Abstract
Unidirectional flow air-conditioning systems are suitable for achieving indoor air quality required in high-performance operating rooms (organ transplants, cardiac surgery, aorta, orthopedic, burns, etc.). This paper analyzes indoor environmental conditions and technical and hygienic requirements for the design of heating, ventilation, and air-Conditioning (HVAC) systems for high-performance operating theatres. The main standards applicable to this type of operating rooms were compiled. Standard UNE 100713:2015, ASHRAE Standard 170-2017, and the European pre-norm EN 16244 were analyzed. A case study shows the lack of uniformity in design criteria and their ranges of values, which generates different design approaches. It was concluded that using these standards applicable to high-performance operating rooms leads to very different indoor environmental conditions for patients and medical personnel—air velocity profiles, air movement pattern, temperature, relative humidity gradients, and pressure stratification. Computational fluid dynamics (CFD) studies have been shown to detect areas of haven that favor microbiological load accumulation. In this way, it is possible to define cleaning protocols to attend these anomalies in a preventive way.
Highlights
The heating, ventilation, and air-Conditioning (HVAC) system of a hospital operating theatre determines the level of sepsis that can be achieved in the surgical field [1]
The risk of getting a nosocomial infection is conditioned by several factors—the patient himself, due to his state of health, the characteristics of the room where he/she is, factors relating to medical procedures, factors relating to HVAC system [4], sectioning of the surgical block, and construction works in the facilities [9]
EN 16244 is based on ISO 14644 of International Organization for Standardization (ISO) classification which establishes environmental requirements in nine categories
Summary
The heating, ventilation, and air-Conditioning (HVAC) system of a hospital operating theatre determines the level of sepsis that can be achieved in the surgical field [1]. Indoor air quality (IAQ) of a surgical room is directly related to the risk of acquiring a nosocomial infection [5]. The risk of getting a nosocomial infection is conditioned by several factors—the patient himself, due to his state of health (immune system), the characteristics of the room where he/she is (degree of cleanliness and presence of contaminants), factors relating to medical procedures (techniques and their application, clothing and protective elements, etc.), factors relating to HVAC system (air changes per hour, air movement pattern, air residence time, etc.) [4], sectioning of the surgical block, and construction works in the facilities [9]. SSI rate is one of the indicators used internationally to quantify the quality of medical services [10]
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