970 resultados para intraaortic balloon pump


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Mode of access: Internet.

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Thesis (Master's)--University of Washington, 2016-06

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Thesis (Ph.D.)--University of Washington, 2016-05

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Current evidence supports parenteral infusion of proton pump inhibitors (PPI) after endoscopic treatment of bleeding peptic ulcers and such treatment seems reasonable where there is active bleeding or visible vessel on endoscopy. Parenteral boluses of PPI can be used in patients nil by mouth who cannot tolerate oral therapy. We sought to examine the appropriateness of parenteral PPI use. Drug utilisation evaluation was performed on 94 patients admitted to a 500 bed metropolitan hospital. 39 patients received continuous parenteral infusion of omeprazole (8 mg/ h) over a mean of 60 ± 29 h. 55 patients had parenteral boluses (40 mg bd) of omeprazole over a mean of 5 ± 4 days. Indications for PPI infusion (n = 39) were: major haemorrhage requiring transfusion (23), minor haemorrhage (8), dyspepsia (4) and others (4). 31 of the 39 patients on PPI infusion had upper gastrointestinal (GI) endoscopy. PPI infusion was commenced prior to endoscopy in 26 (84%) patients. 13 patients (33%) had active bleeding or visible non bleeding vessels at endoscopy. Only 11 patients (28%) had endoscopically treated peptic ulcers. Indications for parenteral PPI boluses (n = 55) included patients nil by mouth unable to take maintenance PPI orally (21), minor haemorrhage (8), peptic ulcer prophylaxis in seriously unwell (6), major haemorrhage (4), dyspepsia (2), postoprative period following peptic ulcer surgery (2) and others (12). Endoscopy was performed in 10 patients (18%) with only 1 endoscopically treated peptic ulcer. Our data suggest significant inappropriate use of parenteral PPI, which may be used for minor GI bleeding and dyspepsia and are typically commenced prior to endoscopy. These findings can explain the costly hospital expenditure on PPI.

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Performance optimisation of ultra-long Raman laser links is studied theoretically and experimentally. We observe that it is possible to reduce signal power excursion by adjusting FBG reflectivity without compromising pump efficiency.

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The purpose of the work described here has been to seek methods of narrowing the present gap between currently realised heat pump performance and the theoretical limit. The single most important pre-requisite to this objective is the identification and quantitative assessment of the various non-idealities and degradative phenomena responsible for the present shortfall. The use of availability analysis has been introduced as a diagnostic tool, and applied to a few very simple, highly idealised Rankine cycle optimisation problems. From this work, it has been demonstrated that the scope for improvement through optimisation is small in comparison with the extensive potential for improvement by reducing the compressor's losses. A fully instrumented heat pump was assembled and extensively tested. This furnished performance data, and led to an improved understanding of the systems behaviour. From a very simple analysis of the resulting compressor performance data, confirmation of the compressor's low efficiency was obtained. In addition, in order to obtain experimental data concerning specific details of the heat pump's operation, several novel experiments were performed. The experimental work was concluded with a set of tests which attempted to obtain definitive performance data for a small set of discrete operating conditions. These tests included an investigation of the effect of two compressor modifications. The resulting performance data was analysed by a sophisticated calculation which used that measurements to quantify each dagradative phenomenon occurring in that compressor, and so indicate where the greatest potential for improvement lies. Finally, in the light of everything that was learnt, specific technical suggestions have been made, to reduce the losses associated with both the refrigerant circuit and the compressor.

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The purpose of this investigation was to design a novel magnetic drive and bearing system for a new centrifugal rotary blood pump (CRBP). The drive system consists of two components: (i) permanent magnets within the impeller of the CRBP; and (ii) the driving electromagnets. Orientation of the magnets varies from axial through to 60° included out-lean (conical configuration). Permanent magnets replace the electromagnet drive to allow easier characterization. The performance characteristics tested were the axial force of attraction between the stator and rotor at angles of rotational alignment, Ø, and the corresponding torque at those angles. The drive components were tested for various magnetic cone angles, ?. The test was repeated for three backing conditions: (i) non-backed; (ii) steel-cupped; and (iii) steel plate back-iron, performed on an Instron tensile testing machine. Experimental results were expanded upon through finite element and boundary element analysis (BEM). The force/torque characteristics were maximal for a 12-magnet configuration at 0° cone angle with steel-back iron (axial force = 60 N, torque = 0.375 Nm). BEM showed how introducing a cone angle increases the radial restoring force threefold while not compromising axial bearing force. Magnets in the drive system may be orientated not only to provide adequate coupling to drive the CRBP, but to provide significant axial and radial bearing forces capable of withstanding over 100 m/s2 shock excitation on the impeller. Although the 12 magnet 0° (?) configuration yielded the greatest force/torque characteristic, this was seen as potentially unattractive as this magnetic cone angle yielded poor radial restoring force characteristics.

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Heat pumps are becoming increasingly popular, but poor electricity generating efficiency limits the potential energy savings of electrically powered units. Thus the work reported in this thesis concerns the development of a range of gas engine driven heat pumps for industrial and commercial heating applications, which recover heat from the prime mover, normally rejected to waste. Despite the convenience of using proprietary engine heat recovery packages, investigations have highlighted the necessity to ensure the engine and the heat recovery equipment are compatible. A problem common •to all air source heat pumps is the formation of frost on the evaporator, which must be removed periodically, with the expenditure of energy, to ensure the continued operation of the plant. An original fluidised bed defrosting mechanism is proposed, which prevents the build-up of this frost, and also improves system performance. Criticisms have been levelled against the rotary sliding vane compressor, in particular the effects of lubrication, which is essential. This thesis compares the rotary sliding vane compressor with other machines, and concludes that many of these criticisms are unfounded. A confidential market survey indicates an increasing demand for heat pumps up to and including 1990, and the technical support needed to penetrate this market is presented. Such support includes the development of a range of modular gas engine driven heat pumps, and a computer aided design for the selection of the optimum units. A case study of a gas engine driven heat pump for a swimming pool application which provided valuable experience is included.

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This project has been undertaken for Hamworthy Hydraulics Limited. Its objective was to design and develop a controller package for a variable displacement, hydraulic pump for use mainly on mobile earth moving machinery. A survey was undertaken of control options used in practice and from this a design specification was formulated, the successful implementation of which would give Hamworthy an advantage over its competitors. Two different modes for the controller were envisaged. One consisted of using conventional hydro-mechanics and the other was based upon a microprocessor. To meet short term customer prototype requirements the first section of work was the realisation of the hydro-mechanical system. Mathematical models were made to evaluate controller stability and hence aid their design. The final package met the requirements of the specification and a single version could operate all sizes of variable displacement pumps in the Hamworthy range. The choice of controller options and combinations totalled twenty-four. The hydro-mechanical controller was complex and it was realised that a micro-processor system would allow all options to be implemented with just one design of hardware, thus greatly simplifying production. The final section of this project was to determine whether such a design was feasible. This entailed finding cheap, reliable transducers, using mathematical models to predict electro-hydraulic interface stability, testing such interfaces and finally incorporating a micro-processor in an interactive control loop. The study revealed that such a system was technically possible but it would cost 60% more than its hydro-mechanical counterpart. It was therefore concluded that, in the short term, for the markets considered, the hydro-mechanical design was the better solution. Regarding the micro-processor system the final conclusion was that, because the relative costs of the two systems are decreasing, the electro-hydraulic controller will gradually become more attractive and therefore Hamworthy should continue with its development.