed spaces. (a) Each enclosed space must be vented or ventilated. (b) There must be a means to close each vent or...

46 CFR 111.103-3 - Machinery space ventilation.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 4 2014-10-01 2014-10-01 false Machinery space ventilation. 111.103-3 Section 111.103-3...-GENERAL REQUIREMENTS Remote Stopping Systems § 111.103-3 Machinery space ventilation. (a) Each machinery space ventilation system must have two controls to stop the ventilation, one of which may be the supply...

46 CFR 111.103-3 - Machinery space ventilation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Machinery space ventilation. 111.103-3 Section 111.103-3...-GENERAL REQUIREMENTS Remote Stopping Systems § 111.103-3 Machinery space ventilation. (a) Each machinery space ventilation system must have two controls to stop the ventilation, one of which may be the supply...

46 CFR 108.181 - Ventilation for enclosed spaces.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 4 2011-10-01 2011-10-01 false Ventilation for enclosed spaces. 108.181 Section 108.181... AND EQUIPMENT Construction and Arrangement Ventilation § 108.181 Ventilation for enclosed spaces. (a) Each enclosed space must be vented or ventilated. (b) There must be a means to close each vent or...

46 CFR 72.15-15 - Ventilation for closed spaces.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 3 2012-10-01 2012-10-01 false Ventilation for closed spaces. 72.15-15 Section 72.15-15... ARRANGEMENT Ventilation § 72.15-15 Ventilation for closed spaces. (a) All enclosed spaces within the vessel... spaces and for closing all doorways, ventilators and annular spaces around funnels and other openings to...

46 CFR 190.15-15 - Ventilation for living spaces and quarters.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Ventilation for living spaces and quarters. 190.15-15... VESSELS CONSTRUCTION AND ARRANGEMENT Ventilation § 190.15-15 Ventilation for living spaces and quarters. (a) All living spaces shall be adequately ventilated in a manner suitable to the purpose of the space...

46 CFR 190.15-15 - Ventilation for living spaces and quarters.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 7 2011-10-01 2011-10-01 false Ventilation for living spaces and quarters. 190.15-15... VESSELS CONSTRUCTION AND ARRANGEMENT Ventilation § 190.15-15 Ventilation for living spaces and quarters. (a) All living spaces shall be adequately ventilated in a manner suitable to the purpose of the space...

46 CFR 190.15-15 - Ventilation for living spaces and quarters.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 7 2014-10-01 2014-10-01 false Ventilation for living spaces and quarters. 190.15-15... VESSELS CONSTRUCTION AND ARRANGEMENT Ventilation § 190.15-15 Ventilation for living spaces and quarters. (a) All living spaces shall be adequately ventilated in a manner suitable to the purpose of the space...

46 CFR 190.15-15 - Ventilation for living spaces and quarters.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 7 2012-10-01 2012-10-01 false Ventilation for living spaces and quarters. 190.15-15... VESSELS CONSTRUCTION AND ARRANGEMENT Ventilation § 190.15-15 Ventilation for living spaces and quarters. (a) All living spaces shall be adequately ventilated in a manner suitable to the purpose of the space...

46 CFR 190.15-15 - Ventilation for living spaces and quarters.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 7 2013-10-01 2013-10-01 false Ventilation for living spaces and quarters. 190.15-15... VESSELS CONSTRUCTION AND ARRANGEMENT Ventilation § 190.15-15 Ventilation for living spaces and quarters. (a) All living spaces shall be adequately ventilated in a manner suitable to the purpose of the space...

Investigation of turbine ventilator performance after added wind cup for room exhaust air applications

NASA Astrophysics Data System (ADS)

Harun, D.; Zulfadhli; Akhyar, H.

2018-05-01

The turbine ventilator is a wind turbine with a vertical axis that has a combined function of the wind turbine and a suction fan. In this study, the turbine ventilator modified by adding a wind cup on the top (cap) turbine ventilator. The purpose of this experiment is to investigated the effect of the addition of wind cup on the turbine ventilator. Turbine ventilator used is type v30 and wind cup with diameter 77 mm. The experiment was conducted using a triangular pentagon model space chamber which was cut off to place the ventilator turbine ventilation cup with a volume of 0.983 m3 (equivalent to 1 mm3). The results of this study indicate that at an average wind speed of 1.8 m/s, the rotation of the turbine produced without a wind cup is 60.6 rpm while with the addition of a wind cup in the turbine ventilator is 69 rpm. The average increase of rotation turbine after added win cup is 8.4 rpm and the efficiency improvement of turbine ventilator is 1.7 %.

Analysis on ventilation pressure of fire area in longitudinal ventilation of underground tunnel

NASA Astrophysics Data System (ADS)

Li, Jiaxin; Li, Yanfeng; Feng, Xiao; Li, Junmei

2018-03-01

In order to solve the problem of ventilation pressure loss in the fire area under the fire condition, the wind pressure loss model of the fire area is established based on the thermodynamic equilibrium relation. The semi-empirical calculation formula is obtained by using the model experiment and CFD simulation. The validity of the formula is verified. The results show that the ventilation pressure loss in the fire zone is proportional to the convective heat release rate at the critical velocity, which is inversely proportional to the upstream ventilation velocity and the tunnel cross-sectional area. The proposed formula is consistent with the law of the tunnel fire test fitting formula that results are close, in contrast, the advantage lies in a clear theoretical basis and ventilation velocity values. The resistance of road tunnel ventilation system is calculated accurately and reliably, and then an effective emergency ventilation operation program is developed. It is necessary to consider the fire zone ventilation pressure loss. The proposed ventilation pressure loss formula can be used for design calculation after thorough verification.

Conservative fluid management prevents age-associated ventilator induced mortality.

PubMed

Herbert, Joseph A; Valentine, Michael S; Saravanan, Nivi; Schneck, Matthew B; Pidaparti, Ramana; Fowler, Alpha A; Reynolds, Angela M; Heise, Rebecca L

2016-08-01

Approximately 800 thousand patients require mechanical ventilation in the United States annually with an in-hospital mortality rate of over 30%. The majority of patients requiring mechanical ventilation are over the age of 65 and advanced age is known to increase the severity of ventilator-induced lung injury (VILI) and in-hospital mortality rates. However, the mechanisms which predispose aging ventilator patients to increased mortality rates are not fully understood. Ventilation with conservative fluid management decreases mortality rates in acute respiratory distress patients, but to date there has been no investigation of the effect of conservative fluid management on VILI and ventilator associated mortality rates. We hypothesized that age-associated increases in susceptibility and incidence of pulmonary edema strongly promote age-related increases in ventilator associated mortality. 2month old and 20month old male C57BL6 mice were mechanically ventilated with either high tidal volume (HVT) or low tidal volume (LVT) for up to 4h with either liberal or conservative fluid support. During ventilation, lung compliance, total lung capacity, and hysteresis curves were quantified. Following ventilation, bronchoalveolar lavage fluid was analyzed for total protein content and inflammatory cell infiltration. Wet to dry ratios were used to directly measure edema in excised lungs. Lung histology was performed to quantify alveolar barrier damage/destruction. Age matched non-ventilated mice were used as controls. At 4h, both advanced age and HVT ventilation significantly increased markers of inflammation and injury, degraded pulmonary mechanics, and decreased survival rates. Conservative fluid support significantly diminished pulmonary edema and improved pulmonary mechanics by 1h in advanced age HVT subjects. In 4h ventilations, conservative fluid support significantly diminished pulmonary edema, improved lung mechanics, and resulted in significantly lower mortality rates in older subjects. Our study demonstrates that conservative fluid alone can attenuate the age associated increase in ventilator associated mortality. Copyright © 2016 Elsevier Inc. All rights reserved.

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

PubMed

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

2016-06-01

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

Invasive Mechanical Ventilation and Mortality in Pediatric Hematopoietic Stem Cell Transplantation: A Multicenter Study.

PubMed

Rowan, Courtney M; Gertz, Shira J; McArthur, Jennifer; Fitzgerald, Julie C; Nitu, Mara E; Loomis, Ashley; Hsing, Deyin D; Duncan, Christine N; Mahadeo, Kris M; Smith, Lincoln S; Moffet, Jerelyn; Hall, Mark W; Pinos, Emily L; Cheifetz, Ira M; Tamburro, Robert F

2016-04-01

To establish the current respiratory practice patterns in pediatric hematopoietic stem cell transplant patients and investigate their associations with mortality across multiple centers. Retrospective cohort between 2009 and 2014. Twelve children's hospitals in the United States. Two hundred twenty-two pediatric allogeneic hematopoietic stem cell transplant recipients with acute respiratory failure using invasive mechanical ventilation. None. PICU mortality of our cohort was 60.4%. Mortality at 180 days post PICU discharge was 74%. Length of PICU stay prior to initiation of invasive mechanical ventilation was significantly lower in survivors, and the odds of mortality increased for longer length of PICU stay prior to intubation. A total of 91 patients (41%) received noninvasive ventilation at some point during their PICU stay prior to intubation. Noninvasive ventilation use preintubation was associated with increased mortality (odds ratio, 2.1; 95% CI, 1.2-3.6; p = 0.010). Patients ventilated longer than 15 days had higher odds of death (odds ratio, 2.4; 95% CI, 1.3-4.2; p = 0.004). Almost 40% of patients (n = 85) were placed on high-frequency oscillatory ventilation with a mortality of 76.5% (odds ratio, 3.3; 95% CI, 1.7-6.5; p = 0.0004). Of the 20 patients who survived high-frequency oscillatory ventilation, 18 were placed on high-frequency oscillatory ventilation no later than the third day of invasive mechanical ventilation. In this subset of 85 patients, transition to high-frequency oscillatory ventilation within 2 days of the start of invasive mechanical ventilation resulted in a 76% decrease in the odds of death compared with those who transitioned to high-frequency oscillatory ventilation later in the invasive mechanical ventilation course. This study suggests that perhaps earlier more aggressive critical care interventions in the pediatric hematopoietic stem cell transplant patient with respiratory failure requiring invasive mechanical ventilation may offer an opportunity to improve outcomes.

Conservative Fluid Management Prevents Age-Associated Ventilator Induced Mortality

PubMed Central

Herbert, Joseph A.; Valentine, Michael S.; Saravanan, Nivi; Schneck, Matthew B.; Pidaparti, Ramana; Fowler, Alpha A.; Reynolds, Angela M.; Heise, Rebecca L.

2017-01-01

Background Approximately 800 thousand patients require mechanical ventilation in the United States annually with an in-hospital mortality rate of over 30%. The majority of patients requiring mechanical ventilation are over the age of 65 and advanced age is known to increase the severity of ventilator-induced lung injury (VILI) and in-hosptial mortality rates. However, the mechanisms which predispose aging ventilator patients to increased mortality rates are not fully understood. Ventilation with conservative fluid management decreases mortality rates in acute respiratory distress patients, but to date there has been no investigation of the effect of conservative fluid management on VILI and ventilator associated mortality rates. We hypothesized that age-associated increases in susceptibility and incidence of pulmonary edema strongly promote age-related increases in ventilator associated mortality. Methods 2 month old and 20 month old male C57BL6 mice were mechanically ventilated with either high tidal volume (HVT) or low tidal volume (LVT) for up to 4 hours with either liberal or conservative fluid support. During ventilation, lung compliance, total lung capacity, and hysteresis curves were quantified. Following ventilation, bronchoalveolar lavage fluid was analyzed for total protein content and inflammatory cell infiltration. Wet to dry ratios were used to directly measure edema in excised lungs. Lung histology was performed to quantify alveolar barrier damage/destruction. Age matched non-ventilated mice were used as controls. Results At 4hrs, both advanced age and HVT ventilation significantly increased markers of inflammation and injury, degraded pulmonary mechanics, and decreased survival rates. Conservative fluid support significantly diminished pulmonary edema and improved pulmonary mechanics by 1hr in advanced age HVT subjects. In 4hr ventilations, conservative fluid support significantly diminished pulmonary edema, improved lung mechanics, and resulted in significantly lower mortality rates in older subjects. Conclusion Our study demonstrates that conservative fluid alone can attenuate the age associated increase in ventilator associated mortality. PMID:27188767

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

PubMed

Slutsky, Arthur S

2015-05-15

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

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

PubMed

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

2009-03-01

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

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

PubMed

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

2016-01-01

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

Mechanical Ventilation in Acute Hypoxemic Respiratory Failure: A Review of New Strategies for the Practicing Hospitalist

PubMed Central

Wilson, Jennifer G.; Matthay, Michael A.

2014-01-01

BACKGROUND The goal of mechanical ventilation in acute hypoxemic respiratory failure is to support adequate gas exchange without harming the lungs. How patients are mechanically ventilated can significantly impact their ultimate outcomes. METHODS This review focuses on emerging evidence regarding strategies for mechanical ventilation in patients with acute hypoxemic respiratory failure including: low tidal volume ventilation in the acute respiratory distress syndrome (ARDS), novel ventilator modes as alternatives to low tidal volume ventilation, adjunctive strategies that may enhance recovery in ARDS, the use of lung-protective strategies in patients without ARDS, rescue therapies in refractory hypoxemia, and an evidence-based approach to weaning from mechanical ventilation. RESULTS Once a patient is intubated and mechanically ventilated, low tidal volume ventilation remains the best strategy in ARDS. Adjunctive therapies in ARDS include a conservative fluid management strategy, as well as neuromuscular blockade and prone positioning in moderate-to-severe disease. There is also emerging evidence that a lung-protective strategy may benefit non-ARDS patients. For patients with refractory hypoxemia, extracorporeal membrane oxygenation should be considered. Once the patient demonstrates signs of recovery, the best approach to liberation from mechanical ventilation involves daily spontaneous breathing trials and protocolized assessment of readiness for extubation. CONCLUSIONS Prompt recognition of ARDS and use of lung-protective ventilation, as well as evidence-based adjunctive therapies, remain the cornerstones of caring for patients with acute hypoxemic respiratory failure. In the absence of contraindications, it is reasonable to consider lung-protective ventilation in non-ARDS patients as well, though the evidence supporting this practice is less conclusive. PMID:24733692

High tidal volume ventilation induces NOS2 and impairs cAMP- dependent air space fluid clearance.

PubMed

Frank, James A; Pittet, Jean-Francois; Lee, Hyon; Godzich, Micaela; Matthay, Michael A

2003-05-01

Tidal volume reduction during mechanical ventilation reduces mortality in patients with acute lung injury and the acute respiratory distress syndrome. To determine the mechanisms underlying the protective effect of low tidal volume ventilation, we studied the time course and reversibility of ventilator-induced changes in permeability and distal air space edema fluid clearance in a rat model of ventilator-induced lung injury. Anesthetized rats were ventilated with a high tidal volume (30 ml/kg) or with a high tidal volume followed by ventilation with a low tidal volume of 6 ml/kg. Endothelial and epithelial protein permeability were significantly increased after high tidal volume ventilation but returned to baseline levels when tidal volume was reduced. The basal distal air space fluid clearance (AFC) rate decreased by 43% (P < 0.05) after 1 h of high tidal volume but returned to the preventilation rate 2 h after tidal volume was reduced. Not all of the effects of high tidal volume ventilation were reversible. The cAMP-dependent AFC rate after 1 h of 30 ml/kg ventilation was significantly reduced and was not restored when tidal volume was reduced. High tidal volume ventilation also increased lung inducible nitric oxide synthase (NOS2) expression and air space total nitrite at 3 h. Inhibition of NOS2 activity preserved cAMP-dependent AFC. Because air space edema fluid inactivates surfactant and reduces ventilated lung volume, the reduction of cAMP-dependent AFC by reactive nitrogen species may be an important mechanism of clinical ventilator-associated lung injury.

The comparison of manual and LabVIEW-based fuzzy control on mechanical ventilation.

PubMed

Guler, Hasan; Ata, Fikret

2014-09-01

The aim of this article is to develop a knowledge-based therapy for management of rats with respiratory distress. A mechanical ventilator was designed to achieve this aim. The designed ventilator is called an intelligent mechanical ventilator since fuzzy logic was used to control the pneumatic equipment according to the rat's status. LabVIEW software was used to control all equipments in the ventilator prototype and to monitor respiratory variables in the experiment. The designed ventilator can be controlled both manually and by fuzzy logic. Eight female Wistar-Albino rats were used to test the designed ventilator and to show the effectiveness of fuzzy control over manual control on pressure control ventilation mode. The anesthetized rats were first ventilated for 20 min manually. After that time, they were ventilated for 20 min by fuzzy logic. Student's t-test for p < 0.05 was applied to the measured minimum, maximum and mean peak inspiration pressures to analyze the obtained results. The results show that there is no statistical difference in the rat's lung parameters before and after the experiments. It can be said that the designed ventilator and developed knowledge-based therapy support artificial respiration of living things successfully. © IMechE 2014.

Comparative study between derivative spectrophotometry and multivariate calibration as analytical tools applied for the simultaneous quantitation of Amlodipine, Valsartan and Hydrochlorothiazide

NASA Astrophysics Data System (ADS)

Darwish, Hany W.; Hassan, Said A.; Salem, Maissa Y.; El-Zeany, Badr A.

2013-09-01

Four simple, accurate and specific methods were developed and validated for the simultaneous estimation of Amlodipine (AML), Valsartan (VAL) and Hydrochlorothiazide (HCT) in commercial tablets. The derivative spectrophotometric methods include Derivative Ratio Zero Crossing (DRZC) and Double Divisor Ratio Spectra-Derivative Spectrophotometry (DDRS-DS) methods, while the multivariate calibrations used are Principal Component Regression (PCR) and Partial Least Squares (PLSs). The proposed methods were applied successfully in the determination of the drugs in laboratory-prepared mixtures and in commercial pharmaceutical preparations. The validity of the proposed methods was assessed using the standard addition technique. The linearity of the proposed methods is investigated in the range of 2-32, 4-44 and 2-20 μg/mL for AML, VAL and HCT, respectively.

Systems Maturity Assessment of the Lithium Ion Battery for Extravehicular Mobility Unit Project

NASA Technical Reports Server (NTRS)

Russell, Samuel P.

2011-01-01

The Long Life (Lithium Ion) Battery (LLB/LIB) is designed to replace the current Extravehicular Mobility Unit (EMU) Silver/Zinc (Ag/Zn) Increased Capacity Battery (ICB), which is used to provide power to the Primary Life Support Subsystem (PLSS) during Extravehicular Activities (EVAs). The LLB (a battery based on commercial lithium ion cell technology) is designed to have the same electrical and mechanical interfaces as the current ICB. The EMU LIB Charger is designed to charge, discharge, and condition the LLB either in a charger-strapped configuration or in an EMU-mounted configuration. This paper will retroactively apply the principles of Systems Maturity Assessment to the LLB project through use of the Integration Readiness Level and Earned Readiness Management. The viability of this methodology will be considered for application to new and existing technology development projects.

Application of mid-frequency ventilation in an animal model of lung injury: a pilot study.

PubMed

Mireles-Cabodevila, Eduardo; Chatburn, Robert L; Thurman, Tracy L; Zabala, Luis M; Holt, Shirley J; Swearingen, Christopher J; Heulitt, Mark J

2014-11-01

Mid-frequency ventilation (MFV) is a mode of pressure control ventilation based on an optimal targeting scheme that maximizes alveolar ventilation and minimizes tidal volume (VT). This study was designed to compare the effects of conventional mechanical ventilation using a lung-protective strategy with MFV in a porcine model of lung injury. Our hypothesis was that MFV can maximize ventilation at higher frequencies without adverse consequences. We compared ventilation and hemodynamic outcomes between conventional ventilation and MFV. This was a prospective study of 6 live Yorkshire pigs (10 ± 0.5 kg). The animals were subjected to lung injury induced by saline lavage and injurious conventional mechanical ventilation. Baseline conventional pressure control continuous mandatory ventilation was applied with V(T) = 6 mL/kg and PEEP determined using a decremental PEEP trial. A manual decision support algorithm was used to implement MFV using the same conventional ventilator. We measured P(aCO2), P(aO2), end-tidal carbon dioxide, cardiac output, arterial and venous blood oxygen saturation, pulmonary and systemic vascular pressures, and lactic acid. The MFV algorithm produced the same minute ventilation as conventional ventilation but with lower V(T) (-1 ± 0.7 mL/kg) and higher frequency (32.1 ± 6.8 vs 55.7 ± 15.8 breaths/min, P < .002). There were no differences between conventional ventilation and MFV for mean airway pressures (16.1 ± 1.3 vs 16.4 ± 2 cm H2O, P = .75) even when auto-PEEP was higher (0.6 ± 0.9 vs 2.4 ± 1.1 cm H2O, P = .02). There were no significant differences in any hemodynamic measurements, although heart rate was higher during MFV. In this pilot study, we demonstrate that MFV allows the use of higher breathing frequencies and lower V(T) than conventional ventilation to maximize alveolar ventilation. We describe the ventilatory or hemodynamic effects of MFV. We also demonstrate that the application of a decision support algorithm to manage MFV is feasible. Copyright © 2014 by Daedalus Enterprises.

Nonlinear optimal control policies for buoyancy-driven flows in the built environment

NASA Astrophysics Data System (ADS)

Nabi, Saleh; Grover, Piyush; Caulfield, Colm

2017-11-01

We consider optimal control of turbulent buoyancy-driven flows in the built environment, focusing on a model test case of displacement ventilation with a time-varying heat source. The flow is modeled using the unsteady Reynolds-averaged equations (URANS). To understand the stratification dynamics better, we derive a low-order partial-mixing ODE model extending the buoyancy-driven emptying filling box problem to the case of where both the heat source and the (controlled) inlet flow are time-varying. In the limit of a single step-change in the heat source strength, our model is consistent with that of Bower et al.. Our model considers the dynamics of both `filling' and `intruding' added layers due to a time-varying source and inlet flow. A nonlinear direct-adjoint-looping optimal control formulation yields time-varying values of temperature and velocity of the inlet flow that lead to `optimal' time-averaged temperature relative to appropriate objective functionals in a region of interest.

46 CFR 32.55-5 - Ventilation of tank vessels constructed between November 10, 1936, and July 1, 1951-TB/ALL.

Code of Federal Regulations, 2010 CFR

2010-10-01

... actuated gas ejectors or blowers or ventilators fitted with heads for natural ventilation, will be approved... 46 Shipping 1 2010-10-01 2010-10-01 false Ventilation of tank vessels constructed between November... HOMELAND SECURITY TANK VESSELS SPECIAL EQUIPMENT, MACHINERY, AND HULL REQUIREMENTS Ventilation and Venting...

46 CFR 92.15-10 - Ventilation for closed spaces.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 4 2012-10-01 2012-10-01 false Ventilation for closed spaces. 92.15-10 Section 92.15-10... CONSTRUCTION AND ARRANGEMENT Ventilation § 92.15-10 Ventilation for closed spaces. (a) Except as noted in paragraph (c) of this section, all enclosed spaces within the vessel shall be properly vented or ventilated...

46 CFR 92.15-10 - Ventilation for closed spaces.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 4 2013-10-01 2013-10-01 false Ventilation for closed spaces. 92.15-10 Section 92.15-10... CONSTRUCTION AND ARRANGEMENT Ventilation § 92.15-10 Ventilation for closed spaces. (a) Except as noted in paragraph (c) of this section, all enclosed spaces within the vessel shall be properly vented or ventilated...

46 CFR 92.15-10 - Ventilation for closed spaces.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Ventilation for closed spaces. 92.15-10 Section 92.15-10... CONSTRUCTION AND ARRANGEMENT Ventilation § 92.15-10 Ventilation for closed spaces. (a) Except as noted in paragraph (c) of this section, all enclosed spaces within the vessel shall be properly vented or ventilated...

46 CFR 92.15-10 - Ventilation for closed spaces.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 4 2011-10-01 2011-10-01 false Ventilation for closed spaces. 92.15-10 Section 92.15-10... CONSTRUCTION AND ARRANGEMENT Ventilation § 92.15-10 Ventilation for closed spaces. (a) Except as noted in paragraph (c) of this section, all enclosed spaces within the vessel shall be properly vented or ventilated...

46 CFR 92.15-10 - Ventilation for closed spaces.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 4 2014-10-01 2014-10-01 false Ventilation for closed spaces. 92.15-10 Section 92.15-10... CONSTRUCTION AND ARRANGEMENT Ventilation § 92.15-10 Ventilation for closed spaces. (a) Except as noted in paragraph (c) of this section, all enclosed spaces within the vessel shall be properly vented or ventilated...

Intraoperative mechanical ventilation for the pediatric patient.

PubMed

Kneyber, Martin C J

2015-09-01

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

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

PubMed

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

2017-06-01

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

[Cases and duration of mechanical ventilation in German hospitals : An analysis of DRG incentives and developments in respiratory medicine].

PubMed

Biermann, A; Geissler, A

2016-09-01

Diagnosis-related groups (DRGs) have been used to reimburse hospitals services in Germany since 2003/04. Like any other reimbursement system, DRGs offer specific incentives for hospitals that may lead to unintended consequences for patients. In the German context, specific procedures and their documentation are suspected to be primarily performed to increase hospital revenues. Mechanical ventilation of patients and particularly the duration of ventilation, which is an important variable for the DRG-classification, are often discussed to be among these procedures. The aim of this study was to examine incentives created by the German DRG-based payment system with regard to mechanical ventilation and to identify factors that explain the considerable increase of mechanically ventilated patients in recent years. Moreover, the assumption that hospitals perform mechanical ventilation in order to gain economic benefits was examined. In order to gain insights on the development of the number of mechanically ventilated patients, patient-level data provided by the German Federal Statistical Office and the German Institute for the Hospital Remuneration System were analyzed. The type of performed ventilation, the total number of ventilation hours, the age distribution, mortality and the DRG distribution for mechanical ventilation were calculated, using methods of descriptive and inferential statistics. Furthermore, changes in DRG-definitions and changes in respiratory medicine were compared for the years 2005-2012. Since the introduction of the DRG-based payment system in Germany, the hours of ventilation and the number of mechanically ventilated patients have substantially increased, while mortality has decreased. During the same period there has been a switch to less invasive ventilation methods. The age distribution has shifted to higher age-groups. A ventilation duration determined by DRG definitions could not be found. Due to advances in respiratory medicine, new ventilation methods have been introduced that are less prone to complications. This development has simultaneously improved survival rates. There was no evidence supporting the assumption that the duration of mechanical ventilation is influenced by the time intervals relevant for DRG grouping. However, presumably operational routines such as staff availability within early and late shifts of the hospital have a significant impact on the termination of mechanical ventilation.

Higher levels of spontaneous breathing reduce lung injury in experimental moderate acute respiratory distress syndrome.

PubMed

Carvalho, Nadja C; Güldner, Andreas; Beda, Alessandro; Rentzsch, Ines; Uhlig, Christopher; Dittrich, Susanne; Spieth, Peter M; Wiedemann, Bärbel; Kasper, Michael; Koch, Thea; Richter, Torsten; Rocco, Patricia R; Pelosi, Paolo; de Abreu, Marcelo Gama

2014-11-01

To assess the effects of different levels of spontaneous breathing during biphasic positive airway pressure/airway pressure release ventilation on lung function and injury in an experimental model of moderate acute respiratory distress syndrome. Multiple-arm randomized experimental study. University hospital research facility. Thirty-six juvenile pigs. Pigs were anesthetized, intubated, and mechanically ventilated. Moderate acute respiratory distress syndrome was induced by repetitive saline lung lavage. Biphasic positive airway pressure/airway pressure release ventilation was conducted using the airway pressure release ventilation mode with an inspiratory/expiratory ratio of 1:1. Animals were randomly assigned to one of four levels of spontaneous breath in total minute ventilation (n = 9 per group, 6 hr each): 1) biphasic positive airway pressure/airway pressure release ventilation, 0%; 2) biphasic positive airway pressure/airway pressure release ventilation, > 0-30%; 3) biphasic positive airway pressure/airway pressure release ventilation, > 30-60%, and 4) biphasic positive airway pressure/airway pressure release ventilation, > 60%. The inspiratory effort measured by the esophageal pressure time product increased proportionally to the amount of spontaneous breath and was accompanied by improvements in oxygenation and respiratory system elastance. Compared with biphasic positive airway pressure/airway pressure release ventilation of 0%, biphasic positive airway pressure/airway pressure release ventilation more than 60% resulted in lowest venous admixture, as well as peak and mean airway and transpulmonary pressures, redistributed ventilation to dependent lung regions, reduced the cumulative diffuse alveolar damage score across lungs (median [interquartile range], 11 [3-40] vs 18 [2-69]; p < 0.05), and decreased the level of tumor necrosis factor-α in ventral lung tissue (median [interquartile range], 17.7 pg/mg [8.4-19.8] vs 34.5 pg/mg [29.9-42.7]; p < 0.05). Biphasic positive airway pressure/airway pressure release ventilation more than 0-30% and more than 30-60% showed a less consistent pattern of improvement in lung function, inflammation, and damage compared with biphasic positive airway pressure/airway pressure release ventilation more than 60%. In this model of moderate acute respiratory distress syndrome in pigs, biphasic positive airway pressure/airway pressure release ventilation with levels of spontaneous breath higher than usually seen in clinical practice, that is, more than 30% of total minute ventilation, reduced lung injury with improved respiratory function, as compared with protective controlled mechanical ventilation.

Summary of human responses to ventilation.

PubMed

Seppänen, O A; Fisk, W J

2004-01-01

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 is seldom possible. The selection of ventilation rates has to be based also on epidemiological research, laboratory and field experiments and experience. The existing literature indicates that ventilation has a significant impact on several important human outcomes including: (1) communicable respiratory illnesses; (2) sick building syndrome symptoms; (3) task performance and productivity, and (4) perceived air quality (PAQ) among occupants or sensory panels (5) respiratory allergies and asthma. In many studies, prevalence of sick building syndrome symptoms has also been associated with characteristics of HVAC-systems. Often the prevalence of SBS symptoms is higher in air-conditioned buildings than in naturally ventilated buildings. The evidence suggests that better hygiene, commissioning, operation and maintenance of air handling systems may be particularly important for reducing the negative effects of HVAC systems. Ventilation may also have harmful effects on indoor air quality and climate if not properly designed, installed, maintained and operated. Ventilation may bring indoors harmful substances or deteriorate indoor environment. Ventilation interacts also with the building envelope and may deteriorate the structures of the building. Ventilation changes the pressure differences across the structures of building and may cause or prevent infiltration of pollutants from structures or adjacent spaces. Ventilation is also in many cases used to control the thermal environment or humidity in buildings. The paper summarises the current knowledge on positive and negative effects of ventilation on health and other human responses. The focus is on office-type working environment and residential buildings. The review shows that ventilation has various positive impacts on health and productivity of building occupants. Ventilation reduces the prevalence of airborne infectious diseases and thus the number of sick leave days. In office environment a ventilation rate up to 20-25 L/s per person seem to decrease the prevalence of SBS-symptoms. Air conditioning systems may increase the prevalence of SBS-symptoms relative to natural ventilation if not clean. In residential buildings the air change rate in cold climates should not be below app. 0.5 ach. Ventilation systems may cause pressure differences over the building envelope and bring harmful pollutants indoors.

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

PubMed

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

2012-04-05

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

Mechanical ventilation during extracorporeal membrane oxygenation. An international survey.

PubMed

Marhong, Jonathan D; Telesnicki, Teagan; Munshi, Laveena; Del Sorbo, Lorenzo; Detsky, Michael; Fan, Eddy

2014-07-01

In patients with severe, acute respiratory failure undergoing venovenous extracorporeal membrane oxygenation (VV-ECMO), the optimal strategy for mechanical ventilation is unclear. Our objective was to describe ventilation practices used in centers registered with the Extracorporeal Life Support Organization (ELSO). We conducted an international cross-sectional survey of medical directors and ECMO program coordinators from all ELSO-registered centers. The survey was distributed using a commercial website that collected information on center characteristics, the presence of a mechanical ventilator protocol, ventilator settings, and weaning practices. E-mails were sent out to medical directors or coordinators at each ELSO center and their responses were pooled for analysis. We analyzed 141 (50%) individual responses from the 283 centers contacted across 28 countries. Only 27% of centers reported having an explicit mechanical ventilation protocol for ECMO patients. The majority of these centers (77%) reported "lung rest" to be the primary goal of mechanical ventilation, whereas 9% reported "lung recruitment" to be their ventilation strategy. A tidal volume of 6 ml/kg or less was targeted by 76% of respondents, and 58% targeted a positive end-expiratory pressure of 6-10 cm H2O while ventilating patients on VV-ECMO. Centers prioritized weaning VV-ECMO before mechanical ventilation. Although ventilation practices in patients supported by VV-ECMO vary across ELSO centers internationally, the majority of centers used a strategy that targeted lung-protective thresholds and prioritized weaning VV-ECMO over mechanical ventilation.

Ventilation via Cut Nasotracheal Tube During General Anesthesia

PubMed Central

Asahi, Yoshinao; Omichi, Shiro; Adachi, Seita; Kagamiuchi, Hajime; Kotani, Junichiro

2013-01-01

Many patients with disabilities need recurrent dental treatment under general anesthesia because of high caries prevalence and the nature of dental treatment. We evaluated the use of a nasal device as a possible substitute for flexible laryngeal mask airway to reduce the risk of unexpected failure accompanying intubation; we succeeded in ventilating the lungs with a cut nasotracheal tube (CNT) with its tip placed in the pharynx. We hypothesized that this technique would be useful during dental treatment under general anesthesia and investigated its usefulness as part of a minimally invasive technique. A prospective study was designed using general anesthesia in 37 dental patients with disabilities such as intellectual impairment, autism, and cerebral palsy. CNT ventilation was compared with mask ventilation with the patient in 3 positions: the neck in flexion, horizontal position, and in extension. The effect of mouth gags was also recorded during CNT ventilation. The percentages of cases with effective ventilation were similar for the 2 techniques in the neck extension and horizontal positions (89.2–97.3%). However, CNT ventilation was significantly more effective than mask ventilation in the neck flexion position (94.6 vs 45.9%; P < .0001). Mouth gags slightly reduced the rate of effective ventilation in the neck flexion position. Most dental treatments involving minor oral surgeries were performed using mouth gags during CNT ventilation. CNT ventilation was shown to be superior to mask ventilation and is useful during dental treatment under general anesthesia. PMID:23506278

Daytime Mouthpiece for Continuous Noninvasive Ventilation in Individuals With Amyotrophic Lateral Sclerosis.

PubMed

Bédard, Marie-Eve; McKim, Douglas A

2016-10-01

Noninvasive ventilation (NIV) is commonly used to provide ventilatory support for individuals with amyotrophic lateral sclerosis (ALS). Once 24-h ventilation is required, the decision between invasive tracheostomy ventilation and palliation is often faced. This study describes the use and outcomes of daytime mouthpiece ventilation added to nighttime mask ventilation for continuous NIV in subjects with ALS as an effective alternative. This was a retrospective study of 39 subjects with ALS using daytime mouthpiece ventilation over a 17-y period. Thirty-one subjects were successful with mouthpiece ventilation, 2 were excluded, 2 stopped because of lack of motivation, and 4 with bulbar subscores of the Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (b-ALSFRS-R) between 0 and 3 physically failed to use it consistently. No subject in the successful group had a b-ALSFRS-R score of <6. Thirty of the successful subjects were able to generate a maximum insufflation capacity - vital capacity difference with lung volume recruitment. The median (range) survival to tracheostomy or death from initiation of nocturnal NIV and mouthpiece ventilation were 648 (176-2,188) and 286 (41-1,769) d, respectively. Peak cough flow with lung-volume recruitment >180 L/min at initiation of mouthpiece ventilation was associated with a longer survival (637 ± 468 vs 240 ± 158 d (P = .01). Mouthpiece ventilation provides effective ventilation and prolonged survival for individuals with ALS requiring full-time ventilatory support and maintaining adequate bulbar function. Copyright © 2016 by Daedalus Enterprises.

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

PubMed

Schädler, Dirk; Weiler, Norbert

2008-06-01

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

Noise measurements during high-frequency oscillatory and conventional mechanical ventilation.

PubMed

Berens, R J; Weigle, C G

1995-10-01

To evaluate the noise levels with high-frequency oscillatory ventilation and conventional mechanical ventilation. An observational, prospective study. Pediatric intensive care unit. The caretakers and environment of the pediatric intensive care unit. High-frequency oscillatory and conventional mechanical ventilation. Caretakers evaluated noise using a visual analog scale. Noise was measured with a decibel meter and an octave band frequency filter. There was twice as much noise perceived by the caretakers and as measured on the decibel A scale. All measures showed significantly greater noise, especially at low frequencies, with high-frequency oscillatory ventilation. High-frequency oscillatory ventilation exposes the patient to twice as much noise as does the use of conventional mechanical ventilation.

High-Frequency Percussive Ventilation Revisited

DTIC Science & Technology

2010-01-01

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

Development of an Outdoor Temperature-Based Control Algorithm for Residential Mechanical Ventilation Control

DOE Office of Scientific and Technical Information (OSTI.GOV)

Less, Brennan; Walker, Iain; Tang, Yihuan

2014-06-01

Smart ventilation systems use controls to ventilate more during those periods that provide either an energy or IAQ advantage (or both) and less during periods that provide a dis advantage. Using detailed building simulations, this study addresses one of the simplest and lowest cost types of smart controllers —outdoor temperature- based control. If the outdoor temperature falls below a certain cut- off, the fan is simply turned off. T he main principle of smart ventilation used in this study is to shift ventilation from time periods with large indoor -outdoor temperature differences, to periods where these differences are smaller, andmore » their energy impacts are expected to be less. Energy and IAQ performance are assessed relative to a base case of a continuously operated ventilation fan sized to comply with ASHRAE 62.2-2013 whole house ventilation requirements. In order to satisfy 62.2-2013, annual pollutant exposure must be equivalent between the temperature controlled and continuous fan cases. This requires ventilation to be greater than 62.2 requirements when the ventilation system operates. This is achieved by increasing the mechanical ventilation system air flow rates.« less

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

PubMed

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

2014-01-01

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

A complete audit cycle to assess adherence to a lung protective ventilation strategy.

PubMed

Joynes, Emma; Dalay, Satinder; Patel, Jaimin M; Fayek, Samia

2014-11-01

There is clear evidence for the use of a protective ventilation protocol in patients with acute respiratory distress syndrome (ARDS). There is evidence to suggest that protective ventilation is beneficial in patients at risk of ARDS. A protective ventilation strategy was implemented on our intensive care unit in critical care patients who required mechanical ventilation for over 48 h, with and at risk for ARDS. A complete audit cycle was performed over 13 months to assess compliance with a safe ventilation protocol in intensive care. The ARDS network mechanical ventilation protocol was used as the standard for our protective ventilation strategy. This recommends ventilation with a tidal volume (V t) of 6 ml/kg of ideal body weight (IBW) and plateau airway pressure of ≤30 cm H2O. The initial audit failed to meet this standard with V t's of 9.5 ml/kg of IBW. Following the implementation of a ventilation strategy and an educational program, we demonstrate a significant improvement in practice with V t's of 6.6 ml/kg of IBW in the re-audit. This highlights the importance of simple interventions and continuous education in maintaining high standards of care.

Variable tidal volumes improve lung protective ventilation strategies in experimental lung injury.

PubMed

Spieth, Peter M; Carvalho, Alysson R; Pelosi, Paolo; Hoehn, Catharina; Meissner, Christoph; Kasper, Michael; Hübler, Matthias; von Neindorff, Matthias; Dassow, Constanze; Barrenschee, Martina; Uhlig, Stefan; Koch, Thea; de Abreu, Marcelo Gama

2009-04-15

Noisy ventilation with variable Vt may improve respiratory function in acute lung injury. To determine the impact of noisy ventilation on respiratory function and its biological effects on lung parenchyma compared with conventional protective mechanical ventilation strategies. In a porcine surfactant depletion model of lung injury, we randomly combined noisy ventilation with the ARDS Network protocol or the open lung approach (n = 9 per group). Respiratory mechanics, gas exchange, and distribution of pulmonary blood flow were measured at intervals over a 6-hour period. Postmortem, lung tissue was analyzed to determine histological damage, mechanical stress, and inflammation. We found that, at comparable minute ventilation, noisy ventilation (1) improved arterial oxygenation and reduced mean inspiratory peak airway pressure and elastance of the respiratory system compared with the ARDS Network protocol and the open lung approach, (2) redistributed pulmonary blood flow to caudal zones compared with the ARDS Network protocol and to peripheral ones compared with the open lung approach, (3) reduced histological damage in comparison to both protective ventilation strategies, and (4) did not increase lung inflammation or mechanical stress. Noisy ventilation with variable Vt and fixed respiratory frequency improves respiratory function and reduces histological damage compared with standard protective ventilation strategies.

Adherence to the items in a bundle for the prevention of ventilator-associated pneumonia.

PubMed

Sachetti, Amanda; Rech, Viviane; Dias, Alexandre Simões; Fontana, Caroline; Barbosa, Gilberto da Luz; Schlichting, Dionara

2014-01-01

To assess adherence to a ventilator care bundle in an intensive care unit and to determine the impact of adherence on the rates of ventilator-associated pneumonia. A total of 198 beds were assessed for 60 days using a checklist that consisted of the following items: bed head elevation to 30 to 45º; position of the humidifier filter; lack of fluid in the ventilator circuit; oral hygiene; cuff pressure; and physical therapy. Next, an educational lecture was delivered, and 235 beds were assessed for the following 60 days. Data were also collected on the incidence of ventilator-acquired pneumonia. Adherence to the following ventilator care bundle items increased: bed head elevation from 18.7% to 34.5%; lack of fluid in the ventilator circuit from 55.6% to 72.8%; oral hygiene from 48.5% to 77.8%; and cuff pressure from 29.8% to 51.5%. The incidence of ventilator-associated pneumonia was statistically similar before and after intervention (p=0.389). The educational intervention performed in this study increased the adherence to the ventilator care bundle, but the incidence of ventilator-associated pneumonia did not decrease in the small sample that was assessed.

Assessment of ventilation and indoor air pollutants in nursery and elementary schools in France.

PubMed

Canha, N; Mandin, C; Ramalho, O; Wyart, G; Ribéron, J; Dassonville, C; Hänninen, O; Almeida, S M; Derbez, M

2016-06-01

The aim of this study was to characterize the relationship between Indoor Air Quality (IAQ) and ventilation in French classrooms. Various parameters were measured over one school week, including volatile organic compounds, aldehydes, particulate matter (PM2.5 mass concentration and number concentration), carbon dioxide (CO2 ), air temperature, and relative humidity in 51 classrooms at 17 schools. The ventilation was characterized by several indicators, such as the air exchange rate, ventilation rate (VR), and air stuffiness index (ICONE), that are linked to indoor CO2 concentration. The influences of the season (heating or non-heating), type of school (nursery or elementary), and ventilation on the IAQ were studied. Based on the minimum value of 4.2 l/s per person required by the French legislation for mechanically ventilated classrooms, 91% of the classrooms had insufficient ventilation. The VR was significantly higher in mechanically ventilated classrooms compared with naturally ventilated rooms. The correlations between IAQ and ventilation vary according to the location of the primary source of each pollutant (outdoor vs. indoor), and for an indoor source, whether it is associated with occupant activity or continuous emission. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

PubMed

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

2017-01-01

Data regarding best practices for ventilator management strategies that improve outcomes in acute respiratory distress syndrome (ARDS) are readily available. However, little is known regarding processes to ensure compliance with these strategies. We developed a goal-directed mechanical ventilation order set that included physician-specified lung-protective ventilation and oxygenation goals to be implemented by respiratory therapists (RTs). We sought as a primary outcome to determine whether an RT-driven order set with predefined oxygenation and ventilation goals could be implemented and associated with improved adherence with best practice. We evaluated 1302 patients undergoing invasive mechanical ventilation (1693 separate episodes of invasive mechanical ventilation) prior to and after institution of a standardized, goal-directed mechanical ventilation order set using a controlled before-and-after study design. Patient-specific goals for oxygenation partial pressure of oxygen in arterial blood (Pao 2 ), ARDS Network [Net] positive end-expiratory pressure [PEEP]/fraction of inspired oxygen [Fio 2 ] table use) and ventilation (pH, partial pressure of carbon dioxide) were selected by prescribers and implemented by RTs. Compliance with the new mechanical ventilation order set was high: 88.2% compliance versus 3.8% before implementation of the order set ( P < .001). Adherence to the PEEP/Fio 2 table after implementation of the order set was significantly greater (86.0% after vs 82.9% before, P = .02). There was no difference in duration of mechanical ventilation, intensive care unit (ICU) length of stay, and in-hospital or ICU mortality. A standardized best practice mechanical ventilation order set can be implemented by a multidisciplinary team and is associated with improved compliance to written orders and adherence to the ARDSNet PEEP/Fio 2 table.

Transtracheal ventilation with a novel ejector-based device (Ventrain) in open, partly obstructed, or totally closed upper airways in pigs.

PubMed

Paxian, M; Preussler, N P; Reinz, T; Schlueter, A; Gottschall, R

2015-08-01

Transtracheal access and subsequent jet ventilation are among the last options in a 'cannot intubate-cannot oxygenate' scenario. These interventions may lead to hypercapnia, barotrauma, and haemodynamic failure in the event of an obstructed upper airway. The aim of the present study was to evaluate the efficacy and the haemodynamic effects of the Ventrain, a manually operated ventilation device that provides expiratory ventilation assistance. Transtracheal ventilation was carried out with the Ventrain in different airway scenarios in live pigs, and its performance was compared with a conventional jet ventilator. Pigs with open, partly obstructed, or completely closed upper airways were transtracheally ventilated either with the Ventrain or by conventional jet ventilation. Airway pressures, haemodynamic parameters, and blood gases obtained in the different settings were compared. Mean (SD) alveolar minute ventilation as reflected by arterial partial pressure of CO2 was superior with the Ventrain in partly obstructed airways after 6 min in comparison with traditional manual jet ventilation [4.7 (0.19) compared with 7.1 (0.37) kPa], and this was also the case in all simulated airway conditions. At the same time, peak airway pressures were significantly lower and haemodynamic parameters were altered to a lesser extent with the Ventrain. The results of this study suggest that the Ventrain device can ensure sufficient oxygenation and ventilation through a small-bore transtracheal catheter when the airway is open, partly obstructed, or completely closed. Minute ventilation and avoidance of high airway pressures were superior in comparison with traditional hand-triggered jet ventilation, particularly in the event of complete upper airway obstruction. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The performances of standard and ResMed masks during bag-valve-mask ventilation.

PubMed

Lee, Hyoung Youn; Jeung, Kyung Woon; Lee, Byung Kook; Lee, Seung Joon; Jung, Yong Hun; Lee, Geo Sung; Min, Yong Il; Heo, Tag

2013-01-01

A tight mask seal is frequently difficult to obtain and maintain during single-rescuer bag-valve-mask (BVM) ventilation. The ResMed mask (Bella Vista, NSW, Australia) is a continuous-positive-airway-pressure mask (CM) designed for noninvasive ventilation. In this study, we compared the ventilation performances of a standard mask (SM) and a ResMed CM using a simulation manikin in an out-of-hospital single-rescuer BVM ventilation scenario. Thirty emergency medical technicians (EMTs) performed two 2-minute attempts to ventilate a simulation manikin using BVM ventilation, alternatively, with the SM or the ResMed CM in a randomized order. Ventilation parameters including tidal volume and peak airway pressure were measured using computer analysis software connected to the simulation manikin. Successful volume delivery was defined as delivery of 440-540 mL of tidal volume in accord with present cardiopulmonary resuscitation guidelines. BVM ventilation using the ResMed CM produced higher mean (± standard deviation) tidal volumes (452 ± 50 mL vs. 394 ± 113 mL, p = 0.014) and had a higher proportion of successful volume deliveries (65.3% vs. 26.7%, p < 0.001) than that using the SM. Peak airway pressure was higher in BVM ventilation using the ResMed CM (p = 0.035). Stomach insufflation did not occur during either method. Twenty-nine of the participants (96.7%) preferred BVM ventilation using the ResMed CM. BVM ventilations using ResMed CM resulted in a significantly higher proportion of successful volume deliveries meeting the currently recommended range of tidal volume. Clinical studies are needed to determine the value of the ResMed CM for BVM ventilation.

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

PubMed Central

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

2016-01-01

Background and Aims: Face mask ventilation of the edentulous patient is often difficult as ineffective seating of the standard mask to the face prevents attainment of an adequate air seal. The efficacy of nasal ventilation in edentulous patients has been cited in case reports but has never been investigated. Material and Methods: Consecutive edentulous adult patients scheduled for surgery under general anesthesia with endotracheal intubation, during a 17-month period, were prospectively evaluated. After induction of anesthesia and administration of neuromuscular blocker, lungs were ventilated with a standard anatomical face mask of appropriate size, using a volume controlled anesthesia ventilator with tidal volume set at 10 ml/kg. In case of inadequate ventilation, the mask position was adjusted to achieve best-fit. Inspired and expired tidal volumes were measured. Thereafter, the face mask was replaced by a nasal mask and after achieving best-fit, the inspired and expired tidal volumes were recorded. The difference in expired tidal volumes and airway pressures at best-fit with the use of the two masks and number of patients with inadequate ventilation with use of the masks were statistically analyzed. Results: A total of 79 edentulous patients were recruited for the study. The difference in expiratory tidal volumes with the use of the two masks at best-fit was statistically significant (P = 0.0017). Despite the best-fit mask placement, adequacy of ventilation could not be achieved in 24.1% patients during face mask ventilation, and 12.7% patients during nasal mask ventilation and the difference was statistically significant. Conclusion: Nasal mask ventilation is more efficient than standard face mask ventilation in edentulous patients. PMID:27625477

The use of chilled condensers for the recovery of perfluorocarbon liquid in an experimental model of perfluorocarbon vapour loss during neonatal partial liquid ventilation

PubMed Central

Dunster, Kimble R; Davies, Mark W; Fraser, John F

2007-01-01

Background Perfluorocarbon (PFC) vapour in the expired gases during partial liquid ventilation should be prevented from entering the atmosphere and recovered for potential reuse. This study aimed to determine how much PFC liquid could be recovered using a conventional humidified neonatal ventilator with chilled condensers in place of the usual expiratory ventilator circuit and whether PFC liquid could be recovered when using the chilled condensers at the ventilator exhaust outlet. Methods Using a model lung, perfluorocarbon vapour loss during humidified partial liquid ventilation of a 3.5 kg infant was approximated. For each test 30 mL of FC-77 was infused into the model lung. Condensers were placed in the expiratory limb of the ventilator circuit and the amounts of PFC (FC-77) and water recovered were measured five times. This was repeated with the condensers placed at the ventilator exhaust outlet. Results When the condensers were used as the expiratory limb, the mean (± SD) volume of FC77 recovered was 16.4 mL (± 0.18 mL). When the condensers were connected to the ventilator exhaust outlet the mean (± SD) volume of FC-77 recovered was 7.6 mL (± 1.14 mL). The volume of FC-77 recovered was significantly higher when the condenser was used as an expiratory limb. Conclusion Using two series connected condensers in the ventilator expiratory line 55% of PFC liquid (FC-77) can be recovered during partial liquid ventilation without altering the function of the of the ventilator circuit. This volume of PFC recovered was just over twice that recovered with the condensers connected to the ventilator exhaust outlet. PMID:17537270

Quantitative analysis of hyperpolarized 129Xe ventilation imaging in healthy volunteers and subjects with chronic obstructive pulmonary disease

PubMed Central

Virgincar, Rohan S.; Cleveland, Zackary I.; Kaushik, S. Sivaram; Freeman, Matthew S.; Nouls, John; Cofer, Gary P.; Martinez-Jimenez, Santiago; He, Mu; Kraft, Monica; Wolber, Jan; McAdams, H. Page; Driehuys, Bastiaan

2013-01-01

In this study, hyperpolarized (HP) 129Xe MR ventilation and 1H anatomical images were obtained from 3 subject groups: young healthy volunteers (HV), subjects with chronic obstructive pulmonary disease (COPD), and age-matched control subjects (AMC). Ventilation images were quantified by 2 methods: an expert reader-based ventilation defect score percentage (VDS%) and a semi-automatic segmentation-based ventilation defect percentage (VDP). Reader-based values were assigned by two experienced radiologists and resolved by consensus. In the semi-automatic analysis, 1H anatomical images and 129Xe ventilation images were both segmented following registration, to obtain the thoracic cavity volume (TCV) and ventilated volume (VV), respectively, which were then expressed as a ratio to obtain the VDP. Ventilation images were also characterized by generating signal intensity histograms from voxels within the TCV, and heterogeneity was analyzed using the coefficient of variation (CV). The reader-based VDS% correlated strongly with the semi-automatically generated VDP (r = 0.97, p < 0.0001), and with CV (r = 0.82, p < 0.0001). Both 129Xe ventilation defect scoring metrics readily separated the 3 groups from one another and correlated significantly with FEV1 (VDS%: r = -0.78, p = 0.0002; VDP: r = -0.79, p = 0.0003; CV: r = -0.66, p = 0.0059) and other pulmonary function tests. In the healthy subject groups (HV and AMC), the prevalence of ventilation defects also increased with age (VDS%: r = 0.61, p = 0.0002; VDP: r = 0.63, p = 0.0002). Moreover, ventilation histograms and their associated CVs distinguished between COPD subjects with similar ventilation defect scores but visibly different ventilation patterns. PMID:23065808

A Case-Control Study on the Impact of Ventilator-Associated Tracheobronchitis in the PICU.

PubMed

Wheeler, Derek S; Whitt, John D; Lake, Michael; Butcher, John; Schulte, Marion; Stalets, Erika

2015-07-01

Hospital-acquired infections increase morbidity, mortality, and charges in the PICU. We implemented a quality improvement bundle directed at ventilator-associated pneumonia in our PICU in 2005. We observed an increase in ventilator-associated tracheobronchitis coincident with the near-elimination of ventilator-associated pneumonia. The impact of ventilator-associated tracheobronchitis on critically ill children has not been previously described. Accordingly, we hypothesized that ventilator-associated tracheobronchitisis associated with increased length of stay, mortality, and hospital charge. Retrospective case-control study. Critically ill children admitted to a quaternary PICU at a free-standing academic children's hospital in the United States. None. We conducted a retrospective case control study, with institutional review board approval, of 77 consecutive cases of ventilator-associated tracheobronchitis admitted to our PICU from 2004-2010. We matched each case with a control based on the following criteria (in rank order): age range (< 30 d, 30 d to 24 mo, 24 mo to 12 yr, > 12 yr), admission Pediatric Risk of Mortality III score ± 10, number of ventilator days of control group (> 75% of days until development of ventilator-associated tracheobronchitis), primary diagnosis, underlying organ system dysfunction, surgical procedure, and gender. The primary outcome measured was PICU length of stay. Secondary outcomes included ventilator days, hospital length of stay, mortality, and PICU and hospital charges. Data was analyzed using chi square analysis and p less than 0.05 was considered significant. We successfully matched 45 of 77 ventilator-associated tracheobronchitis patients with controls. There were no significant differences in age, gender, diagnosis, or Pediatric Risk of Mortality III score between groups. Ventilator-associated tracheobronchitis patients had a longer PICU length of stay (median, 21.5 d, interquartile range, 24 d) compared to controls (median, 18 d; interquartile range, 17 d), although not statistically significant (p = 0.13). Ventilator days were also longer in the ventilator-associated tracheobronchitis patients (median, 17 d; IQR, 22 d) versus control (median, 10.5 d; interquartile range, 13 d) (p = 0.01). There was no significant difference in total hospital length of stay (54 d vs 36 d; p = 0.69). PICU mortality was higher in the ventilator-associated tracheobronchitis group (15% vs 5%; p = 0.14), although not statistically significant. There was an increase in both median PICU charges ($197,393 vs $172,344; p < 0.05) and hospital charges ($421,576 vs $350,649; p < 0.05) for ventilator-associated tracheobronchitis patients compared with controls. Ventilator-associated tracheobronchitis is a clinically significant hospital-acquired infection in the PICU and is associated with longer duration of mechanical ventilation and healthcare costs, possibly through causing a longer PICU length of stay. Quality improvement efforts should be directed at reducing the incidence of ventilator-associated tracheobronchitis in the PICU.

Insights into Ventilatory Inhomogeneity from Respiratory Measurements on Spacelab Mission D-2

NASA Technical Reports Server (NTRS)

Paiva, Manuel; Verbanck, Sylvia; Linnarsson, Dag; Prisk, Kim; West, John B.

1996-01-01

The relative contributions of inter-regional and intra-regional ventilation inhomogeneities of Spacelab astronauts are studied. The classical theory of ventilation distribution in the lung is that the top-to-bottom (inter-regional) ventilation inhomogeneities are primarily gravity dependent, whereas the peripheral (intra-regional) ventilation distribution is gravity independent. Argon rebreathing tests showed that gravity independent specific ventilation (ventilation per unit volume) inhomogeneities are at least as large as gravity dependent ones. Single breath tests with helium and sulfur hexafluoride showed the different sensitivity of these gases to microgravity.

Subglottic secretion drainage for the prevention of ventilator-associated pneumonia: a systematic review and meta-analysis.

PubMed

Muscedere, John; Rewa, Oleksa; McKechnie, Kyle; Jiang, Xuran; Laporta, Denny; Heyland, Daren K

2011-08-01

Aspiration of secretions containing bacterial pathogens into the lower respiratory tract is the main cause of ventilator-associated pneumonia. Endotracheal tubes with subglottic secretion drainage can potentially reduce this and, therefore, the incidence of ventilator-associated pneumonia. New evidence on subglottic secretion drainage as a preventive measure for ventilator-associated pneumonia has been recently published and to consider the evidence in totality, we conducted an updated systematic review and meta-analysis. We searched computerized databases, reference lists, and personal files. We included randomized clinical trials of mechanically ventilated patients comparing standard endotracheal tubes to those with subglottic secretion drainage and reporting on the occurrence of ventilator-associated pneumonia. Studies were meta-analyzed for the primary outcome of ventilator-associated pneumonia and secondary clinical outcomes. We identified 13 randomized clinical trials that met the inclusion criteria with a total of 2442 randomized patients. Of the 13 studies, 12 reported a reduction in ventilator-associated pneumonia rates in the subglottic secretion drainage arm; in meta-analysis, the overall risk ratio for ventilator-associated pneumonia was 0.55 (95% confidence interval, 0.46-0.66; p < .00001) with no heterogeneity (I = 0%). The use of subglottic secretion drainage was associated with reduced intensive care unit length of stay (-1.52 days; 95% confidence interval, -2.94 to -0.11; p = .03); decreased duration of mechanically ventilated (-1.08 days; 95% confidence interval, -2.04 to -0.12; p = .03), and increased time to first episode of ventilator-associated pneumonia (2.66 days; 95% confidence interval, 1.06-4.26; p = .001). There was no effect on adverse events or on hospital or intensive care unit mortality. In those at risk for ventilator-associated pneumonia, the use of endotracheal tubes with subglottic secretion drainage is effective for the prevention of ventilator-associated pneumonia and may be associated with reduced duration of mechanical ventilation and intensive care unit length of stay.

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

PubMed

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

2017-05-01

Pressure support ventilation (PSV) is often associated with patient-ventilator asynchrony. Proportional assist ventilation (PAV) offers inspiratory assistance proportional to patient effort, minimizing patient-ventilator asynchrony. The objective of this study was to evaluate the influence of respiratory mechanics and patient effort on patient-ventilator asynchrony during PSV and PAV plus (PAV+). We used a mechanical lung simulator and studied 3 respiratory mechanics profiles (normal, obstructive, and restrictive), with variations in the duration of inspiratory effort: 0.5, 1.0, 1.5, and 2.0 s. The Auto-Trak system was studied in ventilators when available. Outcome measures included inspiratory trigger delay, expiratory trigger asynchrony, and tidal volume (V T ). Inspiratory trigger delay was greater in the obstructive respiratory mechanics profile and greatest with a effort of 2.0 s (160 ms); cycling asynchrony, particularly delayed cycling, was common in the obstructive profile, whereas the restrictive profile was associated with premature cycling. In comparison with PSV, PAV+ improved patient-ventilator synchrony, with a shorter triggering delay (28 ms vs 116 ms) and no cycling asynchrony in the restrictive profile. V T was lower with PAV+ than with PSV (630 mL vs 837 mL), as it was with the single-limb circuit ventilator (570 mL vs 837 mL). PAV+ mode was associated with longer cycling delays than were the other ventilation modes, especially for the obstructive profile and higher effort values. Auto-Trak eliminated automatic triggering. Mechanical ventilation asynchrony was influenced by effort, respiratory mechanics, ventilator type, and ventilation mode. In PSV mode, delayed cycling was associated with shorter effort in obstructive respiratory mechanics profiles, whereas premature cycling was more common with longer effort and a restrictive profile. PAV+ prevented premature cycling but not delayed cycling, especially in obstructive respiratory mechanics profiles, and it was associated with a lower V T . Copyright © 2017 by Daedalus Enterprises.

Mobile communication devices causing interference in invasive and noninvasive ventilators.

PubMed

Dang, Bao P; Nel, Pierre R; Gjevre, John A

2007-06-01

The aim of this study was to assess if common mobile communication systems would cause significant interference on mechanical ventilation devices and at what distances would such interference occur. We tested all the invasive and noninvasive ventilatory devices used within our region. This consisted of 2 adult mechanical ventilators, 1 portable ventilator, 2 pediatric ventilators, and 2 noninvasive positive pressure ventilatory devices. We operated the mobile devices from the 2 cellular communication systems (digital) and 1 2-way radio system used in our province at varying distances from the ventilators and looked at any interference they created. We tested the 2-way radio system, which had a fixed operation power output of 3.0 watts, the Global Systems for Mobile Communication cellular system, which had a maximum power output of 2.0 watts and the Time Division Multiple Access cellular system, which had a maximum power output of 0.2 watts on our ventilators. The ventilators were ventilating a plastic lung at fixed settings. The mobile communication devices were tested at varying distances starting at zero meter from the ventilator and in all operation modes. The 2-way radio caused the most interference on some of the ventilators, but the maximum distance of interference was 1.0 m. The Global Systems for Mobile Communication system caused significant interference only at 0 m and minor interference at 0.5 m on only 1 ventilator. The Time Division Multiple Access system caused no interference at all. Significant interference consisted of a dramatic rise and fluctuation of the respiratory rate, pressure, and positive end-expiratory pressure of the ventilators with no normalization when the mobile device was removed. From our experiment on our ventilators with the communication systems used in our province, we conclude that mobile communication devices such as cellular phones and 2-way radios are safe and cause no interference unless operated at very close distances of less than 1 meter.

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

PubMed

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

2015-07-21

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

WE-AB-202-06: Correlating Lung CT HU with Transformation-Based and Xe-CT Derived Ventilation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Du, K; Patton, T; Bayouth, J

Purpose: Regional lung ventilation is useful to reduce radiation-induced function damage during lung cancer radiation therapy. Recently a new direct HU (Hounsfield unit)-based method was proposed to estimate the ventilation potential without image registration. The purpose of this study is to examine if there is a functional dependence between HU values and transformation-based or Xe-CT derived ventilation. Methods: 4DCT images acquired from 13 patients prior to radiation therapy and 4 mechanically ventilated sheep subjects which also have associated Xe-CT images were used for this analysis. Transformation-based ventilation was computed using Jacobian determinant of the transformation field between peak-exhale and peak-inhalemore » 4DCT images. Both transformation and Xe-CT derived ventilation was computed for each HU bin. Color scatter plot and cumulative histogram were used to compare and validate the direct HU-based method. Results: There was little change of the center and shape of the HU histograms between free breathing CT and 4DCT average, with or without smoothing, and between the repeated 4DCT scans. HU of −750 and −630 were found to have the greatest transformation-based ventilation for human and sheep subjects, respectively. Maximum Xe-CT derived ventilation was found to locate at HU of −600 in sheep subjects. The curve between Xe-CT ventilation and HU was noisy for tissue above HU −400, possibly due to less intensity change of Xe gas during wash-out and wash-in phases. Conclusion: Both transformation-based and Xe-CT ventilation demonstrated that lung tissues with HU values in the range of (-750, −600) HU have the maximum ventilation potential. The correlation between HU and ventilation suggests that HU might be used to help guide the ventilation calculation and make it more robust to noise and image registration errors. Research support from NIH grants CA166703 and CA166119 and a gift from Roger Koch.« less

Investigation of four-dimensional computed tomography-based pulmonary ventilation imaging in patients with emphysematous lung regions

NASA Astrophysics Data System (ADS)

Yamamoto, Tokihiro; Kabus, Sven; Klinder, Tobias; Lorenz, Cristian; von Berg, Jens; Blaffert, Thomas; Loo, Billy W., Jr.; Keall, Paul J.

2011-04-01

A pulmonary ventilation imaging technique based on four-dimensional (4D) computed tomography (CT) has advantages over existing techniques. However, physiologically accurate 4D-CT ventilation imaging has not been achieved in patients. The purpose of this study was to evaluate 4D-CT ventilation imaging by correlating ventilation with emphysema. Emphysematous lung regions are less ventilated and can be used as surrogates for low ventilation. We tested the hypothesis: 4D-CT ventilation in emphysematous lung regions is significantly lower than in non-emphysematous regions. Four-dimensional CT ventilation images were created for 12 patients with emphysematous lung regions as observed on CT, using a total of four combinations of two deformable image registration (DIR) algorithms: surface-based (DIRsur) and volumetric (DIRvol), and two metrics: Hounsfield unit (HU) change (VHU) and Jacobian determinant of deformation (VJac), yielding four ventilation image sets per patient. Emphysematous lung regions were detected by density masking. We tested our hypothesis using the one-tailed t-test. Visually, different DIR algorithms and metrics yielded spatially variant 4D-CT ventilation images. The mean ventilation values in emphysematous lung regions were consistently lower than in non-emphysematous regions for all the combinations of DIR algorithms and metrics. VHU resulted in statistically significant differences for both DIRsur (0.14 ± 0.14 versus 0.29 ± 0.16, p = 0.01) and DIRvol (0.13 ± 0.13 versus 0.27 ± 0.15, p < 0.01). However, VJac resulted in non-significant differences for both DIRsur (0.15 ± 0.07 versus 0.17 ± 0.08, p = 0.20) and DIRvol (0.17 ± 0.08 versus 0.19 ± 0.09, p = 0.30). This study demonstrated the strong correlation between the HU-based 4D-CT ventilation and emphysema, which indicates the potential for HU-based 4D-CT ventilation imaging to achieve high physiologic accuracy. A further study is needed to confirm these results.

Comparison of exogenous surfactant therapy, mechanical ventilation with high end-expiratory pressure and partial liquid ventilation in a model of acute lung injury.

PubMed

Hartog, A; Vazquez de Anda, G F; Gommers, D; Kaisers, U; Verbrugge, S J; Schnabel, R; Lachmann, B

1999-01-01

We have compared three treatment strategies, that aim to prevent repetitive alveolar collapse, for their effect on gas exchange, lung mechanics, lung injury, protein transfer into the alveoli and surfactant system, in a model of acute lung injury. In adult rats, the lungs were ventilated mechanically with 100% oxygen and a PEEP of 6 cm H2O, and acute lung injury was induced by repeated lung lavage to obtain a PaO2 value < 13 kPa. Animals were then allocated randomly (n = 12 in each group) to receive exogenous surfactant therapy, ventilation with high PEEP (18 cm H2O), partial liquid ventilation or ventilation with low PEEP (8 cm H2O) (ventilated controls). Blood-gas values were measured hourly. At the end of the 4-h study, in six animals per group, pressure-volume curves were constructed and bronchoalveolar lavage (BAL) was performed, whereas in the remaining animals lung injury was assessed. In the ventilated control group, arterial oxygenation did not improve and protein concentration of BAL and conversion of active to non-active surfactant components increased significantly. In the three treatment groups, PaO2 increased rapidly to > 50 kPa and remained stable over the next 4 h. The protein concentration of BAL fluid increased significantly only in the partial liquid ventilation group. Conversion of active to non-active surfactant components increased significantly in the partial liquid ventilation group and in the group ventilated with high PEEP. In the surfactant group and partial liquid ventilation groups, less lung injury was found compared with the ventilated control group and the group ventilated with high PEEP. We conclude that although all three strategies improved PaO2 to > 50 kPa, the impact on protein transfer into the alveoli, surfactant system and lung injury differed markedly.

Multifaceted bench comparative evaluation of latest intensive care unit ventilators.

PubMed

Garnier, M; Quesnel, C; Fulgencio, J-P; Degrain, M; Carteaux, G; Bonnet, F; Similowski, T; Demoule, A

2015-07-01

Independent bench studies using specific ventilation scenarios allow testing of the performance of ventilators in conditions similar to clinical settings. The aims of this study were to determine the accuracy of the latest generation ventilators to deliver chosen parameters in various typical conditions and to provide clinicians with a comprehensive report on their performance. Thirteen modern intensive care unit ventilators were evaluated on the ASL5000 test lung with and without leakage for: (i) accuracy to deliver exact tidal volume (VT) and PEEP in assist-control ventilation (ACV); (ii) performance of trigger and pressurization in pressure support ventilation (PSV); and (iii) quality of non-invasive ventilation algorithms. In ACV, only six ventilators delivered an accurate VT and nine an accurate PEEP. Eleven devices failed to compensate VT and four the PEEP in leakage conditions. Inspiratory delays differed significantly among ventilators in invasive PSV (range 75-149 ms, P=0.03) and non-invasive PSV (range 78-165 ms, P<0.001). The percentage of the ideal curve (concomitantly evaluating the pressurization speed and the levels of pressure reached) also differed significantly (range 57-86% for invasive PSV, P=0.04; and 60-90% for non-invasive PSV, P<0.001). Non-invasive ventilation algorithms efficiently prevented the decrease in pressurization capacities and PEEP levels induced by leaks in, respectively, 10 and 12 out of the 13 ventilators. We observed real heterogeneity of performance amongst the latest generation of intensive care unit ventilators. Although non-invasive ventilation algorithms appear to maintain adequate pressurization efficiently in the case of leakage, basic functions, such as delivered VT in ACV and pressurization in PSV, are often less reliable than the values displayed by the device suggest. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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.

PubMed

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 < 0.001). In both groups, arterial oxygenation decreased when bilateral-lung 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 < 0.001) after the alveolar recruitment maneuver and optimal PEEP adjustment. The alveolar recruitment maneuver did not decrease cardiac index in any patient. During one-lung 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.

Passive continuous positive airway pressure ventilation during cardiopulmonary resuscitation: a randomized cross-over manikin simulation study.

PubMed

Winkler, Bernd E; Muellenbach, Ralf M; Wurmb, Thomas; Struck, Manuel F; Roewer, Norbert; Kranke, Peter

2017-02-01

While controlled ventilation is most frequently used during cardiopulmonary resuscitation (CPR), the application of continuous positive airway pressure (CPAP) and passive ventilation of the lung synchronously with chest compressions and decompressions might represent a promising alternative approach. One benefit of CPAP during CPR is the reduction of peak airway pressures and therefore a potential enhancement in haemodynamics. We therefore evaluated the tidal volumes and airway pressures achieved during CPAP-CPR. During CPR with the LUCAS™ 2 compression device, a manikin model was passively ventilated at CPAP levels of 5, 10, 20 and 30 hPa with the Boussignac tracheal tube and the ventilators Evita ® V500, Medumat ® Transport, Oxylator ® EMX, Oxylog ® 2000, Oxylog ® 3000, Primus ® and Servo ® -i as well as the Wenoll ® diver rescue system. Tidal volumes and airway pressures during CPAP-CPR were recorded and analyzed. Tidal volumes during CPAP-CPR were higher than during compression-only CPR without positive airway pressure. The passively generated tidal volumes increased with increasing CPAP levels and were significantly influenced by the ventilators used. During ventilation at 20 hPa CPAP via a tracheal tube, the mean tidal volumes ranged from 125 ml (Medumat ® ) to 309 ml (Wenoll ® ) and the peak airway pressures from 23 hPa (Primus ® ) to 49 hPa (Oxylog ® 3000). Transport ventilators generated lower tidal volumes than intensive care ventilators or closed-circuit systems. Peak airway pressures during CPAP-CPR were lower than those during controlled ventilation CPR reported in literature. High peak airway pressures are known to limit the applicability of ventilation via facemask or via supraglottic airway devices and may adversely affect haemodynamics. Hence, the application of ventilators generating high tidal volumes with low peak airway pressures appears desirable during CPAP-CPR. The limited CPAP-CPR capabilities of transport ventilators in our study might be prerequisite for future developments of transport ventilators.

[Guide for the use of jet-ventilation during ENT and oral surgery].

PubMed

Bourgain, J-L; Chollet, M; Fischler, M; Gueret, G; Mayne, A

2010-10-01

The aim of this synthesis was to give recommendations on the use of jet-ventilation during ENT surgical and endoscopy procedures. Literature was collected from PUBMED and analysed by the members of French association of anaesthesiologists in ENT surgery, all skilled in this field. Presentation of these recommendations was given during the general assembly held in Reims, the 15th May 2009. Jet-ventilation is especially indicated during upper airway endoscopy and laryngeal invasive endoscopic surgery. Furthermore, transtracheal jet ventilation is included on most of difficult oxygenation and difficult intubation algorithm. The main risk of jet-ventilation is pulmonary barotrauma when expiration of injected gas is impeded by an upper airway obstruction. Failure and complications of tracheal puncture are rare when performed by experimented operators. Clinical use of jet ventilation requires a dedicated device. Practice of jet ventilation without intubation may be dangerous when applied without control of driving pressure and end expiratory tracheal pressure. Every anaesthetist should be familiar with transtracheal ventilation since they may face a "cannot ventilate cannot intubate" situation. Upper airway endoscopy and laryngeal surgery are the ideal field for training jet ventilation, even more so as this technique offers perfect operative conditions. To apply this project, jet ventilation should be used more frequently in routine practice. To maintain skill, regular use of these techniques is required. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Noninvasive Ventilation in Premature Neonates.

PubMed

Flanagan, Keri Ann

2016-04-01

The use of noninvasive ventilation is a constantly evolving treatment option for respiratory disease in the premature infant. The goals of these noninvasive ventilation techniques are to improve gas exchange in the premature infant's lungs and to minimize the need for intubation and invasive mechanical ventilation. The goals of this article are to consider various uses of nasal interfaces, discuss skin care and developmental positioning concerns faced by the bedside nurse, and discuss the medical management aimed to reduce morbidity and mortality. This article explores the nursing role, the advances in medical strategies for noninvasive ventilation, and the team approach to noninvasive ventilation use in this population. Search strategy included a literature review on medical databases, such as EBSCOhost, CINAHL, PubMed, and NeoReviews. Innovative products, nursing research on developmental positioning and skin care, and advanced medical management have led to better and safer outcomes for premature infants requiring noninvasive ventilation. The medical focus of avoiding long-term mechanical ventilation would not be possible without the technology to provide noninvasive ventilation to these premature infants and the watchful eye of the nurse in terms of careful positioning, preventing skin breakdown and facial scarring, and a proper seal to maximize ventilation accuracy. This article encourages nursing-based research to quantify some of the knowledge about skin care and positioning as well as research into most appropriate uses for noninvasive ventilation devices.

Weaning from mechanical ventilation: why are we still looking for alternative methods?

PubMed

Frutos-Vivar, F; Esteban, A

2013-12-01

Most patients who require mechanical ventilation for longer than 24 hours, and who improve the condition leading to the indication of ventilatory support, can be weaned after passing a first spontaneous breathing test. The challenge is to improve the weaning of patients who fail that first test. We have methods that can be referred to as traditional, such as the T-tube, pressure support or synchronized intermittent mandatory ventilation (SIMV). In recent years, however, new applications of usual techniques as noninvasive ventilation, new ventilation methods such as automatic tube compensation (ATC), mandatory minute ventilation (MMV), adaptive support ventilation or automatic weaning systems based on pressure support have been described. Their possible role in weaning from mechanical ventilation among patients with difficult or prolonged weaning remains to be established. Copyright © 2012 Elsevier España, S.L. and SEMICYUC. All rights reserved.

Circuit compliance compensation in lung protective ventilation.

PubMed

Masselli, Grazia Maria Pia; Silvestri, Sergio; Sciuto, Salvatore Andrea; Cappa, Paolo

2006-01-01

Lung protective ventilation utilizes low tidal volumes to ventilate patients with severe lung pathologies. The compensation of breathing circuit effects, i.e. those induced by compressible volume of the circuit, results particularly critical in the calculation of the actual tidal volume delivered to patient's respiratory system which in turns is responsible of the level of permissive hypercapnia. The present work analyzes the applicability of the equation for circuit compressible volume compensation in the case of pressure and volume controlled lung protective ventilation. Experimental tests conducted in-vitro show that the actual tidal volume can be reliably estimated if the compliance of the breathing circuit is measured with the same parameters and ventilation technique that will be utilized in lung protective ventilation. Differences between volume and pressure controlled ventilation are also quantitatively assessed showing that pressure controlled ventilation allows a more reliable compensation of breathing circuit compressible volume.

The Effect of Pressure-Controlled Ventilation and Volume-Controlled Ventilation in Prone Position on Pulmonary Mechanics and Inflammatory Markers.

PubMed

Şenay, Hasan; Sıvacı, Remziye; Kokulu, Serdar; Koca, Buğra; Bakı, Elif Doğan; Ela, Yüksel

2016-08-01

The aim of this present study is to compare the effect of pressure-controlled ventilation and volume-controlled ventilation on pulmonary mechanics and inflammatory markers in prone position. The study included 41 patients undergoing to vertebrae surgery. The patients were randomized into two groups: Group 1 received volume-controlled ventilation, while group 2 received pressure-controlled ventilation. The demographic data, pulmonary mechanics, the inflammatory marker levels just after the induction of anesthetics, at the 6th and 12th hours, and gas analysis from arterial blood samples taken at the beginning and the 30th minute were recorded. The inflammatory marker levels increased in both groups, without any significant difference among groups. Peak inspiratory pressure level was higher in the volume-controlled ventilation group. This study revealed that there is no difference regarding inflammatory marker levels between volume- and pressure-controlled ventilation.

Pleural liquid and kinetic friction coefficient of mesothelium after mechanical ventilation.

PubMed

Bodega, Francesca; Sironi, Chiara; Porta, Cristina; Zocchi, Luciano; Agostoni, Emilio

2015-01-15

Volume and protein concentration of pleural liquid in anesthetized rabbits after 1 or 3h of mechanical ventilation, with alveolar pressure equal to atmospheric at end expiration, were compared to those occurring after spontaneous breathing. Moreover, coefficient of kinetic friction between samples of visceral and parietal pleura, obtained after spontaneous or mechanical ventilation, sliding in vitro at physiological velocity under physiological load, was determined. Volume of pleural liquid after mechanical ventilation was similar to that previously found during spontaneous ventilation. This finding is contrary to expectation of Moriondo et al. (2005), based on measurement of lymphatic and interstitial pressure. Protein concentration of pleural liquid after mechanical ventilation was also similar to that occurring after spontaneous ventilation. Coefficient of kinetic friction after mechanical ventilation was 0.023±0.001, similar to that obtained after spontaneous breathing. Copyright © 2014 Elsevier B.V. All rights reserved.

Numerical simulation of volume-controlled mechanical ventilated respiratory system with 2 different lungs.

PubMed

Shi, Yan; Zhang, Bolun; Cai, Maolin; Zhang, Xiaohua Douglas

2017-09-01

Mechanical ventilation is a key therapy for patients who cannot breathe adequately by themselves, and dynamics of mechanical ventilation system is of great significance for life support of patients. Recently, models of mechanical ventilated respiratory system with 1 lung are used to simulate the respiratory system of patients. However, humans have 2 lungs. When the respiratory characteristics of 2 lungs are different, a single-lung model cannot reflect real respiratory system. In this paper, to illustrate dynamic characteristics of mechanical ventilated respiratory system with 2 different lungs, we propose a mathematical model of mechanical ventilated respiratory system with 2 different lungs and conduct experiments to verify the model. Furthermore, we study the dynamics of mechanical ventilated respiratory system with 2 different lungs. This research study can be used for improving the efficiency and safety of volume-controlled mechanical ventilation system. Copyright © 2016 John Wiley & Sons, Ltd.

Continuous distributions of specific ventilation recovered from inert gas washout

NASA Technical Reports Server (NTRS)

Lewis, S. M.; Evans, J. W.; Jalowayski, A. A.

1978-01-01

A new technique is described for recovering continuous distributions of ventilation as a function of tidal ventilation/volume ratio from the nitrogen washout. The analysis yields a continuous distribution of ventilation as a function of tidal ventilation/volume ratio represented as fractional ventilations of 50 compartments plus dead space. The procedure was verified by recovering known distributions from data to which noise had been added. Using an apparatus to control the subject's tidal volume and FRC, mixed expired N2 data gave the following results: (a) the distributions of young, normal subjects were narrow and unimodal; (b) those of subjects over age 40 were broader with more poorly ventilated units; (c) patients with pulmonary disease of all descriptions showed enlarged dead space; (d) patients with cystic fibrosis showed multimodal distributions with the bulk of the ventilation going to overventilated units; and (e) patients with obstructive lung disease fell into several classes, three of which are illustrated.

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

PubMed

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

2017-06-30

Traditional ventilation approaches, providing high tidal volumes (Vt), produce excessive alveolar distention and lung injury. Protective ventilation, employing lower Vt and positive end-expiratory pressure (PEEP), is an attractive alternative also for neuroanesthesia, when prolonged mechanical ventilation is needed. Nevertheless, protective ventilation during intracranial surgery may exert dangerous effects on intracranial pressure (ICP). We tested the feasibility of a protective ventilation strategy in neurosurgery. Our monocentric, double-blind, 1:1 randomized, 2×2 crossover study aimed at studying the effect size and variability of ICP in patients undergoing elective supratentorial brain tumor removal and alternatively ventilated with Vt 9 mL/kg-PEEP 0 mm Hg and Vt 7 mL/kg-PEEP 5 mm Hg. Respiratory rate was adjusted to maintain comparable end-tidal carbon dioxide between ventilation modes. ICP was measured through a subdural catheter inserted before dural opening. Forty patients were enrolled; 8 (15%) were excluded after enrollment. ICP did not differ between traditional and protective ventilation (11.28±5.37, 11 [7 to 14.5] vs. 11.90±5.86, 11 [8 to 15] mm Hg; P=0.541). End-tidal carbon dioxide (28.91±2.28, 29 [28 to 30] vs. 28.00±2.17, 28 [27 to 29] mm Hg; P<0.001). Peak airway pressure (17.25±1.97, 17 [16 to 18.5] vs. 15.81±2.87, 15.5 [14 to 17] mm Hg; P<0.001) and plateau airway pressure (16.06±2.30, 16 [14.5 to 17] vs. 14.19±2.82, 14 [12.5 to 16] mm Hg; P<0.001) were higher during protective ventilation. Blood pressure, heart rate, and body temperature did not differ between ventilation modes. Dural tension was "acceptable for surgery" in all cases. ICP differences between ventilation modes were not affected by ICP values under traditional ventilation (coefficient=0.067; 95% confidence interval, -0.278 to 0.144; P=0.523). Protective ventilation is a feasible alternative to traditional ventilation during elective neurosurgery.

Variability in Usual Care Mechanical Ventilation for Pediatric Acute Respiratory Distress Syndrome: Time for a Decision Support Protocol?

PubMed

Newth, Christopher J L; Sward, Katherine A; Khemani, Robinder G; Page, Kent; Meert, Kathleen L; Carcillo, Joseph A; Shanley, Thomas P; Moler, Frank W; Pollack, Murray M; Dalton, Heidi J; Wessel, David L; Berger, John T; Berg, Robert A; Harrison, Rick E; Holubkov, Richard; Doctor, Allan; Dean, J Michael; Jenkins, Tammara L; Nicholson, Carol E

2017-11-01

Although pediatric intensivists philosophically embrace lung protective ventilation for acute lung injury and acute respiratory distress syndrome, we hypothesized that ventilator management varies. We assessed ventilator management by evaluating changes to ventilator settings in response to blood gases, pulse oximetry, or end-tidal CO2. We also assessed the potential impact that a pediatric mechanical ventilation protocol adapted from National Heart Lung and Blood Institute acute respiratory distress syndrome network protocols could have on reducing variability by comparing actual changes in ventilator settings to those recommended by the protocol. Prospective observational study. Eight tertiary care U.S. PICUs, October 2011 to April 2012. One hundred twenty patients (age range 17 d to 18 yr) with acute lung injury/acute respiratory distress syndrome. Two thousand hundred arterial and capillary blood gases, 3,964 oxygen saturation by pulse oximetry, and 2,757 end-tidal CO2 values were associated with 3,983 ventilator settings. Ventilation mode at study onset was pressure control 60%, volume control 19%, pressure-regulated volume control 18%, and high-frequency oscillatory ventilation 3%. Clinicians changed FIO2 by ±5 or ±10% increments every 8 hours. Positive end-expiratory pressure was limited at ~10 cm H2O as oxygenation worsened, lower than would have been recommended by the protocol. In the first 72 hours of mechanical ventilation, maximum tidal volume/kg using predicted versus actual body weight was 10.3 (8.5-12.9) (median [interquartile range]) versus 9.2 mL/kg (7.6-12.0) (p < 0.001). Intensivists made changes similar to protocol recommendations 29% of the time, opposite to the protocol's recommendation 12% of the time and no changes 56% of the time. Ventilator management varies substantially in children with acute respiratory distress syndrome. Opportunities exist to minimize variability and potentially injurious ventilator settings by using a pediatric mechanical ventilation protocol offering adequately explicit instructions for given clinical situations. An accepted protocol could also reduce confounding by mechanical ventilation management in a clinical trial.

MO-A-BRD-05: Evaluation of Composed Lung Ventilation with 4DCT and Image Registration

DOE Office of Scientific and Technical Information (OSTI.GOV)

Du, K; Bayouth, J; Reinhardt, J

Purpose: Regional pulmonary function can be derived using fourdimensional computed tomography (4DCT) combined with deformable image registration. However, only peak inhale and exhale phases have been used thus far while the lung ventilation during intermediate phases is not considered. In our previous work, we have investigated the spatiotemporal heterogeneity of lung ventilation and its dependence on respiration effort. In this study, composed ventilation is introduced using all inspiration phases and compared to direct ventilation. Both methods are evaluated against Xe-CT derived ventilation. Methods: Using an in-house tissue volume preserving deformable image registration, unlike the direct ventilation method, which computes frommore » end expiration to end inspiration, Jacobian ventilation maps were computed from one inhale phase to the next and then composed from all inspiration steps. The two methods were compared in both patients prior to RT and mechanically ventilated sheep subjects. In addition, they wereassessed for the correlation with Xe-CT derived ventilation in sheep subjects. Annotated lung landmarks were used to evaluate the accuracy of original and composed deformation field. Results: After registration, the landmark distance for composed deformation field was always higher than that for direct deformation field (0IN to 100IN average in human: 1.03 vs 1.53, p=0.001, and in sheep: 0.80 vs0.94, p=0.009), and both increased with longer phase interval. Direct and composed ventilation maps were similar in both sheep (gamma pass rate 87.6) and human subjects (gamma pass rate 71.9),and showed consistent pattern from ventral to dorsal when compared to Xe-CT derived ventilation. Correlation coefficient between Xe-CT and composed ventilation was slightly better than the direct method but not significant (average 0.89 vs 0.85, p=0.135). Conclusion: More strict breathing control in sheep subjects may explain higher similarity between direct and composed ventilation. When compared to Xe-CT ventilation, no significant difference was found for the composed method. NIH Grant: R01 CA166703.« less

Prediction and outcomes of impossible mask ventilation: a review of 50,000 anesthetics.

PubMed

Kheterpal, Sachin; Martin, Lizabeth; Shanks, Amy M; Tremper, Kevin K

2009-04-01

There are no existing data regarding risk factors for impossible mask ventilation and limited data regarding its incidence. The authors sought to determine the incidence, predictors, and outcomes associated with impossible mask ventilation. The authors performed an observational study over a 4-yr period. For each adult patient undergoing a general anesthetic, preoperative patient characteristics, detailed airway physical exam, and airway outcome data were collected. The primary outcome was impossible mask ventilation defined as the inability to exchange air during bag-mask ventilation attempts, despite multiple providers, airway adjuvants, or neuromuscular blockade. Secondary outcomes included the final, definitive airway management technique and direct laryngoscopy view. The incidence of impossible mask ventilation was calculated. Independent (P < 0.05) predictors of impossible mask ventilation were identified by performing a logistic regression full model fit. Over a 4-yr period from 2004 to 2008, 53,041 attempts at mask ventilation were recorded. A total of 77 cases of impossible mask ventilation (0.15%) were observed. Neck radiation changes, male sex, sleep apnea, Mallampati III or IV, and presence of beard were identified as independent predictors. The receiver-operating-characteristic area under the curve for this model was 0.80 +/- 0.03. Nineteen impossible mask ventilation patients (25%) also demonstrated difficult intubation, with 15 being intubated successfully. Twelve patients required an alternative intubation technique, including two surgical airways and two patients who were awakened and underwent successful fiberoptic intubation. Impossible mask ventilation is an infrequent airway event that is associated with difficult intubation. Neck radiation changes represent the most significant clinical predictor of impossible mask ventilation in the patient dataset.

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

PubMed Central

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

2012-01-01

Objective To evaluate the association of volume limited and pressure limited (lung protective) mechanical ventilation with two year survival in patients with acute lung injury. Design Prospective cohort study. Setting 13 intensive care units at four hospitals in Baltimore, Maryland, USA. Participants 485 consecutive mechanically ventilated patients with acute lung injury. Main outcome measure Two year survival after onset of acute lung injury. Results 485 patients contributed data for 6240 eligible ventilator settings, as measured twice daily (median of eight eligible ventilator settings per patient; 41% of which adhered to lung protective ventilation). Of these patients, 311 (64%) died within two years. After adjusting for the total duration of ventilation and other relevant covariates, each additional ventilator setting adherent to lung protective ventilation was associated with a 3% decrease in the risk of mortality over two years (hazard ratio 0.97, 95% confidence interval 0.95 to 0.99, P=0.002). Compared with no adherence, the estimated absolute risk reduction in two year mortality for a prototypical patient with 50% adherence to lung protective ventilation was 4.0% (0.8% to 7.2%, P=0.012) and with 100% adherence was 7.8% (1.6% to 14.0%, P=0.011). Conclusions Lung protective mechanical ventilation was associated with a substantial long term survival benefit for patients with acute lung injury. Greater use of lung protective ventilation in routine clinical practice could reduce long term mortality in patients with acute lung injury. Trial registration Clinicaltrials.gov NCT00300248. PMID:22491953

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

PubMed Central

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

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

NASA Astrophysics Data System (ADS)

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.

Natural ventilation for the prevention of airborne contagion.

PubMed

Escombe, A Roderick; Oeser, Clarissa C; Gilman, Robert H; Navincopa, Marcos; Ticona, Eduardo; Pan, William; Martínez, Carlos; Chacaltana, Jesus; Rodríguez, Richard; Moore, David A J; Friedland, Jon S; Evans, Carlton A

2007-02-01

Institutional transmission of airborne infections such as tuberculosis (TB) is an important public health problem, especially in resource-limited settings where protective measures such as negative-pressure isolation rooms are difficult to implement. Natural ventilation may offer a low-cost alternative. Our objective was to investigate the rates, determinants, and effects of natural ventilation in health care settings. The study was carried out in eight hospitals in Lima, Peru; five were hospitals of "old-fashioned" design built pre-1950, and three of "modern" design, built 1970-1990. In these hospitals 70 naturally ventilated clinical rooms where infectious patients are likely to be encountered were studied. These included respiratory isolation rooms, TB wards, respiratory wards, general medical wards, outpatient consulting rooms, waiting rooms, and emergency departments. These rooms were compared with 12 mechanically ventilated negative-pressure respiratory isolation rooms built post-2000. Ventilation was measured using a carbon dioxide tracer gas technique in 368 experiments. Architectural and environmental variables were measured. For each experiment, infection risk was estimated for TB exposure using the Wells-Riley model of airborne infection. We found that opening windows and doors provided median ventilation of 28 air changes/hour (ACH), more than double that of mechanically ventilated negative-pressure rooms ventilated at the 12 ACH recommended for high-risk areas, and 18 times that with windows and doors closed (p < 0.001). Facilities built more than 50 years ago, characterised by large windows and high ceilings, had greater ventilation than modern naturally ventilated rooms (40 versus 17 ACH; p < 0.001). Even within the lowest quartile of wind speeds, natural ventilation exceeded mechanical (p < 0.001). The Wells-Riley airborne infection model predicted that in mechanically ventilated rooms 39% of susceptible individuals would become infected following 24 h of exposure to untreated TB patients of infectiousness characterised in a well-documented outbreak. This infection rate compared with 33% in modern and 11% in pre-1950 naturally ventilated facilities with windows and doors open. Opening windows and doors maximises natural ventilation so that the risk of airborne contagion is much lower than with costly, maintenance-requiring mechanical ventilation systems. Old-fashioned clinical areas with high ceilings and large windows provide greatest protection. Natural ventilation costs little and is maintenance free, and is particularly suited to limited-resource settings and tropical climates, where the burden of TB and institutional TB transmission is highest. In settings where respiratory isolation is difficult and climate permits, windows and doors should be opened to reduce the risk of airborne contagion.

Prospective targeting and control of end-tidal CO2 and O2 concentrations

PubMed Central

Slessarev, Marat; Han, Jay; Mardimae, Alexandra; Prisman, Eitan; Preiss, David; Volgyesi, George; Ansel, Cliff; Duffin, James; Fisher, Joseph A

2007-01-01

Current methods of forcing end-tidal PCO2 (PETCO2) and PO2 (PETO2) rely on breath-by-breath adjustment of inspired gas concentrations using feedback loop algorithms. Such servo-control mechanisms are complex because they have to anticipate and compensate for the respiratory response to a given inspiratory gas concentration on a breath-by-breath basis. In this paper, we introduce a low gas flow method to prospectively target and control PETCO2 and PETO2 independent of each other and of minute ventilation in spontaneously breathing humans. We used the method to change PETCO2 from control (40 mmHg for PETCO2 and 100 mmHg for PETO2) to two target PETCO2 values (45 and 50 mmHg) at iso-oxia (100 mmHg), PETO2 to two target values (200 and 300 mmHg) at normocapnia (40 mmHg), and PETCO2 with PETO2 simultaneously to the same targets (45 with 200 mmHg and 50 with 300 mmHg). After each targeted value, PETCO2 and PETO2 were returned to control values. Each state was maintained for 30 s. The average difference between target and measured values for PETCO2 was ± 1 mmHg, and for PETO2 was ± 4 mmHg. PETCO2 varied by ± 1 mmHg and PETO2 by ± 5.6 mmHg (s.d.) over the 30 s stages. This degree of control was obtained despite considerable variability in minute ventilation between subjects (± 7.6 l min−1). We conclude that targeted end-tidal gas concentrations can be attained in spontaneously breathing subjects using this prospective, feed-forward, low gas flow system. PMID:17446225

46 CFR 194.20-5 - Ventilation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OCEANOGRAPHIC RESEARCH VESSELS HANDLING, USE, AND... Ventilation. (a) Chemical storerooms shall be equipped with a power ventilation system of exhaust type. The... based upon the volume of the compartment. (1) Power ventilation units shall have nonsparking impellers...

VENTILATION TECHNOLOGY SYSTEMS ANALYSIS

EPA Science Inventory

The report gives results of a project to develop a systems analysis of ventilation technology and provide a state-of-the-art assessment of ventilation and indoor air quality (IAQ) research needs. (NOTE: Ventilation technology is defined as the hardware necessary to bring outdoor ...

14 CFR 125.117 - Ventilation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Ventilation. 125.117 Section 125.117 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR CARRIERS....117 Ventilation. Each passenger or crew compartment must be suitably ventilated. Carbon monoxide...

SY Tank Farm ventilation isolation option risk assessment report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Powers, T.B.; Morales, S.D.

The safety of the 241-SY Tank Farm ventilation system has been under extensive scrutiny due to safety concerns associated with tank 101-SY. Hydrogen and other gases are generated and trapped in the waste below the liquid surface. Periodically, these gases are released into the dome space and vented through the exhaust system. This attention to the ventilation system has resulted in the development of several alternative ventilation system designs. The ventilation system provides the primary means of mitigation of accidents associated with flammable gases. This report provides an assessment of various alternatives ventilation system designs.

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

PubMed Central

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

2014-01-01

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

A taxonomy for mechanical ventilation: 10 fundamental maxims.

PubMed

Chatburn, Robert L; El-Khatib, Mohamad; Mireles-Cabodevila, Eduardo

2014-11-01

The American Association for Respiratory Care has declared a benchmark for competency in mechanical ventilation that includes the ability to "apply to practice all ventilation modes currently available on all invasive and noninvasive mechanical ventilators." This level of competency presupposes the ability to identify, classify, compare, and contrast all modes of ventilation. Unfortunately, current educational paradigms do not supply the tools to achieve such goals. To fill this gap, we expand and refine a previously described taxonomy for classifying modes of ventilation and explain how it can be understood in terms of 10 fundamental constructs of ventilator technology: (1) defining a breath, (2) defining an assisted breath, (3) specifying the means of assisting breaths based on control variables specified by the equation of motion, (4) classifying breaths in terms of how inspiration is started and stopped, (5) identifying ventilator-initiated versus patient-initiated start and stop events, (6) defining spontaneous and mandatory breaths, (7) defining breath sequences (8), combining control variables and breath sequences into ventilatory patterns, (9) describing targeting schemes, and (10) constructing a formal taxonomy for modes of ventilation composed of control variable, breath sequence, and targeting schemes. Having established the theoretical basis of the taxonomy, we demonstrate a step-by-step procedure to classify any mode on any mechanical ventilator. Copyright © 2014 by Daedalus Enterprises.

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

PubMed Central

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

2016-01-01

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

An easy tool to assess ventilation in health facilities as part of air-borne transmission prevention: a cross-sectional survey from Uganda.

PubMed

Brouwer, Miranda; Katamba, Achilles; Katabira, Elly Tebasoboke; van Leth, Frank

2017-05-03

No guidelines exist on assessing ventilation through air changes per hour (ACH) using a vaneometer. The objective of the study was to evaluate the position and frequency for measuring air velocity using a vaneometer to assess ventilation with ACH; and to assess influence of ambient temperature and weather on ACH. Cross-sectional survey in six urban health facilities in Kampala, Uganda. Measurements consisted of taking air velocity on nine separate moments in five positions in each opening of the TB clinic, laboratory, outpatient consultation and outpatient waiting room using a vaneometer. We assessed in addition the ventilation with the "20% rule", and compared this estimation with the ventilation in ACH assessed using the vaneometer. A total of 189 measurements showed no influence on air velocity of the position and moment of the measurement. No significant influence existed of ambient temperature and a small but significant influence of sunny weather. Ventilation was adequate in 17/24 (71%) of all measurements. Using the "20% rule", ventilation was adequate in 50% of rooms assessed. Agreement between both methods existed in 13/23 (56%) of the rooms assessed. Most rooms had adequate ventilation when assessed using a vaneometer for measuring air velocity. A single vaneometer measurement of air velocity is adequate to assess ventilation in this setting. These findings provide practical input for clear guidelines on assessing ventilation using a vaneometer. Assessing ventilation with a vaneometer differs substantially from applying the "20% rule".

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

PubMed

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

2015-01-01

Wood pellets have been reported to emit toxic gaseous emissions during transport and storage. Carbon monoxide (CO) emission, due to the high toxicity of the gas and the possibility of it being present at high levels, is the most imminent threat to be considered before entering a pellet storage facility. For small-scale (<30 tons storage capacity) residential pellet storage facilities, ventilation, preferably natural ventilation utilizing already existing openings, has become the most favored solution to overcome the problem of high CO concentrations. However, there is little knowledge on the ventilation rates that can be reached and thus on the effectiveness of such measures. The aim of the study was to investigate ventilation rates for a specific small-scale pellet storage system depending on characteristic temperature differences. Furthermore, the influence of the implementation of a chimney and the influence of cross-ventilation on the ventilation rates were investigated. The air exchange rates observed in the experiments ranged between close to zero and up to 8 m(3) h(-1), depending largely on the existing temperature differences and the existence of cross-ventilation. The results demonstrate that implementing natural ventilation is a possible measure to enhance safety from CO emissions, but not one without limitations. © The Author 2014. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

Acetazolamide Therapy for Metabolic Alkalosis in Pediatric Intensive Care Patients.

PubMed

López, Carolina; Alcaraz, Andrés José; Toledo, Blanca; Cortejoso, Lucía; Gil-Ruiz, Maite Augusta

2016-12-01

Patients in PICUs frequently present hypochloremic metabolic alkalosis secondary to loop diuretic treatment, especially those undergoing cardiac surgery. This study evaluates the effectiveness of acetazolamide therapy for metabolic alkalosis in PICU patients. Retrospective, observational study. A tertiary care children's hospital PICU. Children receiving at least a 2-day course of enteral acetazolamide. None. Demographic variables, diuretic treatment and doses of acetazolamide, urine output, serum electrolytes, urea and creatinine, acid-base excess, pH, and use of mechanical ventilation during treatment were collected. Patients were studied according to their pathology (postoperative cardiac surgery, decompensated heart failure, or respiratory disease). A total of 78 episodes in 58 patients were identified: 48 were carried out in cardiac postoperative patients, 22 in decompensated heart failure, and eight in respiratory patients. All patients received loop diuretics. A decrease in pH and PCO2 in the first 72 hours, a decrease in serum HCO3 (mean, 4.65 ± 4.83; p < 0.001), and an increase in anion gap values were observed. Urine output increased in cardiac postoperative patients (4.5 ± 2.2 vs 5.1 ± 2.0; p = 0.020), whereas diuretic treatment was reduced in cardiac patients. There was no significant difference in serum electrolytes, blood urea, creatinine, nor chloride after the administration of acetazolamide from baseline. Acetazolamide treatment was well tolerated in all patients. Acetazolamide decreases serum HCO3 and PCO2 in PICU cardiac patients with metabolic alkalosis secondary to diuretic therapy. Cardiac postoperative patients present a significant increase in urine output after acetazolamide treatment.

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

PubMed

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, the use of appropriate antibiotic therapy for tracheobronchitis was associated with significantly lower progression to pneumonia than was inappropriate treatment (19 [8%] of 250 vs 20 [29%] of 70, p<0·0001; crude odds ratio 0·21 [95% CI 0·11-0·41]). Significantly more patients with ventilator-associated pneumonia died (146 [40%] of 369) than those with tracheobronchitis (93 [29%] of 320) or absence of ventilator-associated lower respiratory tract infections (673 [30%] of 2271, p<0·0001). Median time to discharge from the ICU for survivors was significantly longer in the tracheobronchitis (21 days [IQR 15-34]) and pneumonia (22 [13-36]) groups than in the group with no ventilator-associated lower respiratory tract infections (12 [8-20]; hazard ratio 1·65 [95% CI 1·38-1·97], p<0·0001). This large database study emphasises that ventilator-associated tracheobronchitis is a major health problem worldwide, associated with high resources consumption in all countries. Our findings also show improved outcomes with use of appropriate antibiotic treatment for both ventilator-associated tracheobronchitis and ventilator-associated pneumonia, underlining the importance of treating both infections, since inappropriate treatment of tracheobronchitis was associated with a higher risk of progression to pneumonia. None. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

PubMed Central

Lipes, Jed; Bojmehrani, Azadeh; Lellouche, Francois

2012-01-01

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

Hydrotherapy for the long-term ventilated patient: A case study and implications for practice.

PubMed

Wegner, Sally; Thomas, Peter; James, Christine

2017-11-01

Hydrotherapy of mechanically ventilated patients has been shown to be safe and feasible in both the acute stages of critical illness and in those requiring long term mechanical ventilation. This case study describes the hydrotherapy sessions of a 36 year old female, who after suffering complications of pneumococcal meningitis, became an incomplete quadriplegic and required long term mechanical ventilation. When implementing hydrotherapy with patients on mechanical ventilation a number of factors should be considered. These include staff resources and training, airway and ventilation management, patient preparation and safety procedures. Hydrotherapy can be safely utilised with mechanically ventilated patients, and may facilitate a patient's ability to participate in active exercise and rehabilitation. Copyright © 2017 Australian College of Critical Care Nurses Ltd. All rights reserved.

Ventilation for an enclosure of a gas turbine and related method

DOEpatents

Schroeder, Troy Joseph; Leach, David; O'Toole, Michael Anthony

2002-01-01

A ventilation scheme for a rotary machine supported on pedestals within an enclosure having a roof, end walls and side walls with the machine arranged parallel to the side walls, includes ventilation air inlets located in a first end wall of the enclosure; a barrier wall located within the enclosure, proximate the first end wall to thereby create a plenum chamber. The barrier wall is constructed to provide a substantially annular gap between the barrier wall and a casing of the turbine to thereby direct ventilation air axially along the turbine; one or more ventilation air outlets located proximate a second, opposite end wall on the roof of the enclosure. In addition, one or more fans are provided for pulling ventilating air into said plenum chamber via the ventilation air inlets.

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

PubMed

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

2013-05-01

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

Influence of Mechanical Ventilation on the Incidence of Pneumothorax During Infraclavicular Subclavian Vein Catheterization: A Prospective Randomized Noninferiority Trial.

PubMed

Kim, Eugene; Kim, Hyun Joo; Hong, Deok Man; Park, Hee-Pyoung; Bahk, Jae-Hyon

2016-09-01

It remains unclear whether we have to interrupt mechanical ventilation during infraclavicular subclavian venous catheterization. In practice, the clinicians' choice about lung deflation depends on their own discretion. The purpose of this study was to assess the influence of mechanical ventilation on the incidence of pneumothorax during infraclavicular subclavian venous catheterization. A total of 332 patients, who needed subclavian venous catheterization, were randomly assigned to 1 of the 2 groups: catheterizations were performed with the patients' lungs under mechanical ventilation (ventilation group, n = 165) or without mechanical ventilation (deflation group, n = 167). The incidences of pneumothorax and other complications such as arterial puncture, hemothorax, or catheter misplacements and the success rate of catheterization were compared. The incidences of pneumothorax were 0% (0/165) in the ventilation group and 0.6% (1/167) in the deflation group. The incidence of pneumothorax in the deflation group was 0.6% higher than that in the ventilation group and the 2-sided 90% confidence interval for the difference was (-1.29% to 3.44%). Because the lower bound for the 2-sided 90% confidence interval, -1.29%, was higher than the predefined noninferiority margin of -3%, the inferiority of the ventilation group over the deflation group was rejected at the .05 level of significance. Other complication rates and success rates of catheterization were comparable between 2 groups. The oxygen saturation dropped below 95% in 9 patients in the deflation group, while none in the ventilation group (P = .007). The success and complication rates were similar regardless of mechanical ventilation. During infraclavicular subclavian venous catheterization, interruption of mechanical ventilation does not seem to be necessary for the prevention of pneumothorax.

Feasibility of the capnogram to monitor ventilation rate during cardiopulmonary resuscitation.

PubMed

Aramendi, Elisabete; Elola, Andoni; Alonso, Erik; Irusta, Unai; Daya, Mohamud; Russell, James K; Hubner, Pia; Sterz, Fritz

2017-01-01

The rates of chest compressions (CCs) and ventilations are both important metrics to monitor the quality of cardiopulmonary resuscitation (CPR). Capnography permits monitoring ventilation, but the CCs provided during CPR corrupt the capnogram and compromise the accuracy of automatic ventilation detectors. The aim of this study was to evaluate the feasibility of an automatic algorithm based on the capnogram to detect ventilations and provide feedback on ventilation rate during CPR, specifically addressing intervals where CCs are delivered. The dataset used to develop and test the algorithm contained in-hospital and out-of-hospital cardiac arrest episodes. The method relies on adaptive thresholding to detect ventilations in the first derivative of the capnogram. The performance of the detector was reported in terms of sensitivity (SE) and Positive Predictive Value (PPV). The overall performance was reported in terms of the rate error and errors in the hyperventilation alarms. Results were given separately for the intervals with CCs. A total of 83 episodes were considered, resulting in 4880min and 46,740 ventilations (8741 during CCs). The method showed an overall SE/PPV above 99% and 97% respectively, even in intervals with CCs. The error for the ventilation rate was below 1.8min -1 in any group, and >99% of the ventilation alarms were correctly detected. A method to provide accurate feedback on ventilation rate using only the capnogram is proposed. Its accuracy was proven even in intervals where canpography signal was severely corrupted by CCs. This algorithm could be integrated into monitor/defibrillators to provide reliable feedback on ventilation rate during CPR. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Management and outcome of mechanically ventilated neurologic patients.

PubMed

Pelosi, Paolo; Ferguson, Niall D; Frutos-Vivar, Fernando; Anzueto, Antonio; Putensen, Christian; Raymondos, Konstantinos; Apezteguia, Carlos; Desmery, Pablo; Hurtado, Javier; Abroug, Fekri; Elizalde, José; Tomicic, Vinko; Cakar, Nahit; Gonzalez, Marco; Arabi, Yaseen; Moreno, Rui; Esteban, Andres

2011-06-01

To describe and compare characteristics, ventilatory practices, and associated outcomes among mechanically ventilated patients with different types of brain injury and between neurologic and nonneurologic patients. Secondary analysis of a prospective, observational, and multicenter study on mechanical ventilation. Three hundred forty-nine intensive care units from 23 countries. We included 552 mechanically ventilated neurologic patients (362 patients with stroke and 190 patients with brain trauma). For comparison we used a control group of 4,030 mixed patients who were ventilated for nonneurologic reasons. None. We collected demographics, ventilatory settings, organ failures, and complications arising during ventilation and outcomes. Multivariate logistic regression analysis was performed with intensive care unit mortality as the dependent variable. At admission, a Glasgow Coma Scale score ≤8 was observed in 68% of the stroke, 77% of the brain trauma, and 29% of the nonneurologic patients. Modes of ventilation and use of a lung-protective strategy within the first week of mechanical ventilation were similar between groups. In comparison with nonneurologic patients, patients with neurologic disease developed fewer complications over the course of mechanical ventilation with the exception of a higher rate of ventilator-associated pneumonia in the brain trauma cohort. Neurologic patients showed higher rates of tracheotomy and longer duration of mechanical ventilation. Mortality in the intensive care unit was significantly (p < .001) higher in patients with stroke (45%) than in brain trauma (29%) and nonneurologic disease (30%). Factors associated with mortality were: stroke (in comparison to brain trauma), Glasgow Coma Scale score on day 1, and severity at admission in the intensive care unit. In our study, one of every five mechanically ventilated patients received this therapy as a result of a neurologic disease. This cohort of patients showed a higher mortality rate than nonneurologic patients despite a lower incidence of extracerebral organ dysfunction.

Analysis of a Pediatric Home Mechanical Ventilator Population.

PubMed

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

2018-05-01

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

Protective lung ventilation in operating room: a systematic review.

PubMed

Futier, E; Constantin, J M; Jaber, S

2014-06-01

Postoperative pulmonary and extrapulmonary complications adversely affect clinical outcomes and healthcare utilization, so that prevention has become a measure of the quality of perioperative care. Mechanical ventilation is an essential support therapy to maintain adequate gas exchange during general anesthesia for surgery. Mechanical ventilation using high tidal volume (VT) (between 10 and 15 mL/kg) has been historically encouraged to prevent hypoxemia and atelectasis formation in anesthetized patients undergoing abdominal and thoracic surgery. However, there is accumulating evidence from both experimental and clinical studies that mechanical ventilation, especially the use of high VT and plateau pressure, may potentially aggravate or even initiate lung injury. Ventilator-associated lung injury can result from cyclic alveolar overdistension of non-dependent lung tissue, and repetitive opening and closing of dependent lung tissue resulting in ultrastructural damage at the junction of closed and open alveoli. Lung-protective ventilation, which refers to the use of lower VT and limited plateau pressure to minimize overdistension, and positive end-expiratory pressure to prevent alveolar collapse at end-expiration, was shown to improve outcome in critically ill patients with acute respiratory distress syndrome (ARDS). It has been recently suggested that this approach might also be beneficial in a broader population, especially in critically ill patients without ARDS at the onset of mechanical ventilation. There is, however, little evidence regarding a potential beneficial effect of lung protective ventilation during surgery, especially in patients with healthy lungs. Although surgical patients are frequently exposed to much shorter periods of mechanical ventilation, this is an important gap in knowledge given the number of patients receiving mechanical ventilation in the operating room. This review developed the benefits of lung protective ventilation during surgery and general anesthesia and offers some recommendations for mechanical ventilation in the surgical context.

Autophagy in pulmonary macrophages mediates lung inflammatory injury via NLRP3 inflammasome activation during mechanical ventilation

PubMed Central

Zhang, Yang; Liu, Gongjian; Dull, Randal O.; Schwartz, David E.

2014-01-01

The inflammatory response is a primary mechanism in the pathogenesis of ventilator-induced lung injury. Autophagy is an essential, homeostatic process by which cells break down their own components. We explored the role of autophagy in the mechanisms of mechanical ventilation-induced lung inflammatory injury. Mice were subjected to low (7 ml/kg) or high (28 ml/kg) tidal volume ventilation for 2 h. Bone marrow-derived macrophages transfected with a scrambled or autophagy-related protein 5 small interfering RNA were administered to alveolar macrophage-depleted mice via a jugular venous cannula 30 min before the start of the ventilation protocol. In some experiments, mice were ventilated in the absence and presence of autophagy inhibitors 3-methyladenine (15 mg/kg ip) or trichostatin A (1 mg/kg ip). Mechanical ventilation with a high tidal volume caused rapid (within minutes) activation of autophagy in the lung. Conventional transmission electron microscopic examination of lung sections showed that mechanical ventilation-induced autophagy activation mainly occurred in lung macrophages. Autophagy activation in the lungs during mechanical ventilation was dramatically attenuated in alveolar macrophage-depleted mice. Selective silencing of autophagy-related protein 5 in lung macrophages abolished mechanical ventilation-induced nucleotide-binding oligomerization domain-like receptor containing pyrin domain 3 (NLRP3) inflammasome activation and lung inflammatory injury. Pharmacological inhibition of autophagy also significantly attenuated the inflammatory responses caused by lung hyperinflation. The activation of autophagy in macrophages mediates early lung inflammation during mechanical ventilation via NLRP3 inflammasome signaling. Inhibition of autophagy activation in lung macrophages may therefore provide a novel and promising strategy for the prevention and treatment of ventilator-induced lung injury. PMID:24838752

Minute ventilation of cyclists, car and bus passengers: an experimental study.

PubMed

Zuurbier, Moniek; Hoek, Gerard; van den Hazel, Peter; Brunekreef, Bert

2009-10-27

Differences in minute ventilation between cyclists, pedestrians and other commuters influence inhaled doses of air pollution. This study estimates minute ventilation of cyclists, car and bus passengers, as part of a study on health effects of commuters' exposure to air pollutants. Thirty-four participants performed a submaximal test on a bicycle ergometer, during which heart rate and minute ventilation were measured simultaneously at increasing cycling intensity. Individual regression equations were calculated between heart rate and the natural log of minute ventilation. Heart rates were recorded during 280 two hour trips by bicycle, bus and car and were calculated into minute ventilation levels using the individual regression coefficients. Minute ventilation during bicycle rides were on average 2.1 times higher than in the car (individual range from 1.3 to 5.3) and 2.0 times higher than in the bus (individual range from 1.3 to 5.1). The ratio of minute ventilation of cycling compared to travelling by bus or car was higher in women than in men. Substantial differences in regression equations were found between individuals. The use of individual regression equations instead of average regression equations resulted in substantially better predictions of individual minute ventilations. The comparability of the gender-specific overall regression equations linking heart rate and minute ventilation with one previous American study, supports that for studies on the group level overall equations can be used. For estimating individual doses, the use of individual regression coefficients provides more precise data. Minute ventilation levels of cyclists are on average two times higher than of bus and car passengers, consistent with the ratio found in one small previous study of young adults. The study illustrates the importance of inclusion of minute ventilation data in comparing air pollution doses between different modes of transport.

Ventilator use by emergency medical services during 911 calls in the United States.

PubMed

El Sayed, Mazen; Tamim, Hani; Mailhac, Aurelie; N Clay, Mann

2018-05-01

Emergency and transport ventilators use in the prehospital field is not well described. This study examines trends of ventilator use by EMS agencies during 911 calls in the United States and identifies factors associated with this use. This retrospective study used four consecutive releases of the US National Emergency Medical Services Information System (NEMSIS) public research dataset (2011-2014) to describe scene EMS activations (911 calls) with and without reported ventilator use. Ventilator use was reported in 260,663 out of 28,221,321 EMS 911 scene activations (0.9%). Patients with ventilator use were older (mean age 67±18years), nearly half were males (49.2%), mostly in urban areas (80.2%) and cared for by advanced life support (ALS) EMS services (89.5%). CPAP mode of ventilation was most common (71.6%). "Breathing problem" was the most common dispatch complaint for EMS activations with ventilator use (63.9%). Common provider impression categories included "respiratory distress" (72.5%), "cardiac rhythm disturbance" (4.6%), "altered level of consciousness" (4.3%) and "cardiac arrest"(4.0%). Ventilator use was consistently higher at the Specialty Care Transport (SCT) and Air Medical Transport (AMT) service levels and increased over the study period for both suburban and rural EMS activations. Significant factors for ventilator use included demographic characteristics, EMS agency type, specific complaints, provider's primary impressions and condition codes. Providers at different EMS levels use ventilators during 911 scene calls in the US. Training of prehospital providers on ventilation technology is needed. The benefit and effectiveness of this intervention remain to be assessed. Copyright © 2017 Elsevier Inc. All rights reserved.

Artificial humidification for the mechanically ventilated patient.

PubMed

Selvaraj, N

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

Development of spatial-temporal ventilation heterogeneity and probability analysis tools for hyperpolarized 3He magnetic resonance imaging

NASA Astrophysics Data System (ADS)

Choy, S.; Ahmed, H.; Wheatley, A.; McCormack, D. G.; Parraga, G.

2010-03-01

We developed image analysis tools to evaluate spatial and temporal 3He magnetic resonance imaging (MRI) ventilation in asthma and cystic fibrosis. We also developed temporal ventilation probability maps to provide a way to describe and quantify ventilation heterogeneity over time, as a way to test respiratory exacerbations or treatment predictions and to provide a discrete probability measurement of 3He ventilation defect persistence.

Mask Ventilation during Induction of General Anesthesia: Influences of Obstructive Sleep Apnea.

PubMed

Sato, Shin; Hasegawa, Makoto; Okuyama, Megumi; Okazaki, Junko; Kitamura, Yuji; Sato, Yumi; Ishikawa, Teruhiko; Sato, Yasunori; Isono, Shiroh

2017-01-01

Depending on upper airway patency during anesthesia induction, tidal volume achieved by mask ventilation may vary. In 80 adult patients undergoing general anesthesia, the authors tested a hypothesis that tidal volume during mask ventilation is smaller in patients with sleep-disordered breathing priorly defined as apnea hypopnea index greater than 5 per hour. One-hand mask ventilation with a constant ventilator setting (pressure-controlled ventilation) was started 20 s after injection of rocuronium and maintained for 1 min during anesthesia induction. Mask ventilation efficiency was assessed by the breath number needed to initially exceed 5 ml/kg ideal body weight of expiratory tidal volume (primary outcome) and tidal volumes (secondary outcomes) during initial 15 breaths (UMIN000012494). Tidal volume progressively increased by more than 70% in 1 min and did not differ between sleep-disordered breathing (n = 42) and non-sleep-disordered breathing (n = 38) patients. In post hoc subgroup analyses, the primary outcome breath number (mean [95% CI], 5.7 [4.1 to 7.3] vs. 1.7 [0.2 to 3.2] breath; P = 0.001) and mean tidal volume (6.5 [4.6 to 8.3] vs. 9.6 [7.7 to 11.4] ml/kg ideal body weight; P = 0.032) were significantly smaller in 20 sleep-disordered breathing patients with higher apnea hypopnea index (median [25th to 75th percentile]: 21.7 [17.6 to 31] per hour) than in 20 non-sleep disordered breathing subjects with lower apnea hypopnea index (1.0 [0.3 to 1.5] per hour). Obesity and occurrence of expiratory flow limitation during one-hand mask ventilation independently explained the reduction of efficiency of mask ventilation, while the use of two hands effectively normalized inefficient mask ventilation during one-hand mask ventilation. One-hand mask ventilation is difficult in patients with obesity and severe sleep-disordered breathing particularly when expiratory flow limitation occurs during mask ventilation.

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

PubMed

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 improved patient outcomes. (ClinicalTrials.gov registration NCT02184208.). Copyright © 2017 by Daedalus Enterprises.

The Society for Translational Medicine: clinical practice guidelines for mechanical ventilation management for patients undergoing lobectomy.

PubMed

Gao, Shugeng; Zhang, Zhongheng; Brunelli, Alessandro; Chen, Chang; Chen, Chun; Chen, Gang; Chen, Haiquan; Chen, Jin-Shing; Cassivi, Stephen; Chai, Ying; Downs, John B; Fang, Wentao; Fu, Xiangning; Garutti, Martínez I; He, Jianxing; He, Jie; Hu, Jian; Huang, Yunchao; Jiang, Gening; Jiang, Hongjing; Jiang, Zhongmin; Li, Danqing; Li, Gaofeng; Li, Hui; Li, Qiang; Li, Xiaofei; Li, Yin; Li, Zhijun; Liu, Chia-Chuan; Liu, Deruo; Liu, Lunxu; Liu, Yongyi; Ma, Haitao; Mao, Weimin; Mao, Yousheng; Mou, Juwei; Ng, Calvin Sze Hang; Petersen, René H; Qiao, Guibin; Rocco, Gaetano; Ruffini, Erico; Tan, Lijie; Tan, Qunyou; Tong, Tang; Wang, Haidong; Wang, Qun; Wang, Ruwen; Wang, Shumin; Xie, Deyao; Xue, Qi; Xue, Tao; Xu, Lin; Xu, Shidong; Xu, Songtao; Yan, Tiansheng; Yu, Fenglei; Yu, Zhentao; Zhang, Chunfang; Zhang, Lanjun; Zhang, Tao; Zhang, Xun; Zhao, Xiaojing; Zhao, Xuewei; Zhi, Xiuyi; Zhou, Qinghua

2017-09-01

Patients undergoing lobectomy are at significantly increased risk of lung injury. One-lung ventilation is the most commonly used technique to maintain ventilation and oxygenation during the operation. It is a challenge to choose an appropriate mechanical ventilation strategy to minimize the lung injury and other adverse clinical outcomes. In order to understand the available evidence, a systematic review was conducted including the following topics: (I) protective ventilation (PV); (II) mode of mechanical ventilation [e.g., volume controlled (VCV) versus pressure controlled (PCV)]; (III) use of therapeutic hypercapnia; (IV) use of alveolar recruitment (open-lung) strategy; (V) pre-and post-operative application of positive end expiratory pressure (PEEP); (VI) Inspired Oxygen concentration; (VII) Non-intubated thoracoscopic lobectomy; and (VIII) adjuvant pharmacologic options. The recommendations of class II are non-intubated thoracoscopic lobectomy may be an alternative to conventional one-lung ventilation in selected patients. The recommendations of class IIa are: (I) Therapeutic hypercapnia to maintain a partial pressure of carbon dioxide at 50-70 mmHg is reasonable for patients undergoing pulmonary lobectomy with one-lung ventilation; (II) PV with a tidal volume of 6 mL/kg and PEEP of 5 cmH 2 O are reasonable methods, based on current evidence; (III) alveolar recruitment [open lung ventilation (OLV)] may be beneficial in patients undergoing lobectomy with one-lung ventilation; (IV) PCV is recommended over VCV for patients undergoing lung resection; (V) pre- and post-operative CPAP can improve short-term oxygenation in patients undergoing lobectomy with one-lung ventilation; (VI) controlled mechanical ventilation with I:E ratio of 1:1 is reasonable in patients undergoing one-lung ventilation; (VII) use of lowest inspired oxygen concentration to maintain satisfactory arterial oxygen saturation is reasonable based on physiologic principles; (VIII) Adjuvant drugs such as nebulized budesonide, intravenous sivelestat and ulinastatin are reasonable and can be used to attenuate inflammatory response.

The Society for Translational Medicine: clinical practice guidelines for mechanical ventilation management for patients undergoing lobectomy

PubMed Central

Zhang, Zhongheng; Brunelli, Alessandro; Chen, Chang; Chen, Chun; Chen, Gang; Chen, Haiquan; Chen, Jin-Shing; Cassivi, Stephen; Chai, Ying; Downs, John B.; Fang, Wentao; Fu, Xiangning; Garutti, Martínez I.; He, Jianxing; Hu, Jian; Huang, Yunchao; Jiang, Gening; Jiang, Hongjing; Jiang, Zhongmin; Li, Danqing; Li, Gaofeng; Li, Hui; Li, Qiang; Li, Xiaofei; Li, Yin; Li, Zhijun; Liu, Chia-Chuan; Liu, Deruo; Liu, Lunxu; Liu, Yongyi; Ma, Haitao; Mao, Weimin; Mao, Yousheng; Mou, Juwei; Ng, Calvin Sze Hang; Petersen, René H.; Qiao, Guibin; Rocco, Gaetano; Ruffini, Erico; Tan, Lijie; Tan, Qunyou; Tong, Tang; Wang, Haidong; Wang, Qun; Wang, Ruwen; Wang, Shumin; Xie, Deyao; Xue, Qi; Xue, Tao; Xu, Lin; Xu, Shidong; Xu, Songtao; Yan, Tiansheng; Yu, Fenglei; Yu, Zhentao; Zhang, Chunfang; Zhang, Lanjun; Zhang, Tao; Zhang, Xun; Zhao, Xiaojing; Zhao, Xuewei; Zhi, Xiuyi; Zhou, Qinghua

2017-01-01

Patients undergoing lobectomy are at significantly increased risk of lung injury. One-lung ventilation is the most commonly used technique to maintain ventilation and oxygenation during the operation. It is a challenge to choose an appropriate mechanical ventilation strategy to minimize the lung injury and other adverse clinical outcomes. In order to understand the available evidence, a systematic review was conducted including the following topics: (I) protective ventilation (PV); (II) mode of mechanical ventilation [e.g., volume controlled (VCV) versus pressure controlled (PCV)]; (III) use of therapeutic hypercapnia; (IV) use of alveolar recruitment (open-lung) strategy; (V) pre-and post-operative application of positive end expiratory pressure (PEEP); (VI) Inspired Oxygen concentration; (VII) Non-intubated thoracoscopic lobectomy; and (VIII) adjuvant pharmacologic options. The recommendations of class II are non-intubated thoracoscopic lobectomy may be an alternative to conventional one-lung ventilation in selected patients. The recommendations of class IIa are: (I) Therapeutic hypercapnia to maintain a partial pressure of carbon dioxide at 50–70 mmHg is reasonable for patients undergoing pulmonary lobectomy with one-lung ventilation; (II) PV with a tidal volume of 6 mL/kg and PEEP of 5 cmH2O are reasonable methods, based on current evidence; (III) alveolar recruitment [open lung ventilation (OLV)] may be beneficial in patients undergoing lobectomy with one-lung ventilation; (IV) PCV is recommended over VCV for patients undergoing lung resection; (V) pre- and post-operative CPAP can improve short-term oxygenation in patients undergoing lobectomy with one-lung ventilation; (VI) controlled mechanical ventilation with I:E ratio of 1:1 is reasonable in patients undergoing one-lung ventilation; (VII) use of lowest inspired oxygen concentration to maintain satisfactory arterial oxygen saturation is reasonable based on physiologic principles; (VIII) Adjuvant drugs such as nebulized budesonide, intravenous sivelestat and ulinastatin are reasonable and can be used to attenuate inflammatory response. PMID:29221302

Spontaneous breathing during lung-protective ventilation in an experimental acute lung injury model: high transpulmonary pressure associated with strong spontaneous breathing effort may worsen lung injury.

PubMed

Yoshida, Takeshi; Uchiyama, Akinori; Matsuura, Nariaki; Mashimo, Takashi; Fujino, Yuji

2012-05-01

We investigated whether potentially injurious transpulmonary pressure could be generated by strong spontaneous breathing and exacerbate lung injury even when plateau pressure is limited to <30 cm H2O. Prospective, randomized, animal study. University animal research laboratory. Thirty-two New Zealand White rabbits. Lavage-injured rabbits were randomly allocated to four groups to receive low or moderate tidal volume ventilation, each combined with weak or strong spontaneous breathing effort. Inspiratory pressure for low tidal volume ventilation was set at 10 cm H2O and tidal volume at 6 mL/kg. For moderate tidal volume ventilation, the values were 20 cm H2O and 7-9 mL/kg. The groups were: low tidal volume ventilation+spontaneous breathingweak, low tidal volume ventilation+spontaneous breathingstrong, moderate tidal volume ventilation+spontaneous breathingweak, and moderate tidal volume ventilation+spontaneous breathingstrong. Each group had the same settings for positive end-expiratory pressure of 8 cm H2O. Respiratory variables were measured every 60 mins. Distribution of lung aeration and alveolar collapse were histologically evaluated. Low tidal volume ventilation+spontaneous breathingstrong showed the most favorable oxygenation and compliance of respiratory system, and the best lung aeration. By contrast, in moderate tidal volume ventilation+spontaneous breathingstrong, the greatest atelectasis with numerous neutrophils was observed. While we applied settings to maintain plateau pressure at <30 cm H2O in all groups, in moderate tidal volume ventilation+spontaneous breathingstrong, transpulmonary pressure rose >33 cm H2O. Both minute ventilation and respiratory rate were higher in the strong spontaneous breathing groups. Even when plateau pressure is limited to <30 cm H2O, combined with increased respiratory rate and tidal volume, high transpulmonary pressure generated by strong spontaneous breathing effort can worsen lung injury. When spontaneous breathing is preserved during mechanical ventilation, transpulmonary pressure and tidal volume should be strictly controlled to prevent further lung injury.

Using Hyperpolarized 129Xe MRI to Quantify the Pulmonary Ventilation Distribution

PubMed Central

He, Mu; Driehuys, Bastiaan; Que, Loretta G.; Huang, Yuh-Chin T.

2017-01-01

Background Ventilation heterogeneity is impossible to detect with spirometry. Alternatively, pulmonary ventilation can be imaged 3-dimensionally using inhaled 129Xe MRI. To date such images have been quantified primarily based on ventilation defects. Here, we introduce a robust means to transform 129Xe MRI scans such that the underlying ventilation distribution and its heterogeneity can be quantified. Methods Quantitative 129Xe ventilation MRI was conducted in 12 younger (24.7±5.2 yrs), and 10 older (62.2±7.2 yrs) healthy individuals, as well as 9 younger (25.9±6.4 yrs) and 10 older (63.2±6.1 yrs) asthmatics. The younger healthy population was used to establish a reference ventilation distribution and thresholds for 6 intensity bins. These were used to display and quantify regions of ventilation defect (VDR), low ventilation (LVR) and high ventilation (HVR). Results The ventilation distribution in young subjects was roughly Gaussian with a mean and SD of 0.52±0.18, resulting in VDR=2.1±1.3%, LVR=15.6±5.4% and HVR=17.4±3.1%. Older healthy volunteers exhibited a significantly right-skewed distribution (0.46±0.20, p=0.034), resulting in significantly increased VDR (7.0±4.8%, p=0.008) and LVR (24.5±11.5%, p=0.025). In the asthmatics, VDR and LVR increased in the older population, and HVR was significantly reduced (13.5±4.6% vs 18.9±4.5%, p=0.009). Quantitative 129Xe MRI also revealed different ventilation distribution patterns in response to albuterol in two asthmatics with normal FEV1. Conclusions Quantitative 129Xe MRI provides a robust and objective means to display and quantify the pulmonary ventilation distribution, even in subjects who have airway function impairment not appreciated by spirometry. PMID:27617823

Cost of treating ventilator-associated pneumonia post cardiac surgery in the National Health Service: Results from a propensity-matched cohort study.

PubMed

Luckraz, Heyman; Manga, Na'ngono; Senanayake, Eshan L; Abdelaziz, Mahmoud; Gopal, Shameer; Charman, Susan C; Giri, Ramesh; Oppong, Raymond; Andronis, Lazaros

2018-05-01

Ventilator-associated pneumonia is associated with significant morbidity, mortality and healthcare costs. Most of the cost data that are available relate to general intensive care patients in privately remunerated institutions. This study assessed the cost of managing ventilator-associated pneumonia in a cardiac intensive care unit in the National Health Service in the United Kingdom. Propensity-matched study of prospectively collected data from the cardiac surgical database between April 2011 and December 2014 in all patients undergoing cardiac surgery (n = 3416). Patients who were diagnosed as developing ventilator-associated pneumonia, as per the surveillance definition for ventilator-associated pneumonia (n = 338), were propensity score matched with those who did not (n = 338). Costs of treating post-op cardiac surgery patients in intensive care and cost difference if ventilator-associated pneumonia occurred based on Healthcare Resource Group categories were assessed. Secondary outcomes included differences in morbidity, mortality and cardiac intensive care unit and in-hospital length of stay. There were no significant differences in the pre-operative characteristics or procedures between the groups. Ventilator-associated pneumonia developed in 10% of post-cardiac surgery patients. Post-operatively, the ventilator-associated pneumonia group required longer ventilation (p < 0.01), more respiratory support, longer cardiac intensive care unit (8 vs 3, p < 0.001) and in-hospital stay (16 vs 9) days. The overall cost for post-operative recovery after cardiac surgery for ventilator-associated pneumonia patients was £15,124 compared to £6295 for non-ventilator-associated pneumonia (p < 0.01). The additional cost of treating patients with ventilator-associated pneumonia was £8829. Ventilator-associated pneumonia was associated with significant morbidity to the patients, generating significant costs. This cost was nearer to the lower end for the cost for general intensive care unit patients in privately reimbursed systems.

46 CFR 111.15-10 - Ventilation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... REQUIREMENTS Storage Batteries and Battery Chargers: Construction and Installation § 111.15-10 Ventilation. (a) General. Each room, locker, and box for storage batteries must be arranged or ventilated to prevent... with the battery charger so that the battery cannot be charged without ventilation. (c) Large battery...

46 CFR 111.15-10 - Ventilation.

Code of Federal Regulations, 2013 CFR

2013-10-01

... REQUIREMENTS Storage Batteries and Battery Chargers: Construction and Installation § 111.15-10 Ventilation. (a) General. Each room, locker, and box for storage batteries must be arranged or ventilated to prevent... with the battery charger so that the battery cannot be charged without ventilation. (c) Large battery...

46 CFR 111.15-10 - Ventilation.

Code of Federal Regulations, 2012 CFR

2012-10-01

... REQUIREMENTS Storage Batteries and Battery Chargers: Construction and Installation § 111.15-10 Ventilation. (a) General. Each room, locker, and box for storage batteries must be arranged or ventilated to prevent... with the battery charger so that the battery cannot be charged without ventilation. (c) Large battery...

46 CFR 111.15-10 - Ventilation.

Code of Federal Regulations, 2014 CFR

2014-10-01

... REQUIREMENTS Storage Batteries and Battery Chargers: Construction and Installation § 111.15-10 Ventilation. (a) General. Each room, locker, and box for storage batteries must be arranged or ventilated to prevent... with the battery charger so that the battery cannot be charged without ventilation. (c) Large battery...

46 CFR 111.15-10 - Ventilation.

Code of Federal Regulations, 2011 CFR

2011-10-01

... REQUIREMENTS Storage Batteries and Battery Chargers: Construction and Installation § 111.15-10 Ventilation. (a) General. Each room, locker, and box for storage batteries must be arranged or ventilated to prevent... with the battery charger so that the battery cannot be charged without ventilation. (c) Large battery...

Protective isolation in single-bed rooms: studies in a modified hospital ward

PubMed Central

Ayliffe, G. A. J.; Collins, B. J.; Lowbury, E. J. L.; Wall, Mary

1971-01-01

Studies were made in a modified hospital ward containing 19 beds, 14 of them in the open ward, one in a window-ventilated side-room, two in rooms with partial-recirculation ventilators giving 7-10 air changes per hour, and two in self-contained isolation suites with plenum ventilation (20 air changes per hour), ultra-violet (UV) barriers at doorways and airlocks. Preliminary tests with aerosols of tracer bacteria showed that few bacteria entered the plenum or recirculation-ventilated rooms. Bacteria released inside mechanically ventilated cubicles escaped into the corridor, but this transfer was reduced by the presence of an airlock. UV barriers at the entrance to the airlock and the cubicle reduced the transfer of bacteria from cubicle to corridor. During a period of 4 years while the ward was in use for surgical and gynaecological patients, the incidence of post-operative sepsis and colonization of wounds by multiple-resistant Staphylococcus aureus was lower (though not significantly lower) in the plenum-ventilated rooms than in the open ward, the recirculator-ventilated cubicles and the window-ventilated cubicles. Nasal acquisition of multiple-resistant Staph. aureus was significantly less common in the plenum-ventilated than in the recirculator-ventilated cubicles and in the other areas. Mean counts of bacteria on settle-plates were significantly lower in the plenum-ventilated cubicles than in the other areas; mean settle-plate counts in the recirculator-ventilated cubicles were significantly lower than in the open ward and in the window-ventilated side-room; similar results were shown by slit-sampling of air. Mean settle-plate counts were significantly lower in all areas when the ward was occupied by female patients. Staph. aureus was rarely carried by air from plenum-ventilated or other cubicles to the open ward, or from the open ward to the cubicles; though staphylococci were transferred from one floor area to another, they did not appear to be redispersed into the air in sufficient numbers to infect the patients. Ultra-violet irradiation caused a significant reduction in the total and staphylococcal counts from the floors of airlocks, and a significant reduction of total counts in the air. PMID:5289715

Evaluating the effects of protective ventilation on organ-specific cytokine production in porcine experimental postoperative sepsis.

PubMed

Sperber, Jesper; Lipcsey, Miklós; Larsson, Anders; Larsson, Anders; Sjölin, Jan; Castegren, Markus

2015-05-10

Protective ventilation with lower tidal volume (VT) and higher positive end-expiratory pressure (PEEP) reduces the negative additive effects of mechanical ventilation during systemic inflammatory response syndrome. We hypothesised that protective ventilation during surgery would affect the organ-specific immune response in an experimental animal model of endotoxin-induced sepsis-like syndrome. 30 pigs were laparotomised for 2 hours (h), after which a continuous endotoxin infusion was started at 0.25 micrograms × kg(-1) × h(-1) for 5 h. Catheters were placed in the carotid artery, hepatic vein, portal vein and jugular bulb. Animals were randomised to two protective ventilation groups (n = 10 each): one group was ventilated with VT 6 mL × kg(-1) during the whole experiment while the other group was ventilated during the surgical phase with VT of 10 mL × kg(-1). In both groups PEEP was 5 cmH2O during surgery and increased to 10 cmH2O at the start of endotoxin infusion. A control group (n = 10) was ventilated with VT of 10 mL × kg(-1) and PEEP 5 cm H20 throughout the experiment. In four sample locations we a) simultaneously compared cytokine levels, b) studied the effect of protective ventilation initiated before and during endotoxemia and c) evaluated protective ventilation on organ-specific cytokine levels. TNF-alpha levels were highest in the hepatic vein, IL-6 levels highest in the artery and jugular bulb and IL-10 levels lowest in the artery. Protective ventilation initiated before and during endotoxemia did not differ in organ-specific cytokine levels. Protective ventilation led to lower levels of TNF-alpha in the hepatic vein compared with the control group, whereas no significant differences were seen in the artery, portal vein or jugular bulb. Variation between organs in cytokine output was observed during experimental sepsis. We see no implication from cytokine levels for initiating protective ventilation before endotoxemia. However, during endotoxemia protective ventilation attenuates hepatic inflammatory cytokine output contributing to a reduced total inflammatory burden.

Occupational exposure to nitrous oxide - the role of scavenging and ventilation systems in reducing the exposure level in operating rooms.

PubMed

Krajewski, Wojciech; Kucharska, Malgorzata; Wesolowski, Wiktor; Stetkiewicz, Jan; Wronska-Nofer, Teresa

2007-03-01

The aim of this study was to assess the level of occupational exposure to nitrous oxide (N(2)O) in operating rooms (ORs), as related to different ventilation and scavenging systems used to remove waste anaesthetic gases from the work environment. The monitoring of N(2)O in the air covered 35 ORs in 10 hospitals equipped with different systems for ventilation and anaesthetic scavenging. The examined systems included: natural ventilation with supplementary fresh air provided by a pressure ventilation system (up to 6 air changes/h); pressure and exhaust ventilation systems equipped with ventilation units supplying fresh air to and discharging contaminated air outside the working area (more than 10 air changes/h); complete air-conditioning system with laminar air flow (more than 15 air changes/h). The measurements were carried out during surgical procedures (general anaesthesia induced intravenously and maintained with inhaled N(2)O and sevofluran delivered through cuffed endotracheal tubes) with connected or disconnected air scavenging. Air was collected from the breathing zone of operating personnel continuously through the whole time of anaesthesia to Tedlar((R)) bags, and N(2)O concentrations in air samples were analyzed by adsorption gas chromatography/mass spectrometry. N(2)O levels in excess of the occupational exposure limit (OEL) value of 180mg/m(3) were registered in all ORs equipped with ventilation systems alone. The OEL value was exceeded several times in rooms with natural ventilation plus supplementary pressure ventilations and twice or less in those with pressure/exhaust ventilation systems or air conditioning. N(2)O levels below or within the OEL value were observed in rooms where the system of air conditioning or pressure/exhaust ventilation was combined with scavenging systems. Systems combining natural/pressure ventilation with scavenging were inadequate to maintain N(2)O concentration below the OEL value. Air conditioning and an efficient pressure/exhaust ventilation (above 12 air exchanges/h) together with efficient active scavenging systems are sufficient to sustain N(2)O exposure in ORs at levels below or within the OEL value of 180mg/m(3).

Smart ventilation energy and indoor air quality performance in residential buildings: A review

DOE PAGES

Guyot, Gaelle; Sherman, Max H.; Walker, Iain S.

2017-12-30

To better address energy and indoor air quality issues, ventilation needs to become smarter. A key smart ventilation concept is to use controls to ventilate more at times it provides either an energy or indoor air quality (IAQ) advantage (or both) and less when it provides a disadvantage. A favorable context exists in many countries to include some of the existing smart ventilation strategies in codes and standards. As a result, demand-controlled ventilation (DCV) systems are widely and easily available on the market, with more than 20 DCV systems approved and available in countries such as Belgium, France and themore » Netherlands. This paper provides a literature review on smart ventilation used in residential buildings, based on energy and indoor air quality performance. This meta-analysis includes 38 studies of various smart ventilation systems with control based on CO 2, humidity, combined CO 2 and total volatile organic compounds (TVOC), occupancy, or outdoor temperature. In conclusion, these studies show that ventilation energy savings up to 60% can be obtained without compromising IAQ, even sometimes improving it. However, the meta-analysis included some less than favorable results, with 26% energy overconsumption in some cases.« less

Lung-protective ventilation in abdominal surgery.

PubMed

Futier, Emmanuel; Jaber, Samir

2014-08-01

To provide the most recent and relevant clinical evidence regarding the use of prophylactic lung-protective mechanical ventilation in abdominal surgery. Evidence is accumulating, suggesting an association between intraoperative mechanical ventilation strategy and postoperative pulmonary complications in patients undergoing abdominal surgery. Nonprotective ventilator settings, especially high tidal volume (>10-12 ml/kg), very low level of positive end-expiratory pressure (PEEP, <5 cm H2O), or no PEEP, may cause alveolar overdistension and repetitive tidal recruitment leading to ventilator-associated lung injury in patients with healthy lungs. Stimulated by the previous findings in patients with acute respiratory distress syndrome, the use of lower tidal volume ventilation is becoming increasingly more common in the operating room. However, lowering tidal volume, though important, is only part of the overall multifaceted approach of lung-protective mechanical ventilation. Recent data provide compelling evidence that prophylactic lung-protective mechanical ventilation using lower tidal volume (6-8 ml/kg of predicted body weight), moderate PEEP (6-8 cm H2O), and recruitment maneuvers is associated with improved functional or physiological and clinical postoperative outcome in patients undergoing abdominal surgery. The use of prophylactic lung-protective ventilation can help in improving the postoperative outcome.

Controlled invasive mechanical ventilation strategies in obese patients undergoing surgery.

PubMed

Maia, Lígia de Albuquerque; Silva, Pedro Leme; Pelosi, Paolo; Rocco, Patricia Rieken Macedo

2017-06-01

The obesity prevalence is increasing in surgical population. As the number of obese surgical patients increases, so does the demand for mechanical ventilation. Nevertheless, ventilatory strategies in this population are challenging, since obesity results in pathophysiological changes in respiratory function. Areas covered: We reviewed the impact of obesity on respiratory system and the effects of controlled invasive mechanical ventilation strategies in obese patients undergoing surgery. To date, there is no consensus regarding the optimal invasive mechanical ventilation strategy for obese surgical patients, and no evidence that possible intraoperative beneficial effects on oxygenation and mechanics translate into better postoperative pulmonary function or improved outcomes. Expert commentary: Before determining the ideal intraoperative ventilation strategy, it is important to analyze the pathophysiology and comorbidities of each obese patient. Protective ventilation with low tidal volume, driving pressure, energy, and mechanical power should be employed during surgery; however, further studies are required to clarify the most effective ventilation strategies, such as the optimal positive end-expiratory pressure and whether recruitment maneuvers minimize lung injury. In this context, an ongoing trial of intraoperative ventilation in obese patients (PROBESE) should help determine the mechanical ventilation strategy that best improves clinical outcome in patients with body mass index≥35kg/m 2 .

Smart ventilation energy and indoor air quality performance in residential buildings: A review

DOE Office of Scientific and Technical Information (OSTI.GOV)

Guyot, Gaelle; Sherman, Max H.; Walker, Iain S.

To better address energy and indoor air quality issues, ventilation needs to become smarter. A key smart ventilation concept is to use controls to ventilate more at times it provides either an energy or indoor air quality (IAQ) advantage (or both) and less when it provides a disadvantage. A favorable context exists in many countries to include some of the existing smart ventilation strategies in codes and standards. As a result, demand-controlled ventilation (DCV) systems are widely and easily available on the market, with more than 20 DCV systems approved and available in countries such as Belgium, France and themore » Netherlands. This paper provides a literature review on smart ventilation used in residential buildings, based on energy and indoor air quality performance. This meta-analysis includes 38 studies of various smart ventilation systems with control based on CO 2, humidity, combined CO 2 and total volatile organic compounds (TVOC), occupancy, or outdoor temperature. In conclusion, these studies show that ventilation energy savings up to 60% can be obtained without compromising IAQ, even sometimes improving it. However, the meta-analysis included some less than favorable results, with 26% energy overconsumption in some cases.« less

[Intraoperative monitoring in artificial respiration of premature and newborn infants. I. Monitoring of respiratory parameters and alveolar ventilation].

PubMed

Lenz, G; Heipertz, W; Leidig, E; Madee, S

1986-06-01

Monitoring of ventilation serves to ensure adequate alveolar ventilation and arterial oxygenation, and to avoid pulmonary damage due to mechanical ventilation. Basic clinical monitoring, i.e., inspection, auscultation (including precordial or oesophageal stethoscope) and monitoring of heart rate and blood pressure, is mandatory. Mechanical ventilation is monitored by ventilation pressures (peak pressure, plateau pressure and endexpiratory pressure), ventilation volumes (measured at the in/expiratory valve of the respirator and by hot-wire anemometry at the tube connector), ventilation rate, and inspiratory oxygen concentration (FiO2). Alveolar ventilation should be continuously and indirectly recorded by capnometry (pECO2) and by measurement of transcutaneous pCO2 (tcpCO2), whereas oxygenation is determined via measurement of transcutaneous pO2 (tcpO2). Invasive monitoring of gas exchange is essential in prolonged or intrathoracic interventions as well as in neonates with cardiopulmonary problems. paCO2 may be estimated by capillary or venous blood gas analysis; arterial blood gas analysis is required for exact determination of paCO2 as well as arteriocutaneous pCO2 (atcDCO2) and arterio-end-expiratory (aEDCO2) gradients.