4 resultados para Invasive mechanical ventilation

em CentAUR: Central Archive University of Reading - UK


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Purpose – To evaluate the control strategy for a hybrid natural ventilation wind catchers and air-conditioning system and to assess the contribution of wind catchers to indoor air environments and energy savings if any. Design/methodology/approach – Most of the modeling techniques for assessing wind catchers performance are theoretical. Post-occupancy evaluation studies of buildings will provide an insight into the operation of these building components and help to inform facilities managers. A case study for POE was presented in this paper. Findings – The monitoring of the summer and winter month operations showed that the indoor air quality parameters were kept within the design target range. The design control strategy failed to record data regarding the operation, opening time and position of wind catchers system. Though the implemented control strategy was working effectively in monitoring the operation of mechanical ventilation systems, i.e. AHU, did not integrate the wind catchers with the mechanical ventilation system. Research limitations/implications – Owing to short-falls in the control strategy implemented in this project, it was found difficult to quantify and verify the contribution of the wind catchers to the internal conditions and, hence, energy savings. Practical implications – Controlling the operation of the wind catchers via the AHU will lead to isolation of the wind catchers in the event of malfunctioning of the AHU. Wind catchers will contribute to the ventilation of space, particularly in the summer months. Originality/value – This paper demonstrates the value of POE as indispensable tool for FM professionals. It further provides insight into the application of natural ventilation systems in building for healthier indoor environments at lower energy cost. The design of the control strategy for natural ventilation and air-conditioning should be considered at the design stage involving the FM personnel.

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Interest in the effects of insulin on the heart came with the recognition that hyperglycemia in the context of myocardial infarction is associated with increased risks of mortality, congestive heart failure, or cardiogenic shock. More recently, instigated by research findings on stress hyperglycemia in critical illness, this interest has been extended to the influence of insulin on clinical outcome after cardiac surgery. Even in nondiabetic individuals, stress hyperglycemia commonly occurs as a key metabolic response to critical illness, eg, after surgical trauma. It is recognized as a major pathophysiological feature of organ dysfunction in the critically ill. The condition stems from insulin resistance brought about by dysregulation of key homeostatic processes, which implicates immune/inflammatory, endocrine, and metabolic pathways. It has been associated with adverse clinical outcomes, including increased mortality, increased duration of mechanical ventilation, increased intensive care unit (ICU) and hospital stay, and increased risk of infection. Hyperglycemia in critical illness is managed with exogenous insulin as standard treatment; however, there is considerable disagreement among experts in the field as to what target blood glucose level is optimal for the critically ill patient. Conventionally, the aim of insulin therapy has been to maintain blood glucose levels below the renal threshold, typically 220 mg/dL (12.2 mmol/L). In recent years, some have advocated tight glycemic control (TGC) with intensive insulin therapy (IIT) to normalize blood glucose levels to within the euglycemic range, typically 80 to 110 mg/dL (4.4–6.1 mmol/L).

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The built environment in China is required to achieve a 50% reduction in carbon emissions by 2020 against the 1980 design standard. A particular challenge is how to maintain acceptable comfort conditions through the hot humid summers and cold desiccating winters of its continental climate regions. Fully air-conditioned sealed envelopes, often fully glazed, are becoming increasingly common in these regions. Remedial strategies involve technical refinements to the air-handling equipment and a contribution from renewable energy sources in an attempt to achieve the prescribed net reduction in energy use. However an alternative hybrid environmental design strategy is developed in this research project. It exploits observed temperate periods of weeks, days, even hours in duration to free-run an office and exhibition building configured to promote natural stack ventilation when ambient conditions permit and mechanical ventilation when conditions require it, the two modes delivered through the same physical infrastructure. The proposal is modelled in proprietary software and the methodology adopted is described. The challenge is compounded by its first practical application to an existing reinforced concrete frame originally designed to receive a highly glazed envelope. This original scheme is reviewed in comparison. Furthermore the practical delivery of the proposal value engineered out a proportion of the ventilation stacks. The likely consequence of this for the environmental performance of the building is investigated through a sensitivity study.

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This article addresses the need for providing good standards of indoor air quality (IAQ) in buildings from the view point of health, well-being and productivity of building occupants. It briefly outlines the role of ventilation in achieving the required IAQ targets and discusses the performance of different types of ventilation systems in use. As a result of new energy efficiency directives and legislations in Europe and elsewhere, the ventilation energy component of HVAC systems has increased in relative terms and this article introduces a method for evaluating the performance air distribution systems that is based on ventilation and energy effectiveness. A range of ventilation systems are discussed, including mechanical and natural ventilation, and results for more recently developed mechanical air distribution systems are compared with conventional systems. The article provides an assessment and comparison of some of these systems with reference to ventilation performance and energy efficiency