14 CFR 23.967 - Fuel tank installation.

Code of Federal Regulations, 2011 CFR

2011-01-01

....967 Fuel tank installation. (a) Each fuel tank must be supported so that tank loads are not... tank liner is used, it must be supported so that it is not required to withstand fluid loads; (4... securing or loss of the fuel filler cap. (b) Each tank compartment must be ventilated and drained to...

14 CFR 23.967 - Fuel tank installation.

Code of Federal Regulations, 2012 CFR

2012-01-01

....967 Fuel tank installation. (a) Each fuel tank must be supported so that tank loads are not... tank liner is used, it must be supported so that it is not required to withstand fluid loads; (4... securing or loss of the fuel filler cap. (b) Each tank compartment must be ventilated and drained to...

14 CFR 23.967 - Fuel tank installation.

Code of Federal Regulations, 2013 CFR

2013-01-01

....967 Fuel tank installation. (a) Each fuel tank must be supported so that tank loads are not... tank liner is used, it must be supported so that it is not required to withstand fluid loads; (4... securing or loss of the fuel filler cap. (b) Each tank compartment must be ventilated and drained to...

14 CFR 23.967 - Fuel tank installation.

Code of Federal Regulations, 2014 CFR

2014-01-01

....967 Fuel tank installation. (a) Each fuel tank must be supported so that tank loads are not... tank liner is used, it must be supported so that it is not required to withstand fluid loads; (4... securing or loss of the fuel filler cap. (b) Each tank compartment must be ventilated and drained to...

Dual Tank Fuel System

DOEpatents

Wagner, Richard William; Burkhard, James Frank; Dauer, Kenneth John

1999-11-16

A dual tank fuel system has primary and secondary fuel tanks, with the primary tank including a filler pipe to receive fuel and a discharge line to deliver fuel to an engine, and with a balance pipe interconnecting the primary tank and the secondary tank. The balance pipe opens close to the bottom of each tank to direct fuel from the primary tank to the secondary tank as the primary tank is filled, and to direct fuel from the secondary tank to the primary tank as fuel is discharged from the primary tank through the discharge line. A vent line has branches connected to each tank to direct fuel vapor from the tanks as the tanks are filled, and to admit air to the tanks as fuel is delivered to the engine.

Modeling a full-scale primary sedimentation tank using artificial neural networks.

PubMed

Gamal El-Din, A; Smith, D W

2002-05-01

Modeling the performance of full-scale primary sedimentation tanks has been commonly done using regression-based models, which are empirical relationships derived strictly from observed daily average influent and effluent data. Another approach to model a sedimentation tank is using a hydraulic efficiency model that utilizes tracer studies to characterize the performance of model sedimentation tanks based on eddy diffusion. However, the use of hydraulic efficiency models to predict the dynamic behavior of a full-scale sedimentation tank is very difficult as the development of such models has been done using controlled studies of model tanks. In this paper, another type of model, namely artificial neural network modeling approach, is used to predict the dynamic response of a full-scale primary sedimentation tank. The neuralmodel consists of two separate networks, one uses flow and influent total suspended solids data in order to predict the effluent total suspended solids from the tank, and the other makes predictions of the effluent chemical oxygen demand using data of the flow and influent chemical oxygen demand as inputs. An extensive sampling program was conducted in order to collect a data set to be used in training and validating the networks. A systematic approach was used in the building process of the model which allowed the identification of a parsimonious neural model that is able to learn (and not memorize) from past data and generalize very well to unseen data that were used to validate the model. Theresults seem very promising. The potential of using the model as part of a real-time process control system isalso discussed.

46 CFR 151.25-1 - Cargo tank.

Code of Federal Regulations, 2014 CFR

2014-10-01

... not react with the cargo. (c) Ventilated (forced). Vapor space above the liquid surface in the tank is... (natural). Vapor space above the liquid surface in the tank is continuously swept with atmospheric air... LIQUID HAZARDOUS MATERIAL CARGOES Environmental Control § 151.25-1 Cargo tank. When carrying certain...

46 CFR 151.25-1 - Cargo tank.

Code of Federal Regulations, 2012 CFR

2012-10-01

... not react with the cargo. (c) Ventilated (forced). Vapor space above the liquid surface in the tank is... (natural). Vapor space above the liquid surface in the tank is continuously swept with atmospheric air... LIQUID HAZARDOUS MATERIAL CARGOES Environmental Control § 151.25-1 Cargo tank. When carrying certain...

46 CFR 151.25-1 - Cargo tank.

Code of Federal Regulations, 2011 CFR

2011-10-01

... not react with the cargo. (c) Ventilated (forced). Vapor space above the liquid surface in the tank is... (natural). Vapor space above the liquid surface in the tank is continuously swept with atmospheric air... LIQUID HAZARDOUS MATERIAL CARGOES Environmental Control § 151.25-1 Cargo tank. When carrying certain...

46 CFR 151.25-1 - Cargo tank.

Code of Federal Regulations, 2013 CFR

2013-10-01

... not react with the cargo. (c) Ventilated (forced). Vapor space above the liquid surface in the tank is... (natural). Vapor space above the liquid surface in the tank is continuously swept with atmospheric air... LIQUID HAZARDOUS MATERIAL CARGOES Environmental Control § 151.25-1 Cargo tank. When carrying certain...

46 CFR 151.25-1 - Cargo tank.

Code of Federal Regulations, 2010 CFR

2010-10-01

... not react with the cargo. (c) Ventilated (forced). Vapor space above the liquid surface in the tank is... (natural). Vapor space above the liquid surface in the tank is continuously swept with atmospheric air... LIQUID HAZARDOUS MATERIAL CARGOES Environmental Control § 151.25-1 Cargo tank. When carrying certain...

Tank vapor mitigation requirements for Hanford Tank Farms

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

Rakestraw, L.D.

1994-11-15

Westinghouse Hanford Company has contracted Los Alamos Technical Associates to listing of vapors and aerosols that are or may be emitted from the High Level Waste (HLW) tanks at Hanford. Mitigation requirements under Federal and State law, as well as DOE Orders, are included in the listing. The lists will be used to support permitting activities relative to tank farm ventilation system up-grades. This task is designated Task 108 under MJB-SWV-312057 and is an extension of efforts begun under Task 53 of Purchase Order MPB-SVV-03291 5 for Mechanical Engineering Support. The results of that task, which covered only thirty-nine tanks,more » are repeated here to provide a single source document for vapor mitigation requirements for all 177 HLW tanks.« less

Effect of micro-aeration on anaerobic digestion of primary sludge under septic tank conditions.

PubMed

Diak, James; Örmeci, Banu; Kennedy, Kevin J

2013-04-01

Micro-aeration, which refers to the addition of very small amounts of air, is a simple technology that can potentially be incorporated in septic tanks to improve the digestion performance. The purpose of this study was to investigate and compare the effects of micro-aeration on anaerobic digestion of primary sludge under septic tank conditions. 1.6 L batch reactor experiments were carried out in duplicate using raw primary sludge, with 4.1 % total solids, and diluted primary sludge, with 2.1 % total solids. Reactors were operated for 5 weeks at room temperature to simulate septic tank conditions. Micro-aeration rate of 0.00156 vvm effectively solubilised chemical oxygen demand (COD) and improved the subsequent degradation of COD. Micro-aeration also increased the generation of ammonia and soluble proteins, but did not improve the reduction in total and volatile solids, or the reduction in carbohydrates. Experiments using diluted sludge samples showed similar trends as the experiments with raw sludge, which suggest that initial solids concentration did not have a significant effect on the degradation of primary sludge under septic tank conditions.

46 CFR 32.56-60 - Ventilation ducts-T/ALL.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 1 2011-10-01 2011-10-01 false Ventilation ducts-T/ALL. 32.56-60 Section 32.56-60 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY TANK VESSELS SPECIAL EQUIPMENT, MACHINERY, AND HULL....56-60 Ventilation ducts—T/ALL. (a) Each duct for ventilation of Category A machinery spaces that...

46 CFR 32.56-60 - Ventilation ducts-T/ALL.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 1 2010-10-01 2010-10-01 false Ventilation ducts-T/ALL. 32.56-60 Section 32.56-60 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY TANK VESSELS SPECIAL EQUIPMENT, MACHINERY, AND HULL....56-60 Ventilation ducts—T/ALL. (a) Each duct for ventilation of Category A machinery spaces that...

46 CFR 36.20-5 - Ventilation of pumproom-TB/ALL.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 1 2010-10-01 2010-10-01 false Ventilation of pumproom-TB/ALL. 36.20-5 Section 36.20-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY TANK VESSELS ELEVATED TEMPERATURE CARGOES Vents and Ventilation § 36.20-5 Ventilation of pumproom—TB/ALL. (a) Where personnel are required to enter pumprooms...

46 CFR 169.629 - Compartments containing gasoline machinery or fuel tanks.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 7 2012-10-01 2012-10-01 false Compartments containing gasoline machinery or fuel tanks... gasoline machinery or fuel tanks. Spaces containing gasoline machinery or fuel tanks must have natural... Standard H-2.5, “Design and Construction; Ventilation of Boats Using Gasoline. ...

46 CFR 169.629 - Compartments containing gasoline machinery or fuel tanks.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Compartments containing gasoline machinery or fuel tanks... gasoline machinery or fuel tanks. Spaces containing gasoline machinery or fuel tanks must have natural... Standard H-2.5, “Design and Construction; Ventilation of Boats Using Gasoline. ...

46 CFR 169.629 - Compartments containing gasoline machinery or fuel tanks.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 7 2013-10-01 2013-10-01 false Compartments containing gasoline machinery or fuel tanks... gasoline machinery or fuel tanks. Spaces containing gasoline machinery or fuel tanks must have natural... Standard H-2.5, “Design and Construction; Ventilation of Boats Using Gasoline. ...

46 CFR 169.629 - Compartments containing gasoline machinery or fuel tanks.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 7 2011-10-01 2011-10-01 false Compartments containing gasoline machinery or fuel tanks... gasoline machinery or fuel tanks. Spaces containing gasoline machinery or fuel tanks must have natural... Standard H-2.5, “Design and Construction; Ventilation of Boats Using Gasoline. ...

46 CFR 169.629 - Compartments containing gasoline machinery or fuel tanks.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 7 2014-10-01 2014-10-01 false Compartments containing gasoline machinery or fuel tanks... gasoline machinery or fuel tanks. Spaces containing gasoline machinery or fuel tanks must have natural... Standard H-2.5, “Design and Construction; Ventilation of Boats Using Gasoline. ...

46 CFR 169.627 - Compartments containing diesel fuel tanks.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 7 2011-10-01 2011-10-01 false Compartments containing diesel fuel tanks. 169.627 Section 169.627 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS Machinery and Electrical Ventilation § 169.627 Compartments containing diesel fuel tanks...

46 CFR 169.627 - Compartments containing diesel fuel tanks.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Compartments containing diesel fuel tanks. 169.627 Section 169.627 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS Machinery and Electrical Ventilation § 169.627 Compartments containing diesel fuel tanks...

HOW THE LEED VENTILATION CREDIT IMPACTS ENERGY CONSUMPTION OF GSHP SYSTEMS A CASE STUDY FOR PRIMARY SCHOOLS

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

Liu, Xiaobing

2011-01-01

This paper presents a study on the impacts of increased outdoor air (OA) ventilation on the performance of ground-source heat pump (GSHP) systems that heat and cool typical primary schools. Four locations Phoenix, Miami, Seattle, and Chicago are selected in this study to represent different climate zones in the United States. eQUEST, an integrated building and HVAC system energy analysis program, is used to simulate a typical primary school and the GSHP system at the four locations with minimum and 30% more than minimum OA ventilation. The simulation results show that, without an energy recovery ventilator, the 30% more OAmore » ventilation results in an 8.0 13.3% increase in total GSHP system energy consumption at the four locations. The peak heating and cooling loads increase by 20.2 30% and 14.9 18.4%, respectively, at the four locations. The load imbalance of the ground heat exchanger is increased in hot climates but reduced in mild and cold climates.« less

HANFORD DST THERMAL & SEISMIC PROJECT ANSYS BENCHMARK ANALYSIS OF SEISMIC INDUCED FLUID STRUCTURE INTERACTION IN A HANFORD DOUBLE SHELL PRIMARY TANK

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

MACKEY, T.C.

M&D Professional Services, Inc. (M&D) is under subcontract to Pacific Northwest National Laboratories (PNNL) to perform seismic analysis of the Hanford Site Double-Shell Tanks (DSTs) in support of a project entitled ''Double-Shell Tank (DSV Integrity Project-DST Thermal and Seismic Analyses)''. The overall scope of the project is to complete an up-to-date comprehensive analysis of record of the DST System at Hanford in support of Tri-Party Agreement Milestone M-48-14. The work described herein was performed in support of the seismic analysis of the DSTs. The thermal and operating loads analysis of the DSTs is documented in Rinker et al. (2004). Themore » overall seismic analysis of the DSTs is being performed with the general-purpose finite element code ANSYS. The overall model used for the seismic analysis of the DSTs includes the DST structure, the contained waste, and the surrounding soil. The seismic analysis of the DSTs must address the fluid-structure interaction behavior and sloshing response of the primary tank and contained liquid. ANSYS has demonstrated capabilities for structural analysis, but the capabilities and limitations of ANSYS to perform fluid-structure interaction are less well understood. The purpose of this study is to demonstrate the capabilities and investigate the limitations of ANSYS for performing a fluid-structure interaction analysis of the primary tank and contained waste. To this end, the ANSYS solutions are benchmarked against theoretical solutions appearing in BNL 1995, when such theoretical solutions exist. When theoretical solutions were not available, comparisons were made to theoretical solutions of similar problems and to the results from Dytran simulations. The capabilities and limitations of the finite element code Dytran for performing a fluid-structure interaction analysis of the primary tank and contained waste were explored in a parallel investigation (Abatt 2006). In conjunction with the results of the global ANSYS

Laboratory and Physical Modelling of Building Ventilation Flows

NASA Astrophysics Data System (ADS)

Hunt, Gary

2001-11-01

Heating and ventilating buildings accounts for a significant fraction of the total energy budget of cities and an immediate challenge in building physics is for the design of sustainable, low-energy buildings. Natural ventilation provides a low-energy solution as it harness the buoyancy force associated with temperature differences between the internal and external environment, and the wind to drive a ventilating flow. Modern naturally-ventilated buildings use innovative design solutions, e.g. glazed atria and solar chimneys, to enhance the ventilation and demand for these and other designs has far outstripped our understanding of the fluid mechanics within these buildings. Developing an understanding of the thermal stratification and movement of air provides a considerable challenge as the flows involve interactions between stratification and turbulence and often in complex geometries. An approach that has provided significant new insight into these flows and which has led to the development of design guidelines for architects and ventilation engineers is laboratory modelling at small-scale in water tanks combined with physical modelling. Density differences to drive the flow in simplified plexiglass models of rooms or buildings are provided by fresh and salt water solutions, and wind flow is represented by a mean flow in a flume tank. In tandom with the experiments, theoretical models that capture the essential physics of these flows have been developed in order to generalise the experimental results to a wide range of typical building geometries and operating conditions. This paper describes the application and outcomes of these modelling techniques to the study of a variety of natural ventilation flows in buildings.

A demonstration of NIOSH push-pull ventilation criteria.

PubMed

Klein, M K

1987-03-01

This paper summarizes the results of a study performed on an actual chrome plating tank in order to validate criteria for push-pull ventilation systems developed by Huebener and Hughes at NIOSH. Validation of the criteria was made by taking area industrial hygiene samples for hexavalent and total chrome at ten locations around the plating tank. The sampling was performed during actual production runs or while the tank was operating with a dummy load. The sampling data are summarized. The data show that the push-pull system, operating at Huebener's criteria, could control emissions to below the current standards and guidelines. Conclusions and recommendations are included.

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...

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.

[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

Effect of enzymes on anaerobic digestion of primary sludge and septic tank performance.

PubMed

Diak, James; Örmeci, Banu; Kennedy, Kevin J

2012-11-01

Enzyme additives are believed to improve septic tank performance by increasing the hydrolysis and digestion rates and maintaining a healthy microbial population. Previous studies reported mixed results on the effectiveness of enzymes on mesophilic and thermophilic digestion, and it is not clear whether enzymes would be effective under septic tank conditions where there is no heating or mixing, quantities of enzymes added are small, and they can be washed out quickly. In this study, batch reactors and continuous-flow reactors designed and operated as septic tanks were used to evaluate whether enzymatic treatment would increase the hydrolysis and digestion rates in primary sludge. Total solids, volatile solids, total suspended solids, total and soluble chemical oxygen demand, concentrations of protein, carbohydrate, ammonia and volatile acids in sludge and effluent samples were measured to determine the differences in digestion rates in the presence and absence of enzymes. Overall, no significant improvement was observed in enzyme-treated reactors compared with the control reactors.

46 CFR 38.20-10 - Ventilation-T/ALL.

Code of Federal Regulations, 2011 CFR

2011-10-01

... space surrounding tanks whose manhole openings are below the weather deck in accordance with § 38.05-10... containing pumps, compressors, pipes, control spaces, etc. connected with the cargo handling facilities... located at points where concentrations of vapors may be expected. Ventilation from the weather deck shall...

46 CFR 38.20-10 - Ventilation-T/ALL.

Code of Federal Regulations, 2012 CFR

2012-10-01

... space surrounding tanks whose manhole openings are below the weather deck in accordance with § 38.05-10... containing pumps, compressors, pipes, control spaces, etc. connected with the cargo handling facilities... located at points where concentrations of vapors may be expected. Ventilation from the weather deck shall...

46 CFR 38.20-10 - Ventilation-T/ALL.

Code of Federal Regulations, 2013 CFR

2013-10-01

... space surrounding tanks whose manhole openings are below the weather deck in accordance with § 38.05-10... containing pumps, compressors, pipes, control spaces, etc. connected with the cargo handling facilities... located at points where concentrations of vapors may be expected. Ventilation from the weather deck shall...

46 CFR 38.20-10 - Ventilation-T/ALL.

Code of Federal Regulations, 2014 CFR

2014-10-01

... space surrounding tanks whose manhole openings are below the weather deck in accordance with § 38.05-10... containing pumps, compressors, pipes, control spaces, etc. connected with the cargo handling facilities... located at points where concentrations of vapors may be expected. Ventilation from the weather deck shall...

241-AP Tank Farm Construction Extent of Condition Review for Tank Integrity

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

Barnes, Travis J.; Gunter, Jason R.; Reeploeg, Gretchen E.

2014-04-04

This report provides the results of an extent of condition construction history review for the 241-AP tank farm. The construction history of the 241-AP tank farm has been reviewed to identify issues similar to those experienced during tank AY-102 construction. Those issues and others impacting integrity are discussed based on information found in available construction records, using tank AY-102 as the comparison benchmark. In the 241-AP tank farm, the sixth double-shell tank farm constructed, tank bottom flatness, refractory material quality, post-weld stress relieving, and primary tank bottom weld rejection were improved.

System design description for portable 1,000 CFM exhauster Skids POR-007/Skid E and POR-008/Skid F

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

Nelson, O.D.

1998-07-25

The primary purpose of the two 1,000 CFM Exhauster Skids, POR-007-SKID E and POR-008-SKID F, is to provide backup to the waste tank primary ventilation systems for tanks 241-C-106 and 241-AY-102, and the AY-102 annulus in the event of a failure during the sluicing of tank 241-C-106 and subsequent transfer of sluiced waste to 241-AY-102. This redundancy is required since both of the tank ventilation systems have been declared as Safety Class systems.

STEADY STATE FLAMMABLE GAS RELEASE RATE CALCULATION AND LOWER FLAMMABILITY LEVEL EVALUATION FOR HANFORD TANK WASTE

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

HU TA

2009-10-26

Assess the steady-state flammability level at normal and off-normal ventilation conditions. The hydrogen generation rate was calculated for 177 tanks using the rate equation model. Flammability calculations based on hydrogen, ammonia, and methane were performed for 177 tanks for various scenarios.

Exposures to jet fuel and benzene during aircraft fuel tank repair in the U.S. Air Force.

PubMed

Carlton, G N; Smith, L B

2000-06-01

Jet fuel and benzene vapor exposures were measured during aircraft fuel tank entry and repair at twelve U.S. Air Force bases. Breathing zone samples were collected on the fuel workers who performed the repair. In addition, instantaneous samples were taken at various points during the procedures with SUMMA canisters and subsequent analysis by mass spectrometry. The highest eight-hour time-weighted average (TWA) fuel exposure found was 1304 mg/m3; the highest 15-minute short-term exposure was 10,295 mg/m3. The results indicate workers who repair fuel tanks containing explosion suppression foam have a significantly higher exposure to jet fuel as compared to workers who repair tanks without foam (p < 0.001). It is assumed these elevations result from the tendency for fuel, absorbed by the foam, to volatilize during the foam removal process. Fuel tanks that allow flow-through ventilation during repair resulted in lower exposures compared to those tanks that have only one access port and, as a result, cannot be ventilated efficiently. The instantaneous sampling results confirm that benzene exposures occur during fuel tank repair; levels up to 49.1 mg/m3 were found inside the tanks during the repairs. As with jet fuel, these elevated benzene concentrations were more likely to occur in foamed tanks. The high temperatures associated with fuel tank repair, along with the requirement to wear vapor-permeable cotton coveralls for fire reasons, could result in an increase in the benzene body burden of tank entrants.

77 FR 62224 - Hanford Tank Farms Flammable Gas Safety Strategy

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-12

... believes that actions are necessary to install real time monitoring to measure tank ventilation flowrates... monitoring. In its August letter, the Board noted that DOE's SAC for flammable gas monitoring exhibited a... flammable gas monitoring, it remained inadequate as a credited safety control. The SAC is less reliable than...

Pediatric Ventilator-Associated Infections: The Ventilator-Associated INfection Study.

PubMed

Willson, Douglas F; Hoot, Michelle; Khemani, Robinder; Carrol, Christopher; Kirby, Aileen; Schwarz, Adam; Gedeit, Rainer; Nett, Sholeen T; Erickson, Simon; Flori, Heidi; Hays, Spencer; Hall, Mark

2017-01-01

Suspected ventilator-associated infection is the most common reason for antibiotics in the PICU. We sought to characterize the clinical variables associated with continuing antibiotics after initial evaluation for suspected ventilator-associated infection and to determine whether clinical variables or antibiotic treatment influenced outcomes. Prospective, observational cohort study conducted in 47 PICUs in the United States, Canada, and Australia. Two hundred twenty-nine pediatric patients ventilated more than 48 hours undergoing respiratory secretion cultures were enrolled as "suspected ventilator-associated infection" in a prospective cohort study, those receiving antibiotics of less than or equal to 3 days were categorized as "evaluation only," and greater than 3 days as "treated." Demographics, diagnoses, comorbidities, culture results, and clinical data were compared between evaluation only and treated subjects and between subjects with positive versus negative cultures. PICUs in 47 hospitals in the United States, Canada, and Australia. All patients undergoing respiratory secretion cultures during the 6 study periods. None. Treated subjects differed from evaluation-only subjects only in frequency of positive cultures (79% vs 36%; p < 0.0001). Subjects with positive cultures were more likely to have chronic lung disease, tracheostomy, and shorter PICU stay, but there were no differences in ventilator days or mortality. Outcomes were similar in subjects with positive or negative cultures irrespective of antibiotic treatment. Immunocompromise and higher Pediatric Logistic Organ Dysfunction scores were the only variables associated with mortality in the overall population, but treated subjects with endotracheal tubes had significantly lower mortality. Positive respiratory cultures were the primary determinant of continued antibiotic treatment in children with suspected ventilator-associated infection. Positive cultures were not associated with worse outcomes

Wind Extraction for Natural Ventilation

NASA Astrophysics Data System (ADS)

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

2017-11-01

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

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

Tank Inspection NDE Results for Fiscal Year 2014, Waste Tanks 26, 27, 28 and 33

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

Elder, J.; Vandekamp, R.

2014-09-29

Ultrasonic nondestructive examinations (NDE) were performed on waste storage tanks 26, 27, 28 and 33 at the Savannah River Site as a part of the “In-Service Inspection (ISI) Program for High Level Waste Tanks.” No reportable conditions were identified during these inspections. The results indicate that the implemented corrosion control program continues to effectively mitigate corrosion in the SRS waste tanks. Ultrasonic inspection (UT) is used to detect general wall thinning, pitting and interface attack, as well as vertically oriented cracks through inspection of an 8.5 inch wide strip extending over the accessible height of the primary tank wall andmore » accessible knuckle regions. Welds were also inspected in tanks 27, 28 and 33 with no reportable indications. In a Type III/IIIA primary tank, a complete vertical strip includes scans of five plates (including knuckles) so five “plate/strips” would be completed at each vertical strip location. In FY 2014, a combined total of 79 plate/strips were examined for thickness mapping and crack detection, equating to over 45,000 square inches of area inspected on the primary tank wall. Of the 79 plate/strips examined in FY 2014 all but three have average thicknesses that remain at or above the construction minimum thickness which is nominal thickness minus 0.010 inches. There were no service induced reportable thicknesses or cracking encountered. A total of 2 pits were documented in 2014 with the deepest being 0.032 inches deep. One pit was detected in Tank 27 and one in Tank 33. No pitting was identified in Tanks 26 or 28. The maximum depth of any pit encountered in FY 2014 is 5% of nominal thickness, which is less than the minimum reportable criteria of 25% through-wall for pitting. In Tank 26 two vertical strips were inspected, as required by the ISI Program, due to tank conditions being outside normal chemistry controls for more than 3 months. Tank 28 had an area of localized thinning on the exterior wall

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.

46 CFR 28.340 - Ventilation of enclosed engine and fuel tank spaces.

Code of Federal Regulations, 2010 CFR

2010-10-01

... prevent the entrapment of vapors or be ventilated by a mechanical exhaust system with a nonsparking fan. The fan motor must comply with 46 CFR 111.105-23. (c) Alternative standards. A vessel less than 65...

Inhalation dose due to presence of 131I in air above septic tank system of an endocrinology hospital.

PubMed

Mietelski, J W; Grabowska, S; Nowak, T; Bogacz, J; Gaca, P; Bartyzel, M; Budzanowski, M

2005-01-01

We present here measurements of the 131I concentration for both: gaseous and aerosol fraction of 131I in the air above the septic tank containing wastes from medical application of this isotope. Aerosols were collected using air filters, whereas gaseous forms of iodine were trapped in KI impregnated charcoal double layer cartridge. Besides an active method (pumping of the air through system of filters) an attempt for using a passive method (charcoal traps) for monitoring of radio-iodine is described. For better characterisation of a site the external kerma was determined by means of G-M and TLD techniques as well as the activity kept in the septic tank was measured by gamma spectrometry. Results show that the activity of the aerosol fraction can be neglected compared to that of the gaseous fraction. He measured activity of air is low, on the level of 1 Bq m(-3), even during simulated failure of the ventilation system. Estimated inhalation dose for the serviceman of septic tanks is low ( approximately 10%) compared with external dose obtained by such person due to gamma radiation from the tank (on the level approximately 500 nSv h(-1)). Therefore, the concept of passive monitoring of the iodine in air was abandoned. Also estimated is the efficiency of 131I reduction by a charcoal filter of the ventilation system and 131I input to the environment by the ventilation chimney.

Fire tests to evaluate the potential fire threat and its effects on HEPA filter integrity in cell ventilation at the Oak Ridge National Laboratory, Building 7920

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

Hasegawa, H.K.; Staggs, K.J.; Doughty, S.M.

1992-12-01

As a result of a DOE (Tiger Team) Technical Safety Appraisal (November 1990) of the Radiochemical Engineering Development Center (REDC), ORNL Building 7920, a number of fire protection concerns were identified. The primary concern was the perceived loss of ventilation system containment due to the thermal destruction and/or breaching of the prefilters and/or high-efficiency particulate air filters (HEPA `s) and the resultant radioactive release to the external environment. The following report describes the results of an extensive fire test program performed by the Fire Research Discipline (FRD) of the Special Projects Division of Lawrence Livermore National Lab (LLNL) and fundedmore » by ORNL to address these concerns. Full scale mock-ups of a REDC hot cell tank pit, adjacent cubicle pit, and associated ventilation system were constructed at LLNL and 13 fire experiments were conducted to specifically answer the questions raised by the Tiger Team. Our primary test plan was to characterize the burning of a catastrophic solvent spill (kerosene) of 40 liters and its effect on the containment ventilation system prefilters and HEPA filters. In conjunction with ORNL and Lockwood Greene we developed a test matrix that assessed the fire performance of the prefilters and HEPA filters; evaluated the fire response of the fiber reinforced plastic (FRP) epoxy ventilation duct work; the response and effectiveness of the fire protection system, the effect of fire in a cubicle on the vessel off-gas (VOG) elbow, and other fire safety questions.« less

HANFORD DOUBLE SHELL TANK THERMAL AND SEISMIC PROJECT SEISMIC ANALYSIS IN SUPPORT OF INCREASED LIQUID LEVEL IN 241-AP TANK FARMS

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

TC MACKEY; FG ABATT; MW RINKER

2009-01-14

The essential difference between Revision 1 and the original issue of this report is in the spring constants used to model the anchor bolt response for the anchor bolts that tie the steel dome of the primary tank to the concrete tank dome. Consequently, focus was placed on the changes in the anchor bolt responses, and a full reevaluation of all tank components was judged to be unnecessary. To confirm this judgement, primary tank stresses from the revised analysis of the BES-BEC case are compared to the original analysis and it was verified that the changes are small, as expected.

46 CFR 32.55-1 - Ventilation of tank vessels constructed on or after July 1, 1951-TB/ALL.

Code of Federal Regulations, 2011 CFR

2011-10-01

... VESSELS SPECIAL EQUIPMENT, MACHINERY, AND HULL REQUIREMENTS Ventilation and Venting § 32.55-1 Ventilation... means of ventilation. (b) Compartments containing machinery where sources of vapor ignition are normally... approved for this purpose. Machinery spaces below the freeboard deck, in which fuels with flash point of...

46 CFR 32.55-1 - Ventilation of tank vessels constructed on or after July 1, 1951-TB/ALL.

Code of Federal Regulations, 2012 CFR

2012-10-01

... VESSELS SPECIAL EQUIPMENT, MACHINERY, AND HULL REQUIREMENTS Ventilation and Venting § 32.55-1 Ventilation... means of ventilation. (b) Compartments containing machinery where sources of vapor ignition are normally... approved for this purpose. Machinery spaces below the freeboard deck, in which fuels with flash point of...

46 CFR 32.55-1 - Ventilation of tank vessels constructed on or after July 1, 1951-TB/ALL.

Code of Federal Regulations, 2014 CFR

2014-10-01

... VESSELS SPECIAL EQUIPMENT, MACHINERY, AND HULL REQUIREMENTS Ventilation and Venting § 32.55-1 Ventilation... means of ventilation. (b) Compartments containing machinery where sources of vapor ignition are normally... approved for this purpose. Machinery spaces below the freeboard deck, in which fuels with flash point of...

46 CFR 32.55-1 - Ventilation of tank vessels constructed on or after July 1, 1951-TB/ALL.

Code of Federal Regulations, 2010 CFR

2010-10-01

... VESSELS SPECIAL EQUIPMENT, MACHINERY, AND HULL REQUIREMENTS Ventilation and Venting § 32.55-1 Ventilation... means of ventilation. (b) Compartments containing machinery where sources of vapor ignition are normally... approved for this purpose. Machinery spaces below the freeboard deck, in which fuels with flash point of...

46 CFR 32.55-1 - Ventilation of tank vessels constructed on or after July 1, 1951-TB/ALL.

Code of Federal Regulations, 2013 CFR

2013-10-01

... VESSELS SPECIAL EQUIPMENT, MACHINERY, AND HULL REQUIREMENTS Ventilation and Venting § 32.55-1 Ventilation... means of ventilation. (b) Compartments containing machinery where sources of vapor ignition are normally... approved for this purpose. Machinery spaces below the freeboard deck, in which fuels with flash point of...

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

PubMed

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

2012-09-01

Recent papers suggest protective ventilation (PV) as a primary ventilation strategy during one-lung ventilation (OLV) to reduce postoperative pulmonary morbidity. However, data regarding the advantage of the PV strategy in patients with normal preoperative pulmonary function are inconsistent, especially in the case of minimally invasive thoracic surgery. Therefore we compared conventional OLV (VT 10 ml/kg, FiO2 1.0, zero PEEP) to protective OLV (VT 6 ml/kg, FiO2 0.5, PEEP 5 cmH2O) in patients with normal preoperative pulmonary function tests undergoing video-assisted thoracic surgery. Oxygenation, respiratory mechanics, plasma interleukin-6 and malondialdehyde levels were measured at baseline, 15 and 60 minutes after OLV and 15 minutes after restoration of two-lung ventilation. PaO2 and PaO2/FiO2 were higher in conventional OLV than in protective OLV (P<0.001). Interleukin-6 and malondialdehyde increased over time in both groups (P<0.05); however, the magnitudes of increase were not different between the groups. Postoperatively there were no differences in the number of patients with PaO2/FiO2<300 mmHg or abnormalities on chest radiography. Protective ventilation did not provide advantages over conventional ventilation for video-assisted thoracic surgery in this group of patients with normal lung function.

Progress in Hanford's Double-Shell Tank Integrity Project

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

Bryson, D.C.; Washenfelder, D.J.; Boomer, K.D.

2008-07-01

The U.S. Department of Energy's Office of River Protection has an extensive integrity assessment program for the Hanford Site Double-Shell Tank System. The DOE Orders and environmental protection regulations provide the guidelines for the activities used to inspect and maintain 28 double-shell tanks (DSTs), the waste evaporator, and ancillary equipment that compose this system. This program has been reviewed by oversight and regulatory bodies and found to comply with the established guidelines. The basis for the DOE Order 435.1-1 for tank integrity comes from the Tank Structural Integrity Panel led by Brookhaven National Laboratory during the late 1990's. These guidelinesmore » established criteria for performing Non-Destructive Examination (NDE), for acceptance of the NDE results, for waste chemistry control, and for monitoring the tanks. The environmental regulations mirror these requirements and allow for the tank integrity program to provide compliant storage of the tanks. Both sets of requirements provide additional guidance for the protection of ancillary equipment. CH2M HILL uses two methods of NDE: visual inspection and Ultrasonic Testing (UT). The visual inspection program examines the primary tank and secondary liner of the DST. The primary tank is examined both on the interior surface above the waste in the tank and on the exterior surface facing the annulus of the DST. The interior surface of the tank liner is examined at the same time as the outer surface of the primary tank. The UT program examines representative areas of the primary tank and secondary liner by deploying equipment in the annulus of the tank. Both programs have led to the development of new equipment for remote inspection of the tanks. Compact camera and enhanced lighting systems have been designed and deployed through narrow access ports (called risers) into the tanks. The UT program has designed two generations of crawlers and equipment for deployment through risers into the

EXPLORING ENGINEERING CONTROL THROUGH PROCESS MANIPULATION OF RADIOACTIVE LIQUID WASTE TANK CHEMICAL CLEANING

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

Brown, A.

2014-04-27

One method of remediating legacy liquid radioactive waste produced during the cold war, is aggressive in-tank chemical cleaning. Chemical cleaning has successfully reduced the curie content of residual waste heels in large underground storage tanks; however this process generates significant chemical hazards. Mercury is often the bounding hazard due to its extensive use in the separations process that produced the waste. This paper explores how variations in controllable process factors, tank level and temperature, may be manipulated to reduce the hazard potential related to mercury vapor generation. When compared using a multivariate regression analysis, findings indicated that there was amore » significant relationship between both tank level (p value of 1.65x10{sup -23}) and temperature (p value of 6.39x10{sup -6}) to the mercury vapor concentration in the tank ventilation system. Tank temperature showed the most promise as a controllable parameter for future tank cleaning endeavors. Despite statistically significant relationships, there may not be confidence in the ability to control accident scenarios to below mercury’s IDLH or PAC-III levels for future cleaning initiatives.« less

46 CFR 169.631 - Separation of machinery and fuel tank spaces from accommodation spaces.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 7 2011-10-01 2011-10-01 false Separation of machinery and fuel tank spaces from accommodation spaces. 169.631 Section 169.631 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS Machinery and Electrical Ventilation § 169.631 Separation of...

[Pediatric home ventilation--practical approach].

PubMed

Rath-Wacenovsky, Regina

2015-09-01

Out-of-hospital ventilation represents only a marginal area of paediatric therapeutic concepts. In Austria, the proportion of children to be supplied with invasive and non-invasive ventilation increases significantly, together with the challenges of caring for their long-term demands. Neuromuscular diseases accounted for almost the sole indication group. Premature and newborn infants with persistent respiratory failures are an increasing group, needing more extensive care due to additional comorbidities. Children with congenital disorder have often been tracheotomised in order to secure their airway, and non-invasive ventilation as a bridge- or long-term therapy gains in importance more and more. Usually, infants with primary or secondary CNS disorders suffer from respiratory complications and eventually from chronic respiratory insufficiencies during adolescence or young adulthood. Here, invasive or non-invasive ventilation can contribute both to a significant stabilisation of health status and also quality of life. Spirit of research, experience, appropriate support structures, and appropriate networking constitute the most relevant quality- and success criteria for home care.

46 CFR 32.35-15 - Installation of air compressors on tank vessels contracted for on or after June 15, 1977-TB/ALL.

Code of Federal Regulations, 2011 CFR

2011-10-01

... June 15, 1977—TB/ALL. No tank vessel, except an oil pollution clean-up vessel, that carries petroleum... compressor intake installed in any of the following cargo areas: (a) A cargo handling room. (b) An enclosed... or ventilation opening to a cargo handling room. (f) Except for tank barges, the cargo deck space...

46 CFR 32.35-15 - Installation of air compressors on tank vessels contracted for on or after June 15, 1977-TB/ALL.

Code of Federal Regulations, 2013 CFR

2013-10-01

... June 15, 1977—TB/ALL. No tank vessel, except an oil pollution clean-up vessel, that carries petroleum... compressor intake installed in any of the following cargo areas: (a) A cargo handling room. (b) An enclosed... or ventilation opening to a cargo handling room. (f) Except for tank barges, the cargo deck space...

46 CFR 32.35-15 - Installation of air compressors on tank vessels contracted for on or after June 15, 1977-TB/ALL.

Code of Federal Regulations, 2012 CFR

2012-10-01

... June 15, 1977—TB/ALL. No tank vessel, except an oil pollution clean-up vessel, that carries petroleum... compressor intake installed in any of the following cargo areas: (a) A cargo handling room. (b) An enclosed... or ventilation opening to a cargo handling room. (f) Except for tank barges, the cargo deck space...

46 CFR 32.35-15 - Installation of air compressors on tank vessels contracted for on or after June 15, 1977-TB/ALL.

Code of Federal Regulations, 2010 CFR

2010-10-01

... June 15, 1977—TB/ALL. No tank vessel, except an oil pollution clean-up vessel, that carries petroleum... compressor intake installed in any of the following cargo areas: (a) A cargo handling room. (b) An enclosed... or ventilation opening to a cargo handling room. (f) Except for tank barges, the cargo deck space...

46 CFR 32.35-15 - Installation of air compressors on tank vessels contracted for on or after June 15, 1977-TB/ALL.

Code of Federal Regulations, 2014 CFR

2014-10-01

... June 15, 1977—TB/ALL. No tank vessel, except an oil pollution clean-up vessel, that carries petroleum... compressor intake installed in any of the following cargo areas: (a) A cargo handling room. (b) An enclosed... or ventilation opening to a cargo handling room. (f) Except for tank barges, the cargo deck space...

Low tidal volume mechanical ventilation against no ventilation during cardiopulmonary bypass heart surgery (MECANO): study protocol for a randomized controlled trial.

PubMed

Nguyen, Lee S; Merzoug, Messaouda; Estagnasie, Philippe; Brusset, Alain; Law Koune, Jean-Dominique; Aubert, Stephane; Waldmann, Thierry; Grinda, Jean-Michel; Gibert, Hadrien; Squara, Pierre

2017-12-02

Postoperative pulmonary complications are a leading cause of morbidity and mortality after cardiac surgery. There are no recommendations on mechanical ventilation associated with cardiopulmonary bypass (CPB) during surgery and anesthesiologists perform either no ventilation (noV) at all during CPB or maintain low tidal volume (LTV) ventilation. Indirect evidence points towards better pulmonary outcomes when LTV is performed but no large-scale prospective trial has yet been published in cardiac surgery. The MECANO trial is a single-center, double-blind, randomized, controlled trial comparing two mechanical ventilation strategies, noV and LTV, during cardiac surgery with CPB. In total, 1500 patients are expected to be included, without any restrictions. They will be randomized between noV and LTV on a 1:1 ratio. The noV group will receive no ventilation during CPB. The LTV group will receive 5 breaths/minute with a tidal volume of 3 mL/kg and positive end-expiratory pressure of 5 cmH2O. The primary endpoint will be a composite of all-cause mortality, early respiratory failure defined as a ratio of partial pressure of oxygen/fraction of inspired oxygen <200 mmHg at 1 hour after arrival in the ICU, heavy oxygenation support (defined as a patient requiring either non-invasive ventilation, mechanical ventilation or high-flow oxygen) at 2 days after arrival in the ICU or ventilator-acquired pneumonia defined by the Center of Disease Control. Lung recruitment maneuvers will be performed in the noV and LTV groups at the end of surgery and at arrival in ICU with an insufflation at +30 cmH20 for 5 seconds. Secondary endpoints are those composing the primary endpoint with the addition of pneumothorax, CPB duration, quantity of postoperative bleeding, red blood cell transfusions, revision surgery requirements, length of stay in the ICU and in the hospital and total hospitalization costs. Patients will be followed until hospital discharge. The MECANO trial is the first of

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

PubMed

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

2016-01-01

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

49 CFR 172.331 - Bulk packagings other than portable tanks, cargo tanks, tank cars and multi-unit tank car tanks.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 2 2012-10-01 2012-10-01 false Bulk packagings other than portable tanks, cargo tanks, tank cars and multi-unit tank car tanks. 172.331 Section 172.331 Transportation Other Regulations... packagings other than portable tanks, cargo tanks, tank cars and multi-unit tank car tanks. (a) Each person...

49 CFR 172.331 - Bulk packagings other than portable tanks, cargo tanks, tank cars and multi-unit tank car tanks.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 2 2010-10-01 2010-10-01 false Bulk packagings other than portable tanks, cargo tanks, tank cars and multi-unit tank car tanks. 172.331 Section 172.331 Transportation Other Regulations... packagings other than portable tanks, cargo tanks, tank cars and multi-unit tank car tanks. (a) Each person...

49 CFR 172.331 - Bulk packagings other than portable tanks, cargo tanks, tank cars and multi-unit tank car tanks.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 2 2014-10-01 2014-10-01 false Bulk packagings other than portable tanks, cargo tanks, tank cars and multi-unit tank car tanks. 172.331 Section 172.331 Transportation Other Regulations... packagings other than portable tanks, cargo tanks, tank cars and multi-unit tank car tanks. (a) Each person...

49 CFR 172.331 - Bulk packagings other than portable tanks, cargo tanks, tank cars and multi-unit tank car tanks.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 2 2011-10-01 2011-10-01 false Bulk packagings other than portable tanks, cargo tanks, tank cars and multi-unit tank car tanks. 172.331 Section 172.331 Transportation Other Regulations... packagings other than portable tanks, cargo tanks, tank cars and multi-unit tank car tanks. (a) Each person...

49 CFR 172.331 - Bulk packagings other than portable tanks, cargo tanks, tank cars and multi-unit tank car tanks.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 2 2013-10-01 2013-10-01 false Bulk packagings other than portable tanks, cargo tanks, tank cars and multi-unit tank car tanks. 172.331 Section 172.331 Transportation Other Regulations... packagings other than portable tanks, cargo tanks, tank cars and multi-unit tank car tanks. (a) Each person...

A case of acute gasoline intoxication at the scene of washing a petrol tank.

PubMed

Takamiya, Masataka; Niitsu, Hisae; Saigusa, Kiyoshi; Kanetake, Jun; Aoki, Yasuhiro

2003-09-01

We encountered a case of acute gasoline intoxication at the scene of washing the inner wall of a petrol tank. The decedent was a 50-year-old male, who was the supervisor. Two young workers wearing mask respirators began to wash the inner wall of the gasoline tank under poor ventilation. About 1 h later, because one of the workers lost consciousness, the supervisor entered the tank, without a mask respirator, to rescue the worker. However, the supervisor immediately fainted, and died 26 h after the accident. In the autopsy, blisters were observed on the skin of the face, neck, anterior chest, upper extremities, and back. The heart contained hemolyzed blood. Histologically, hemorrhagic pulmonary edema, pneumonia, and proximal tubular necrosis were found. In the toxicological analyzes, toluene, xylene, and trimethylbenzene were detected in the blood, brain, and gastric contents. Toluene concentrations in the blood and brain were 0.3 mug/ml and 3.7 mug/g, respectively. Since pathological findings were consistent with the reported findings concerning gasoline intoxication, and constituents of gasoline were in the body, death was attributed to acute gasoline intoxication. It was considered that sufficient ventilation and proper use of a mask respirator were essential for this kind of work.

Final Report For The Erosion And Corrosion Analysis Of Waste Transfer Primary Pipeline Sections From 241-SY Tank Farm

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

Page, J. S.; Wyrwas, R. B.; Cooke, G. A.

Three sections of primary transfer pipeline removed from the 241-SY Tank Farm in Hanford's 200 West area, labeled as SN-285, SN-286, and SN-278, were analyzed for the presence and amount of corrosion and erosion on the inside surface of the transfer pipe. All three sections of pipe, ranging in length between 6 and 8 in., were received at the 222-S Laboratory still in the pipe-in-pipe assembly. The annular spaces were filled with urethane foam injected into the pipes for as low as reasonably achievable (ALARA) purposes. The 3-in. primary transfer pipes were first separated from the outer encasement, 6-in. pipes.more » The pipes were cut into small sections, or coupons, based upon the results of a non-destructive pipe wall thickness measurement which used an ultrasonic transducer. Following removal of the foam, the coupons were subjected to a series of analytical methods utilizing both optical microscopy and scanning electron microscopy to obtain erosion and corrosion information. The ultrasonic transducer analysis of the SN-285 primary pipe did not show any thinned locations in the pipe wall which were outside the expected range for the 3-in. schedule 40 pipe of 216 mils. A coupon was cut from the thinnest area on the pipe, and analysis of the inside surface, which was in contact with the tank waste, revealed a continuous layer of corrosion ~ 100 11m (4 mils) thick under a semi-continuous layer of tank waste residue ~ 20 11m (1 mil) thick. This residue layer was composed of an amorphous phase rich in chromium, magnesium, calcium, and chlorine. Small pits were detected throughout the inside pipe surface with depths up to ~ 50 11m (2 mils). Similarly, the SN-286 primary pipe did not show, by the ultrasonic transducer measurements, any thinned locations in the pipe wall which were outside the expected range for this pipe. Analysis of the coupon cut from the pipe section showed the presence of a tank waste layer containing sodium aluminate and phases rich in iron

Advance statement of consent from patients with primary CNS tumours to organ donation and elective ventilation.

PubMed

Patel, Umang Jash

2013-03-01

A deficit in the number of organs available for transplantation persists even with an increase in donation rates. One possible choice of donor for organs that appears under-referred and/or unaccepted is patients with primary brain tumours. In spite of advances in the treatment of high-grade primary central nervous system (CNS) tumours, the prognosis remains dire. A working group on organs from donors with primary CNS tumours showed that the risk of transmission is small and outweighs the benefits of waiting for a normal donor, in survival and organ life-years, with caveats. This paper explores the possibility that, if information on organ donation were made available to patients and their families with knowledge of their inevitable fate, perhaps some will choose to donate. It would be explained that to achieve this, elective ventilation would be performed in their final moments. This would obviate the consent question because of an advance statement. It is accepted that these are sensitive matters and there will be logistic issues. This will need discussion with the public and other professionals, but it could increase the number of donors and can be extrapolated to encompass other primary CNS tumours.

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.

49 CFR 173.318 - Cryogenic liquids in cargo tanks.

Code of Federal Regulations, 2014 CFR

2014-10-01

... than two times the tank's design pressure. (6) Maximum filling rate. (i) For a tank used in oxygen and... the design service temperature of the packaging. (2) A cargo tank may not be loaded with any material... two independent pressure relief systems which are not connected in series, namely: (A) A primary...

49 CFR 173.318 - Cryogenic liquids in cargo tanks.

Code of Federal Regulations, 2013 CFR

2013-10-01

... than two times the tank's design pressure. (6) Maximum filling rate. (i) For a tank used in oxygen and... the design service temperature of the packaging. (2) A cargo tank may not be loaded with any material... two independent pressure relief systems which are not connected in series, namely: (A) A primary...

49 CFR 173.318 - Cryogenic liquids in cargo tanks.

Code of Federal Regulations, 2011 CFR

2011-10-01

... than two times the tank's design pressure. (6) Maximum filling rate. (i) For a tank used in oxygen and... the design service temperature of the packaging. (2) A cargo tank may not be loaded with any material... two independent pressure relief systems which are not connected in series, namely: (A) A primary...

49 CFR 173.318 - Cryogenic liquids in cargo tanks.

Code of Federal Regulations, 2010 CFR

2010-10-01

... than two times the tank's design pressure. (6) Maximum filling rate. (i) For a tank used in oxygen and... the design service temperature of the packaging. (2) A cargo tank may not be loaded with any material... two independent pressure relief systems which are not connected in series, namely: (A) A primary...

Functions and requirements for tank farm restoration and safe operations, Project W-314. Revision 3

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

Garrison, R.C.

1995-02-01

This Functions and Requirements document (FRD) establishes the basic performance criteria for Project W-314, in accordance with the guidance outlined in the letter from R.W. Brown, RL, to President, WHC, ``Tank Waste Remediation System (TWRS) Project Documentation Methodology,`` 94-PRJ-018, dated 3/18/94. The FRD replaces the Functional Design Criteria (FDC) as the project technical baseline documentation. Project W-314 will improve the reliability of safety related systems, minimize onsite health and safety hazards, and support waste retrieval and disposal activities by restoring and/or upgrading existing Tank Farm facilities and systems. The scope of Project W-314 encompasses the necessary restoration upgrades of themore » Tank Farms` instrumentation, ventilation, electrical distribution, and waste transfer systems.« less

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.

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

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.

Riser Difference Uncertainty Methodology Based on Tank AY-101 Wall Thickness Measurements with Application to Tank AN-107

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

Weier, Dennis R.; Anderson, Kevin K.; Berman, Herbert S.

2005-03-10

The DST Integrity Plan (RPP-7574, 2003, Double-Shell Tank Integrity Program Plan, Rev. 1A, CH2M HILL Hanford Group, Inc., Richland, Washington.) requires the ultrasonic wall thickness measurement of two vertical scans of the tank primary wall while using a single riser location. The resulting measurements are then used in extreme value methodology to predict the minimum wall thickness expected for the entire tank. The representativeness of using a single riser in this manner to draw conclusions about the entire circumference of a tank has been questioned. The only data available with which to address the representativeness question comes from Tank AY-101more » since only for that tank have multiple risers been used for such inspection. The purpose of this report is to (1) further characterize AY-101 riser differences (relative to prior work); (2) propose a methodology for incorporating a ''riser difference'' uncertainty for subsequent tanks for which only a single riser is used, and (3) specifically apply the methodology to measurements made from a single riser in Tank AN-107.« less

A 'two-tank' seasonal storage concept for solar space heating of buildings

NASA Astrophysics Data System (ADS)

Cha, B. K.; Connor, D. W.; Mueller, R. O.

This paper presents an analysis of a novel 'two-tank' water storage system, consisting of a large primary water tank for seasonal storage of solar energy plus a much smaller secondary water tank for storage of solar energy collected during the heating season. The system offers the advantages of high collection efficiency during the early stages of the heating season, a period when the temperature of the primary tank is generally high. By preferentially drawing energy from the small secondary tank to meet load, its temperature can be kept well below that of the larger primary tank, thereby providing a lower-temperature source for collector inlet fluid. The resulting improvement in annual system efficiency through the addition of a small secondary tank is found to be substantial - for the site considered in the paper (Madison, Wisconsin), the relative percentage gain in annual performance is in the range of 10 to 20%. A simple computer model permits accurate hour-by-hour transient simulation of thermal performance over a yearly cycle. The paper presents results of detailed simulations of collectors and storage sizing and design trade-offs for solar energy systems supplying 90% to 100% of annual heating load requirements.

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

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.

49 CFR 172.330 - Tank cars and multi-unit tank car tanks.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 2 2013-10-01 2013-10-01 false Tank cars and multi-unit tank car tanks. 172.330..., TRAINING REQUIREMENTS, AND SECURITY PLANS Marking § 172.330 Tank cars and multi-unit tank car tanks. (a... material— (1) In a tank car unless the following conditions are met: (i) The tank car must be marked on...

49 CFR 172.330 - Tank cars and multi-unit tank car tanks.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 2 2012-10-01 2012-10-01 false Tank cars and multi-unit tank car tanks. 172.330..., TRAINING REQUIREMENTS, AND SECURITY PLANS Marking § 172.330 Tank cars and multi-unit tank car tanks. (a... material— (1) In a tank car unless the following conditions are met: (i) The tank car must be marked on...

49 CFR 172.330 - Tank cars and multi-unit tank car tanks.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 2 2014-10-01 2014-10-01 false Tank cars and multi-unit tank car tanks. 172.330..., TRAINING REQUIREMENTS, AND SECURITY PLANS Marking § 172.330 Tank cars and multi-unit tank car tanks. (a... material— (1) In a tank car unless the following conditions are met: (i) The tank car must be marked on...

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.

49 CFR 174.63 - Portable tanks, IM portable tanks, IBCs, Large Packagings, cargo tanks, and multi-unit tank car...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 2 2014-10-01 2014-10-01 false Portable tanks, IM portable tanks, IBCs, Large Packagings, cargo tanks, and multi-unit tank car tanks. 174.63 Section 174.63 Transportation Other....63 Portable tanks, IM portable tanks, IBCs, Large Packagings, cargo tanks, and multi-unit tank car...

49 CFR 174.63 - Portable tanks, IM portable tanks, IBCs, Large Packagings, cargo tanks, and multi-unit tank car...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 2 2010-10-01 2010-10-01 false Portable tanks, IM portable tanks, IBCs, Large Packagings, cargo tanks, and multi-unit tank car tanks. 174.63 Section 174.63 Transportation Other....63 Portable tanks, IM portable tanks, IBCs, Large Packagings, cargo tanks, and multi-unit tank car...

49 CFR 174.63 - Portable tanks, IM portable tanks, IBCs, Large Packagings, cargo tanks, and multi-unit tank car...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 2 2011-10-01 2011-10-01 false Portable tanks, IM portable tanks, IBCs, Large Packagings, cargo tanks, and multi-unit tank car tanks. 174.63 Section 174.63 Transportation Other....63 Portable tanks, IM portable tanks, IBCs, Large Packagings, cargo tanks, and multi-unit tank car...

49 CFR 174.63 - Portable tanks, IM portable tanks, IBCs, Large Packagings, cargo tanks, and multi-unit tank car...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 2 2013-10-01 2013-10-01 false Portable tanks, IM portable tanks, IBCs, Large Packagings, cargo tanks, and multi-unit tank car tanks. 174.63 Section 174.63 Transportation Other....63 Portable tanks, IM portable tanks, IBCs, Large Packagings, cargo tanks, and multi-unit tank car...

49 CFR 174.63 - Portable tanks, IM portable tanks, IBCs, Large Packagings, cargo tanks, and multi-unit tank car...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 2 2012-10-01 2012-10-01 false Portable tanks, IM portable tanks, IBCs, Large Packagings, cargo tanks, and multi-unit tank car tanks. 174.63 Section 174.63 Transportation Other....63 Portable tanks, IM portable tanks, IBCs, Large Packagings, cargo tanks, and multi-unit tank car...

Adaptive Servo-Ventilation for Central Sleep Apnea in Systolic Heart Failure.

PubMed

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

2015-09-17

Central sleep apnea is associated with poor prognosis and death in patients with heart failure. Adaptive servo-ventilation is a therapy that uses a noninvasive ventilator to treat central sleep apnea by delivering servo-controlled inspiratory pressure support on top of expiratory positive airway pressure. We investigated the effects of adaptive servo-ventilation in patients who had heart failure with reduced ejection fraction and predominantly central sleep apnea. We randomly assigned 1325 patients with a left ventricular ejection fraction of 45% or less, an apnea-hypopnea index (AHI) of 15 or more events (occurrences of apnea or hypopnea) per hour, and a predominance of central events to receive guideline-based medical treatment with adaptive servo-ventilation or guideline-based medical treatment alone (control). The primary end point in the time-to-event analysis was the first event of death from any cause, lifesaving cardiovascular intervention (cardiac transplantation, implantation of a ventricular assist device, resuscitation after sudden cardiac arrest, or appropriate lifesaving shock), or unplanned hospitalization for worsening heart failure. In the adaptive servo-ventilation group, the mean AHI at 12 months was 6.6 events per hour. The incidence of the primary end point did not differ significantly between the adaptive servo-ventilation group and the control group (54.1% and 50.8%, respectively; hazard ratio, 1.13; 95% confidence interval [CI], 0.97 to 1.31; P=0.10). All-cause mortality and cardiovascular mortality were significantly higher in the adaptive servo-ventilation group than in the control group (hazard ratio for death from any cause, 1.28; 95% CI, 1.06 to 1.55; P=0.01; and hazard ratio for cardiovascular death, 1.34; 95% CI, 1.09 to 1.65; P=0.006). Adaptive servo-ventilation had no significant effect on the primary end point in patients who had heart failure with reduced ejection fraction and predominantly central sleep apnea, but all-cause and

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.

Hanford Double-Shell Tank AY-102 Radioactive Waste Leak Investigation Update - 15302

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

Washenfelder, D. J.; Johnson, J. M.

2014-12-22

Tank AY-102 was the first of 28 double-shell radioactive waste storage tanks constructed at the U. S. Department of Energy’s Hanford Site, near Richland, WA. The tank was completed in 1970, and entered service in 1971. In August, 2012, an accumulation of material was discovered at two sites on the floor of the annulus that separates the primary tank from the secondary liner. The material was sampled and determined to originate from the primary tank. This paper summarizes the changes in leak behavior that have occurred during the past two years, inspections to determine the capability of the secondary linermore » to continue safely containing the leakage, and the initial results of testing to determine the leak mechanism.« less

Analysis of suspended solids transport processes in primary settling tanks.

PubMed

Patziger, Miklós; Kiss, Katalin

2015-01-01

The paper shows the results of a long-term research comprising FLUENT-based numerical modeling, in situ measurements and laboratory tests to analyze suspended solids (SS) transport processes in primary settling tanks (PSTs). The investigated PST was one of the rectangular horizontal flow PSTs at a large municipal wastewater treatment plant (WWTP) of a capacity of 500,000 population equivalent. Many middle-sized and large WWTPs are equipped with such PSTs. The numerical PST model was calibrated and validated based on the results of comprehensive in situ flow and SS concentration measurements from low (5 m/h) up to quite high surface overflow rates of 9.5 and 13.0 m/h and on settling and other laboratory tests. The calibrated and validated PST model was also successfully used for evaluation of some slight modifications of the inlet geometry (removing lamellas, installing a flocculation 'box', shifting the inlet into a 'bottom-near' or into a 'high' position), which largely affect PST behavior and performance. The investigations provided detailed insight into the flow and SS transport processes within the investigated PST, which strongly contributes to hydrodynamically driven design and upgrading of PSTs.

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.

Inclusion of tank configurations as a variable in the cost optimization of branched piped-water networks

NASA Astrophysics Data System (ADS)

Hooda, Nikhil; Damani, Om

2017-06-01

The classic problem of the capital cost optimization of branched piped networks consists of choosing pipe diameters for each pipe in the network from a discrete set of commercially available pipe diameters. Each pipe in the network can consist of multiple segments of differing diameters. Water networks also consist of intermediate tanks that act as buffers between incoming flow from the primary source and the outgoing flow to the demand nodes. The network from the primary source to the tanks is called the primary network, and the network from the tanks to the demand nodes is called the secondary network. During the design stage, the primary and secondary networks are optimized separately, with the tanks acting as demand nodes for the primary network. Typically the choice of tank locations, their elevations, and the set of demand nodes to be served by different tanks is manually made in an ad hoc fashion before any optimization is done. It is desirable therefore to include this tank configuration choice in the cost optimization process itself. In this work, we explain why the choice of tank configuration is important to the design of a network and describe an integer linear program model that integrates the tank configuration to the standard pipe diameter selection problem. In order to aid the designers of piped-water networks, the improved cost optimization formulation is incorporated into our existing network design system called JalTantra.

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

PubMed

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

2017-08-01

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

Computational Analyses of Pressurization in Cryogenic Tanks

NASA Technical Reports Server (NTRS)

Ahuja, Vineet; Hosangadi, Ashvin; Mattick, Stephen; Lee, Chun P.; Field, Robert E.; Ryan, Harry

2008-01-01

A) Advanced Gas/Liquid Framework with Real Fluids Property Routines: I. A multi-fluid formulation in the preconditioned CRUNCH CFD(Registered TradeMark) code developed where a mixture of liquid and gases can be specified: a) Various options for Equation of state specification available (from simplified ideal fluid mixtures, to real fluid EOS such as SRK or BWR models). b) Vaporization of liquids driven by pressure value relative to vapor pressure and combustion of vapors allowed. c) Extensive validation has been undertaken. II. Currently working on developing primary break-up models and surface tension effects for more rigorous phase-change modeling and interfacial dynamics B) Framework Applied to Run-time Tanks at Ground Test Facilities C) Framework Used For J-2 Upper Stage Tank Modeling: 1) NASA MSFC tank pressurization: a) Hydrogen and oxygen tank pre-press, repress and draining being modeled at NASA MSFC. 2) NASA AMES tank safety effort a) liquid hydrogen and oxygen are separated by a baffle in the J-2 tank. We are modeling pressure rise and possible combustion if a hole develops in the baffle and liquid hydrogen leaks into the oxygen tank. Tank pressure rise rates simulated and risk of combustion evaluated.

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

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.

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.

Effect of Dexmedetomidine on Mortality and Ventilator-Free Days in Patients Requiring Mechanical Ventilation With Sepsis

PubMed Central

Kawazoe, Yu; Miyamoto, Kyohei; Morimoto, Takeshi; Yamamoto, Tomonori; Fuke, Akihiro; Hashimoto, Atsunori; Koami, Hiroyuki; Beppu, Satoru; Katayama, Yoichi; Itoh, Makoto; Ohta, Yoshinori

2017-01-01

Importance Dexmedetomidine provides sedation for patients undergoing ventilation; however, its effects on mortality and ventilator-free days have not been well studied among patients with sepsis. Objectives To examine whether a sedation strategy with dexmedetomidine can improve clinical outcomes in patients with sepsis undergoing ventilation. Design, Setting, and Participants Open-label, multicenter randomized clinical trial conducted at 8 intensive care units in Japan from February 2013 until January 2016 among 201 consecutive adult patients with sepsis requiring mechanical ventilation for at least 24 hours. Interventions Patients were randomized to receive either sedation with dexmedetomidine (n = 100) or sedation without dexmedetomidine (control group; n = 101). Other agents used in both groups were fentanyl, propofol, and midazolam. Main Outcomes and Measures The co–primary outcomes were mortality and ventilator-free days (over a 28-day duration). Sequential Organ Failure Assessment score (days 1, 2, 4, 6, 8), sedation control, occurrence of delirium and coma, intensive care unit stay duration, renal function, inflammation, and nutrition state were assessed as secondary outcomes. Results Of the 203 screened patients, 201 were randomized. The mean age was 69 years (SD, 14 years); 63% were male. Mortality at 28 days was not significantly different in the dexmedetomidine group vs the control group (19 patients [22.8%] vs 28 patients [30.8%]; hazard ratio, 0.69; 95% CI, 0.38-1.22; P = .20). Ventilator-free days over 28 days were not significantly different between groups (dexmedetomidine group: median, 20 [interquartile range, 5-24] days; control group: median, 18 [interquartile range, 0.5-23] days; P = .20). The dexmedetomidine group had a significantly higher rate of well-controlled sedation during mechanical ventilation (range, 17%-58% vs 20%-39%; P = .01); other outcomes were not significantly different between groups. Adverse events

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.

Mechanical Ventilation and ARDS in the ED

PubMed Central

Mohr, Nicholas M.; Miller, Christopher N.; Deitchman, Andrew R.; Castagno, Nicole; Hassebroek, Elizabeth C.; Dhedhi, Adam; Scott-Wittenborn, Nicholas; Grace, Edward; Lehew, Courtney; Kollef, Marin H.

2015-01-01

BACKGROUND: There are few data regarding mechanical ventilation and ARDS in the ED. This could be a vital arena for prevention and treatment. METHODS: This study was a multicenter, observational, prospective, cohort study aimed at analyzing ventilation practices in the ED. The primary outcome was the incidence of ARDS after admission. Multivariable logistic regression was used to determine the predictors of ARDS. RESULTS: We analyzed 219 patients receiving mechanical ventilation to assess ED ventilation practices. Median tidal volume was 7.6 mL/kg predicted body weight (PBW) (interquartile range, 6.9-8.9), with a range of 4.3 to 12.2 mL/kg PBW. Lung-protective ventilation was used in 122 patients (55.7%). The incidence of ARDS after admission from the ED was 14.7%, with a mean onset of 2.3 days. Progression to ARDS was associated with higher illness severity and intubation in the prehospital environment or transferring facility. Of the 15 patients with ARDS in the ED (6.8%), lung-protective ventilation was used in seven (46.7%). Patients who progressed to ARDS experienced greater duration in organ failure and ICU length of stay and higher mortality. CONCLUSIONS: Lung-protective ventilation is infrequent in patients receiving mechanical ventilation in the ED, regardless of ARDS status. Progression to ARDS is common after admission, occurs early, and worsens outcome. Patient- and treatment-related factors present in the ED are associated with ARDS. Given the limited treatment options for ARDS, and the early onset after admission from the ED, measures to prevent onset and to mitigate severity should be instituted in the ED. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT01628523; URL: www.clinicaltrials.gov PMID:25742126

Hanford Double-Shell Tank Extent-of-Condition Review - 15498

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

Johnson, J. M.; Baide, D. D.; Barnes, T. J.

2014-11-19

During routine visual inspections of Hanford double-shell waste tank 241-AY-102 (AY-102), anomalies were identified on the annulus floor which resulted in further evaluations. Following a formal leak assessment in October 2012, Washington River Protection Solutions, LLC (WRPS) determined that the primary tank of AY-102 was leaking. A formal leak assessment, documented in RPP-ASMT-53793, Tank 241-AY-102 Leak Assessment Report, identified first-of-a-kind construction difficulties and trial-and-error repairs as major contributing factors to tank failure.1 To determine if improvements in double-shell tank (DST) construction occurred after construction of tank AY-102, a detailed review and evaluation of historical construction records was performed for Hanford’smore » remaining twenty-seven DSTs. Review involved research of 241 boxes of historical project documentation to better understand the condition of the Hanford DST farms, noting similarities in construction difficulties/issues to tank AY-102. Information gathered provides valuable insight regarding construction difficulties, future tank operations decisions, and guidance of the current tank inspection program. Should new waste storage tanks be constructed in the future, these reviews also provide valuable lessons-learned.« less

[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.

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

Ventilation Inception and Washout, Scaling, and Effects on Hydrodynamic Performance of a Surface Piercing Strut

NASA Astrophysics Data System (ADS)

Harwood, Casey; Young, Yin Lu; Ceccio, Steven

2014-11-01

High-lift devices that operate at or near a fluid free surface (such as surface-piercing or shallowly-submerged propellers and hydrofoils) are prone to a multiphase flow phenomenon called ventilation, wherein non-condensable gas is entrained in the low-pressure flow, forming a cavity around the body and dramatically altering the global hydrodynamic forces. Experiments are being conducted at the University of Michigan's towing tank using a canonical surface-piercing strut to investigate atmospheric ventilation. The goals of the work are (i) to gain an understanding of the dominant physics in fully wetted, partially ventilated, and fully ventilated flow regimes, (ii) to quantify the effects of governing dimensionless parameters on the transition between flow regimes, and (iii) to develop scaling relations for the transition between flow regimes. Using theoretical arguments and flow visualization techniques, new criteria are developed for classifying flow regimes and transition mechanisms. Unsteady transition mechanisms are described and mapped as functions of the governing non-dimensional parameters. A theoretical scaling relationship is developed for ventilation washout, which is shown to adequately capture the experimentally-observed washout boundary. This material is based upon work supported by the National Science Foundation Graduate Student Research Fellowship under Grant No. DGE 1256260. Support also comes from the Naval Engineering Education Center (Award No. N65540-10-C-003).

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

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.

Integrated Stress Response Mediates Epithelial Injury in Mechanical Ventilation.

PubMed

Dolinay, Tamas; Himes, Blanca E; Shumyatcher, Maya; Lawrence, Gladys Gray; Margulies, Susan S

2017-08-01

Ventilator-induced lung injury (VILI) is a severe complication of mechanical ventilation that can lead to acute respiratory distress syndrome. VILI is characterized by damage to the epithelial barrier with subsequent pulmonary edema and profound hypoxia. Available lung-protective ventilator strategies offer only a modest benefit in preventing VILI because they cannot impede alveolar overdistension and concomitant epithelial barrier dysfunction in the inflamed lung regions. There are currently no effective biochemical therapies to mitigate injury to the alveolar epithelium. We hypothesize that alveolar stretch activates the integrated stress response (ISR) pathway and that the chemical inhibition of this pathway mitigates alveolar barrier disruption during stretch and mechanical ventilation. Using our established rat primary type I-like alveolar epithelial cell monolayer stretch model and in vivo rat mechanical ventilation that mimics the alveolar overdistension seen in acute respiratory distress syndrome, we studied epithelial responses to mechanical stress. Our studies revealed that the ISR signaling pathway is a key modulator of epithelial permeability. We show that prolonged epithelial stretch and injurious mechanical ventilation activate the ISR, leading to increased alveolar permeability, cell death, and proinflammatory signaling. Chemical inhibition of protein kinase RNA-like endoplasmic reticulum kinase, an upstream regulator of the pathway, resulted in decreased injury signaling and improved barrier function after prolonged cyclic stretch and injurious mechanical ventilation. Our results provide new evidence that therapeutic targeting of the ISR can mitigate VILI.

Expert Panel Recommendations for Hanford Double-Shell Tank Life Extension

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

Stewart, Charles W; Bush, Spencer H; Berman, Herbert Stanton

2001-06-29

Expert workshops were held in Richland in May 2001 to review the Hanford Double-Shell Tank Integrity Project and make recommendations to extend the life of Hanford's double-shell waste tanks. The workshop scope was limited to corrosion of the primary tank liner, and the main areas for review were waste chemistry control, tank inspection, and corrosion monitoring. Participants were corrosion experts from Hanford, Savannah River Site, Brookhaven National Lab., Pacific Northwest National Lab., and several consultants. This report describes the current state of the three areas of the program, the final recommendations of the workshop, and the rationale for their selection.

ICPP tank farm closure study. Volume 1

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

Spaulding, B.C.; Gavalya, R.A.; Dahlmeir, M.M.

1998-02-01

The disposition of INEEL radioactive wastes is now under a Settlement Agreement between the DOE and the State of Idaho. The Settlement Agreement requires that existing liquid sodium bearing waste (SBW), and other liquid waste inventories be treated by December 31, 2012. This agreement also requires that all HLW, including calcined waste, be disposed or made road ready to ship from the INEEL by 2035. Sodium bearing waste (SBW) is produced from decontamination operations and HLW from reprocessing of SNF. SBW and HLW are radioactive and hazardous mixed waste; the radioactive constituents are regulated by DOE and the hazardous constituentsmore » are regulated by the Resource Conservation and Recovery Act (RCRA). Calcined waste, a dry granular material, is produced in the New Waste Calcining Facility (NWCF). Two primary waste tank storage locations exist at the ICPP: Tank Farm Facility (TFF) and the Calcined Solids Storage Facility (CSSF). The TFF has the following underground storage tanks: four 18,400-gallon tanks (WM 100-102, WL 101); four 30,000-gallon tanks (WM 103-106); and eleven 300,000+ gallon tanks. This includes nine 300,000-gallon tanks (WM 182-190) and two 318,000 gallon tanks (WM 180-181). This study analyzes the closure and subsequent use of the eleven 300,000+ gallon tanks. The 18,400 and 30,000-gallon tanks were not included in the work scope and will be closed as a separate activity. This study was conducted to support the HLW Environmental Impact Statement (EIS) waste separations options and addresses closure of the 300,000-gallon liquid waste storage tanks and subsequent tank void uses. A figure provides a diagram estimating how the TFF could be used as part of the separations options. Other possible TFF uses are also discussed in this study.« less

Noninvasive ventilation.

PubMed

Rabatin, J T; Gay, P C

1999-08-01

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

49 CFR 173.172 - Aircraft hydraulic power unit fuel tank.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 2 2012-10-01 2012-10-01 false Aircraft hydraulic power unit fuel tank. 173.172... Class 1 and Class 7 § 173.172 Aircraft hydraulic power unit fuel tank. Aircraft hydraulic power unit... consist of an aluminum pressure vessel made from tubing and having welded heads. Primary containment of...

49 CFR 173.172 - Aircraft hydraulic power unit fuel tank.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 2 2014-10-01 2014-10-01 false Aircraft hydraulic power unit fuel tank. 173.172... Class 1 and Class 7 § 173.172 Aircraft hydraulic power unit fuel tank. Aircraft hydraulic power unit... consist of an aluminum pressure vessel made from tubing and having welded heads. Primary containment of...

49 CFR 173.172 - Aircraft hydraulic power unit fuel tank.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 2 2011-10-01 2011-10-01 false Aircraft hydraulic power unit fuel tank. 173.172... Class 1 and Class 7 § 173.172 Aircraft hydraulic power unit fuel tank. Aircraft hydraulic power unit... consist of an aluminum pressure vessel made from tubing and having welded heads. Primary containment of...

49 CFR 173.172 - Aircraft hydraulic power unit fuel tank.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 2 2013-10-01 2013-10-01 false Aircraft hydraulic power unit fuel tank. 173.172... Class 1 and Class 7 § 173.172 Aircraft hydraulic power unit fuel tank. Aircraft hydraulic power unit... consist of an aluminum pressure vessel made from tubing and having welded heads. Primary containment of...

49 CFR 173.172 - Aircraft hydraulic power unit fuel tank.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 2 2010-10-01 2010-10-01 false Aircraft hydraulic power unit fuel tank. 173.172... Class 1 and Class 7 § 173.172 Aircraft hydraulic power unit fuel tank. Aircraft hydraulic power unit... consist of an aluminum pressure vessel made from tubing and having welded heads. Primary containment of...

Simulation of Hanford Tank 241-C-106 Waste Release into Tank 241-Y-102

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

KP Recknagle; Y Onishi

Waste stored in Hdord single-shell Tank 241-C-106 will be sluiced with a supernatant liquid from doubIe-shell Tank 241 -AY- 102 (AY-1 02) at the U.S. Department of Energy's Har@ord Site in Eastern Washington. The resulting slurry, containing up to 30 wtYo solids, will then be transferred to Tank AY-102. During the sluicing process, it is important to know the mass of the solids being transferred into AY- 102. One of the primary instruments used to measure solids transfer is an E+ densitometer located near the periphery of the tank at riser 15S. This study was undert.dcen to assess how wellmore » a densitometer measurement could represent the total mass of soiids transferred if a uniform lateral distribution was assumed. The study evaluated the C-1 06 slurry mixing and accumulation in Tank AY- 102 for the following five cases: Case 1: 3 wt'%0 slurry in 6.4-m AY-102 waste Case 2: 3 w-t% slurry in 4.3-m AY-102 waste Case 3: 30 wtYo slurry in 6.4-m AY-102 waste Case 4: 30 wt% slurry in 4.3-m AY-102 waste Case 5: 30 wt% slurry in 5. O-m AY-102 waste. The tirne-dependent, three-dimensional, TEMPEST computer code was used to simulate solid deposition and accumulation during the injection of the C-106 slurry into AY-102 through four injection nozzles. The TEMPEST computer code was applied previously to other Hanford tanks, AP-102, SY-102, AZ-101, SY-101, AY-102, and C-106, to model tank waste mixing with rotating pump jets, gas rollover events, waste transfer from one tank to another, and pump-out retrieval of the sluiced waste. The model results indicate that the solid depth accumulated at the densitometer is within 5% of the average depth accumulation. Thus the reading of the densitometer is expected to represent the total mass of the transferred solids reasonably well.« less

Hanford Double-Shell Tank Extent-of-Condition Construction Review

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

Venetz, Theodore J.; Johnson, Jeremy M.; Gunter, Jason R.

2013-11-14

During routine visual inspections of Hanford double-shell waste tank 241-AY-102 (AY-102), anomalies were identified on the annulus floor which resulted in further evaluations. Following a formal leak assessment in October 2012, Washington River Protection Solutions, LLC (WRPS) determined that the primary tank of AY-102 was leaking. The formal leak assessment, documented in RPP-ASMT-53793,Tank 241-AY-102 Leak Assessment Report, identified first-of-a-kind construction difficulties and trial-and-error repairs as major contributing factors to tank failure. To determine if improvements in double-shell tank (DST) construction occurred after construction of tank AY-102, a detailed review and evaluation of historical construction records were performed for the firstmore » three DST tank farms constructed, which included tanks 241-AY-101, 241-AZ-101, 241-AZ-102, 241-SY-101, 241-SY-102, and 241-SY-103. The review for these six tanks involved research and review of dozens of boxes of historical project documentation. These reviews form a basis to better understand the current condition of the three oldest Hanford DST farms. They provide a basis for changes to the current tank inspection program and also provide valuable insight into future tank use decisions. If new tanks are constructed in the future, these reviews provide valuable "lessons-learned" information about expected difficulties as well as construction practices and techniques that are likely to be successful.« less

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

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

Selected topics in railroad tank car safety research. Volume 1 : fatigue evaluation of prototype tank car head shield

DOT National Transportation Integrated Search

1978-08-01

The characteristics of a prototype head shield for hazardous material tank cars were evaluated with respect to the maintenance of its structural integrity under normal service conditions. The primary concern was with the resistance to fatigue damage ...

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

Evaluation of waste tank 16 using a field mercury analyzer

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

Looney, B.; Cook, J.R.

1988-05-12

Liquid radioactive wastes from the chemical processing of nuclear materials at the Savannah River Plant (SRP) are stored in large tanks buried near the ground surface. Each tank has multiple containment barriers designed to prevent leakage to the surrounding soil and groundwater. The only incident in which waste leaked through the multiple containment of a waste tank at SRP occurred at Tank 16 on September 8, 1960 (Poe, 1974; Prendergast, 1982). Tank 16 was built in 1955 and has a capacity of approximately one million gallons. Tank 16 consists of a steel primary containment vessel resting in a shallow steelmore » pan. A massive concrete encasement surrounds the tank and pan. After the leak in 1960, the tank was removed from service until 1967; at that time it was placed into service for lower activity wastes. In 1972 the tank was removed from service. Subsequently, all of the waste except a sludge heel of 67,000 gallons was removed from the tank. In 1980, this sludge was removed. Following the sludge removal, the tank was exhaustively cleaned and rinsed. Concentrations of radioactivity in the rinsewater suggested that the cleaning of the tank was effective (West and Morris, 1980). Recently, there has been concern about residual nonradioactive constituents, such as mercury, in the tank. To assist in evaluating the potential for residual mercury contamination, a survey method was developed and a survey of several tanks was conducted. 3 refs., 1 tab.« less

Tank 19F Folding Crawler Final Evaluation, Rev. 0

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

Nance, T.

2000-10-25

The Department of Energy (DOE) is committed to removing millions of gallons of high-level radioactive waste from 51 underground waste storage tanks at the Savannah River Site (SRS). The primary radioactive waste constituents are strontium, plutonium,and cesium. It is recognized that the continued storage of this waste is a risk to the public, workers, and the environment. SRS was the first site in the DOE complex to have emptied and operationally closed a high-level radioactive waste tank. The task of emptying and closing the rest of the tanks will be completed by FY28.

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

PubMed

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

2014-01-01

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

Ventilation.

PubMed

Turner, W A; Bearg, D W; Brennan, T

1995-01-01

This chapter begins with an overview of the history of ventilation guidelines, which has led to the guidelines that are in effect today. Of particular interest is the most recent return in the past 5 years to ventilation rates that more closely reflect a mean or average of the range of guidelines that have existed over the past century. OSHA's and the EPA's recognition of the need to operate ventilation systems in buildings in an accountable manner is also of note. Of even more interest is the resurgence of the concept of minimum mixing and once-through ventilation air that has been pursued in parts of Northern Europe for the past 10 years, and in a school that is being designed with this concept in New Hampshire. In addition, the design concept of equipping office buildings with low pressure drop high efficiency particle filtration to remove fine particles from all of the air that is supplied to the occupants is being used increasingly in the U.S. This chapter also presents an overview of the various types of ventilation systems found in homes and commercial office buildings and the common indoor air quality problems that may be associated with them. It also offers an overview of common HVAC evaluation techniques that can be used to determine if a ventilation system is performing in a manner that makes sense for the use of the space and the needs of the occupants. Are the occupants receiving a reasonable supply of outdoor air? Is the air that they receive of reasonable quality? Are obvious pollutants being exhausted? Ventilation systems have become extremely complex and more difficult to run and maintain over the past 40 years. This trend will continue to drive the need for professionally maintained HVAC equipment that is serviced and run by individuals who are accountable for the quality of the air that the system delivers.

Unexpectedly high bacteriochlorophyll a concentrations in neotropical tank bromeliads.

PubMed

Lehours, Anne-Catherine; Jeune, Anne-Hélène Le; Aguer, Jean-Pierre; Céréghino, Régis; Corbara, Bruno; Kéraval, Benoit; Leroy, Céline; Perrière, Fanny; Jeanthon, Christian; Carrias, Jean-François

2016-06-06

The contribution of bacteriochlorophyll a (BChl a) to photosynthetically driven electron transport is generally low in aquatic and terrestrial systems. Here, we provide evidence that anoxygenic bacterial phototrophy is widespread and substantial in water retained by tank bromeliads of a primary rainforest in French Guiana. An analysis of the water extracted from 104 randomly selected tank bromeliads using infrared fluorimetry suggested the overall presence of abundant anoxygenic phototrophic bacterial populations. We found that purple bacteria dominated these populations responsible for unusually high BChl a/chlorophyll a ratios (>50%). Our data suggest that BChl a-based phototrophy in tank bromeliads can have significant effects on the ecology of tank-bromeliad ecosystems and on the carbon and energy fluxes in Neotropical forests. © 2016 Society for Applied Microbiology and John Wiley & Sons Ltd.

Ventilation/odor study, field study. Final report, Volume I

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

Duffee, R.A.; Jann, P.

1981-04-01

The results are presented of field investigations in schools, hospitals, and an office building on the relation between ventilation rate and odor within the buildings. The primary objective of the study was to determine: the reduction in ventilation rates that could be achieved in public buildings without causing adverse effects on odor; the sources of odor in public buildings; and the identity of the odorants. The variables of particular interest include: type of odor, occupant density, odorant identity and concentration, differences in impressions between occupants adapted to prevailing conditions and visitors, and the influence of temperature and humidity on bothmore » the generation and perception of common contaminants. Sensory odor measurements, chemical measurements, fresh air ventilation measurements, and acceptability evaluations via questionnaires were made. Sensory odor levels were found to be quite low in most buildings tested. A three-to-five-fold reduction in the fresh air ventilation in schools, hospitals, and office buildings can be achieved without significantly affecting perceived odor intensities or detectability. Tobacco smoking was found to be the most significant, pervasive contributor to interior odor level. Total hydrocarbon content of indoor air varies directly with ventilation rates; odor, however, does not. The complete set of reduced data are contained in Volume II. (LEW)« less

33 CFR 157.15 - Slop tanks in tank vessels.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Slop tanks in tank vessels. 157... (CONTINUED) POLLUTION RULES FOR THE PROTECTION OF THE MARINE ENVIRONMENT RELATING TO TANK VESSELS CARRYING OIL IN BULK Design, Equipment, and Installation § 157.15 Slop tanks in tank vessels. (a) Number. A...

33 CFR 157.15 - Slop tanks in tank vessels.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Slop tanks in tank vessels. 157... (CONTINUED) POLLUTION RULES FOR THE PROTECTION OF THE MARINE ENVIRONMENT RELATING TO TANK VESSELS CARRYING OIL IN BULK Design, Equipment, and Installation § 157.15 Slop tanks in tank vessels. (a) Number. A...

33 CFR 157.15 - Slop tanks in tank vessels.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Slop tanks in tank vessels. 157... (CONTINUED) POLLUTION RULES FOR THE PROTECTION OF THE MARINE ENVIRONMENT RELATING TO TANK VESSELS CARRYING OIL IN BULK Design, Equipment, and Installation § 157.15 Slop tanks in tank vessels. (a) Number. A...

33 CFR 157.15 - Slop tanks in tank vessels.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Slop tanks in tank vessels. 157... (CONTINUED) POLLUTION RULES FOR THE PROTECTION OF THE MARINE ENVIRONMENT RELATING TO TANK VESSELS CARRYING OIL IN BULK Design, Equipment, and Installation § 157.15 Slop tanks in tank vessels. (a) Number. A...

TankSIM: A Cryogenic Tank Performance Prediction Program

NASA Technical Reports Server (NTRS)

Bolshinskiy, L. G.; Hedayat, A.; Hastings, L. J.; Moder, J. P.; Schnell, A. R.; Sutherlin, S. G.

2015-01-01

Accurate prediction of the thermodynamic state of the cryogenic propellants in launch vehicle tanks is necessary for mission planning and successful execution. Cryogenic propellant storage and transfer in space environments requires that tank pressure be controlled. The pressure rise rate is determined by the complex interaction of external heat leak, fluid temperature stratification, and interfacial heat and mass transfer. If the required storage duration of a space mission is longer than the period in which the tank pressure reaches its allowable maximum, an appropriate pressure control method must be applied. Therefore, predictions of the pressurization rate and performance of pressure control techniques in cryogenic tanks are required for development of cryogenic fluid long-duration storage technology and planning of future space exploration missions. This paper describes an analytical tool, Tank System Integrated Model (TankSIM), which can be used for modeling pressure control and predicting the behavior of cryogenic propellant for long-term storage for future space missions. It is written in the FORTRAN 90 language and can be compiled with any Visual FORTRAN compiler. A thermodynamic vent system (TVS) is used to achieve tank pressure control. Utilizing TankSIM, the following processes can be modeled: tank self-pressurization, boiloff, ullage venting, and mixing. Details of the TankSIM program and comparisons of its predictions with test data for liquid hydrogen and liquid methane will be presented in the final paper.

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

27 CFR 24.229 - Tank car and tank truck requirements.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Tank car and tank truck... BUREAU, DEPARTMENT OF THE TREASURY ALCOHOL WINE Spirits § 24.229 Tank car and tank truck requirements. Railroad tank cars and tank trucks used to transport spirits for use in wine production will be constructed...

27 CFR 24.229 - Tank car and tank truck requirements.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Tank car and tank truck... BUREAU, DEPARTMENT OF THE TREASURY LIQUORS WINE Spirits § 24.229 Tank car and tank truck requirements. Railroad tank cars and tank trucks used to transport spirits for use in wine production will be constructed...

27 CFR 24.229 - Tank car and tank truck requirements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Tank car and tank truck... BUREAU, DEPARTMENT OF THE TREASURY LIQUORS WINE Spirits § 24.229 Tank car and tank truck requirements. Railroad tank cars and tank trucks used to transport spirits for use in wine production will be constructed...

27 CFR 24.229 - Tank car and tank truck requirements.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Tank car and tank truck... BUREAU, DEPARTMENT OF THE TREASURY ALCOHOL WINE Spirits § 24.229 Tank car and tank truck requirements. Railroad tank cars and tank trucks used to transport spirits for use in wine production will be constructed...

27 CFR 24.229 - Tank car and tank truck requirements.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Tank car and tank truck... BUREAU, DEPARTMENT OF THE TREASURY LIQUORS WINE Spirits § 24.229 Tank car and tank truck requirements. Railroad tank cars and tank trucks used to transport spirits for use in wine production will be constructed...

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.

WASTE HANDLING BUILDING VENTILATION SYSTEM DESCRIPTION DOCUMENT

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

P.A. Kumar

2000-06-21

The Waste Handling Building Ventilation System provides heating, ventilation, and air conditioning (HVAC) for the contaminated, potentially contaminated, and uncontaminated areas of the Monitored Geologic Repository's (MGR) Waste Handling Building (WHB). In the uncontaminated areas, the non-confinement area ventilation system maintains the proper environmental conditions for equipment operation and personnel comfort. In the contaminated and potentially contaminated areas, in addition to maintaining the proper environmental conditions for equipment operation and personnel comfort, the contamination confinement area ventilation system directs potentially contaminated air away from personnel in the WHB and confines the contamination within high-efficiency particulate air (HEPA) filtration units. Themore » contamination confinement areas ventilation system creates airflow paths and pressure zones to minimize the potential for spreading contamination within the building. The contamination confinement ventilation system also protects the environment and the public by limiting airborne releases of radioactive or other hazardous contaminants from the WHB. The Waste Handling Building Ventilation System is designed to perform its safety functions under accident conditions and other Design Basis Events (DBEs) (such as earthquakes, tornadoes, fires, and loss of the primary electric power). Additional system design features (such as compartmentalization with independent subsystems) limit the potential for cross-contamination within the WHB. The system provides status of important system parameters and equipment operation, and provides audible and/or visual indication of off-normal conditions and equipment failures. The Waste Handling Building Ventilation System confines the radioactive and hazardous material within the building such that the release rates comply with regulatory limits. The system design, operations, and maintenance activities incorporate ALARA (as low as is

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.

Discovery of the First Leaking Double-Shell Tank - Hanford Tank 241-AY-102

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

Harrington, Stephanie J.; Sams, Terry L.

Full text - Long Abstract. A routine video inspection of the annulus region of double-shell tank 241-A Y-102 in August of 2012 indicated the presence material in the annulus space between the primary and secondary liners. A comparison was made to previous inspections performed in 2006 and 2007. which indicated that a change had occurred. The material was observed at two locations on the floor of the annulus and one location at the top of the annulus region where the primary and secondary top knuckles meet (RPP-ASMT-53793). Subsequent inspections were performed. leading to additional material observed on the floor ofmore » the annulus space in a region that had not previously been inspected (WRPS-PER-2012-1363). The annulus Continuous Air Monitor (CAM) was still operational and was not indicating elevated radiation levels in the annulus region. When the camera from the inspections was recovered. it also did not indicate increased radiation above minimum contamination levels (WRPS-PER-2012-1363). A formal leak assessment team was established August 10, 2012 to review tank 241-AY-102 construction and operating histories and to determine whether the material observed in the annulus had resulted from a leak in the primary tank. The team consisted of individuals from Engineering. Base Operations and Environmental Protection. As this was a first-of-its-kind task. a method for obtaining a sample of the material in the annulus was needed. The consistency of the material was unknown.and the location of a majority of the material was not conducive to using the sampling devices that were currently available at Hanford. A subcontractor was tasked with the development fabrication.and testing of a sampling device that would be able to obtain multiple samples from the material on the annulus floor. as well as the material originating from a refractory air-slot near the floor of the annulus space. This sampler would need to be able to collect and dispense the material it

Structural Arrangement Trade Study. Volume 1: Reusable Hydrogen Composite Tank System (RHCTS) and Graphite Composite Primary Structures (GCPS). Executive summary

NASA Astrophysics Data System (ADS)

1995-03-01

This volume is the first of a three volume set that discusses the structural arrangement trade study plan that will identify the most suitable configuration for an SSTO winged vehicle capable of delivering 25,000 lbs to a 220 nm circular orbit at 51.6 deg inclination. The Reusable Hydrogen Composite Tank System (RHCTS), and Graphite Composite Primary Structures most suitable for intertank, wing and thrust structures are identified. This executive summary presents the trade study process, the selection process, requirements used, analysis performed and data generated. Conclusions and recommendations are also presented.

Structural Arrangement Trade Study. Volume 1: Reusable Hydrogen Composite Tank System (RHCTS) and Graphite Composite Primary Structures (GCPS). Executive summary

NASA Technical Reports Server (NTRS)

1995-01-01

This volume is the first of a three volume set that discusses the structural arrangement trade study plan that will identify the most suitable configuration for an SSTO winged vehicle capable of delivering 25,000 lbs to a 220 nm circular orbit at 51.6 deg inclination. The Reusable Hydrogen Composite Tank System (RHCTS), and Graphite Composite Primary Structures most suitable for intertank, wing and thrust structures are identified. This executive summary presents the trade study process, the selection process, requirements used, analysis performed and data generated. Conclusions and recommendations are also presented.

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.

49 CFR 180.519 - Periodic retest and inspection of tank cars other than single-unit tank car tanks.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 2 2010-10-01 2010-10-01 false Periodic retest and inspection of tank cars other than single-unit tank car tanks. 180.519 Section 180.519 Transportation Other Regulations Relating to... of Tank Cars § 180.519 Periodic retest and inspection of tank cars other than single-unit tank car...

The Use of Stepper Motor-Controlled Proportional Valve for Fio2 Calculation in the Ventilator and its Control with Fuzzy Logic.

PubMed

Gölcük, Adem; Güler, İnan

2017-01-01

This article proposes the employment of a proportional valve that can calculate the amount of oxygen in the air to be given to patient in accordance with the amount of FiO 2 which is set from the control menu of the ventilation device. To actualize this, a stepper motor-controlled proportional valve was used. Two counts of valves were employed in order to control the gases with 2 bar pressure that came from both the oxygen and medical air tanks. Oxygen and medical air manometers alongside the pressure regulators were utilized to perform this task. It is a fuzzy-logic-based controller which calculates at what rate the proportional valves will be opened and closed for FiO 2 calculation. Fluidity and pressure of air given by the ventilation device were tested with a FlowMeter while the oxygen level was tested using the electronic lung model. The obtained results from the study revealed that stepper motor controlled proportional valve could be safely used in ventilation devices. In this article, it was indicated that fluidity and pressure control could be carried out with just two counts of proportional valve, which could be done with many solenoid valves, so this reduces the cost of ventilator, electrical power consumed by the ventilator, and the dimension of ventilator.

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

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...

Development of deep drawn aluminum piston tanks

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

Whitehead, J.C.; Bronder, R.L.; Kilgard, L.W.

1990-06-08

An aluminum piston tank has been developed for applications requiring lightweight, low cost, low pressure, positive-expulsion liquid storage. The 3 liter (183 in{sup 3}) vessel is made primarily from aluminum sheet, using production forming and joining operations. The development process relied mainly on pressurizing prototype parts and assemblies to failure, as the primary source of decision making information for driving the tank design toward its optimum minimum-mass configuration. Critical issues addressed by development testing included piston operation, strength of thin-walled formed shells, alloy choice, and joining the end cap to the seamless deep drawn can. 9 refs., 8 figs.

The effect of ventilation on indoor exposure to semivolatile organic compounds.

PubMed

Liu, C; Zhang, Y; Benning, J L; Little, J C

2015-06-01

A mechanistic model was developed to examine how natural ventilation influences residential indoor exposure to semivolatile organic compounds (SVOCs) via inhalation, dermal sorption, and dust ingestion. The effect of ventilation on indoor particle mass concentration and mass transfer at source/sink surfaces, and the enhancing effect of particles on mass transfer at source/sink surfaces are included. When air exchange rate increases from 0.6/h to 1.8/h, the steady-state SVOC (gas-phase plus particle phase with log KOA varying from 9 to 13) concentration in the idealized model decreases by about 60%. In contrast, for the same change in ventilation, the simulated indoor formaldehyde (representing volatile organic compounds) gas-phase concentration decreases by about 70%. The effect of ventilation on exposure via each pathway has a relatively insignificant association with the KOA of the SVOCs: a change of KOA from 10(9) to 10(13) results in a change of only 2-30%. Sensitivity analysis identifies the deposition rate of PM2.5 as a primary factor influencing the relationship between ventilation and exposure for SVOCs with log KOA = 13. The relationship between ventilation rate and air speed near surfaces needs to be further substantiated. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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.

International Space Station (ISS) Advanced Recycle Filter Tank Assembly (ARFTA)

NASA Technical Reports Server (NTRS)

Nasrullah, Mohammed K.

2013-01-01

The International Space Station (ISS) Recycle Filter Tank Assembly (RFTA) provides the following three primary functions for the Urine Processor Assembly (UPA): volume for concentrating/filtering pretreated urine, filtration of product distillate, and filtration of the Pressure Control and Pump Assembly (PCPA) effluent. The RFTAs, under nominal operations, are to be replaced every 30 days. This poses a significant logistical resupply problem, as well as cost in upmass and new tanks purchase. In addition, it requires significant amount of crew time. To address and resolve these challenges, NASA required Boeing to develop a design which eliminated the logistics and upmass issues and minimize recurring costs. Boeing developed the Advanced Recycle Filter Tank Assembly (ARFTA) that allowed the tanks to be emptied on-orbit into disposable tanks that eliminated the need for bringing the fully loaded tanks to earth for refurbishment and relaunch, thereby eliminating several hundred pounds of upmass and its associated costs. The ARFTA will replace the RFTA by providing the same functionality, but with reduced resupply requirements

Laboratory septic tank performance response to electrolytic stimulation.

PubMed

Zaveri, Rahul M; Flora, Joseph R V

2002-11-01

This research investigated the effects of electrolytic stimulation on the performance of two laboratory-scale septic tanks. The tanks were fed a synthetic solution that included cellulose, peptone trypticase, beef extract, and urea. After a baseline period with no passed current, currents ranging from 100 to 500 mA were passed through the electrodes. The chemical oxygen demand (COD) removal efficiency from the tanks improved when a current was passed, with higher removal efficiencies observed at higher levels of passed current. Hydrolytic reactions resulted in ammonia and phosphate levels in the tanks that were higher than the influent. At currents > 300 mA, these hydrolytic reactions were suppressed, resulting in phosphate levels similar to the influent and ammonia levels lower than the influent because of the settling of ammonia-containing components of the feed solution. A slight increase in nitrate levels was observed when a current was passed, indicating minimal stimulation of nitrification activity. Abiotic studies confirmed that the COD can be removed via electrolysis and the removal was proportional to the passed current. Under the conditions of this study, the primary benefit of electrolytic stimulation of the septic tank is enhanced COD removal.

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.

Think Tanks

NASA Technical Reports Server (NTRS)

2001-01-01

A new inspection robot from Solex Robotics Systems was designed to eliminate hazardous inspections of petroleum and chemical storage tanks. The submersible robot, named Maverick, is used to inspect the bottoms of tanks, keeping the tanks operational during inspection. Maverick is able to provide services that will make manual tank inspections obsolete. While the inspection is conducted, Maverick's remote human operators remain safe outside of the tank. The risk to human health and life is now virtually eliminated. The risk to the environment is also minimal because there is a reduced chance of spillage from emptying and cleaning the tanks, where previously, tons of pollutants were released through the process of draining and refilling.

Glass Science tutorial lecture No. 5: Historical review of USDOE tank waste management

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

McDaniel, E.W.

1995-02-01

This is a two day course whose objective is to present an unbiased historical overview of the DOE tank waste activities. World events which impacted the US nuclear program (or vise versa) will be presented. Liquid, mostly tank waste, and sludge are the primary concerns of this course.

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

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 Clinical

Building Component Maintenance and Repair Data Base: Heating, Ventilating, and Air Conditioning (HVAC) Systems

DTIC Science & Technology

1991-05-01

Building Component Maintenance and Repair Data Base: Heating, Ventilating, and Air Conditioning (HVAC) Systems by Edgar S. Neely Robert D. Neathammer...Repair Data Base: Heating, Ventilating, and Air Conditioning (HVAC) Systems RDTE dated 1980EIMB 1984 - 1989 6. AUTHOR(S) Edgar S. Neely, Robert D...Laboratory (USACERL). The Principal Investigators were Dr. Edgar Neely and Mr. Robert Neathammer (USACERL-FS). The primary contractor for much of the

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.

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.

33 CFR 157.15 - Slop tanks in tank vessels.

Code of Federal Regulations, 2010 CFR

2010-07-01

... tank. (2) A new vessel of 70,000 tons DWT or more must have at least two slop tanks. (b) Capacity. Slop tanks must have the total capacity to retain oily mixtures from cargo tank washings, oil residue, and ballast water containing an oily mixture of 3 percent or more of the oil carrying capacity. Two percent...

Tank System Integrated Model: A Cryogenic Tank Performance Prediction Program

NASA Technical Reports Server (NTRS)

Bolshinskiy, L. G.; Hedayat, A.; Hastings, L. J.; Sutherlin, S. G.; Schnell, A. R.; Moder, J. P.

2017-01-01

Accurate predictions of the thermodynamic state of the cryogenic propellants, pressurization rate, and performance of pressure control techniques in cryogenic tanks are required for development of cryogenic fluid long-duration storage technology and planning for future space exploration missions. This Technical Memorandum (TM) presents the analytical tool, Tank System Integrated Model (TankSIM), which can be used for modeling pressure control and predicting the behavior of cryogenic propellant for long-term storage for future space missions. Utilizing TankSIM, the following processes can be modeled: tank self-pressurization, boiloff, ullage venting, mixing, and condensation on the tank wall. This TM also includes comparisons of TankSIM program predictions with the test data andexamples of multiphase mission calculations.

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.

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.

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.

Secondary Containment Design for the LLNL B801 Diala Oil Tank

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

Mertesdorf, E.

2016-12-14

Design is to add an extension to the secondary containment of tank T1-A3 at building 801. Piping from the inner tank penetrates the secondary containment tank below the liquid level of the primary tank. To meet Oil Pollution Prevention Regulation 40 CFR 120.7 the single wall piping needs to be provided with secondary containment. Steel Tank Institute (STI) conference publication states: §112.3(d)(1)(iii) –SPCC Plan requirements- Systems shall be designed in accordance with good engineering practice, including consideration of applicable industry standards and that procedures for required inspections and testing have been established. Section 112.7(a)(2) allows for deviations from specific rulemore » requirements, provided the Owner/operator responsible to select, document and implement alternate measure and a PE certifies the SPCC Plan in accordance with good engineering practices, including consideration of industry standards« less

49 CFR 179.400 - General specification applicable to cryogenic liquid tank car tanks.

Code of Federal Regulations, 2010 CFR

2010-10-01

... liquid tank car tanks. 179.400 Section 179.400 Transportation Other Regulations Relating to... MATERIALS REGULATIONS SPECIFICATIONS FOR TANK CARS Specification for Cryogenic Liquid Tank Car Tanks and... liquid tank car tanks. ...

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).

49 CFR 179.100 - General specifications applicable to pressure tank car tanks.

Code of Federal Regulations, 2012 CFR

2012-10-01

... car tanks. 179.100 Section 179.100 Transportation Other Regulations Relating to Transportation...) SPECIFICATIONS FOR TANK CARS Specifications for Pressure Tank Car Tanks (Classes DOT-105, 109, 112, 114 and 120) § 179.100 General specifications applicable to pressure tank car tanks. ...

49 CFR 179.100 - General specifications applicable to pressure tank car tanks.

Code of Federal Regulations, 2013 CFR

2013-10-01

... car tanks. 179.100 Section 179.100 Transportation Other Regulations Relating to Transportation...) SPECIFICATIONS FOR TANK CARS Specifications for Pressure Tank Car Tanks (Classes DOT-105, 109, 112, 114 and 120) § 179.100 General specifications applicable to pressure tank car tanks. ...

49 CFR 179.100 - General specifications applicable to pressure tank car tanks.

Code of Federal Regulations, 2010 CFR

2010-10-01

... car tanks. 179.100 Section 179.100 Transportation Other Regulations Relating to Transportation... REGULATIONS SPECIFICATIONS FOR TANK CARS Specifications for Pressure Tank Car Tanks (Classes DOT-105, 109, 112, 114 and 120) § 179.100 General specifications applicable to pressure tank car tanks. ...

49 CFR 179.100 - General specifications applicable to pressure tank car tanks.

Code of Federal Regulations, 2011 CFR

2011-10-01

... car tanks. 179.100 Section 179.100 Transportation Other Regulations Relating to Transportation...) SPECIFICATIONS FOR TANK CARS Specifications for Pressure Tank Car Tanks (Classes DOT-105, 109, 112, 114 and 120) § 179.100 General specifications applicable to pressure tank car tanks. ...

Efficacy of continuous versus intermittent subglottic secretion drainage in preventing ventilator-associated pneumonia in patients requiring mechanical ventilation: A single-center randomized controlled trial.

PubMed

Fujimoto, Hiroko; Yamaguchi, Osamu; Hayami, Hajime; Shimosaka, Mika; Tsuboi, Sayaka; Sato, Mitsunori; Takebayashi, Shigeo; Morita, Satoshi; Saito, Mari; Goto, Takahisa; Kurahashi, Kiyoyasu

2018-03-23

Aspiration of subglottic secretion is a widely used intervention to prevent ventilator-associated pneumonia (VAP). This study aimed to compare the efficacy of continuous and intermittent subglottic secretion drainage (SSD) in preventing VAP. A single-center randomized controlled trial was conducted on adult postoperative patients who were expected to undergo mechanical ventilation for more than 48 hours. Primary outcome measure was incidence of VAP and secondary outcome measures were length of mechanical ventilation and intensive-care unit (ICU) stay. Fifty-nine patients received continuous SSD, while 60 patients received intermittent SSD. Of these 119 patients, 88 (74%) were excluded and 15 and 16 patients were allocated to receive continuous and intermittent SSD, respectively. VAP was detected in 4 (26.7%) and 7 (43.8%) patients in the continuous and intermittent groups, respectively, (p=0.320). The length of mechanical ventilation was significantly shorter (p=0.034) in the continuous group (99.5±47.1 h) than in the intermittent group (159.9±94.5 h). The length of ICU stay was also shorter (p=0.0097) in the continuous group (6.3±2.1 days) than the intermittent group (9.8±4.8 days). Although continuous SSD did not reduce the incidence of VAP, it reduced the length of mechanical ventilation and ICU stay when compared to intermittent SSD.

Negative pressure ventilation and positive pressure ventilation promote comparable levels of ventilator-induced diaphragmatic dysfunction in rats.

PubMed

Bruells, Christian S; Smuder, Ashley J; Reiss, Lucy K; Hudson, Matthew B; Nelson, William Bradley; Wiggs, Michael P; Sollanek, Kurt J; Rossaint, Rolf; Uhlig, Stefan; Powers, Scott K

2013-09-01

Mechanical ventilation is a life-saving intervention for patients with respiratory failure. Unfortunately, a major complication associated with prolonged mechanical ventilation is ventilator-induced diaphragmatic atrophy and contractile dysfunction, termed ventilator-induced diaphragmatic dysfunction (VIDD). Emerging evidence suggests that positive pressure ventilation (PPV) promotes lung damage (ventilator-induced lung injury [VILI]), resulting in the release of signaling molecules that foster atrophic signaling in the diaphragm and the resultant VIDD. Although a recent report suggests that negative pressure ventilation (NPV) results in less VILI than PPV, it is unknown whether NPV can protect against VIDD. Therefore, the authors tested the hypothesis that compared with PPV, NPV will result in a lower level of VIDD. Adult rats were randomly assigned to one of three experimental groups (n = 8 each): (1) acutely anesthetized control (CON), (2) 12 h of PPV, and (3) 12 h of NPV. Dependent measures included indices of VILI, diaphragmatic muscle fiber cross-sectional area, diaphragm contractile properties, and the activity of key proteases in the diaphragm. Our results reveal that no differences existed in the degree of VILI between PPV and NPV animals as evidenced by VILI histological scores (CON = 0.082 ± 0.001; PPV = 0.22 ± 0.04; NPV = 0.25 ± 0.02; mean ± SEM). Both PPV and NPV resulted in VIDD. Importantly, no differences existed between PPV and NPV animals in diaphragmatic fiber cross-sectional area, contractile properties, and the activation of proteases. These results demonstrate that NPV and PPV result in similar levels of VILI and that NPV and PPV promote comparable levels of VIDD in rats.

49 CFR 179.102 - Special commodity requirements for pressure tank car tanks.

Code of Federal Regulations, 2010 CFR

2010-10-01

... car tanks. 179.102 Section 179.102 Transportation Other Regulations Relating to Transportation... REGULATIONS SPECIFICATIONS FOR TANK CARS Specifications for Pressure Tank Car Tanks (Classes DOT-105, 109, 112, 114 and 120) § 179.102 Special commodity requirements for pressure tank car tanks. (a) In addition to...

Gas exchange and intrapulmonary distribution of ventilation during continuous-flow ventilation

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

Vettermann, J.; Brusasco, V.; Rehder, K.

1988-05-01

In 12 anesthetized paralyzed dogs, pulmonary gas exchange and intrapulmonary inspired gas distribution were compared between continuous-flow ventilation (CFV) and conventional mechanical ventilation (CMV). Nine dogs were studied while they were lying supine, and three dogs were studied while they were lying prone. A single-lumen catheter for tracheal insufflation and a double-lumen catheter for bilateral endobronchial insufflation (inspired O2 fraction = 0.4; inspired minute ventilation = 1.7 +/- 0.3 (SD) 1.kg-1.min-1) were evaluated. Intrapulmonary gas distribution was assessed from regional 133Xe clearances. In dogs lying supine, CO2 elimination was more efficient with endobronchial insufflation than with tracheal insufflation, but themore » alveolar-arterial O2 partial pressure difference was larger during CFV than during CMV, regardless of the type of insufflation. By contrast, endobronchial insufflation maintained both arterial PCO2 and alveolar-arterial O2 partial pressure difference at significantly lower levels in dogs lying prone than in dogs lying supine. In dogs lying supine, the dependent lung was preferentially ventilated during CMV but not during CFV. In dogs lying prone, gas distribution was uniform with both modes of ventilation. The alveolar-arterial O2 partial pressure difference during CFV in dogs lying supine was negatively correlated with the reduced ventilation of the dependent lung, which suggests that increased ventilation-perfusion mismatching was responsible for the increase in alveolar-arterial O2 partial pressure difference. The more efficient oxygenation during CFV in dogs lying prone suggests a more efficient matching of ventilation to perfusion, presumably because the distribution of blood flow is also nearly uniform.« less

Modification of a liquid hydrogen tank for integrated refrigeration and storage

NASA Astrophysics Data System (ADS)

Swanger, A. M.; Jumper, K. M.; Fesmire, J. E.; Notardonato, W. U.

2015-12-01

The modification and outfitting of a 125,000-liter liquid hydrogen tank was performed to provide integrated refrigeration and storage capability. These functions include zero boil-off, liquefaction, and densification and therefore require provisions for sub-atmospheric tank pressures within the vacuum-jacketed, multilayer insulated tank. The primary structural modification was to add stiffening rings inside the inner vessel. The internal stiffening rings were designed, built, and installed per the ASME Boiler and Pressure Vessel Code, Section VIII, to prevent collapse in the case of vacuum jacket failure in combination with sub-atmospheric pressure within the tank. For the integrated refrigeration loop, a modular, skeleton-type heat exchanger, with refrigerant temperature instrumentation, was constructed using the stiffening rings as supports. To support the system thermal performance testing, three custom temperature rakes were designed and installed along the 21-meter length of the tank, once again using rings as supports. The temperature rakes included a total of 20 silicon diode temperature sensors mounted both vertically and radially to map the bulk liquid temperature within the tank. The tank modifications were successful and the system is now operational for the research and development of integrated refrigeration technology.

49 CFR 179.102 - Special commodity requirements for pressure tank car tanks.

Code of Federal Regulations, 2013 CFR

2013-10-01

... car tanks. 179.102 Section 179.102 Transportation Other Regulations Relating to Transportation...) SPECIFICATIONS FOR TANK CARS Specifications for Pressure Tank Car Tanks (Classes DOT-105, 109, 112, 114 and 120) § 179.102 Special commodity requirements for pressure tank car tanks. (a) In addition to §§ 179.100 and...

49 CFR 179.102 - Special commodity requirements for pressure tank car tanks.

Code of Federal Regulations, 2012 CFR

2012-10-01

... car tanks. 179.102 Section 179.102 Transportation Other Regulations Relating to Transportation...) SPECIFICATIONS FOR TANK CARS Specifications for Pressure Tank Car Tanks (Classes DOT-105, 109, 112, 114 and 120) § 179.102 Special commodity requirements for pressure tank car tanks. (a) In addition to §§ 179.100 and...

49 CFR 179.102 - Special commodity requirements for pressure tank car tanks.

Code of Federal Regulations, 2011 CFR

2011-10-01

... car tanks. 179.102 Section 179.102 Transportation Other Regulations Relating to Transportation...) SPECIFICATIONS FOR TANK CARS Specifications for Pressure Tank Car Tanks (Classes DOT-105, 109, 112, 114 and 120) § 179.102 Special commodity requirements for pressure tank car tanks. (a) In addition to §§ 179.100 and...

27 CFR 24.230 - Examination of tank car or tank truck.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Examination of tank car or... TRADE BUREAU, DEPARTMENT OF THE TREASURY ALCOHOL WINE Spirits § 24.230 Examination of tank car or tank truck. Upon arrival of a tank car or tank truck at the bonded wine premises, the proprietor shall...

27 CFR 24.230 - Examination of tank car or tank truck.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Examination of tank car or... TRADE BUREAU, DEPARTMENT OF THE TREASURY ALCOHOL WINE Spirits § 24.230 Examination of tank car or tank truck. Upon arrival of a tank car or tank truck at the bonded wine premises, the proprietor shall...

27 CFR 24.230 - Examination of tank car or tank truck.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Examination of tank car or... TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS WINE Spirits § 24.230 Examination of tank car or tank truck. Upon arrival of a tank car or tank truck at the bonded wine premises, the proprietor shall...

27 CFR 24.230 - Examination of tank car or tank truck.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Examination of tank car or... TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS WINE Spirits § 24.230 Examination of tank car or tank truck. Upon arrival of a tank car or tank truck at the bonded wine premises, the proprietor shall...

27 CFR 24.230 - Examination of tank car or tank truck.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Examination of tank car or... TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS WINE Spirits § 24.230 Examination of tank car or tank truck. Upon arrival of a tank car or tank truck at the bonded wine premises, the proprietor shall...

Comparison of invasive and noninvasive positive pressure ventilation delivered by means of a helmet for weaning of patients from mechanical ventilation.

PubMed

Carron, Michele; Rossi, Sandra; Carollo, Cristiana; Ori, Carlo

2014-08-01

The effectiveness of noninvasive positive pressure ventilation delivered by helmet (H-NPPV) as a weaning approach in patients with acute respiratory failure is unclear. We randomly and evenly assigned 64 patients intubated for acute respiratory failure to conventional weaning with invasive mechanical ventilation (IMV) or H-NPPV. The primary end point was a reduction in IMV duration by 6 days between the 2 groups. Secondary end points were the occurrence of ventilator-associated pneumonia and major complications, duration of mechanical ventilation and weaning, intensive care unit and hospital length of stay, and survival. The mean duration of IMV was significantly reduced in the H-NPPV group compared with the IMV group (P<.0001), without significant difference in duration of weaning (P=.26) and total ventilatory support (P=.45). In the H-NPPV group, the incidence of major complications was less than the IMV group (P=.032). Compared with the H-NPPV group, the IMV group was associated with a greater incidence of VAP (P=.018) and an increased risk of nosocomial pneumonia (P=.049). The mortality rate was similar between the groups, with no significant difference in overall intensive care unit (P=.47) or hospital length of stay (P=.37). H-NPPV was well tolerated and effective in patients who were difficult to wean. Copyright © 2014 Elsevier Inc. All rights reserved.

Classroom ventilation and indoor air quality-results from the FRESH intervention study.

PubMed

Rosbach, J; Krop, E; Vonk, M; van Ginkel, J; Meliefste, C; de Wind, S; Gehring, U; Brunekreef, B

2016-08-01

Inadequate ventilation of classrooms may lead to increased concentrations of pollutants generated indoors in schools. The FRESH study, on the effects of increased classroom ventilation on indoor air quality, was performed in 18 naturally ventilated classrooms of 17 primary schools in the Netherlands during the heating seasons of 2010-2012. In 12 classrooms, ventilation was increased to targeted CO2 concentrations of 800 or 1200 ppm, using a temporary CO2 controlled mechanical ventilation system. Six classrooms were included as controls. In each classroom, data on endotoxin, β(1,3)-glucans, and particles with diameters of <10 μm (PM10 ) and <2.5 μm (PM2.5 ) and nitrogen dioxide (NO2 ) were collected during three consecutive weeks. Associations between the intervention and these measured indoor air pollution levels were assessed using mixed models, with random classroom effects. The intervention lowered endotoxin and β(1,3)-glucan levels and PM10 concentrations significantly. PM10 for instance was reduced by 25 μg/m³ (95% confidence interval 13-38 μg/m³) from 54 μg/m³ at maximum ventilation rate. No significant differences were found between the two ventilation settings. Concentrations of PM2.5 and NO2 were not affected by the intervention. Our results provide evidence that increasing classroom ventilation is effective in decreasing the concentrations of some indoor-generated pollutants. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

49 CFR 179.500 - Specification DOT-107A * * * * seamless steel tank car tanks.

Code of Federal Regulations, 2011 CFR

2011-10-01

... car tanks. 179.500 Section 179.500 Transportation Other Regulations Relating to Transportation...) SPECIFICATIONS FOR TANK CARS Specification for Cryogenic Liquid Tank Car Tanks and Seamless Steel Tanks (Classes DOT-113 and 107A) § 179.500 Specification DOT-107A * * * * seamless steel tank car tanks. ...

49 CFR 179.101 - Individual specification requirements applicable to pressure tank car tanks.

Code of Federal Regulations, 2010 CFR

2010-10-01

... to pressure tank car tanks. 179.101 Section 179.101 Transportation Other Regulations Relating to... MATERIALS REGULATIONS SPECIFICATIONS FOR TANK CARS Specifications for Pressure Tank Car Tanks (Classes DOT... tank car tanks. Editorial Note: At 66 FR 45186, Aug. 28, 2001, an amendment published amending a table...

49 CFR 179.400 - General specification applicable to cryogenic liquid tank car tanks.

Code of Federal Regulations, 2012 CFR

2012-10-01

... liquid tank car tanks. 179.400 Section 179.400 Transportation Other Regulations Relating to... (CONTINUED) SPECIFICATIONS FOR TANK CARS Specification for Cryogenic Liquid Tank Car Tanks and Seamless Steel Tanks (Classes DOT-113 and 107A) § 179.400 General specification applicable to cryogenic liquid tank car...

49 CFR 179.500 - Specification DOT-107A * * * * seamless steel tank car tanks.

Code of Federal Regulations, 2010 CFR

2010-10-01

... car tanks. 179.500 Section 179.500 Transportation Other Regulations Relating to Transportation... REGULATIONS SPECIFICATIONS FOR TANK CARS Specification for Cryogenic Liquid Tank Car Tanks and Seamless Steel Tanks (Classes DOT-113 and 107A) § 179.500 Specification DOT-107A * * * * seamless steel tank car tanks. ...

49 CFR 179.500 - Specification DOT-107A * * * * seamless steel tank car tanks.

Code of Federal Regulations, 2012 CFR

2012-10-01

... car tanks. 179.500 Section 179.500 Transportation Other Regulations Relating to Transportation...) SPECIFICATIONS FOR TANK CARS Specification for Cryogenic Liquid Tank Car Tanks and Seamless Steel Tanks (Classes DOT-113 and 107A) § 179.500 Specification DOT-107A * * * * seamless steel tank car tanks. ...

49 CFR 179.500 - Specification DOT-107A * * * * seamless steel tank car tanks.

Code of Federal Regulations, 2013 CFR

2013-10-01

... car tanks. 179.500 Section 179.500 Transportation Other Regulations Relating to Transportation...) SPECIFICATIONS FOR TANK CARS Specification for Cryogenic Liquid Tank Car Tanks and Seamless Steel Tanks (Classes DOT-113 and 107A) § 179.500 Specification DOT-107A * * * * seamless steel tank car tanks. ...

49 CFR 179.400 - General specification applicable to cryogenic liquid tank car tanks.

Code of Federal Regulations, 2013 CFR

2013-10-01

... liquid tank car tanks. 179.400 Section 179.400 Transportation Other Regulations Relating to... (CONTINUED) SPECIFICATIONS FOR TANK CARS Specification for Cryogenic Liquid Tank Car Tanks and Seamless Steel Tanks (Classes DOT-113 and 107A) § 179.400 General specification applicable to cryogenic liquid tank car...

49 CFR 179.400 - General specification applicable to cryogenic liquid tank car tanks.

Code of Federal Regulations, 2011 CFR

2011-10-01

... liquid tank car tanks. 179.400 Section 179.400 Transportation Other Regulations Relating to... (CONTINUED) SPECIFICATIONS FOR TANK CARS Specification for Cryogenic Liquid Tank Car Tanks and Seamless Steel Tanks (Classes DOT-113 and 107A) § 179.400 General specification applicable to cryogenic liquid tank car...

33 CFR 157.147 - Similar tank design: Inspections on foreign tank vessels.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Similar tank design: Inspections... § 157.147 Similar tank design: Inspections on foreign tank vessels. (a) If a foreign tank vessel has..., for only one of those tanks to be inspected under § 157.140(a)(1). (b) Only one tank of a group of...

27 CFR 27.174 - Tank cars and tank trucks to be sealed.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Tank cars and tank trucks... Tank cars and tank trucks to be sealed. Where a shipment of distilled spirits from customs custody to the distilled spirits plant is made in a tank car or tank truck, all openings affording access to the...

27 CFR 27.174 - Tank cars and tank trucks to be sealed.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Tank cars and tank trucks... Tank cars and tank trucks to be sealed. Where a shipment of distilled spirits from customs custody to the distilled spirits plant is made in a tank car or tank truck, all openings affording access to the...

27 CFR 27.174 - Tank cars and tank trucks to be sealed.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Tank cars and tank trucks... Tank cars and tank trucks to be sealed. Where a shipment of distilled spirits from customs custody to the distilled spirits plant is made in a tank car or tank truck, all openings affording access to the...

46 CFR 153.250 - Double-bottom and deep tanks as cargo tanks.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 5 2011-10-01 2011-10-01 false Double-bottom and deep tanks as cargo tanks. 153.250... Equipment Cargo Tanks § 153.250 Double-bottom and deep tanks as cargo tanks. Except in those cases in which Commandant (CG-522) specifically approves another arrangement, such as a double-bottom or deep tank as a...

46 CFR 153.250 - Double-bottom and deep tanks as cargo tanks.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 5 2013-10-01 2013-10-01 false Double-bottom and deep tanks as cargo tanks. 153.250... Equipment Cargo Tanks § 153.250 Double-bottom and deep tanks as cargo tanks. Except in those cases in which Commandant (CG-ENG) specifically approves another arrangement, such as a double-bottom or deep tank as a...

46 CFR 153.250 - Double-bottom and deep tanks as cargo tanks.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 5 2010-10-01 2010-10-01 false Double-bottom and deep tanks as cargo tanks. 153.250... Equipment Cargo Tanks § 153.250 Double-bottom and deep tanks as cargo tanks. Except in those cases in which Commandant (CG-522) specifically approves another arrangement, such as a double-bottom or deep tank as a...

46 CFR 153.250 - Double-bottom and deep tanks as cargo tanks.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 5 2014-10-01 2014-10-01 false Double-bottom and deep tanks as cargo tanks. 153.250... Equipment Cargo Tanks § 153.250 Double-bottom and deep tanks as cargo tanks. Except in those cases in which Commandant (CG-ENG) specifically approves another arrangement, such as a double-bottom or deep tank as a...

46 CFR 153.250 - Double-bottom and deep tanks as cargo tanks.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 5 2012-10-01 2012-10-01 false Double-bottom and deep tanks as cargo tanks. 153.250... Equipment Cargo Tanks § 153.250 Double-bottom and deep tanks as cargo tanks. Except in those cases in which Commandant (CG-ENG) specifically approves another arrangement, such as a double-bottom or deep tank as a...

49 CFR 179.301 - Individual specification requirements for multi-unit tank car tanks.

Code of Federal Regulations, 2012 CFR

2012-10-01

...-unit tank car tanks. 179.301 Section 179.301 Transportation Other Regulations Relating to... (CONTINUED) SPECIFICATIONS FOR TANK CARS Specifications for Multi-Unit Tank Car Tanks (Classes DOT-106A and 110AW) § 179.301 Individual specification requirements for multi-unit tank car tanks. (a) In addition to...

49 CFR 179.301 - Individual specification requirements for multi-unit tank car tanks.

Code of Federal Regulations, 2010 CFR

2010-10-01

...-unit tank car tanks. 179.301 Section 179.301 Transportation Other Regulations Relating to... MATERIALS REGULATIONS SPECIFICATIONS FOR TANK CARS Specifications for Multi-Unit Tank Car Tanks (Classes DOT-106A and 110AW) § 179.301 Individual specification requirements for multi-unit tank car tanks. (a) In...

49 CFR 179.301 - Individual specification requirements for multi-unit tank car tanks.

Code of Federal Regulations, 2013 CFR

2013-10-01

...-unit tank car tanks. 179.301 Section 179.301 Transportation Other Regulations Relating to... (CONTINUED) SPECIFICATIONS FOR TANK CARS Specifications for Multi-Unit Tank Car Tanks (Classes DOT-106A and 110AW) § 179.301 Individual specification requirements for multi-unit tank car tanks. (a) In addition to...

49 CFR 179.301 - Individual specification requirements for multi-unit tank car tanks.

Code of Federal Regulations, 2011 CFR

2011-10-01

...-unit tank car tanks. 179.301 Section 179.301 Transportation Other Regulations Relating to... (CONTINUED) SPECIFICATIONS FOR TANK CARS Specifications for Multi-Unit Tank Car Tanks (Classes DOT-106A and 110AW) § 179.301 Individual specification requirements for multi-unit tank car tanks. (a) In addition to...

241-AY-101 Tank Construction Extent of Condition Review for Tank Integrity

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

Barnes, Travis J.; Gunter, Jason R.

2013-08-26

This report provides the results of an extent of condition construction history review for tank 241-AY-101. The construction history of tank 241-AY-101 has been reviewed to identify issues similar to those experienced during tank AY-102 construction. Those issues and others impacting integrity are discussed based on information found in available construction records, using tank AY-102 as the comparison benchmark. In tank 241-AY-101, the second double-shell tank constructed, similar issues as those with tank 241-AY-102 construction reoccurred. The overall extent of similary and affect on tank 241-AY-101 integrity is described herein.

49 CFR 180.519 - Periodic retest and inspection of tank cars other than single-unit tank car tanks.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 3 2011-10-01 2011-10-01 false Periodic retest and inspection of tank cars other than single-unit tank car tanks. 180.519 Section 180.519 Transportation Other Regulations Relating to... (CONTINUED) CONTINUING QUALIFICATION AND MAINTENANCE OF PACKAGINGS Qualification and Maintenance of Tank Cars...

49 CFR 180.519 - Periodic retest and inspection of tank cars other than single-unit tank car tanks.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 3 2013-10-01 2013-10-01 false Periodic retest and inspection of tank cars other than single-unit tank car tanks. 180.519 Section 180.519 Transportation Other Regulations Relating to... (CONTINUED) CONTINUING QUALIFICATION AND MAINTENANCE OF PACKAGINGS Qualification and Maintenance of Tank Cars...

49 CFR 180.519 - Periodic retest and inspection of tank cars other than single-unit tank car tanks.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 3 2012-10-01 2012-10-01 false Periodic retest and inspection of tank cars other than single-unit tank car tanks. 180.519 Section 180.519 Transportation Other Regulations Relating to... (CONTINUED) CONTINUING QUALIFICATION AND MAINTENANCE OF PACKAGINGS Qualification and Maintenance of Tank Cars...

49 CFR 180.519 - Periodic retest and inspection of tank cars other than single-unit tank car tanks.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 3 2014-10-01 2014-10-01 false Periodic retest and inspection of tank cars other than single-unit tank car tanks. 180.519 Section 180.519 Transportation Other Regulations Relating to... (CONTINUED) CONTINUING QUALIFICATION AND MAINTENANCE OF PACKAGINGS Qualification and Maintenance of Tank Cars...

49 CFR 179.500 - Specification DOT-107A * * * * seamless steel tank car tanks.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 3 2014-10-01 2014-10-01 false Specification DOT-107A * * * * seamless steel tank...) SPECIFICATIONS FOR TANK CARS Specification for Cryogenic Liquid Tank Car Tanks and Seamless Steel Tanks (Classes DOT-113 and 107A) § 179.500 Specification DOT-107A * * * * seamless steel tank car tanks. ...

ADM. Tanks: from left to right: fuel oil tank, fuel ...

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

ADM. Tanks: from left to right: fuel oil tank, fuel pump house (TAN-611), engine fuel tank, water pump house, water storage tank. Camera facing northwest. Not edge of shielding berm at left of view. Date: November 25, 1953. INEEL negative no. 9217 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

Optimizing Oxygenation in the Mechanically Ventilated Patient: Nursing Practice Implications.

PubMed

Barton, Glenn; Vanderspank-Wright, Brandi; Shea, Jacqueline

2016-12-01

Critical care nurses constitute front-line care provision for patients in the intensive care unit (ICU). Hypoxemic respiratory compromise/failure is a primary reason that patients require ICU admission and mechanical ventilation. Critical care nurses must possess advanced knowledge, skill, and judgment when caring for these patients to ensure that interventions aimed at optimizing oxygenation are both effective and safe. This article discusses fundamental aspects of respiratory physiology and clinical indices used to describe oxygenation status. Key nursing interventions including patient assessment, positioning, pharmacology, and managing hemodynamic parameters are discussed, emphasizing their effects toward mitigating ventilation-perfusion mismatch and optimizing oxygenation. Copyright © 2016 Elsevier Inc. All rights reserved.

The growing role of noninvasive ventilation in patients requiring prolonged mechanical ventilation.

PubMed

Hess, Dean R

2012-06-01

For many patients with chronic respiratory failure requiring ventilator support, noninvasive ventilation (NIV) is preferable to invasive support by tracheostomy. Currently available evidence does not support the use of nocturnal NIV in unselected patients with stable COPD. Several European studies have reported benefit for high intensity NIV, in which setting of inspiratory pressure and respiratory rate are selected to achieve normocapnia. There have also been studies reporting benefit for the use of NIV as an adjunct to exercise training. NIV may be useful as an adjunct to airway clearance techniques in patients with cystic fibrosis. Accumulating evidence supports the use of NIV in patients with obesity hypoventilation syndrome. There is considerable observational evidence supporting the use of NIV in patients with chronic respiratory failure related to neuromuscular disease, and one randomized controlled trial reported that the use of NIV was life-prolonging in patients with amyotrophic lateral sclerosis. A variety of interfaces can be used to provide NIV in patients with stable chronic respiratory failure. The mouthpiece is an interface that is unique in this patient population, and has been used with success in patients with neuromuscular disease. Bi-level pressure ventilators are commonly used for NIV, although there are now a new generation of intermediate ventilators that are portable, have a long battery life, and can be used for NIV and invasive applications. Pressure support ventilation, pressure controlled ventilation, and volume controlled ventilation have been used successfully for chronic applications of NIV. New modes have recently become available, but their benefits await evidence to support their widespread use. The success of NIV in a given patient population depends on selection of an appropriate patient, selection of an appropriate interface, selection of an appropriate ventilator and ventilator settings, the skills of the clinician, the

VENTILATION TECHNOLOGY SYSTEMS ANALYSIS

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 ...

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

Characteristics of rain penetration through a gravity ventilator used for natural ventilation.

PubMed

Kim, Taehyeung; Lee, Dong Ho; Ahn, Kwangseog; Ha, Hyunchul; Park, Heechang; Piao, Cheng Xu; Li, Xiaoyu; Seo, Jeoungyoon

2008-01-01

Gravity ventilators rely simply on air buoyancy to extract air and are widely used to exhaust air contaminants and heat from workplaces using minimal energy. They are designed to maximize the exhaust flow rate, but the rain penetration sometimes causes malfunctioning. In this study, the characteristics of rain penetration through a ventilator were examined as a preliminary study to develop a ventilator with the maximum exhaust capacity while minimizing rain penetration. A model ventilator was built and exposed to artificial rain and wind. The paths, intensities and amounts of penetration through the ventilator were observed and measured in qualitative and quantitative fashions. In the first phase, the pathways and intensities of rain penetration were visually observed. In the second phase, the amounts of rain penetration were quantitatively measured under the different configurations of ventilator components that were installed based on the information obtained in the first-phase experiment. The effects of wind speed, grill direction, rain drainage width, outer wall height, neck height and leaning angle of the outer wall from the vertical position were analyzed. Wind speed significantly affected rain penetration. Under the low crosswind conditions, the rain penetration intensities were under the limit of detection. Under the high crosswind conditions, grill direction and neck height were the most significant factors in reducing rain penetration. The installation of rain drainage was also important in reducing rain penetration. The experimental results suggest that, with proper configurations of its components, a gravity ventilator can be used for natural ventilation without significant rain penetration problems.

Education on invasive mechanical ventilation involving intensive care nurses: a systematic review.

PubMed

Guilhermino, Michelle C; Inder, Kerry J; Sundin, Deborah

2018-03-26

Intensive care unit nurses are critical for managing mechanical ventilation. Continuing education is essential in building and maintaining nurses' knowledge and skills, potentially improving patient outcomes. The aim of this study was to determine whether continuing education programmes on invasive mechanical ventilation involving intensive care unit nurses are effective in improving patient outcomes. Five electronic databases were searched from 2001 to 2016 using keywords such as mechanical ventilation, nursing and education. Inclusion criteria were invasive mechanical ventilation continuing education programmes that involved nurses and measured patient outcomes. Primary outcomes were intensive care unit mortality and in-hospital mortality. Secondary outcomes included hospital and intensive care unit length of stay, length of intubation, failed weaning trials, re-intubation incidence, ventilation-associated pneumonia rate and lung-protective ventilator strategies. Studies were excluded if they excluded nurses, patients were ventilated for less than 24 h, the education content focused on protocol implementation or oral care exclusively or the outcomes were participant satisfaction. Quality was assessed by two reviewers using an education intervention critical appraisal worksheet and a risk of bias assessment tool. Data were extracted independently by two reviewers and analysed narratively due to heterogeneity. Twelve studies met the inclusion criteria for full review: 11 pre- and post-intervention observational and 1 quasi-experimental design. Studies reported statistically significant reductions in hospital length of stay, length of intubation, ventilator-associated pneumonia rates, failed weaning trials and improvements in lung-protective ventilation compliance. Non-statistically significant results were reported for in-hospital and intensive care unit mortality, re-intubation and intensive care unit length of stay. Limited evidence of the effectiveness of

241-AW Tank Farm Construction Extent of Condition Review for Tank Integrity

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

Barnes, Travis J.; Gunter, Jason R.; Reeploeg, Gretchen E.

2013-11-19

This report provides the results of an extent of condition construction history review for the 241-AW tank farm. The construction history of the 241-AW tank farm has been reviewed to identify issues similar to those experienced during tank AY-102 construction. Those issues and others impacting integrity are discussed based on information found in available construction records, using tank AY-102 as the comparison benchmark. In the 241-AW tank farm, the fourth double-shell tank farm constructed, similar issues as those with tank 241-AY-102 construction occured. The overall extent of similary and affect on 241-AW tank farm integrity is described herein.

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.

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

Cardiopulmonary resuscitation by chest compression alone or with mouth-to-mouth ventilation.

PubMed

Hallstrom, A; Cobb, L; Johnson, E; Copass, M

2000-05-25

Despite extensive training of citizens of Seattle in cardiopulmonary resuscitation (CPR), bystanders do not perform CPR in almost half of witnessed cardiac arrests. Instructions in chest compression plus mouth-to-mouth ventilation given by dispatchers over the telephone can require 2.4 minutes. In experimental studies, chest compression alone is associated with survival rates similar to those with chest compression plus mouth-to-mouth ventilation. We conducted a randomized study to compare CPR by chest compression alone with CPR by chest compression plus mouth-to-mouth ventilation. The setting of the trial was an urban, fire-department-based, emergency-medical-care system with central dispatching. In a randomized manner, telephone dispatchers gave bystanders at the scene of apparent cardiac arrest instructions in either chest compression alone or chest compression plus mouth-to-mouth ventilation. The primary end point was survival to hospital discharge. Data were analyzed for 241 patients randomly assigned to receive chest compression alone and 279 assigned to chest compression plus mouth-to-mouth ventilation. Complete instructions were delivered in 62 percent of episodes for the group receiving chest compression plus mouth-to-mouth ventilation and 81 percent of episodes for the group receiving chest compression alone (P=0.005). Instructions for compression required 1.4 minutes less to complete than instructions for compression plus mouth-to-mouth ventilation. Survival to hospital discharge was better among patients assigned to chest compression alone than among those assigned to chest compression plus mouth-to-mouth ventilation (14.6 percent vs. 10.4 percent), but the difference was not statistically significant (P=0.18). The outcome after CPR with chest compression alone is similar to that after chest compression with mouth-to-mouth ventilation, and chest compression alone may be the preferred approach for bystanders inexperienced in CPR.

49 CFR 179.101 - Individual specification requirements applicable to pressure tank car tanks.

Code of Federal Regulations, 2011 CFR

2011-10-01

... to pressure tank car tanks. 179.101 Section 179.101 Transportation Other Regulations Relating to... (CONTINUED) SPECIFICATIONS FOR TANK CARS Specifications for Pressure Tank Car Tanks (Classes DOT-105, 109, 112, 114 and 120) § 179.101 Individual specification requirements applicable to pressure tank car...

49 CFR 179.101 - Individual specification requirements applicable to pressure tank car tanks.

Code of Federal Regulations, 2013 CFR

2013-10-01

... to pressure tank car tanks. 179.101 Section 179.101 Transportation Other Regulations Relating to... (CONTINUED) SPECIFICATIONS FOR TANK CARS Specifications for Pressure Tank Car Tanks (Classes DOT-105, 109, 112, 114 and 120) § 179.101 Individual specification requirements applicable to pressure tank car...

49 CFR 179.101 - Individual specification requirements applicable to pressure tank car tanks.

Code of Federal Regulations, 2012 CFR

2012-10-01

... to pressure tank car tanks. 179.101 Section 179.101 Transportation Other Regulations Relating to... (CONTINUED) SPECIFICATIONS FOR TANK CARS Specifications for Pressure Tank Car Tanks (Classes DOT-105, 109, 112, 114 and 120) § 179.101 Individual specification requirements applicable to pressure tank car...

Soil load above Hanford waste storage tanks (2 volumes)

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

Pianka, E.W.

1995-01-25

This document is a compilation of work performed as part of the Dome Load Control Project in 1994. Section 2 contains the calculations of the weight of the soil over the tank dome for each of the 75-feet-diameter waste-storage tanks located at the Hanford Site. The chosen soil specific weight and soil depth measured at the apex of the dome crown are the same as those used in the primary analysis that qualified the design. Section 3 provides reference dimensions for each of the tank farm sites. The reference dimensions spatially orient the tanks and provide an outer diameter formore » each tank. Section 4 summarizes the available soil surface elevation data. It also provides examples of the calculations performed to establish the present soil elevation estimates. The survey data and other data sources from which the elevation data has been obtained are printed separately in Volume 2 of this Supporting Document. Section 5 contains tables that provide an overall summary of the present status of dome loads. Tables summarizing the load state corresponding to the soil depth and soil specific weight for the original qualification analysis, the gravity load requalification for soil depth and soil specific weight greater than the expected actual values, and a best estimate condition of soil depth and specific weight are presented for the Double-Shell Tanks. For the Single-Shell Tanks, only the original qualification analysis is available; thus, the tabulated results are for this case only. Section 6 provides a brief overview of past analysis and testing results that given an indication of the load capacity of the waste storage tanks that corresponds to a condition approaching ultimate failure of the tank. 31 refs.« less

Mechanical ventilator - infants

MedlinePlus

... this page: //medlineplus.gov/ency/article/007240.htm Mechanical ventilator - infants To use the sharing features on this page, please enable JavaScript. A mechanical ventilator is a machine that assists with breathing. ...

Severity of illness and outcome in adult patients with primary varicella pneumonia.

PubMed

Gregorakos, Leonidas; Myrianthefs, Pavlos; Markou, Nikolaos; Chroni, Despina; Sakagianni, Ekaterini

2002-01-01

Varicella pneumonia is a serious complication of primary varicella infection in adults that often results in respiratory failure and death. To analyze the clinical and laboratory manifestations of primary varicella pneumonia in patients admitted to our intensive care unit (ICU). Retrospective study on patients treated in our ICU with a diagnosis of primary varicella pneumonia during a period of 15 years. We recorded age, gender, smoking habits, clinical and laboratory findings, arterial blood gases, chest radiograph, illness severity (SAPS II), length of stay, necessity for mechanical ventilation, complications, therapy and survival. We examined the influence of the duration of respiratory symptoms and rash prior to admission, and the influence of illness severity on outcome. There was a statistically significant difference in duration of respiratory symptoms, duration of rash and SAPS II on admission between: (a) mechanically ventilated patients vs. spontaneously breathing patients (p < 0.007, p < 0.00, p < 0.00), (b) patients who survived vs. patients with poor outcome (p < 0.001, p < 0.000, p < 0.000), and (c) mechanically ventilated patients with poor outcome vs. mechanically ventilated patients who survived (p < 0.001, p < 0.00, p < 0.000). Overall mortality was 13.6%; death occurred only in mechanically ventilated patients (mortality 33.3%). Primary varicella pneumonia remains a critical problem with significant mortality. When recognized before respiratory failure ensues and mechanical ventilation becomes mandatory, patients could have an excellent outcome. Adult patients who delay asking for medical support, the disease may lead to the need for mechanical ventilation and severe complications with a fatal outcome. Copyright 2002 S. Karger AG, Basel

Fuel tank integrity research : fuel tank analyses and test plans

DOT National Transportation Integrated Search

2013-04-15

The Federal Railroad Administrations Office of Research : and Development is conducting research into fuel tank : crashworthiness. Fuel tank research is being performed to : determine strategies for increasing the fuel tank impact : resistance to ...

Liquid ventilation.

PubMed

Sarkar, Suman; Paswan, Anil; Prakas, S

2014-01-01

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

CFD and ventilation research.

PubMed

Li, Y; Nielsen, P V

2011-12-01

There has been a rapid growth of scientific literature on the application of computational fluid dynamics (CFD) in the research of ventilation and indoor air science. With a 1000-10,000 times increase in computer hardware capability in the past 20 years, CFD has become an integral part of scientific research and engineering development of complex air distribution and ventilation systems in buildings. This review discusses the major and specific challenges of CFD in terms of turbulence modelling, numerical approximation, and boundary conditions relevant to building ventilation. We emphasize the growing need for CFD verification and validation, suggest ongoing needs for analytical and experimental methods to support the numerical solutions, and discuss the growing capacity of CFD in opening up new research areas. We suggest that CFD has not become a replacement for experiment and theoretical analysis in ventilation research, rather it has become an increasingly important partner. We believe that an effective scientific approach for ventilation studies is still to combine experiments, theory, and CFD. We argue that CFD verification and validation are becoming more crucial than ever as more complex ventilation problems are solved. It is anticipated that ventilation problems at the city scale will be tackled by CFD in the next 10 years. © 2011 John Wiley & Sons A/S.

Design criteria monograph for metal tanks and tank components

NASA Technical Reports Server (NTRS)

1975-01-01

Significant elements in detail tank design are wall and end structures, weld joints at bulkhead and attachment junctures, and ports and access openings. Additional design considerations are influence and effect of fabrication processes on tank component design, and finally, testing and inspection that are required to establish confidence in tank design.

Ventilation through a small-bore catheter: optimizing expiratory ventilation assistance.

PubMed

Hamaekers, A E W; Borg, P A J; Götz, T; Enk, D

2011-03-01

Emergency ventilation through a small-bore transtracheal catheter can be lifesaving in a 'cannot intubate, cannot ventilate' situation. Ejectors, capable of creating suction by the Bernoulli principle, have been proposed to facilitate expiration through small-bore catheters. In this bench study, we compared a novel, purpose-built ventilation ejector (DE 5) with a previously proposed, modified industrial ejector (SBP 07). The generated insufflation pressures, suction pressures in static and dynamic situations, and also suction capacities and entrainment ratios of the SBP 07 and the DE 5 were determined. The DE 5 was also tested in a lung simulator with a simulated complete upper airway obstruction. Inspiratory and expiratory times through a transtracheal catheter were measured at various flow rates and achievable minute volumes were calculated. In a static situation, the SBP 07 showed a more negative pressure build-up compared with the DE 5. However, in a dynamic situation, the DE 5 generated a more negative pressure, resulting in a higher suction capacity. Employment of the DE 5 at a flow rate of 18 litre min(-1) allowed a minute volume through the transtracheal catheter of up to 8.27 litre min(-1) at a compliance of 100 ml cm H(2)O(-1). The efficiency of the DE 5 depended on the flow rate of the driving gas and the compliance of the lung simulator. In laboratory tests, the DE 5 is an optimized ventilation ejector suitable for applying expiratory ventilation assistance. Further research may confirm the clinical applicability as a portable emergency ventilator for use with small-bore catheters.

Impact of Fire Ventilation on General Ventilation in the Building

NASA Astrophysics Data System (ADS)

Zender-Świercz, Ewa; Telejko, Marek

2017-10-01

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

49 CFR 179.103 - Special requirements for class 114A * * * tank car tanks.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 3 2013-10-01 2013-10-01 false Special requirements for class 114A * * * tank car...) SPECIFICATIONS FOR TANK CARS Specifications for Pressure Tank Car Tanks (Classes DOT-105, 109, 112, 114 and 120) § 179.103 Special requirements for class 114A * * * tank car tanks. (a) In addition to the applicable...

49 CFR 179.103 - Special requirements for class 114A * * * tank car tanks.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 3 2011-10-01 2011-10-01 false Special requirements for class 114A * * * tank car...) SPECIFICATIONS FOR TANK CARS Specifications for Pressure Tank Car Tanks (Classes DOT-105, 109, 112, 114 and 120) § 179.103 Special requirements for class 114A * * * tank car tanks. (a) In addition to the applicable...

49 CFR 179.103 - Special requirements for class 114A * * * tank car tanks.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 3 2012-10-01 2012-10-01 false Special requirements for class 114A * * * tank car...) SPECIFICATIONS FOR TANK CARS Specifications for Pressure Tank Car Tanks (Classes DOT-105, 109, 112, 114 and 120) § 179.103 Special requirements for class 114A * * * tank car tanks. (a) In addition to the applicable...

49 CFR 179.103 - Special requirements for class 114A * * * tank car tanks.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 2 2010-10-01 2010-10-01 false Special requirements for class 114A * * * tank car... SPECIFICATIONS FOR TANK CARS Specifications for Pressure Tank Car Tanks (Classes DOT-105, 109, 112, 114 and 120) § 179.103 Special requirements for class 114A * * * tank car tanks. (a) In addition to the applicable...

49 CFR 179.201 - Individual specification requirements applicable to non-pressure tank car tanks.

Code of Federal Regulations, 2010 CFR

2010-10-01

... to non-pressure tank car tanks. 179.201 Section 179.201 Transportation Other Regulations Relating to... MATERIALS REGULATIONS SPECIFICATIONS FOR TANK CARS Specifications for Non-Pressure Tank Car Tanks (Classes... car tanks. ...

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

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.

49 CFR 179.201 - Individual specification requirements applicable to non-pressure tank car tanks.

Code of Federal Regulations, 2013 CFR

2013-10-01

... to non-pressure tank car tanks. 179.201 Section 179.201 Transportation Other Regulations Relating to... (CONTINUED) SPECIFICATIONS FOR TANK CARS Specifications for Non-Pressure Tank Car Tanks (Classes DOT-111AW and 115AW) § 179.201 Individual specification requirements applicable to non-pressure tank car tanks. ...

49 CFR 179.201 - Individual specification requirements applicable to non-pressure tank car tanks.

Code of Federal Regulations, 2012 CFR

2012-10-01

... to non-pressure tank car tanks. 179.201 Section 179.201 Transportation Other Regulations Relating to... (CONTINUED) SPECIFICATIONS FOR TANK CARS Specifications for Non-Pressure Tank Car Tanks (Classes DOT-111AW and 115AW) § 179.201 Individual specification requirements applicable to non-pressure tank car tanks. ...

49 CFR 179.201 - Individual specification requirements applicable to non-pressure tank car tanks.

Code of Federal Regulations, 2011 CFR

2011-10-01

... to non-pressure tank car tanks. 179.201 Section 179.201 Transportation Other Regulations Relating to... (CONTINUED) SPECIFICATIONS FOR TANK CARS Specifications for Non-Pressure Tank Car Tanks (Classes DOT-111AW and 115AW) § 179.201 Individual specification requirements applicable to non-pressure tank car tanks. ...

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

PubMed

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

2017-09-01

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

Synchronous deglacial thermocline and deep-water ventilation in the eastern equatorial Pacific

PubMed Central

Umling, Natalie E.; Thunell, Robert C.

2017-01-01

The deep ocean is most likely the primary source of the radiocarbon-depleted CO2 released to the atmosphere during the last deglaciation. While there are well-documented millennial scale Δ14C changes during the most recent deglaciation, most marine records lack the resolution needed to identify more rapid ventilation events. Furthermore, potential age model problems with marine Δ14C records may obscure our understanding of the phase relationship between inter-ocean ventilation changes. Here we reconstruct changes in deep water and thermocline radiocarbon content over the last deglaciation in the eastern equatorial Pacific (EEP) using benthic and planktonic foraminiferal 14C. Our records demonstrate that ventilation of EEP thermocline and deep waters occurred synchronously during the last deglaciation. In addition, both gradual and rapid deglacial radiocarbon changes in these Pacific records are coeval with changes in the Atlantic records. This in-phase behaviour suggests that the Southern Ocean overturning was the dominant driver of changes in the Atlantic and Pacific ventilation during deglaciation. PMID:28112161

49 CFR 179.101 - Individual specification requirements applicable to pressure tank car tanks.

Code of Federal Regulations, 2014 CFR

2014-10-01

... to pressure tank car tanks. 179.101 Section 179.101 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) SPECIFICATIONS FOR TANK CARS Specifications for Pressure Tank Car Tanks (Classes DOT-105, 109...

Tank 241-C-112 vapor sampling and analysis tank characterization report. Revision 1

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

Huckaby, J.L.

1995-05-31

Tank 241-C-112 headspace gas and vapor samples were collected and analyzed to help determine the potential risks to tank farm workers due to fugitive emissions from the tank. The drivers and objectives of waste tank headspace sampling and analysis are discussed in {open_quotes}Program Plan for the Resolution of Tank Vapor Issues.{close_quotes} Tank 241-C-112 was vapor sampled in accordance with {open_quotes}Data Quality Objectives for Generic In-Tank Health and Safety Issue Resolution.{close_quotes}

Influence of Applying Additional Forcing Fans for the Air Distribution in Ventilation Network

NASA Astrophysics Data System (ADS)

Szlązak, Nikodem; Obracaj, Dariusz; Korzec, Marek

2016-09-01

Mining progress in underground mines cause the ongoing movement of working areas. Consequently, it becomes necessary to adapt the ventilation network of a mine to direct airflow into newly-opened districts. For economic reasons, opening new fields is often achieved via underground workings. Length of primary intake and return routes increases and also increases the total resistance of a complex ventilation network. The development of a subsurface structure can make it necessary to change the air distribution in a ventilation network. Increasing airflow into newly-opened districts is necessary. In mines where extraction does not entail gas-related hazards, there is possibility of implementing a push-pull ventilation system in order to supplement airflows to newly developed mining fields. This is achieved by installing subsurface fan stations with forcing fans at the bottom of downcast shaft. In push-pull systems with multiple main fans, it is vital to select forcing fans with characteristic curves matching those of the existing exhaust fans to prevent undesirable mutual interaction. In complex ventilation networks it is necessary to calculate distribution of airflow (especially in networks with a large number of installed fans). In the article the influence of applying additional forcing fans for the air distribution in ventilation network for underground mine were considered. There are also analysed the extent of overpressure caused by the additional forcing fan in branches of the ventilation network (the operating range of additional forcing fan). Possibilities of increasing airflow rate in working areas were conducted.

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

Liquid rocket metal tanks and tank components

NASA Technical Reports Server (NTRS)

Wagner, W. A.; Keller, R. B. (Editor)

1974-01-01

Significant guidelines are presented for the successful design of aerospace tanks and tank components, such as expulsion devices, standpipes, and baffles. The state of the art is reviewed, and the design criteria are presented along with recommended practices. Design monographs are listed.

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

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.

241-AZ Tank Farm Construction Extent of Condition Review for Tank Integrity

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

Barnes, Travis J.; Boomer, Kayle D.; Gunter, Jason R.

2013-07-30

This report provides the results of an extent of condition construction history review for tanks 241-AZ-101 and 241-AZ-102. The construction history of the 241-AZ tank farm has been reviewed to identify issues similar to those experienced during tank AY-102 construction. Those issues and others impacting integrity are discussed based on information found in available construction records, using tank AY-102 as the comparison benchmark. In the 241-AZ tank farm, the second DST farm constructed, both refractory quality and tank and liner fabrication were improved.

[Oesophagitis during mechanical ventilation].

PubMed

Gastinne, H; Canard, J M; Pillegand, B; Voultoury, J C; Catanzano, A; Claude, R; Gay, R

1982-10-16

Twenty-one patients whose condition required mechanical ventilation with nasogastric intubation were investigated for oesophagitis before the 3rd day and on the 15th day of treatment, including endoscopy and biopsy. Lesions of oesophagitis were detected in 14 cases during the initial examination and in 19 cases on the second endoscopy. The course of the lesions varied from one patient to another and appeared to be unrelated to the course of the primary disease. Oesophagitis in these patients is probably due to frequent episodes of gastro-oesophageal reflux encouraged by cough, impaired consciousness and the presence of a tube. Reflux may also be the cause of inapparent and recurrent lung aspiration.

49 CFR 179.100 - General specifications applicable to pressure tank car tanks.

Code of Federal Regulations, 2014 CFR

2014-10-01

... car tanks. 179.100 Section 179.100 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) SPECIFICATIONS FOR TANK CARS Specifications for Pressure Tank Car Tanks (Classes DOT-105, 109, 112, 114 and 120...

49 CFR 179.102 - Special commodity requirements for pressure tank car tanks.

Code of Federal Regulations, 2014 CFR

2014-10-01

... car tanks. 179.102 Section 179.102 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) SPECIFICATIONS FOR TANK CARS Specifications for Pressure Tank Car Tanks (Classes DOT-105, 109, 112, 114 and 120...

Overview of Hanford Single Shell Tank (SST) Structural Integrity

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

Rast, Richard S.; Washenfelder, Dennis J.; Johnson, Jeremy M.

2013-11-14

To improve the understanding of the single-shell tanks (SSTs) integrity, Washington River Protection Solutions, LLC (WRPS), the USDOE Hanford Site tank contractor, developed an enhanced Single-Shell Tank Integrity Project (SSTIP) in 2009. An expert panel on SST integrity, consisting of various subject matters experts in industry and academia, was created to provide recommendations supporting the development of the project. This panel developed 33 recommendations in four main areas of interest: structural integrity, liner degradation, leak integrity and prevention, and mitigation of contamination migration, Seventeen of these recommendations were used to develop the basis for the M-45-10-1 Change Package for themore » Hanford Federal Agreement and Compliance Order, which is also known as the Tri-Party Agreement. The structural integrity of the tanks is a key element in completing the cleanup mission at the Hanford Site. There are eight primary recommendations related to the structural integrity of Hanford Single-Shell Tanks. Six recommendations are being implemented through current and planned activities. The structural integrity of the Hanford is being evaluated through analysis, monitoring, inspection, materials testing, and construction document review. Structural evaluation in the form of analysis is performed using modern finite element models generated in ANSYS. The analyses consider in-situ, thermal, operating loads and natural phenomena such as earthquakes. Structural analysis of 108 of 149 Hanford Single-Shell Tanks has concluded that the tanks are structurally sound and meet current industry standards. Analysis of the remaining Hanford Single-Shell Tanks is scheduled for FY2014. Hanford Single-Shell Tanks are monitored through a dome deflection program. The program looks for deflections of the tank dome greater than 1/4 inch. No such deflections have been recorded. The tanks are also subjected to visual inspection. Digital cameras record the interior

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.

SINDA/FLUINT Stratified Tank Modeling for Cryrogenic Propellant Tanks

NASA Technical Reports Server (NTRS)

Sakowski, Barbara

2014-01-01

A general purpose SINDA/FLUINT (S/F) stratified tank model was created to simulate self-pressurization and axial jet TVS; Stratified layers in the vapor and liquid are modeled using S/F lumps.; The stratified tank model was constructed to permit incorporating the following additional features:, Multiple or singular lumps in the liquid and vapor regions of the tank, Real gases (also mixtures) and compressible liquids, Venting, pressurizing, and draining, Condensation and evaporation/boiling, Wall heat transfer, Elliptical, cylindrical, and spherical tank geometries; Extensive user logic is used to allow detailed tailoring - Don't have to rebuilt everything from scratch!!; Most code input for a specific case is done through the Registers Data Block:, Lump volumes are determined through user input:; Geometric tank dimensions (height, width, etc); Liquid level could be input as either a volume percentage of fill level or actual liquid level height

Atelectasis and mechanical ventilation mode during conservative oxygen therapy: A before-and-after study.

PubMed

Suzuki, Satoshi; Eastwood, Glenn M; Goodwin, Mark D; Noë, Geertje D; Smith, Paul E; Glassford, Neil; Schneider, Antoine G; Bellomo, Rinaldo

2015-12-01

The purpose of the study is to assess the effect of a conservative oxygen therapy (COT) (target SpO2 of 90%-92%) on radiological atelectasis and mechanical ventilation modes. We conducted a secondary analysis of 105 intensive care unit patients from a pilot before-and-after study. The primary outcomes of this study were changes in atelectasis score (AS) of 555 chest radiographs assessed by radiologists blinded to treatment allocation and time to weaning from mandatory ventilation and first spontaneous ventilation trial (SVT). There was a significant difference in overall AS between groups, and COT was associated with lower time-weighted average AS. In addition, in COT patients, change from mandatory to spontaneous ventilation or time to first SVT was shortened. After adjustment for baseline characteristics and interactions between oxygen therapy, radiological atelectasis, and mechanical ventilation management, patients in the COT group had significantly lower "best" AS (adjusted odds ratio, 0.28 [95% confidence interval {CI}, 0.12-0.66]; P=.003) and greater improvement in AS in the first 7 days (adjusted odds ratio, 0.42 [95% CI, 0.17-0.99]; P=.049). Moreover, COT was associated with significantly earlier successful weaning from a mandatory ventilation mode (adjusted hazard ratio, 2.96 [95% CI, 1.73-5.04]; P<.001) and with shorter time to first SVT (adjusted hazard ratio, 1.77 [95% CI, 1.13-2.78]; P=.013). In mechanically ventilated intensive care unit patients, COT might be associated with decreased radiological evidence of atelectasis, earlier weaning from mandatory ventilation modes, and earlier first trial of spontaneous ventilation. Copyright © 2015 Elsevier Inc. All rights reserved.

Effluent migration from septic tank systems in two different lithologies, Broward County, Florida

USGS Publications Warehouse

Waller, B.G.; Howie, Barbara; Causaras, C.R.

1987-01-01

Two septic tank test sites, one in sand and one in limestone, in Broward County, Florida, were analyzed for effluent migration. Groundwater from shallow wells, both in background areas and hydraulically down-gradient of the septic tank system, was sampled during a 16-month period from April 1983 through August 1984. Water quality indicators were used to determine the effluent affected zone near the septic tank systems. Specific conductance levels and concentrations of chloride, sulfate, ammonium, and nitrate indicated effluent movement primarily in a vertical direction with abrupt dilution as it moved down-gradient. Effluent was detected in the sand to a depth more than 20 ft below the septic tank outlet, but was diluted to near background conditions 50 ft down-gradient from the tank. Effluent in the limestone was detected in all three observation wells to depths exceeding 25 ft below the septic tank outlet and was diluted, but still detectable, 40 ft down-gradient. The primary controls on effluent movement from septic tank systems in Broward County are the lithology and layering of the geologic materials, hydraulic gradients, and the volume and type of use the system receives. (Author 's abstract)

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...

46 CFR 32.65-30 - Tank vessels with independent tanks-TB/ALL.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 1 2012-10-01 2012-10-01 false Tank vessels with independent tanks-TB/ALL. 32.65-30 Section 32.65-30 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY TANK VESSELS SPECIAL EQUIPMENT, MACHINERY, AND HULL REQUIREMENTS Hull Requirements for Tank Vessels Constructed On or After November 10...

46 CFR 32.65-30 - Tank vessels with independent tanks-TB/ALL.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 1 2011-10-01 2011-10-01 false Tank vessels with independent tanks-TB/ALL. 32.65-30 Section 32.65-30 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY TANK VESSELS SPECIAL EQUIPMENT, MACHINERY, AND HULL REQUIREMENTS Hull Requirements for Tank Vessels Constructed On or After November 10...

46 CFR 32.65-30 - Tank vessels with independent tanks-TB/ALL.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 1 2014-10-01 2014-10-01 false Tank vessels with independent tanks-TB/ALL. 32.65-30 Section 32.65-30 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY TANK VESSELS SPECIAL EQUIPMENT, MACHINERY, AND HULL REQUIREMENTS Hull Requirements for Tank Vessels Constructed On or After November 10...

46 CFR 32.65-30 - Tank vessels with independent tanks-TB/ALL.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 1 2013-10-01 2013-10-01 false Tank vessels with independent tanks-TB/ALL. 32.65-30 Section 32.65-30 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY TANK VESSELS SPECIAL EQUIPMENT, MACHINERY, AND HULL REQUIREMENTS Hull Requirements for Tank Vessels Constructed On or After November 10...

Pretest Predictions for Ventilation Tests

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

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

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

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...

Cardiovascular Outcomes With Minute Ventilation-Targeted Adaptive Servo-Ventilation Therapy in Heart Failure: The CAT-HF Trial.

PubMed

O'Connor, Christopher M; Whellan, David J; Fiuzat, Mona; Punjabi, Naresh M; Tasissa, Gudaye; Anstrom, Kevin J; Benjafield, Adam V; Woehrle, Holger; Blase, Amy B; Lindenfeld, JoAnn; Oldenberg, Olaf

2017-03-28

Sleep apnea is common in hospitalized heart failure (HF) patients and is associated with increased morbidity and mortality. The CAT-HF (Cardiovascular Improvements With MV-ASV Therapy in Heart Failure) trial investigated whether minute ventilation (MV) adaptive servo-ventilation (ASV) improved cardiovascular outcomes in hospitalized HF patients with moderate-to-severe sleep apnea. Eligible patients hospitalized with HF and moderate-to-severe sleep apnea were randomized to ASV plus optimized medical therapy (OMT) or OMT alone (control). The primary endpoint was a composite global rank score (hierarchy of death, cardiovascular hospitalizations, and percent changes in 6-min walk distance) at 6 months. 126 of 215 planned patients were randomized; enrollment was stopped early following release of the SERVE-HF (Adaptive Servo-Ventilation for Central Sleep Apnea in Systolic Heart Failure) trial results. Average device usage was 2.7 h/night. Mean number of events measured by the apnea-hypopnea index decreased from 35.7/h to 2.1/h at 6 months in the ASV group versus 35.1/h to 19.0/h in the control group (p < 0.0001). The primary endpoint did not differ significantly between the ASV and control groups (p = 0.92 Wilcoxon). Changes in composite endpoint components were not significantly different between ASV and control. There was no significant interaction between treatment and ejection fraction (p = 0.10 Cox model); however, pre-specified subgroup analysis suggested a positive effect of ASV in patients with HF with preserved ejection fraction (p = 0.036). In hospitalized HF patients with moderate-to-severe sleep apnea, adding ASV to OMT did not improve 6-month cardiovascular outcomes. Study power was limited for detection of safety signals and identifying differential effects of ASV in patients with HF with preserved ejection fraction, but additional studies are warranted in this population. (Cardiovascular Improvements With MV ASV Therapy in Heart Failure [CAT-HF]; NCT

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

PubMed

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

2017-11-01

Experimental animal models of acute respiratory distress syndrome (ARDS) have shown that the updated airway pressure release ventilation (APRV) methodologies may significantly improve oxygenation, maximize lung recruitment, and attenuate lung injury, without circulatory depression. This led us to hypothesize that early application of APRV in patients with ARDS would allow pulmonary function to recover faster and would reduce the duration of mechanical ventilation as compared with low tidal volume lung protective ventilation (LTV). A total of 138 patients with ARDS who received mechanical ventilation for <48 h between May 2015 to October 2016 while in the critical care medicine unit (ICU) of the West China Hospital of Sichuan University were enrolled in the study. Patients were randomly assigned to receive APRV (n = 71) or LTV (n = 67). The settings for APRV were: high airway pressure (P high ) set at the last plateau airway pressure (P plat ), not to exceed 30 cmH 2 O) and low airway pressure ( P low ) set at 5 cmH 2 O; the release phase (T low ) setting adjusted to terminate the peak expiratory flow rate to ≥ 50%; release frequency of 10-14 cycles/min. The settings for LTV were: target tidal volume of 6 mL/kg of predicted body weight; P plat not exceeding 30 cmH 2 O; positive end-expiratory pressure (PEEP) guided by the PEEP-FiO 2 table according to the ARDSnet protocol. The primary outcome was the number of days without mechanical ventilation from enrollment to day 28. The secondary endpoints included oxygenation, P plat , respiratory system compliance, and patient outcomes. Compared with the LTV group, patients in the APRV group had a higher median number of ventilator-free days {19 [interquartile range (IQR) 8-22] vs. 2 (IQR 0-15); P < 0.001}. This finding was independent of the coexisting differences in chronic disease. The APRV group had a shorter stay in the ICU (P = 0.003). The ICU mortality rate was 19.7% in the APRV group versus 34.3% in the

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

PubMed

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

2014-10-01

Acute respiratory distress syndrome (ARDS) is common following aneurysmal subarachnoid hemorrhage (SAH), but the influence of mechanical ventilator settings on its development is unclear. We sought to determine adherence to lung protective thresholds in ventilated patients with SAH and describe the association between ventilator settings and subsequent development of ARDS. We conducted a retrospective cohort study of consecutive patients receiving mechanical ventilation within 72 h of SAH at a single academic center. Ventilator settings and blood gas data were collected twice daily for the first 7 days of ventilation along with ICU and hospital outcomes. Lung protective ventilation was defined as follows: tidal volume ≤8 mL/kg of predicted body weight, positive end-expiratory pressure (PEEP) ≥5 cm H(2)O, and peak or plateau pressure ≤30 cm H(2)O. The development of ARDS was ascertained retrospectively by PaO(2)/FiO(2) ≤300 with new bilateral lung opacities on chest X-ray within one day of hypoxemia. We identified 62 patients who underwent early mechanical ventilation following SAH. PS and Continuous Positive Airway Pressure were common ventilator modes with a median tidal volume of 7.8 mL/kg [interquartile range 6.8-8.8], median peak pressure of 14 cm H(2)O [IQR 12-17], and median PEEP of 5 cm H(2)O [IQR 5-6]. Adherence to tidal volumes ≤8 mL/kg was seen in 64 % of all observations and peak pressures <30 cm H(2)O were 94 % of all observations. All three lung protective criteria were seen in 58 % of all observations. Thirty-one patients (50 %) were determined to have ARDS. ARDS patients were more frequently ventilated with a peak pressure >30 cm H(2)O (11.3 % of ARDS ventilation days vs. 0 % of non-ARDS ventilation days; p < 0.01). Initial tidal volume was not associated with subsequent development of ARDS in univariate (p = 0.6) or multivariate analysis (p = 0.49). Only the number of ARDS risk factors was independently associated with the development of

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

49 CFR 179.201 - Individual specification requirements applicable to non-pressure tank car tanks.

Code of Federal Regulations, 2014 CFR

2014-10-01

... to non-pressure tank car tanks. 179.201 Section 179.201 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) SPECIFICATIONS FOR TANK CARS Specifications for Non-Pressure Tank Car Tanks (Classes DOT-111AW...

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...

Ventilating Air-Conditioner

NASA Technical Reports Server (NTRS)

Dinh, Khanh

1994-01-01

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

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

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

Tank characterization report for double-shell tank 241-AW-105

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

Sasaki, L.M.

1997-06-05

One of the major functions of the Tank Waste Remediation System (TWRS) is to characterize wastes in support of waste management and disposal activities at the Hanford Site. Analytical data from sampling and analysis, along with other available information about a tank, are compiled and maintained in a tank characterization report (TCR). This report and its appendices serve as the TCR for double-shell tank 241-AW-105. The objectives of this report are to use characterization data in response to technical issues associated with tank 241-AW-105 waste; and to provide a standard characterization of this waste in terms of a best-basis inventorymore » estimate. The response to technical issues is summarized in Section 2.0, and the best-basis inventory estimate is presented in Section 3.0. Recommendations regarding safety status and additional sampling needs are provided in Section 4.0. Supporting data and information are contained in the appendices. This report supports the requirements of the Hanford Federal Facility Agreement and Consent Order milestone Characterization. information presented in this report originated from sample analyses and known historical sources. While only the results of a recent sampling event will be used to fulfill the requirements of the data quality objectives (DQOs), other information can be used to support or question conclusions derived from these results. Historical information for tank 241-AW-105 is provided in Appendix A, including surveillance information, records pertaining to waste transfers and tank operations, and expected tank contents derived from a process knowledge model. The recent sampling event listed, as well as pertinent sample data obtained before 1996, are summarized in Appendix B along with the sampling results. The results of the 1996 grab sampling event satisfied the data requirements specified in the sampling and analysis plan (SAP) for this tank. In addition, the tank headspace flammability was measured, which

Protective garment ventilation system

NASA Technical Reports Server (NTRS)

Lang, R. (Inventor)

1970-01-01

A method and apparatus for ventilating a protective garment, space suit system, and/or pressure suits to maintain a comfortable and nontoxic atmosphere within is described. The direction of flow of a ventilating and purging gas in portions of the garment may be reversed in order to compensate for changes in environment and activity of the wearer. The entire flow of the ventilating gas can also be directed first to the helmet associated with the garment.

Evidence-based practice: use of the ventilator bundle to prevent ventilator-associated pneumonia.

PubMed

Tolentino-DelosReyes, Arlene F; Ruppert, Susan D; Shiao, Shyang-Yun Pamela K

2007-01-01

To examine critical care nurses' knowledge about the use of the ventilator bundle to prevent ventilator-associated pneumonia. Published reports were reviewed for current evidence on the use of the ventilator bundle to prevent ventilator-associated pneumonia, and education sessions were held to present the findings to 61 nurses in coronary care and surgical intensive care units. Changes in the nurses' knowledge were evaluated by using a 10-item test, given both before and after the sessions. Changes in the nurses' practices related to ventilator-associated pneumonia, including elevation of the head of the bed to 30 degrees to 45 degrees , were observed in 99 intubated patients. After the education sessions, the nurses performed better on 8 of the 10 items tested (P from .03 to <.001). The areas of most significant improvement were elevation of the head of the bed (P < .001), charting of the elevation of the head of the bed (P= .009), oral care (P= .009), checking of the nasogastric tube for residual volume (P = .008), washing of hands before contact with patients (P < .001), and limiting the wearing of rings (P < .001) and nail polish (P = .04). Even after the education sessions, the nurses' compliance with hand-washing recommendations before contact with patients was low, though statistically some improvement was apparent. Contraindications to elevation of the head of the bed did not appear to affect the nurses' practices (P= .38). Education sessions designed to inform nurses about the ventilator bundle and its use to prevent ventilator-associated pneumonia have a significant effect on participants' knowledge and subsequent clinical practice.

50 CFR 14.172 - Primary enclosures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Wild Mammals and Birds to the United States Specifications for Birds § 14.172 Primary enclosures. (a) A primary enclosure for birds shall have ventilation openings on two vertical sides that comprise at least... creating a draft. (b) Perches shall be provided for birds that rest by perching. The diameter of the perch...

49 CFR 179.103 - Special requirements for class 114A * * * tank car tanks.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 3 2014-10-01 2014-10-01 false Special requirements for class 114A * * * tank car...) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) SPECIFICATIONS FOR TANK CARS Specifications for Pressure Tank Car Tanks (Classes DOT-105, 109, 112, 114 and 120...

The impact of a ventilator bundle on preventing ventilator-associated pneumonia: a multicenter study.

PubMed

Eom, Joong Sik; Lee, Mi-Suk; Chun, Hee-Kyung; Choi, Hee Jung; Jung, Sun-Young; Kim, Yeon-Sook; Yoon, Seon Jin; Kwak, Yee Gyung; Oh, Gang-Bok; Jeon, Min-Hyok; Park, Sun-Young; Koo, Hyun-Sook; Ju, Young-Su; Lee, Jin Seo

2014-01-01

For prevention of ventilator-associated pneumonia (VAP), a bundle approach was applied to patients receiving mechanical ventilation in intensive care units. The incidence of VAP and the preventive efficacy of the VAP bundle were investigated. A quasi-experimental study was conducted in adult intensive care units of 6 university hospitals with similar VAP rates. We implemented the VAP bundle between March 2011 and June 2011, then compared the rate of VAP after implementation of the VAP bundle with the rate in the previous 8 months. Our ventilator bundle included head of bed elevation, peptic ulcer disease prophylaxis, deep venous thrombosis prophylaxis, and oral decontamination with chlorhexidine 0.12%. Continuous aspiration of subglottic secretions was an option. Implementation of the VAP bundle reduced the VAP rate from a mean of 4.08 cases per 1,000 ventilator-days to 1.16 cases per 1,000 ventilator-days. The incidence density ratio (rate) was 0.28 (95% confidence interval, 0.275-0.292). Implementing the appropriate VAP bundle significantly decreased the incidence of VAP in patients with mechanical ventilation. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

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

PubMed

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

1988-01-01

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

Initial parametric study of the flammability of plume releases in Hanford waste tanks

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

Antoniak, Z.I.; Recknagle, K.P.

This study comprised systematic analyses of waste tank headspace flammability following a plume-type of gas release from the waste. First, critical parameters affecting plume flammability were selected, evaluated, and refined. As part of the evaluation the effect of ventilation (breathing) air inflow on the convective flow field inside the tank headspace was assessed, and the magnitude of the so-called {open_quotes}numerical diffusion{close_quotes} on numerical simulation accuracy was investigated. Both issues were concluded to be negligible influences on predicted flammable gas concentrations in the tank headspace. Previous validation of the TEMPEST code against experimental data is also discussed, with calculated results inmore » good agreements with experimental data. Twelve plume release simulations were then run, using release volumes and flow rates that were thought to cover the range of actual release volumes and rates. The results indicate that most plume-type releases remain flammable only during the actual release ends. Only for very large releases representing a significant fraction of the volume necessary to make the entire mixed headspace flammable (many thousands of cubic feet) can flammable concentrations persist for several hours after the release ends. However, as in the smaller plumes, only a fraction of the total release volume is flammable at any one time. The transient evolution of several plume sizes is illustrated in a number of color contour plots that provide insight into plume mixing behavior.« less

Mechanical ventilation weaning and extubation after spinal cord injury: a Western Trauma Association multicenter study.

PubMed

Kornblith, Lucy Z; Kutcher, Matthew E; Callcut, Rachael A; Redick, Brittney J; Hu, Charles K; Cogbill, Thomas H; Baker, Christopher C; Shapiro, Mark L; Burlew, Clay C; Kaups, Krista L; DeMoya, Marc A; Haan, James M; Koontz, Christopher H; Zolin, Samuel J; Gordy, Stephanie D; Shatz, David V; Paul, Doug B; Cohen, Mitchell J

2013-12-01

Respiratory failure after acute spinal cord injury (SCI) is well recognized, but data defining which patients need long-term ventilator support and criteria for weaning and extubation are lacking. We hypothesized that many patients with SCI, even those with cervical SCI, can be successfully managed without long-term mechanical ventilation and its associated morbidity. Under the auspices of the Western Trauma Association Multi-Center Trials Group, a retrospective study of patients with SCI at 14 major trauma centers was conducted. Comprehensive injury, demographic, and outcome data on patients with acute SCI were compiled. The primary outcome variable was the need for mechanical ventilation at discharge. Secondary outcomes included the use of tracheostomy and development of acute lung injury and ventilator-associated pneumonia. A total of 360 patients had SCI requiring mechanical ventilation. Sixteen patients were excluded for death within the first 2 days of hospitalization. Of the 344 patients included, 222 (64.5%) had cervical SCI. Notably, 62.6% of the patients with cervical SCI were ventilator free by discharge. One hundred forty-nine patients (43.3%) underwent tracheostomy, and 53.7% of them were successfully weaned from the ventilator, compared with an 85.6% success rate among those with no tracheostomy (p < 0.05). Patients who underwent tracheostomy had significantly higher rates of ventilator-associated pneumonia (61.1% vs. 20.5%, p < 0.05) and acute lung injury (12.8% vs. 3.6%, p < 0.05) and fewer ventilator-free days (1 vs. 24 p < 0.05). When controlled for injury severity, thoracic injury, and respiratory comorbidities, tracheostomy after cervical SCI was an independent predictor of ventilator dependence with an associated 14-fold higher likelihood of prolonged mechanical ventilation (odds ratio, 14.1; 95% confidence interval, 2.78-71.67; p < 0.05). While many patients with SCI require short-term mechanical ventilation, the majority can be successfully

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

PubMed

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

2017-01-01

The discontinuation of mechanical ventilation after coronary surgery may prolong and significantly increase the load on intensive care unit personnel. We hypothesized that automated mode using INTELLiVENT-ASV can decrease duration of postoperative mechanical ventilation, reduce workload on medical staff, and provide safe ventilation after off-pump coronary artery bypass grafting (OPCAB). The primary endpoint of our study was to assess the duration of postoperative mechanical ventilation during different modes of weaning from respiratory support (RS) after OPCAB. The secondary endpoint was to assess safety of the automated weaning mode and the number of manual interventions to the ventilator settings during the weaning process in comparison with the protocolized weaning mode. Forty adult patients undergoing elective OPCAB were enrolled into a prospective single-center study. Patients were randomized into two groups: automated weaning ( n  = 20) using INTELLiVENT-ASV mode with quick-wean option; and protocolized weaning ( n  = 20), using conventional synchronized intermittent mandatory ventilation (SIMV) + pressure support (PS) mode. We assessed the duration of postoperative ventilation, incidence and duration of unacceptable RS, and the load on medical staff. We also performed the retrospective analysis of 102 patients (standard weaning) who were weaned from ventilator with SIMV + PS mode based on physician's experience without prearranged algorithm. Realization of the automated weaning protocol required change in respiratory settings in 2 patients vs. 7 (5-9) adjustments per patient in the protocolized weaning group. Both incidence and duration of unacceptable RS were reduced significantly by means of the automated weaning approach. The FiO 2 during spontaneous breathing trials was significantly lower in the automated weaning group: 30 (30-35) vs. 40 (40-45) % in the protocolized weaning group ( p  < 0.01). The average time until tracheal

Mechanical Ventilation and ARDS in the ED: A Multicenter, Observational, Prospective, Cross-sectional Study.

PubMed

Fuller, Brian M; Mohr, Nicholas M; Miller, Christopher N; Deitchman, Andrew R; Levine, Brian J; Castagno, Nicole; Hassebroek, Elizabeth C; Dhedhi, Adam; Scott-Wittenborn, Nicholas; Grace, Edward; Lehew, Courtney; Kollef, Marin H

2015-08-01

There are few data regarding mechanical ventilation and ARDS in the ED. This could be a vital arena for prevention and treatment. This study was a multicenter, observational, prospective, cohort study aimed at analyzing ventilation practices in the ED. The primary outcome was the incidence of ARDS after admission. Multivariable logistic regression was used to determine the predictors of ARDS. We analyzed 219 patients receiving mechanical ventilation to assess ED ventilation practices. Median tidal volume was 7.6 mL/kg predicted body weight (PBW) (interquartile range, 6.9-8.9), with a range of 4.3 to 12.2 mL/kg PBW. Lung-protective ventilation was used in 122 patients (55.7%). The incidence of ARDS after admission from the ED was 14.7%, with a mean onset of 2.3 days. Progression to ARDS was associated with higher illness severity and intubation in the prehospital environment or transferring facility. Of the 15 patients with ARDS in the ED (6.8%), lung-protective ventilation was used in seven (46.7%). Patients who progressed to ARDS experienced greater duration in organ failure and ICU length of stay and higher mortality. Lung-protective ventilation is infrequent in patients receiving mechanical ventilation in the ED, regardless of ARDS status. Progression to ARDS is common after admission, occurs early, and worsens outcome. Patient- and treatment-related factors present in the ED are associated with ARDS. Given the limited treatment options for ARDS, and the early onset after admission from the ED, measures to prevent onset and to mitigate severity should be instituted in the ED. ClinicalTrials.gov; No.: NCT01628523; URL: www.clinicaltrials.gov.

Mechanical ventilation for severe asthma.

PubMed

Leatherman, James

2015-06-01

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

ENHANCED CHEMICAL CLEANING: A NEW PROCESS FOR CHEMICALLY CLEANING SAVANNAH RIVER WASTE TANKS

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

Ketusky, E; Neil Davis, N; Renee Spires, R

2008-01-17

The Savannah River Site (SRS) has 49 high level waste (HLW) tanks that must be emptied, cleaned, and closed as required by the Federal Facilities Agreement. The current method of chemical cleaning uses several hundred thousand gallons per tank of 8 weight percent (wt%) oxalic acid to partially dissolve and suspend residual waste and corrosion products such that the waste can be pumped out of the tank. This adds a significant quantity of sodium oxalate to the tanks and, if multiple tanks are cleaned, renders the waste incompatible with the downstream processing. Tank space is also insufficient to store thismore » stream given the large number of tanks to be cleaned. Therefore, a search for a new cleaning process was initiated utilizing the TRIZ literature search approach, and Chemical Oxidation Reduction Decontamination--Ultraviolet (CORD-UV), a mature technology currently used for decontamination and cleaning of commercial nuclear reactor primary cooling water loops, was identified. CORD-UV utilizes oxalic acid for sludge dissolution, but then decomposes the oxalic acid to carbon dioxide and water by UV treatment outside the system being treated. This allows reprecipitation and subsequent deposition of the sludge into a selected container without adding significant volume to that container, and without adding any new chemicals that would impact downstream treatment processes. Bench top and demonstration loop measurements on SRS tank sludge stimulant demonstrated the feasibility of applying CORD-UV for enhanced chemical cleaning of SRS HLW tanks.« less

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.

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.

Variable versus conventional lung protective mechanical ventilation during open abdominal surgery: study protocol for a randomized controlled trial.

PubMed

Spieth, Peter M; Güldner, Andreas; Uhlig, Christopher; Bluth, Thomas; Kiss, Thomas; Schultz, Marcus J; Pelosi, Paolo; Koch, Thea; Gama de Abreu, Marcelo

2014-05-02

General anesthesia usually requires mechanical ventilation, which is traditionally accomplished with constant tidal volumes in volume- or pressure-controlled modes. Experimental studies suggest that the use of variable tidal volumes (variable ventilation) recruits lung tissue, improves pulmonary function and reduces systemic inflammatory response. However, it is currently not known whether patients undergoing open abdominal surgery might benefit from intraoperative variable ventilation. The PROtective VARiable ventilation trial ('PROVAR') is a single center, randomized controlled trial enrolling 50 patients who are planning for open abdominal surgery expected to last longer than 3 hours. PROVAR compares conventional (non-variable) lung protective ventilation (CV) with variable lung protective ventilation (VV) regarding pulmonary function and inflammatory response. The primary endpoint of the study is the forced vital capacity on the first postoperative day. Secondary endpoints include further lung function tests, plasma cytokine levels, spatial distribution of ventilation assessed by means of electrical impedance tomography and postoperative pulmonary complications. We hypothesize that VV improves lung function and reduces systemic inflammatory response compared to CV in patients receiving mechanical ventilation during general anesthesia for open abdominal surgery longer than 3 hours. PROVAR is the first randomized controlled trial aiming at intra- and postoperative effects of VV on lung function. This study may help to define the role of VV during general anesthesia requiring mechanical ventilation. Clinicaltrials.gov NCT01683578 (registered on September 3 3012).

Mechanical ventilation in abdominal surgery.

PubMed

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

2014-01-01

One of the key challenges in perioperative care is to reduce postoperative morbidity and mortality. Patients who develop postoperative morbidity but survive to leave hospital have often reduced functional independence and long-term survival. Mechanical ventilation provides a specific example that may help us to shift thinking from treatment to prevention of postoperative complications. Mechanical ventilation in patients undergoing surgery has long been considered only as a modality to ensure gas exchange while allowing maintenance of anesthesia with delivery of inhaled anesthetics. Evidence is accumulating, however, suggesting an association between intraoperative mechanical ventilation strategy and postoperative pulmonary function and clinical outcome in patients undergoing abdominal surgery. Non-protective ventilator settings, especially high tidal volume (VT) (>10-12mL/kg) and the use of very low level of positive end-expiratory pressure (PEEP) (PEEP<5cmH2O) or no PEEP, may cause alveolar overdistension and repetitive tidal recruitment leading to ventilator-associated lung injury in patients with healthy lungs. Stimulated by previous findings in patients with acute respiratory distress syndrome, the use of lower tidal volume ventilation is becoming increasingly more common in the operating room. However, lowering tidal volume, though important, is only part of the overall multifaceted approach of lung protective mechanical ventilation. In this review, we aimed at providing the most recent and relevant clinical evidence regarding the use of mechanical ventilation in patients undergoing abdominal surgery. Copyright © 2014 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

Retrospective Application of New Pediatric Ventilator-Associated Pneumonia Criteria Identifies a High-Risk Population.

PubMed

Gionfriddo, Ashley; Nonoyama, Mika L; Laussen, Peter C; Cox, Peter N; Clarke, Megan; Floh, Alejandro A

2018-06-01

To promote standardization, the Centers for Disease Control and Prevention introduced a new ventilator-associated pneumonia classification, which was modified for pediatrics (pediatric ventilator-associated pneumonia according to proposed criteria [PVAP]). We evaluated the frequency of PVAP in a cohort of children diagnosed with ventilator-associated pneumonia according to traditional criteria and compared their strength of association with clinically relevant outcomes. Retrospective cohort study. Tertiary care pediatric hospital. Critically ill children (0-18 yr) diagnosed with ventilator-associated pneumonia between January 2006 and December 2015 were identified from an infection control database. Patients were excluded if on high frequency ventilation, extracorporeal membrane oxygenation, or reintubated 24 hours following extubation. None. Patients were assessed for PVAP diagnosis. Primary outcome was the proportion of subjects diagnosed with PVAP. Secondary outcomes included association with intervals of care. Two hundred seventy-seven children who had been diagnosed with ventilator-associated pneumonia were eligible for review; 46 were excluded for being ventilated under 48 hours (n = 16), on high frequency ventilation (n = 12), on extracorporeal membrane oxygenation (n = 8), ineligible bacteria isolated from culture (n = 8), and other causes (n = 4). ICU admission diagnoses included congenital heart disease (47%), neurological (16%), trauma (7%), respiratory (7%), posttransplant (4%), neuromuscular (3%), and cardiomyopathy (3%). Only 16% of subjects (n = 45) met the new PVAP definition, with 18% (n = 49) having any ventilator-associated condition. Failure to fulfill new definitions was based on inadequate increase in mean airway pressure in 90% or FIO2 in 92%. PVAP was associated with prolonged ventilation (median [interquartile range], 29 d [13-51 d] vs 16 d [8-34.5 d]; p = 0.002), ICU (median [interquartile range], 40 d [20-100 d] vs 25 d [14-61 d]; p = 0

Tank characterization report for single-shell tank 241-C-109

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

Simpson, B.C.

1997-05-23

One of the major functions of the Tank Waste Remediation System (TWRS) is to characterize wastes in support of waste management and disposal activities at the Hanford Site. Analytical data from sampling and analysis, along with other available information about a tank, are compiled and maintained in a tank characterization report (TCR). This report and its appendices serve as the TCR for single-shell tank 241-C-109. The objectives of this report are: (1) to use characterization data in response to technical issues associated with tank 241 C-109 waste; and (2) to provide a standard characterization of this waste in terms ofmore » a best-basis inventory estimate. The response to technical issues is summarized in Section 2.0, and the best-basis inventory estimate is presented in Section 3.0. Recommendations regarding safety status and additional sampling needs are provided in Section 4.0. Supporting data and information are contained in the appendices.« less

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

PubMed

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

2017-01-01

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

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

PubMed Central

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

2017-01-01

Objective To compare the effects of high-frequency oscillatory ventilation and conventional protective mechanical ventilation associated with the prone position on oxygenation, histology and pulmonary oxidative damage in an experimental model of acute lung injury. Methods Forty-five rabbits with tracheostomy and vascular access were underwent mechanical ventilation. Acute lung injury was induced by tracheal infusion of warm saline. Three experimental groups were formed: healthy animals + conventional protective mechanical ventilation, supine position (Control Group; n = 15); animals with acute lung injury + conventional protective mechanical ventilation, prone position (CMVG; n = 15); and animals with acute lung injury + high-frequency oscillatory ventilation, prone position (HFOG; n = 15). Ten minutes after the beginning of the specific ventilation of each group, arterial gasometry was collected, with this timepoint being called time zero, after which the animal was placed in prone position and remained in this position for 4 hours. Oxidative stress was evaluated by the total antioxidant performance assay. Pulmonary tissue injury was determined by histopathological score. The level of significance was 5%. Results Both groups with acute lung injury showed worsening of oxygenation after induction of injury compared with the Control Group. After 4 hours, there was a significant improvement in oxygenation in the HFOG group compared with CMVG. Analysis of total antioxidant performance in plasma showed greater protection in HFOG. HFOG had a lower histopathological lesion score in lung tissue than CMVG. Conclusion High-frequency oscillatory ventilation, associated with prone position, improves oxygenation and attenuates oxidative damage and histopathological lung injury compared with conventional protective mechanical ventilation. PMID:29236845

RECOMMENDATIONS FOR SAMPLING OF TANK 19 IN F TANK FARM

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

Harris, S.; Shine, G.

2009-12-14

Representative sampling is required for characterization of the residual material in Tank 19 prior to operational closure. Tank 19 is a Type IV underground waste storage tank located in the F-Tank Farm. It is a cylindrical-shaped, carbon steel tank with a diameter of 85 feet, a height of 34.25 feet, and a working capacity of 1.3 million gallons. Tank 19 was placed in service in 1961 and initially received a small amount of low heat waste from Tank 17. It then served as an evaporator concentrate (saltcake) receiver from February 1962 to September 1976. Tank 19 also received the spentmore » zeolite ion exchange media from a cesium removal column that once operated in the Northeast riser of the tank to remove cesium from the evaporator overheads. Recent mechanical cleaning of the tank removed all mounds of material. Anticipating a low level of solids in the residual waste, Huff and Thaxton [2009] developed a plan to sample the waste during the final clean-up process while it would still be resident in sufficient quantities to support analytical determinations in four quadrants of the tank. Execution of the plan produced fewer solids than expected to support analytical determinations in all four quadrants. Huff and Thaxton [2009] then restructured the plan to characterize the residual separately in the North and the South regions: two 'hemispheres.' This document provides sampling recommendations to complete the characterization of the residual material on the tank bottom following the guidance in Huff and Thaxton [2009] to split the tank floor into a North and a South hemisphere. The number of samples is determined from a modification of the formula previously published in Edwards [2001] and the sample characterization data for previous sampling of Tank 19 described by Oji [2009]. The uncertainty is quantified by an upper 95% confidence limit (UCL95%) on each analyte's mean concentration in Tank 19. The procedure computes the uncertainty in analyte concentration as

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

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

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

Tank Closure Progress at the Department of Energy's Idaho National Engineering Laboratory Tank Farm Facility

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

Quigley, K.D.; Butterworth, St.W.; Lockie, K.A.

2008-07-01

Significant progress has been made at the U.S. Department of Energy (DOE) Idaho National Laboratory (INL) to empty, clean and close radioactive liquid waste storage tanks at the Idaho Nuclear Technology and Engineering Center (INTEC) Tank Farm Facility (TFF). The TFF includes eleven 1,135.6-kL (300,000-gal) underground stainless steel storage tanks and four smaller, 113.5-kL (30,000-gal) stainless steel tanks, along with tank vaults, interconnecting piping, and ancillary equipment. The TFF tanks have historically been used to store a variety of radioactive liquid waste, including wastes associated with past spent nuclear fuel reprocessing. Although four of the large storage tanks remain inmore » use for waste storage, the other seven 1,135.6-kL (300,000-gal) tanks and the four 113.5-kL (30,000-gal) tanks have been emptied of waste, cleaned and filled with grout. A water spray cleaning system was developed and deployed to clean internal tank surfaces and remove remaining tank wastes. The cleaning system was effective in removing all but a very small volume of solid residual waste particles. Recent issuance of an Amended Record of Decision (ROD) in accordance with the National Environmental Policy Act, and a Waste Determination complying with Section 3116 of the Ronald W. Reagan National Defense Authorization Act (NDAA) for Fiscal Year 2005, has allowed commencement of grouting activities on the cleaned tanks. The first three 113.5-kL (30,000-gal) tanks were grouted in the Fall of 2006 and the fourth tank and the seven 1,135.6-kL (300,000-gal) tanks were filled with grout in 2007 to provide long-term stability. It is currently planned that associated tank valve boxes and interconnecting piping, will be stabilized with grout as early as 2008. (authors)« less

Mechanical ventilation during extracorporeal membrane oxygenation.

PubMed

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

2014-01-21

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

Mechanical ventilation during extracorporeal membrane oxygenation

PubMed Central

2014-01-01

The timing of extracorporeal membrane oxygenation (ECMO) initiation and its outcome in the management of respiratory and cardiac failure have received considerable attention, but very little attention has been given to mechanical ventilation during ECMO. Mechanical ventilation settings in non-ECMO studies have been shown to have an effect on survival and may also have contributed to a treatment effect in ECMO trials. Protective lung ventilation strategies established for non-ECMO-supported respiratory failure patients may not be optimal for more severe forms of respiratory failure requiring ECMO support. The influence of positive end-expiratory pressure on the reduction of the left ventricular compliance may be a matter of concern for patients receiving ECMO support for cardiac failure. The objectives of this review were to describe potential mechanisms for lung injury during ECMO for respiratory or cardiac failure, to assess the possible benefits from the use of ultra-protective lung ventilation strategies and to review published guidelines and expert opinions available on mechanical ventilation-specific management of patients requiring ECMO, including mode and ventilator settings. Articles were identified through a detailed search of PubMed, Ovid, Cochrane databases and Google Scholar. Additional references were retrieved from the selected studies. Growing evidence suggests that mechanical ventilation settings are important in ECMO patients to minimize further lung damage and improve outcomes. An ultra-protective ventilation strategy may be optimal for mechanical ventilation during ECMO for respiratory failure. The effects of airway pressure on right and left ventricular afterload should be considered during venoarterial ECMO support of cardiac failure. Future studies are needed to better understand the potential impact of invasive mechanical ventilation modes and settings on outcomes. PMID:24447458

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.

[Mechanical ventilation in acute asthma crisis].

PubMed

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

2007-06-01

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

Sensor-based demand controlled ventilation

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

De Almeida, A.T.; Fisk, W.J.

In most buildings, occupancy and indoor pollutant emission rates vary with time. With sensor-based demand-controlled ventilation (SBDCV), the rate of ventilation (i.e., rate of outside air supply) also varies with time to compensate for the changes in pollutant generation. In other words, SBDCV involves the application of sensing, feedback and control to modulate ventilation. Compared to ventilation without feedback, SBDCV offers two potential advantages: (1) better control of indoor pollutant concentrations; and (2) lower energy use and peak energy demand. SBDCV has the potential to improve indoor air quality by increasing the rate of ventilation when indoor pollutant generation ratesmore » are high and occupants are present. SBDCV can also save energy by decreasing the rate of ventilation when indoor pollutant generation rates are low or occupants are absent. After providing background information on indoor air quality and ventilation, this report provides a relatively comprehensive discussion of SBDCV. Topics covered in the report include basic principles of SBDCV, sensor technologies, technologies for controlling air flow rates, case studies of SBDCV, application of SBDCV to laboratory buildings, and research needs. SBDCV appears to be an increasingly attractive technology option. Based on the review of literature and theoretical considerations, the application of SBDCV has the potential to be cost-effective in applications with the following characteristics: (a) a single or small number of dominant pollutants, so that ventilation sufficient to control the concentration of the dominant pollutants provides effective control of all other pollutants; (b) large buildings or rooms with unpredictable temporally variable occupancy or pollutant emission; and (c) climates with high heating or cooling loads or locations with expensive energy.« less

The fluid mechanics of natural ventilation

NASA Astrophysics Data System (ADS)

Linden, Paul

1999-11-01

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

Biogeochemical Implications of Recent Changes in the Ventilation of the Japan/East Sea

NASA Astrophysics Data System (ADS)

Jenkins, W. J.

2006-12-01

The Japan/East Sea (JES) is a highly productive marine ecosystem that constitutes an important fisheries resource for a number of nations. As a weakly stratified marginal sea separated from the Pacific Ocean by shallow straits, the ventilation of the abyssal JES is remarkably susceptible to climate change. Not surprisingly, such changes have indeed been noted for the late-glacial and Holocene. Over the past half-century or more, there has been a trend toward increasing deep water temperatures, increasing dissolved inorganic nutrients, and decreasing dissolved oxygen levels that are consistent with a reduction in deep ventilation in recent decades. I present a minimum complexity model of the Japan Sea that utilize observations of the transient tracers CFCs, tritium, and 3He to place useful constraints on the character, magnitude, and timing of these changes. I describe these changes within the context of differing mechanisms for deep water formation and ventilation. The converse of ventilation is the return of deep nutrients to the surface ocean, which in turn forms the basis of the food pyramid, and hence the support for new primary production in this strategically important marginal sea. The tracer constrained model calculations suggest that the primary (convective) supply of inorganic nitrogen to the shallow JES reduced by nearly a factor of two (from 1.7 to 0.9 Tmoles) in the latter half of the 20^th century. I relate the changes in abyssal nutrient reflux to climatic modulation of water mass formation changes, and present the implications for water column remineralization processes. The implications of the large scale changes for the sustenance of fishery stocks is significant.

27 CFR 25.35 - Tanks.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Tanks. 25.35 Section 25.35... TREASURY LIQUORS BEER Construction and Equipment Equipment § 25.35 Tanks. Each stationary tank, vat, cask... contents of tanks or containers in lieu of providing each tank or container with a measuring device. (Sec...

27 CFR 25.35 - Tanks.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Tanks. 25.35 Section 25.35... TREASURY ALCOHOL BEER Construction and Equipment Equipment § 25.35 Tanks. Each stationary tank, vat, cask... contents of tanks or containers in lieu of providing each tank or container with a measuring device. (Sec...

Inhalation therapy in mechanical ventilation

PubMed Central

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

2015-01-01

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

Ventilation of an hydrofoil wake

NASA Astrophysics Data System (ADS)

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

2013-11-01

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

Project W-211 Initial Tank Retrieval Systems (ITRS) Description of Operations for 241-AZ-102

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

BRIGGS, S.R.

2000-02-25

The primary purpose of the Initial Tank Retrieval Systems (ITRS) is to provide systems for retrieval of radioactive wastes stored in underground double-shell tanks (DSTs) for transfer to alternate storage, evaporation, pretreatment or treatment, while concurrently reducing risks associated with safety watch list and other DSTs. This Description of Operation (DOO) defines the control philosophy for the waste retrieval system for Tank 241-AZ-102 (AZ-102). This DOO provides a basis for the detailed design of the Project W-211 Retrieval Control System (RCS) for AZ-102 and also establishes test criteria for the RCS.

Effect of On-Demand vs Routine Nebulization of Acetylcysteine With Salbutamol on Ventilator-Free Days in Intensive Care Unit Patients Receiving Invasive Ventilation: A Randomized Clinical Trial.

PubMed

van Meenen, David M P; van der Hoeven, Sophia M; Binnekade, Jan M; de Borgie, Corianne A J M; Merkus, Maruschka P; Bosch, Frank H; Endeman, Henrik; Haringman, Jasper J; van der Meer, Nardo J M; Moeniralam, Hazra S; Slabbekoorn, Mathilde; Muller, Marcella C A; Stilma, Willemke; van Silfhout, Bart; Neto, Ary Serpa; Ter Haar, Hans F M; Van Vliet, Jan; Wijnhoven, Jan Willem; Horn, Janneke; Juffermans, Nicole P; Pelosi, Paolo; Gama de Abreu, Marcelo; Schultz, Marcus J; Paulus, Frederique

2018-03-13

It remains uncertain whether nebulization of mucolytics with bronchodilators should be applied for clinical indication or preventively in intensive care unit (ICU) patients receiving invasive ventilation. To determine if a strategy that uses nebulization for clinical indication (on-demand) is noninferior to one that uses preventive (routine) nebulization. Randomized clinical trial enrolling adult patients expected to need invasive ventilation for more than 24 hours at 7 ICUs in the Netherlands. On-demand nebulization of acetylcysteine or salbutamol (based on strict clinical indications, n = 471) or routine nebulization of acetylcysteine with salbutamol (every 6 hours until end of invasive ventilation, n = 473). The primary outcome was the number of ventilator-free days at day 28, with a noninferiority margin for a difference between groups of -0.5 days. Secondary outcomes included length of stay, mortality rates, occurrence of pulmonary complications, and adverse events. Nine hundred twenty-two patients (34% women; median age, 66 (interquartile range [IQR], 54-75 years) were enrolled and completed follow-up. At 28 days, patients in the on-demand group had a median 21 (IQR, 0-26) ventilator-free days, and patients in the routine group had a median 20 (IQR, 0-26) ventilator-free days (1-sided 95% CI, -0.00003 to ∞). There was no significant difference in length of stay or mortality, or in the proportion of patients developing pulmonary complications, between the 2 groups. Adverse events (13.8% vs 29.3%; difference, -15.5% [95% CI, -20.7% to -10.3%]; P < .001) were more frequent with routine nebulization and mainly related to tachyarrhythmia (12.5% vs 25.9%; difference, -13.4% [95% CI, -18.4% to -8.4%]; P < .001) and agitation (0.2% vs 4.3%; difference, -4.1% [95% CI, -5.9% to -2.2%]; P < .001). Among ICU patients receiving invasive ventilation who were expected to not be extubated within 24 hours, on-demand compared with routine nebulization of

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

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.

6. VIEW LOOKING SOUTHEAST AT VENTILATION EQUIPMENT IN SOUTH VENTILATION ...

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

6. VIEW LOOKING SOUTHEAST AT VENTILATION EQUIPMENT IN SOUTH VENTILATION HOUSE. THIS AIR CONDITIONING SYSTEM WAS INSTALLED BY PARKS-CRAMER COMPANY OF FITCHBURG, MASSACHUSETTS WHEN THE MILL WAS CONSTRUCTED IN 1923-24. ONE AIR WASHER AND FAN ROOM EXTERIOR IS VISIBLE ON THE RIGHT. THE DUCTS FROM BOTH FAN ROOMS (CURVED METAL STRUCTURES AT CENTER AND LEFT OF PHOTO) ARE CONNECTED TO A COMMON AIR SHAFT. - Stark Mill, 117 Corinth Road, Hogansville, Troup County, GA

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

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...

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.

49 CFR 238.423 - Fuel tanks.

Code of Federal Regulations, 2010 CFR

2010-10-01

....423 Fuel tanks. (a) External fuel tanks. Each type of external fuel tank must be approved by FRA's... equivalent to a fuel tank that complies with the external fuel tank requirements in § 238.223(a). (b) Internal fuel tanks. Internal fuel tanks shall comply with the requirements specified in § 238.223(b). ...

Annual Report, Fall 2016: Identifying Cost Effective Tank Waste Characterization Approaches

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

Reboul, S. H.; DiPrete, D. P.

2016-12-12

This report documents the activities that were performed during the second year of a project undertaken to improve the cost effectiveness and timeliness of SRNL’s tank closure characterization practices. The activities performed during the first year of the project were previously reported in SRNL-STI-2015-00144. The scope of the second year activities was divided into the following three primary tasks: 1) develop a technical basis and strategy for improving the cost effectiveness and schedule of SRNL’s tank closure characterization program; 2) initiate the design and assembly of a new waste removal system for improving the throughput and reducing the personnel dosemore » associated with extraction chromatography radiochemical separations; and 3) develop and perform feasibility testing of three alternative radiochemical separation protocols holding promise for improving high resource demand/time consuming tank closure sample analysis methods.« less

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...

Tank characterization report for single-shell tank 241-U-110. Revision 1

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

Brown, T.M.; Jensen, L.

1993-09-01

Tank 241-U-110 (U-110) is a Hanford Site waste tank that was ;most recently sampled in November and December 1989. Analysis of the samples obtained from tank U-110 was conducted to support the characterization of the contents of this tank and to support Hanford Federal Facility Agreement and Consent Order milestone M-10-00 (Ecology, et al. 1992). Because of incomplete recovery of the waste during sampling, there may be bias in the results of this characterization report.

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.

Protective mechanical ventilation during general anesthesia for open abdominal surgery improves postoperative pulmonary function.

PubMed

Severgnini, Paolo; Selmo, Gabriele; Lanza, Christian; Chiesa, Alessandro; Frigerio, Alice; Bacuzzi, Alessandro; Dionigi, Gianlorenzo; Novario, Raffaele; Gregoretti, Cesare; de Abreu, Marcelo Gama; Schultz, Marcus J; Jaber, Samir; Futier, Emmanuel; Chiaranda, Maurizio; Pelosi, Paolo

2013-06-01

The impact of intraoperative ventilation on postoperative pulmonary complications is not defined. The authors aimed at determining the effectiveness of protective mechanical ventilation during open abdominal surgery on a modified Clinical Pulmonary Infection Score as primary outcome and postoperative pulmonary function. Prospective randomized, open-label, clinical trial performed in 56 patients scheduled to undergo elective open abdominal surgery lasting more than 2 h. Patients were assigned by envelopes to mechanical ventilation with tidal volume of 9 ml/kg ideal body weight and zero-positive end-expiratory pressure (standard ventilation strategy) or tidal volumes of 7 ml/kg ideal body weight, 10 cm H2O positive end-expiratory pressure, and recruitment maneuvers (protective ventilation strategy). Modified Clinical Pulmonary Infection Score, gas exchange, and pulmonary functional tests were measured preoperatively, as well as at days 1, 3, and 5 after surgery. Patients ventilated protectively showed better pulmonary functional tests up to day 5, fewer alterations on chest x-ray up to day 3 and higher arterial oxygenation in air at days 1, 3, and 5 (mmHg; mean ± SD): 77.1 ± 13.0 versus 64.9 ± 11.3 (P = 0.0006), 80.5 ± 10.1 versus 69.7 ± 9.3 (P = 0.0002), and 82.1 ± 10.7 versus 78.5 ± 21.7 (P = 0.44) respectively. The modified Clinical Pulmonary Infection Score was lower in the protective ventilation strategy at days 1 and 3. The percentage of patients in hospital at day 28 after surgery was not different between groups (7 vs. 15% respectively, P = 0.42). A protective ventilation strategy during abdominal surgery lasting more than 2 h improved respiratory function and reduced the modified Clinical Pulmonary Infection Score without affecting length of hospital stay.

National Trends (2009-2013) for Palliative Care Utilization for Patients Receiving Prolonged Mechanical Ventilation.

PubMed

Chatterjee, Kshitij; Goyal, Abhinav; Kakkera, Krishna; Harrington, Sarah; Corwin, Howard L

2018-05-04

Patients requiring mechanical ventilation have high morbidity and mortality. Providing palliative care services has been suggested as a way to improve comprehensive management of critically ill patients. We examined the trend in the utilization of palliative care among adults who require prolonged mechanical ventilation. Primary objectives were to determine the trend in palliative care utilization over time, predictors for palliative care utilization, and palliative care impact on hospital length of stay. Retrospective, cross-sectional study. The National Inpatient Sample data between 2009 and 2013 was used for this study. Adults (age ≥ 18 yr) who underwent prolonged mechanical ventilation (≥ 96 consecutive hr) were studied. Palliative care and mechanical ventilation were identified using the corresponding International Classification of Diseases, 9th revision, Clinical Modification, codes. A total of 1,751,870 hospitalizations with prolonged mechanical ventilation were identified between 2009 and 2013. The utilization of palliative care increased yearly from 6.5% in 2009 to 13.1% in 2013 (p < 0.001). Among the mechanically ventilated patients who died, palliative care increased from 15.9% in 2009 to 33.3% in 2013 (p < 0.001). Median hospital length of stay for patients with and without palliative care was 13 and 17 days, respectively (p < 0.001). Patients discharged to either short- or long-term care facilities had a shorter length of stay if palliative care was provided (15 vs 19 d; p < 0.001). The factors associated with a higher palliative care utilization included older age, malignancy, larger hospitals in urban areas, and teaching hospitals. Non-Caucasian race was associated with lower palliative care utilization. Among patients who undergo prolonged mechanical ventilation, palliative care utilization is increasing, particularly in patients who die during hospitalization. Using palliative care for mechanically ventilated patients who are discharged to

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

PubMed

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

2017-12-01

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

Developments in the safe design of LNG tanks

NASA Astrophysics Data System (ADS)

Fulford, N. J.; Slatter, M. D.

The objective of this paper is to discuss how the gradual development of design concepts for liquefied natural gas (LNG) storage systems has helped to enhance storage safety and economy. The experience in the UK is compared with practice in other countries with similar LNG storage requirements. Emphasis is placed on the excellent record of safety and reliability exhibited by tanks with a primary metal container designed and constructed to approved standards. The work carried out to promote the development of new materials, fire protection, and monitoring systems for use in LNG storage is also summarized, and specific examples described from British Gas experience. Finally, the trends in storage tank design world-wide and options for future design concepts are discussed, bearing in mind planned legislation and design codes governing hazardous installations.

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...

[Ventilator associated pneumonia].

PubMed

Bellani, S; Nesci, M; Celotto, S; Lampati, L; Lucchini, A

2003-04-01

Ventilator associated pneumonia (VAP) is a nosocomial lower respiratory tract infection that ensues in critically ill patients undergoing mechanical ventilation. The reported incidence of VAP varies between 9% and 68% with a mortality ranging between 33% and 71%. Two key factors are implicated in the pathogenesis of VAP: bacterial colonization of the upper digestive-respiratory tract and aspiration of oral secretions into the trachea. Preventive measurements are advocated to reduce the incidence of VAP, such as selective decontamination of the digestive tract (SDD), supraglottic aspiration and positioning. Prompt recognition and treatment of established VAP has also been demostrated to affect outcome. Therefore, the knowledge of risk factors associated with the development of VAP and the implementation of strategies to prevent, diagnose and treat VAP are mainstems in the nursing of mechanically ventilated patients.

Tank characterization report for single-shell tank 241-S-111

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

Conner, J.M.

1997-04-28

One of the major functions of the Tank Waste Remediation System (TWRS) is to characterize wastes in support of waste management and disposal activities at the Hanford Site. Analytical data from sampling and analysis, along with other available information about a tank, are compiled and maintained in a tank characterization report (TCR). This report and its appendices serve as the TCR for single-shell tank 241-S-111. The objectives of this report are: (1) to use characterization data to address technical issues associated with tank 241-S-111 waste; and (2) to provide a standard characterization of this waste in terms of a best-basismore » inventory estimate. The response to technical issues is summarized in Section 2.0, and the best-basis inventory estimate is presented in Section 3.0. Recommendations regarding safety status and additional sampling needs are provided in Section 4.0. Supporting data and information are contained in the appendices. This report also supports the requirements of Hanford Federal Facility Agreement and Consent Order (Ecology et al. 1996) milestone M-44-10.« less

Creating Innovative Research Designs: The 10-Year Methodological Think Tank Case Study

PubMed Central

Katerndahl, David; Crabtree, Benjamin

2006-01-01

PURPOSE Addressing important but complex research questions often necessitates the creation of innovative mixed methods designs. This report describes an approach to developing research designs for studying important but methodologically challenging research questions. METHODS The Methodological Think Tank has been held annually in conjunction with the Primary Care Research Methods and Statistics Conference in San Antonio since 1994. A group of 3 to 4 methodologists with expertise balanced between quantitative and qualitative backgrounds is invited by the think tank coordinators to serve on a 2-day think tank to discuss a research question selected from those submitted in response to a call for proposals. During the first half-day, these experts explore the content area with the investigator, often challenging beliefs and assumptions. During the second half-day, the think tank participants systematically prune potential approaches until a desirable research method is identified. RESULTS To date, the most recent 7 think tanks have produced fundable research designs, with 1 being funded by a K award and 4 by R01 grants. All participating investigators attributed much of their success to think tank participation. Lessons learned include (1) the importance of careful selection of participating methodologists, (2) all think tank communities of inquiry must go through 4 stages of development from pseudocommunity to community, and (3) the critical importance of listening by the investigator. CONCLUSION Researchers and academic departments could use this process locally to develop innovative research designs. PMID:17003146

Electrical Resistivity Imaging Below Nuclear Waste Tank Farms at the Hanford Site

NASA Astrophysics Data System (ADS)

Rucker, D. F.; Levitt, M. T.

2006-12-01

The Hanford Site, a Department of Energy nuclear processing facility in eastern Washington, contains a complex series of radiological liquid waste disposal and storage facilities. The primary method of interim storage is the use of large single-shelled steel tanks with capacities of up to 3790 m3 (1 million gallons). The tanks are organized below ground into tank farms, with about 12 tanks per farm. The liquid waste within the tanks is primarily comprised of inorganic salts with minor constituents of heavy metals and radiological metals. The electrical properties of the radiological waste are significantly different to that of the surrounding engineered fill and native geologic formations. Over the past 60 years since the earliest tanks have been in use, many have been known to leak. An electrical resistivity survey was conducted within a tank farm to map the extent of the plumes resulting from historic leaks. Traditional surface-based electrical resistivity surveys resulted in unusable data due to the significant subsurface infrastructure that included a network of delivery pipes, wells, fences, and electrical discharge sources . HGI adapted the resistivity technique to include the site infrastructure as transceivers to augment data density and geometry. The results show a distribution of low resistivity values within the farm in areas that match known historic leak sites. The addition of site infrastructure as sensors demonstrates that the electrical resistivity technique can be used in highly industrial sites.

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

Tank Closure Progress at the Department of Energy's Idaho National Engineering Laboratory Tank Farm Facility

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

Lockie, K.A.; Suttora, L.C.; Quigley, K.D.

2007-07-01

Significant progress has been made at the U.S. Department of Energy (DOE) Idaho National Laboratory (INL) to clean and close emptied radioactive liquid waste storage tanks at the Idaho Nuclear Technology and Engineering Center (INTEC) Tank Farm Facility (TFF). The TFF includes eleven 1,135.6-kL (300,000-gal) underground stainless steel storage tanks and four smaller, 113.5-kL (30,000-gal) stainless steel tanks, along with tank vaults, interconnecting piping, and ancillary equipment. The TFF tanks have historically been used to store a variety of radioactive liquid waste, including wastes associated with past spent nuclear fuel reprocessing. Although four of the large storage tanks remain inmore » use for waste storage, the other seven 1,135.6-kL (300,000-gal) tanks and the four 113.5-kL (30,000-gal) tanks have been emptied of waste and cleaned in preparation of final closure. A water spray cleaning system was developed and deployed to clean internal tank surfaces and remove remaining tank wastes. The cleaning system was effective in removing all but a very small volume of solid residual waste particles. Recent issuance of an Amended Record of Decision (ROD) in accordance with the National Environmental Policy Act, and a Waste Determination complying with Section 3116 of the Ronald W. Reagan National Defense Authorization Act (NDAA) for Fiscal Year 2005, has allowed commencement of grouting activities on the cleaned tanks. In November 2006, three of the 113.5-kL (30,000-gal) tanks were filled with grout to provide long-term stability. It is currently planned that all seven cleaned 1,135.6-kL (300,000-gal) tanks, as well as the four 113.5-kL (30,000-gal) tanks and all associated tank vaults and interconnecting piping, will be stabilized with grout as early as 2008. (authors)« less

View of tanks T18 and T19 with redwood tanks to ...

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

View of tanks T18 and T19 with redwood tanks to right. Old rain shed (Building No. 43) can be seen behind the tanks. Ground catchment can be seen at left in background. - Hawaii Volcanoes National Park Water Collection System, Hawaii Volcanoes National Park, Volcano, Hawaii County, HI

Investigation of induced recirculation during planned ventilation system maintenance

PubMed Central

Pritchard, C.J.; Scott, D.F.; Noll, J.D.; Voss, B.; Leonis, D.

2015-01-01

The Office of Mine Safety and Health Research (OMSHR) investigated ways to increase mine airflow to underground metal/nonmetal (M/NM) mine working areas to improve miners’ health and safety. One of those areas is controlled recirculation. Because the quantity of mine air often cannot be increased, reusing part of the ventilating air can be an effective alternative, if implemented properly, until the capacity of the present system is improved. The additional airflow can be used to provide effective dilution of contaminants and higher flow velocities in the underground mine environment. Most applications of controlled recirculation involve taking a portion of the return air and passing it back into the intake to increase the air volume delivered to the desired work areas. OMSHR investigated a Nevada gold mine where shaft rehabilitation was in progress and one of the two main fans was shut down to allow reduced air velocity for safe shaft work. Underground booster fan operating pressures were kept constant to maintain airflow to work areas, inducing controlled recirculation in one work zone. Investigation into system behavior and the effects of recirculation on the working area during times of reduced primary ventilation system airflow would provide additional information on implementation of controlled recirculation into the system and how these events affect M/NM ventilation systems. The National Institute for Occupational Safety and Health monitored the ventilation district when both main fans were operating and another scenario with one of the units turned off for maintenance. Airflow and contaminants were measured to determine the exposure effects of induced recirculation on miner health. Surveys showed that 19% controlled recirculation created no change in the overall district airflow distribution and a small reduction in district fresh air intake. Total dust levels increased only modestly and respirable dust levels were also low. Diesel particulate matter

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

PubMed

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

2015-07-01

Recent studies show that intraoperative mechanical ventilation using low tidal volumes (VT) can prevent postoperative pulmonary complications (PPCs). The aim of this individual patient data meta-analysis is to evaluate the individual associations between VT size and positive end-expiratory pressure (PEEP) level and occurrence of PPC. Randomized controlled trials comparing protective ventilation (low VT with or without high levels of PEEP) and conventional ventilation (high VT with low PEEP) in patients undergoing general surgery. The primary outcome was development of PPC. Predefined prognostic factors were tested using multivariate logistic regression. Fifteen randomized controlled trials were included (2,127 patients). There were 97 cases of PPC in 1,118 patients (8.7%) assigned to protective ventilation and 148 cases in 1,009 patients (14.7%) assigned to conventional ventilation (adjusted relative risk, 0.64; 95% CI, 0.46 to 0.88; P < 0.01). There were 85 cases of PPC in 957 patients (8.9%) assigned to ventilation with low VT and high PEEP levels and 63 cases in 525 patients (12%) assigned to ventilation with low VT and low PEEP levels (adjusted relative risk, 0.93; 95% CI, 0.64 to 1.37; P = 0.72). A dose-response relationship was found between the appearance of PPC and VT size (R2 = 0.39) but not between the appearance of PPC and PEEP level (R2 = 0.08). These data support the beneficial effects of ventilation with use of low VT in patients undergoing surgery. Further trials are necessary to define the role of intraoperative higher PEEP to prevent PPC during nonopen abdominal surgery.

Nebulized heparin is associated with fewer days of mechanical ventilation in critically ill patients: a randomized controlled trial.

PubMed

Dixon, Barry; Schultz, Marcus J; Smith, Roger; Fink, James B; Santamaria, John D; Campbell, Duncan J

2010-01-01

Prolonged mechanical ventilation has the potential to aggravate or initiate pulmonary inflammation and cause lung damage through fibrin deposition. Heparin may reduce pulmonary inflammation and fibrin deposition. We therefore assessed whether nebulized heparin improved lung function in patients expected to require prolonged mechanical ventilation. Fifty patients expected to require mechanical ventilation for more than 48 hours were enrolled in a double-blind randomized placebo-controlled trial of nebulized heparin (25,000 U) or placebo (normal saline) 4 or 6 hourly, depending on patient height. The study drug was continued while the patient remained ventilated to a maximum of 14 days from randomization. Nebulized heparin was not associated with a significant improvement in the primary end-point, the average daily partial pressure of oxygen to inspired fraction of oxygen ratio while mechanically ventilated, but was associated with improvement in the secondary end-point, ventilator-free days amongst survivors at day 28 (22.6 ± 4.0 versus 18.0 ± 7.1, treatment difference 4.6 days, 95% CI 0.9 to 8.3, P = 0.02). Heparin administration was not associated with any increase in adverse events. Nebulized heparin was associated with fewer days of mechanical ventilation in critically ill patients expected to require prolonged mechanical ventilation. Further trials are required to confirm these findings. The Australian Clinical Trials Registry (ACTR-12608000121369).

49 CFR 179.200 - General specifications applicable to non-pressure tank car tanks (Class DOT-111).

Code of Federal Regulations, 2010 CFR

2010-10-01

... tank car tanks (Class DOT-111). 179.200 Section 179.200 Transportation Other Regulations Relating to Transportation PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION HAZARDOUS MATERIALS REGULATIONS SPECIFICATIONS FOR TANK CARS Specifications for Non-Pressure Tank Car Tanks (Classes...

49 CFR 173.314 - Compressed gases in tank cars and multi-unit tank cars.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 2 2010-10-01 2010-10-01 false Compressed gases in tank cars and multi-unit tank cars. 173.314 Section 173.314 Transportation Other Regulations Relating to Transportation PIPELINE AND... Compressed gases in tank cars and multi-unit tank cars. (a) Definitions. For definitions of compressed gases...

49 CFR 173.314 - Compressed gases in tank cars and multi-unit tank cars.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 2 2011-10-01 2011-10-01 false Compressed gases in tank cars and multi-unit tank cars. 173.314 Section 173.314 Transportation Other Regulations Relating to Transportation PIPELINE AND... Compressed gases in tank cars and multi-unit tank cars. (a) Definitions. For definitions of compressed gases...

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

PubMed

Cheng, Y; Lin, Z

2015-12-01

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

Supporting document for the historical tank content estimate for AY-tank farm

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

Brevick, C H; Stroup, J L; Funk, J. W.

1997-03-12

This Supporting Document provides historical in-depth characterization information on AY-Tank Farm, such as historical waste transfer and level data, tank physical information, temperature plots, liquid observation well plots, chemical analyte and radionuclide inventories for the Historical Tank Content Estimate Report for the Southeast Quadrant of the Hanford 200 Areas.

49 CFR 179.200 - General specifications applicable to non-pressure tank car tanks (Class DOT-111).

Code of Federal Regulations, 2013 CFR

2013-10-01

... tank car tanks (Class DOT-111). 179.200 Section 179.200 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) SPECIFICATIONS FOR TANK CARS Specifications for Non-Pressure Tank Car Tanks (Classes DOT-111AW...

49 CFR 179.200 - General specifications applicable to non-pressure tank car tanks (Class DOT-111).

Code of Federal Regulations, 2014 CFR

2014-10-01

... tank car tanks (Class DOT-111). 179.200 Section 179.200 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) SPECIFICATIONS FOR TANK CARS Specifications for Non-Pressure Tank Car Tanks (Classes DOT-111AW...

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.

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

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...

Space station ventilation study

NASA Technical Reports Server (NTRS)

Colombo, G. V.; Allen, G. E.

1972-01-01

A ventilation system design and selection method which is applicable to any manned vehicle were developed. The method was used to generate design options for the NASA 33-foot diameter space station, all of which meet the ventilation system design requirements. System characteristics such as weight, volume, and power were normalized to dollar costs for each option. Total system costs for the various options ranged from a worst case $8 million to a group of four which were all approximately $2 million. A system design was then chosen from the $2 million group and is presented in detail. A ventilation system layout was designed for the MSFC space station mockup which provided comfortable, efficient ventilation of the mockup. A conditioned air distribution system design for the 14-foot diameter modular space station, using the same techniques, is also presented. The tradeoff study resulted in the selection of a system which costs $1.9 million, as compared to the alternate configuration which would have cost $2.6 million.

Characterization of the potential impact of retention tank emptying on wastewater primary treatment: a new element for CSO management.

PubMed

Maruejouls, T; Lessard, P; Wipliez, B; Pelletier, G; Vanrolleghem, P A

2011-01-01

Theoretical studies have shown that discharges from retention tanks could have a negative impact on the WWTP's (Wastewater Treatment Plant) effluent. Characterization of such discharges is necessary to better understand these impacts. This study aims at: (1) characterizing water quality during emptying of a tank; and (2) characterizing the temporal variation of settling velocities of the waters released to the WWTP. Two full-scale sampling campaigns (18 rain events) have been realized in Quebec City and laboratory analyses have shown a wide variability of total suspended solids (TSS) and Chemical Oxygen Demand (COD) concentrations in the water released from the tank. Suspended solids seem to settle quickly because they are only found in large amounts during the first 15 min of pumping to the WWTP. These solids are hypothesized to come from the pumping in which solids remained after a previous event. When these solids are evacuated, low TSS containing waters are pumped from the retention tank. A second concentration peak occurs at the end of the emptying period when the tank is cleaned with wash water. Finally, settling velocity studies allowed characterizing combined sewer wastewaters by separating three main fractions of pollutants which correspond to the beginning, middle and end of emptying. In most cases, it is noticed that particle settling velocities increase as the pollutant load increases.

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.

STATISTICAL ANALYSIS OF TANK 5 FLOOR SAMPLE RESULTS

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

Shine, E.

2012-03-14

Sampling has been completed for the characterization of the residual material on the floor of Tank 5 in the F-Area Tank Farm at the Savannah River Site (SRS), near Aiken, SC. The sampling was performed by Savannah River Remediation (SRR) LLC using a stratified random sampling plan with volume-proportional compositing. The plan consisted of partitioning the residual material on the floor of Tank 5 into three non-overlapping strata: two strata enclosed accumulations, and a third stratum consisted of a thin layer of material outside the regions of the two accumulations. Each of three composite samples was constructed from five primarymore » sample locations of residual material on the floor of Tank 5. Three of the primary samples were obtained from the stratum containing the thin layer of material, and one primary sample was obtained from each of the two strata containing an accumulation. This report documents the statistical analyses of the analytical results for the composite samples. The objective of the analysis is to determine the mean concentrations and upper 95% confidence (UCL95) bounds for the mean concentrations for a set of analytes in the tank residuals. The statistical procedures employed in the analyses were consistent with the Environmental Protection Agency (EPA) technical guidance by Singh and others [2010]. Savannah River National Laboratory (SRNL) measured the sample bulk density, nonvolatile beta, gross alpha, radionuclide, inorganic, and anion concentrations three times for each of the composite samples. The analyte concentration data were partitioned into three separate groups for further analysis: analytes with every measurement above their minimum detectable concentrations (MDCs), analytes with no measurements above their MDCs, and analytes with a mixture of some measurement results above and below their MDCs. The means, standard deviations, and UCL95s were computed for the analytes in the two groups that had at least some measurements above

Statistical Analysis of Tank 5 Floor Sample Results

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

Shine, E. P.

2013-01-31

Sampling has been completed for the characterization of the residual material on the floor of Tank 5 in the F-Area Tank Farm at the Savannah River Site (SRS), near Aiken, SC. The sampling was performed by Savannah River Remediation (SRR) LLC using a stratified random sampling plan with volume-proportional compositing. The plan consisted of partitioning the residual material on the floor of Tank 5 into three non-overlapping strata: two strata enclosed accumulations, and a third stratum consisted of a thin layer of material outside the regions of the two accumulations. Each of three composite samples was constructed from five primarymore » sample locations of residual material on the floor of Tank 5. Three of the primary samples were obtained from the stratum containing the thin layer of material, and one primary sample was obtained from each of the two strata containing an accumulation. This report documents the statistical analyses of the analytical results for the composite samples. The objective of the analysis is to determine the mean concentrations and upper 95% confidence (UCL95) bounds for the mean concentrations for a set of analytes in the tank residuals. The statistical procedures employed in the analyses were consistent with the Environmental Protection Agency (EPA) technical guidance by Singh and others [2010]. Savannah River National Laboratory (SRNL) measured the sample bulk density, nonvolatile beta, gross alpha, and the radionuclide1, elemental, and chemical concentrations three times for each of the composite samples. The analyte concentration data were partitioned into three separate groups for further analysis: analytes with every measurement above their minimum detectable concentrations (MDCs), analytes with no measurements above their MDCs, and analytes with a mixture of some measurement results above and below their MDCs. The means, standard deviations, and UCL95s were computed for the analytes in the two groups that had at least some

Statistical Analysis Of Tank 5 Floor Sample Results

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

Shine, E. P.