Transmission of Mycobacterium chimaera from Heater-Cooler Units during Cardiac Surgery despite an Ultraclean Air Ventilation System.

Heater-cooler units (HCUs) were recently identified as a source of Mycobacterium chimaera causing surgical site infections. We investigated transmission of this bacterium from HCUs to the surgical field by using a thermic anemometer and particle counter, videotape of an operating room equipped with an ultraclean laminar airflow ventilation system, and bacterial culture sedimentation plates in a nonventilated room. Smoke from the HCU reached the surgical field in 23 s by merging with ultraclean air. The HCU produced on average 5.2, 139, and 14.8 particles/min in the surgical field at positions Off, On/oriented toward, and On/oriented away, respectively. Culture plates were positive for M. chimaera <5 m from the HCU in the test room. These experiments confirm airborne transmission of M. chimaera aerosols from a contaminated HCU to an open surgical field despite ultraclean air ventilation. Efforts to mitigate infectious risks during surgery should consider contamination from water sources and airflow-generating devices.

Gene expression profile in newborn rat lungs after two days of recovery of mechanical ventilation.

BACKGROUND Preterm infants having immature lungs often require respiratory support, potentially leading to bronchopulmonary dysplasia (BPD). Conventional BPD rodent models based on mechanical ventilation (MV) present outcome measured at the end of the ventilation period. A reversible intubation and ventilation model in newborn rats recently allowed discovering that different sets of genes modified their expression related to time after MV. In a newborn rat model, the expression profile 48 h after MV was analyzed with gene arrays to detect potentially interesting candidates with an impact on BPD development. METHODS Rat pups were injected P4-5 with 2 mg/kg lipopolysaccharide (LPS). One day later, MV with 21 or 60% oxygen was applied during 6 h. Animals were sacrified 48 h after end of ventilation. Affymetrix gene arrays assessed the total gene expression profile in lung tissue. RESULTS In fully treated animals (LPS + MV + 60% O(2)) vs. controls, 271 genes changed expression significantly. All modified genes could be classified in six pathways: tissue remodeling/wound repair, immune system and inflammatory response, hematopoiesis, vasodilatation, and oxidative stress. Major alterations were found in the MMP and complement system. CONCLUSION MMPs and complement factors play a central role in several of the pathways identified and may represent interesting targets for BPD treatment/prevention.Bronchopulmonary dysplasia (BPD) is a chronic lung disease occurring in ~30% of preterm infants born less than 30 wk of gestation (1). Its main risk factors include lung immaturity due to preterm delivery, mechanical ventilation (MV), oxygen toxicity, chorioamnionitis, and sepsis. The main feature is an arrest of alveolar and capillary formation (2). Models trying to decipher genes involved in the pathophysiology of BPD are mainly based on MV and oxygen application to young mammals with immature lungs of different species (3). In newborn rodent models, analyses of lung structure and gene and protein expression are performed for practical reasons directly at the end of MV (4,5,6). However, later appearing changes of gene expression might also have an impact on lung development and the evolution towards BPD and cannot be discovered by such models. Recently, we developed a newborn rat model of MV using an atraumatic (orotracheal) intubation technique that allows the weaning of the newborn animal off anesthesia and MV, the extubation to spontaneous breathing, and therefore allows the evaluation of effects of MV after a ventilation-free period of recovery (7). Indeed, applying this concept of atraumatic intubation by direct laryngoscopy, we recently were able to show significant differences between gene expression changes appearing directly after MV compared to those measured after a ventilation-free interval of 48 h. Immediately after MV, inflammation-related genes showed a transitory modified expression, while another set of more structurally related genes changed their expression only after a delay of 2 d (7). Lung structure, analyzed by conventional 2D histology and also by 3D reconstruction using synchrotron x-ray tomographic microscopy revealed, 48 h after end of MV, a reduced complexity of lung architecture compared to the nonventilated rat lungs, similar to the typical findings in BPD. To extend these observations about late gene expression modifications, we performed with a similar model a full gene expression profile of lung tissue 48 h after the end of MV with either room air or 60% oxygen. Essentially, we measured changes in the expression of genes related to the MMPs and complement system which played a role in many of the six identified mostly affected pathways.

Correlation between alveolar ventilation and electrical properties of lung parenchyma.

One key problem in modern medical imaging is linking measured data and actual physiological quantities. In this article we derive such a link between the electrical bioimpedance of lung parenchyma, which can be measured by electrical impedance tomography (EIT), and the magnitude of regional ventilation, a key to understanding lung mechanics and developing novel protective ventilation strategies. Two rat-derived three-dimensional alveolar microstructures obtained from synchrotron-based x-ray tomography are each exposed to a constant potential difference for different states of ventilation in a finite element simulation. While the alveolar wall volume remains constant during stretch, the enclosed air volume varies, similar to the lung volume during ventilation. The enclosed air, serving as insulator in the alveolar ensemble, determines the resulting current and accordingly local tissue bioimpedance. From this we can derive a relationship between lung tissue bioimpedance and regional alveolar ventilation. The derived relationship shows a linear dependence between air content and tissue impedance and matches clinical data determined from a ventilated patient at the bedside.

Records of past mid-depth ventilation: Cretaceous ocean anoxic event 2 vs. recent oxygen minimum zones

Present day oceans are well ventilated, with the exception of mid-depth oxygen minimum zones (OMZs) under high surface water productivity, regions of sluggish circulation, and restricted marginal basins. In the Mesozoic, however, entire oceanic basins transiently became dysoxic or anoxic. The Cretaceous ocean anoxic events (OAEs) were characterised by laminated organic-carbon rich shales and low-oxygen indicating trace fossils preserved in the sedimentary record. Yet assessments of the intensity and extent of Cretaceous near-bottom water oxygenation have been hampered by deep or long-term diagenesis and the evolution of marine biota serving as oxygen indicators in today's ocean. Sedimentary features similar to those found in Cretaceous strata were observed in deposits underlying Recent OMZs, where bottom-water oxygen levels, the flux of organic matter, and benthic life have been studied thoroughly. Their implications for constraining past bottom-water oxygenation are addressed in this review. We compared OMZ sediments from the Peruvian upwelling with deposits of the late Cenomanian OAE 2 from the north-west African shelf. Holocene laminated sediments are encountered at bottom-water oxygen levels of < 7 µmol/kg under the Peruvian upwelling and < 5 µmol/kg in California Borderland basins and the Pakistan Margin. Seasonal to decadal changes of sediment input are necessary to create laminae of different composition. However, bottom currents may shape similar textures that are difficult to discern from primary seasonal laminae. The millimetre-sized trace fossil Chondrites was commonly found in Cretaceous strata and Recent oxygen-depleted environments where its diameter increased with oxygen levels from 5 to 45 µmol/kg. Chondrites has not been reported in Peruvian sediments but centimetre-sized crab burrows appeared around 10 µmol/kg, which may indicate a minimum oxygen value for bioturbated Cretaceous strata. Organic carbon accumulation rates ranged from 0.7 and 2.8 g C /cm2 /kyr in laminated OAE 2 sections in Tarfaya Basin, Morocco, matching late Holocene accumulation rates of laminated Peruvian sediments under Recent oxygen levels below 5 µmol/kg. Sediments deposited at > 10 µmol/kg showed an inverse exponential relationship of bottom-water oxygen levels and organic carbon accumulation depicting enhanced bioirrigation and decomposition of organic matter with increased oxygen supply. In the absence of seasonal laminations and under conditions of low burial diagenesis, this relationship may facilitate quantitative estimates of palaeo-oxygenation. Similarities and differences between Cretaceous OAEs and late Quaternary OMZs have to be further explored to improve our understanding of sedimentary systems under hypoxic conditions.

On the role of circulation and mixing in the ventilation of oxygen minimum zones with a focus on the eastern tropical North Atlantic

Ocean observations carried out in the framework of the Collaborative Research Center 754 (SFB 754) "Climate-Biogeochemistry Interactions in the Tropical Ocean" are used to study (1) the structure of tropical oxygen minimum zones (OMZs), (2) the processes that contribute to the oxygen budget, and (3) long-term changes in the oxygen distribution. The OMZ of the eastern tropical North Atlantic (ETNA), located between the well-ventilated subtropical gyre and the equatorial oxygen maximum, is composed of a deep OMZ at about 400 m depth with its core region centred at about 20° W, 10° N and a shallow OMZ at about 100 m depth with lowest oxygen concentrations in proximity to the coastal upwelling region off Mauritania and Senegal. The oxygen budget of the deep OMZ is given by oxygen consumption mainly balanced by the oxygen supply due to meridional eddy fluxes (about 60%) and vertical mixing (about 20%, locally up to 30%). Advection by zonal jets is crucial for the establishment of the equatorial oxygen maximum. In the latitude range of the deep OMZ, it dominates the oxygen supply in the upper 300 to 400 m and generates the intermediate oxygen maximum between deep and shallow OMZs. Water mass ages from transient tracers indicate substantially older water masses in the core of the deep OMZ (about 120-180 years) compared to regions north and south of it. The deoxygenation of the ETNA OMZ during recent decades suggests a substantial imbalance in the oxygen budget: about 10% of the oxygen consumption during that period was not balanced by ventilation. Long-term oxygen observations show variability on interannual, decadal and multidecadal time scales that can partly be attributed to circulation changes. In comparison to the ETNA OMZ the eastern tropical South Pacific OMZ shows a similar structure including an equatorial oxygen maximum driven by zonal advection, but overall much lower oxygen concentrations approaching zero in extended regions. As the shape of the OMZs is set by ocean circulation, the widespread misrepresentation of the intermediate circulation in ocean circulation models substantially contributes to their oxygen bias, which might have significant impacts on predictions of future oxygen levels.

Sistemas de seguridad: ventilación, filtrado y extinción = Safety systems: ventilation, filtering and extintion

El proyecto, construcción y explotación de los túneles de Calle 30, la vía urbana de circunvalación más importante de la ciudad de Madrid, ha supuesto un importante reto por multitud de factores característicos entre los los que cabe citar las restricciones geométricas, el entorno de la vía y la composición del tráfico. Ésto ha quedado reflejado en el hecho de que, tan pronto como se ha puesto en servicio, la infraestructura se ha convertido en una referencia internacional. En el ámbito de la seguridad, partiendo de un enfoque global que contempla el conjunto de medidas disponibles se han utilizado las más modernas tecnologías disponibles aplicando, a su vez, procedimientos de trabajo y metodologías. En particular, ha sido especialmente destacable la persistencia en mantener, como objetivo principal, la definicición de criterios de proyecto homogéneos y coherentes que permitiesen explotar la compleja red de túneles como una única infraestructura. En el caso del sistema de ventilación, para cumplir estos objetivos se ha realizado un enorme esfuerzo de coordinación y homogeneización de criterios lo que, junto a la utilización de novedosas tecnologías, ha supuesto un apasionante desafío. Como resultado, el presenta artículoo, partiendo de la exposición de los criterios asociados a la solución conceptual, profundiza en aquellos aspectos que, por su novedad, se consideran de interés para el lector.

Natural ventilation in underground wine cellars

The main objective of this research is to promote passive thermal design techniques in the construction of wineries. Natural ventilation in underground cellars is analyzed, focusing on the entrance tunnel, the ventilation chimney and the cave. A monitoring system was designed in order to detect changes in the indoor conditions and outdoor air infiltration. Monitoring process was carried out during one year. Results show the influence of outside temperature, ventilation chimney and access tunnel on the conditions inside the underground cellar. During hot periods, natural ventilation has a negligible influence on the indoor ambience, despite the permanently open vents in the door and chimney. The tunnel and ventilation chimney work as a temperature regulator, dampening outside fluctuations. Forced ventilation is necessary when a high air exchange ratio is needed. During cold periods, there is greater instability as a result of increased natural ventilation. The temperature differences along the tunnel are reduced, reflecting a homogenization and mixing of the air. The ventilation flow is sufficient to modify the temperature and relative humidity of the cave. Forced ventilation is not necessary in this period. During the intermediate periods --autumn and spring-- occurs different behaviors based on time of day.

Ventilation system design and large scale fire tests

The design, construction and operation of the tunnels of M-30, the major ring road in the city of Madrid (Spain), represent a very interesting project in wich a wide variety of situations -geometrical, topographical, etc.- had to be covered, in variable conditions of traffic. For that reasons, the M-30 project is a remarkable technical challenge, which, after its completion, turned into an international reference. From the "design for safety" perspective, a holistic approach has been used to deal with new technologies, integration of systems and development of the procedures to reach the maximum level. However, one of the primary goals has been to achieve reasonable homogeneity characteristics which can permit operate a netword of tunels as one only infraestructure. In the case of the ventilation system the mentioned goals have implied innovative solutions and coordination efforts of great interest. Consequently, this paper describes the principal ideas underlying the conceptual solution developed focusing on the principal peculiarities of the project.

Probabilistic approach for longitudinal ventilation system design in fire situations

The main objective of ventilation systems in tunnels is to reach the highest possible safety level both in service and fire situation; being the fire one, the most relevant when designing the system. When designing a longitudinal ventilation system, the methodology to evaluate the capacity of the system is similar both in service and fire situation, with the exception of the chimney effect and the phenomena of thermal transfer which is responsible or the changes in the density of the air. When facing the dimensioning task for longitudinal ventilated tunnels, although similar methodologies are used in different countries, specific hypothesis (aerodynamic, thermal properties, traffic) even if discussed in the literature or current practice, are not usually detailed in the regulations or recommendations. The aim of this paper is to propose a probabilistic approach to the problem which would allow the designer, and the tunnel owner, to understand the uncertainty and sensibility adopted in the results and, eventually, identify possible ways of optimizing the ventilation solution to be adopted.

Ventilation and FFFS fire tests for “Calle 30” road tunnels

Between 2003 and 2007 an urban network or road tunnels with a total constructed tubes length of 45 km was built in the city of Madrid. This amazing engineering work, known as "Calle 30 Project" counted with different kinds of tunnel typologies and ventilation systems. Due to the length of the tunnels and the impact of the work itself, the tunnels were endowed with a great variety of installations to provide the maximum levels of safety both for users and the infrastructure includieng, in some parts of the tunnel, fixed fire fighting system based on water mist. Whithin this framework a large-scale programme of fire tests was planned to study different aspects related to fire safety in the tunnels including the phenomena of the interaction between ventilation and extinguishing system. In addition, these large scale fire tests allowed fire brigades of the city of Madrid an opportunity to define operational procedures for specific fire fighting in tunnels and evaluate the possibilities of fixed fire fighting systems. The tests were carried out in the Center of Experimentation "San pedro of Anes" which includes a 600 m tunnel with a removable false ceiling for reproducing different ceiling heights and ventilation conditions (transverse and longitudinal ones). Interesting conclusions on the interaction of ventilation and water mist systems were obtained but also on other aspects including performance of water mist system in terms of reduction of gas temperatures or visibility conditions. This paper presents a description of the test's programme carried out and some previous results obtained.

Cross Ventilation CFD Modeling: Characterization and Study of Different Façade Openings Configurations at the Refurbishment of a Residential Building in Málaga (Spain)

The opening of new windows on the façade is proposed as a refurbishment strategy in an existing building in Málaga to facilitate cross ventilation of dwellings. The building is a residential block of 140 public housing units for rent for people with low income in Málaga (Spain), property of the City Council. By modeling with Computational Fluid Dynamics (CFD), eleven configurations of openings are studied in two different areas of the main housing type of the building. The quantity of introduced/extracted air into/from the room and the generated airflow patterns are obtained. The modeling allows comparing the different openings configurations to determine the most appropriate ventilation option for every room.