Aid Of Mechanical Ventilation Research Articles

Establishing Indoor Comfort Temperature (Neutral Temperature) in Naturally Ventilated (NV) Office Buildings in Jos, Nigeria

The aim of the research is to grant understanding to the concept of thermal sensation, acclimatization and by extension establishing Neutral Temperature for office users. The Neutral Temperature is the indoor temperature in which an average office occupant feels comfortable without the aid of mechanical ventilation. Ten (10) naturally ventilated (NV) office buildings were randomly selected within Jos urban conurbation in northern Nigeria. Using research techniques established by Han et al (2007), Wang (2006) and Becker et al (2002) which are adaptive in nature, the research established a Neutral Temperature of 29.4 o C for the occupants of these building types. This Neutral Temperature is 4.34 o C higher than that established by Ogbonna & Harris 2007 in similar locality i.e northern Nigeria. It is also 0.31 o C higher than that executed in a warm humid climate of southern Nigeria (Adebamowo, 2007). It should be noted here that the aforementioned researches were conducted for residential buildings where factors such as activity level, adaptation, level of clothing of respondents and ambient weather differed. The research recommends further studies using similar methodology but in varying seasons and geographical locations. This is to establish further credence to indoor thermal comfort studies using the adaptive method. Keywords: Neutral Temperature, Acclimatization, Thermal Sensation, Adaptive Model, Productivity, Sustainability. DOI: 10.7176/JETP/10-3-05 Publication date: July 31 st 2020

Simulation Study of a Naturally Ventilated Building Integrated Photovoltaic (BIPV) Envelope

This paper addresses the numerical simulation of a partially transparent, ventilated PV façade designed for cooling in summer (by natural convection) and for heat recovery in winter (with the aid of mechanical ventilation). For both configurations, air in the cavity between the two building skins (photovoltaic façade and the primary building wall) is heated by transmission through transparent glazed sections, and by convective and radiative exchange. First we describe the model for the naturally ventilated envelope. Validation of the model and the subsequent simulation of a building-coupled system are then presented, which were undertaken using experimental data from the RESSOURCES project (ANR-PREBAT 2007). The dataset comprise measurements from a full scale prototype system installed on a real office building in Toulouse, France. Finally the heating and cooling needs of a simulated building were calculated and the impact of climatic variations on the system performance was investigated. The PV double-skin was found to result in a slight increase in cooling needs for all the French climates considered, whereas the impact of the façade on heating needs was found to be not predominant from point of view energetic.

High-protein enteral nutrition enriched with immune-modulating nutrients vs standard high-protein enteral nutrition and nosocomial infections in the ICU: a randomized clinical trial.

Enteral administration of immune-modulating nutrients (eg, glutamine, omega-3 fatty acids, selenium, and antioxidants) has been suggested to reduce infections and improve recovery from critical illness. However, controversy exists on the use of immune-modulating enteral nutrition, reflected by lack of consensus in guidelines. To determine whether high-protein enteral nutrition enriched with immune-modulating nutrients (IMHP) reduces the incidence of infections compared with standard high-protein enteral nutrition (HP) in mechanically ventilated critically ill patients. The MetaPlus study, a randomized, double-blind, multicenter trial, was conducted from February 2010 through April 2012 including a 6-month follow-up period in 14 intensive care units (ICUs) in the Netherlands, Germany, France, and Belgium. A total of 301 adult patients who were expected to be ventilated for more than 72 hours and to require enteral nutrition for more than 72 hours were randomized to the IMHP (n = 152) or HP (n = 149) group and included in an intention-to-treat analysis, performed for the total population as well as predefined medical, surgical, and trauma subpopulations. High-protein enteral nutrition enriched with immune-modulating nutrients vs standard high-protein enteral nutrition, initiated within 48 hours of ICU admission and continued during the ICU stay for a maximum of 28 days. The primary outcome measure was incidence of new infections according to the Centers for Disease Control and Prevention (CDC) definitions. Secondary end points included mortality, Sequential Organ Failure Assessment (SOFA) scores, mechanical ventilation duration, ICU and hospital lengths of stay, and subtypes of infections according CDC definitions. There were no statistically significant differences in incidence of new infections between the groups: 53% (95% CI, 44%-61%) in the IMHP group vs 52% (95% CI, 44%-61%) in the HP group (P = .96). No statistically significant differences were observed in other end points, except for a higher 6-month mortality rate in the medical subgroup: 54% (95% CI, 40%-67%) in the IMHP group vs 35% (95% CI, 22%-49%) in the HP group (P = .04), with a hazard ratio of 1.57 (95% CI, 1.03-2.39; P = .04) for 6-month mortality adjusted for age and Acute Physiology and Chronic Health Evaluation II score comparing the groups. Among adult patients breathing with the aid of mechanical ventilation in the ICU, IMHP compared with HP did not improve infectious complications or other clinical end points and may be harmful as suggested by increased adjusted mortality at 6 months. These findings do not support the use of IMHP nutrients in these patients. trialregister.nl Identifier: NTR2181.

A Simple Modification Results in Greater Success in the Model of Coronary Artery Ligation and Myocardial Ischemia in Mice

Mouse models of myocardial ischemic preconditioning (IPC) and ischemic postconditioning (IPD) have proven to be very useful models of cardiovascular diseases. In 2010, Gao described a novel procedure without the aid of mechanical ventilation. However, the technique of heart externalization could not be applied to mouse models of IPC or IPD due to the limited time frame of the technique. We proposed a modified simple and safe method using lung recruitment and short-term ventilation to perform the procedure in mice with IPC or IPD. The mice were randomly divided into 4 groups: the modified groups, M-IPC and M-IPD, and the conventional groups, C-IPC and C-IPD. In the 2 modified groups, the mice were removed from the ventilator and allowed to resume breathing spontaneously upon completion of the lung recruitment and the rapid closure of the thorax. Our study demonstrated that the postoperative recovery time was significantly reduced for the modified groups compared with the 2 conventional groups. Moreover, the inflammatory damages were attenuated by the modified method compared with the conventional method. In addition, the modified method significantly increased the survival rates of mice with IPC or IPD. The modified method improved the survival rates of mouse models of myocardial ischemia.

Phrenic Nerve Stimulation for Diaphragm Pacing in a Quadriplegic Patient

Chronic hypoventilation due to injury to the brain stem respiratory center or high cervical cord (above the C3 level) can result in dependence to prolonged mechanical ventilation with tracheostomy, frequent nosocomial pneumonia, and prolonged hospitalization. Diaphragm pacing through electrical stimulation of the phrenic nerve is an established treatment for central hypoventilation syndrome. We performed chronic phrenic nerve stimulation for diaphragm pacing with the spinal cord stimulator for pain control in a quadriplegic patient with central apnea due to complete spinal cord injury at the level of C2 from cervical epidural hematoma. After diaphragmatic pacing, the patient who was completely dependent on the mechanical ventilator could ambulate up to three hours every day without aid of mechanical ventilation during the 12 months of follow-up. Diaphragm pacing through unilateral phrenic nerve stimulation with spinal cord stimulator was feasible in an apneic patient with complete quadriplegia who was completely dependent on mechanical ventilation. Diaphragm pacing with the spinal cord stimulator is feasible and effective for the treatment of the central hypoventilation syndrome.

Decapitation and the definition of death

Although established in the law and current practice, the determination of death according to neurological criteria continues to be controversial. Some scholars have advocated return to the traditional circulatory and...

The Incoherence of Determining Death by Neurological Criteria: A Commentary on Controversies in the Determination of Death , A White Paper by the President’s Council on Bioethics

Traditionally the cessation of breathing and heart beat has marked the passage from life to death. Shortly after death was determined, the body became a cold corpse, suitable for burial or cremation. Two technological changes in the second half of the twentieth century prompted calls for a new, or at least expanded, definition of death: the development of intensive care medicine, especially the use of mechanical ventilators, and the advent of successful transplantation of vital organs. Patients with profound neurological damage, leaving them incapable of breathing on their own and in an irreversible coma, could be maintained for some period of time with the aid of mechanical ventilation. The situation of these patients posed two ethical questions. Is it appropriate to stop life-sustaining treatment? If so, is it acceptable to retrieve vital organs for transplantation to save the lives of others before stopping treatment? In 1968, the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death proposed that death could be determined on the basis of neurological criteria, thus providing a positive answer to these two questions (Ad Hoc Committee 1968). According to the position of this committee, patients diagnosed with the cessation of brain function are dead, despite the fact that they breathe and circulate blood with the aid of mechanical ventilation.

Endoscopic Intubation with Aid of Mechanical Ventilation via a Dedicated Nasopharyngeal Airway

A young child with jaw-neck-sternum immobility suffering from acute upper airway obstruction was treated with nasotracheal intubation using flexible endoscope (FE). During this difficult intubation, an inserted trimming endotracheal tube acted as a nasopharyngeal airway and simultaneous supplement with mechanical ventilation through the tube successfully resuscitated and improved the patients ventilation and oxygenation. This management can greatly facilitate visualization of the laryngeal apparatus and translaryngeal passage of the FE. This technique can be helpful in resuscitative ventilation and difficult intubation in a critical upper airway emergency.

Echogenic intravascular and hepatic microbubbles associated with necrotizing enterocolitis

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Prognosis of children surviving with the aid of mechanical ventilation in the newborn period

Fifty-five infants who survived respiratory failure in the neonatal period with the aid of assisted ventilation were studied in order to evaluate their long-term prognosis. Over 80 per cent of these infants had normal intelligence and either minimal or no neurologic abnormalities. Only four infants had I.Q. scores of less than 85. The incidence of neurologic and intellectual handicaps was highest in low-birth-weight infants (