Do simple ventilation and gas exchange measurements predict early successful weaning from respiratory support in unselected general intensive care patients?

Background. The value of respiratory variables as weaning predictors in the intensive care unit (ICU) is controversial. We evaluated the ability of tidal volume (Vtexp), respiratory rate ( f ), minute volume (MVexp), rapid shallow breathing index ( f/Vt), inspired–expired oxygen concentration difference [(I–E)O2], and end-tidal carbon dioxide concentration (PE′CO2) at the end of a weaning trial to predict early weaning outcomes. Methods. Seventy-three patients who required .24 h of mechanical ventilation were studied. A controlled pressure support weaning trial was undertaken until 5 cm H2O continuous positive airway pressure or predefined criteria were reached. The ability of data from the last 5 min of the trial to predict whether a predefined endpoint indicating discontinuation of ventilator support within the next 24 h was evaluated. Results. Pre-test probability for achieving the outcome was 44% in the cohort (n¼32). Non-achievers were older, had higher APACHE II and organ failure scores before the trial, and higher baseline arterial H+ concentrations. The Vt, MV, f, and f/Vt had no predictive power using a range of cut-off values or from receiver operating characteristic (ROC) analysis. The [I–E]O2 and PE′CO2 had weak discriminatory power [areaunder the ROC curve: [I–E]O2 0.64 (P¼0.03); PE′CO2 0.63 (P¼0.05)]. Using best cut-off values for [I–E]O2 of 5.6% and PE′CO2 of 5.1 kPa, positive and negative likelihood ratios were 2 and 0.5, respectively, which only changed the pre- to post-test probability by about 20%. Conclusions. In unselected ICU patients, respiratory variables predict early weaning from mechanical ventilation poorly.

Toxic Legacies, Slow Violence, and Environmental Injustice at Giant Mine, Northwest Territories

For fifty years (1949–99) the now-abandoned Giant Mine in Yellowknife emitted arsenic air and water pollution into the surrounding environment. Arsenic pollution from Giant Mine had particularly acute health impacts on the nearby Yellowknives Dene First Nation (YKDFN), who were reliant on local lakes, rivers, and streams for their drinking water, in addition to frequent use of local berries, garden produce, and medicine plants. Currently, the Canadian government is undertaking a remediation project at Giant Mine to clean up contaminated soils and tailings on the surface and contain 237,000 tonnes of arsenic dust that are stored underground at the Giant Mine. Using documentary sources and statements of Yellowknives Dene members before various public hearings on the arsenic issue, this paper examines the history of arsenic pollution at Giant Mine as a form of “slow violence,” a concept that reconfigures the arsenic issue not simply as a technical problem, but as a historical agent of colonial dispossession that alienated an Indigenous group from their traditional territory. The long-term storage of arsenic at the former mine site means the effects of this slow violence are not merely historical, but extend to the potentially far distant future.

The study of the impact of demand controlled ventilation in energy consumption of offices in Portuguese commercial buildings

Indoor Air 2016 - The 14th International Conference of Indoor Air Quality and Climate

La mine d'alunite de Wenzhou : mémoires et stratégies de valorisation

lNTRODUCTION; This part is the general introduction of this thesis. The research subject, alunite mine of Wenzhou, has a history of more than 600 years. Not only in the history, has it still played an important role in the people's daily life of Fanshan Town. According to the legend, it was Qin Fu, a refugee, found the way of produce the alum totally by accident. However, we try to find out the real history of its mining and production of alum. ln fact, we have found some ancient documents concerning its history. Especially in the book « The chronicles of Wenzhou Fu of Hongzhi », we found some original information, such as the ancient method of mining and producing alum, etc. ln some other ancient documents, we found some important information, too. With such a long history, the alunite mine has held a lot of heritage, no matter tangible or intangible. Unfortunately, due to some reasons, the condition of the mine becomes worse and worse. ln studying his history, technology and the present situation, we intend to find some ways to solve the problems, and restart its development in other fields. Certainly, we should make a brief introduction of the alunite as well as the alum. The second part of the introduction concentrates in the uses of alum, providing an easier comprehension of this object.

Characterization of patients undergoing noninvasive ventilation admitted in unit intermediate care

Non-invasive ventilation (NIV) is the application of a ventilatory support without resorting to invasive methods. Today it’s considered a credible therapeutic option, with enough scientiic evidence to support its application in various situations and clinical settings related to the treatment of acute respiratory disease, as well as chronic respiratory disease. Objectives: Characterize patients undergoing NIV admitted in Unit Intermediate Care (ICU) in the period from October 1st 2015 to June 30th 2016. Methods: Prospective study conducted in ICU between October 2015 and June 2016. In this study were included all patients hospitalized in this unit (ICU) and in that time period a sample of 57 participants was obtained. As data collection instruments we used a questionnaire for sociodemographic and clinical data and the Braden scale. Results: Participants were mostly male 38 (66.7%), the average age 69.5 ± 11.3 years, ranging between 43 and 92 years. They weighed on average 76.6 kg (52 and 150), with an average body mass index of 28.5 kg/m2 (20 to 58.5). With skin intact 28 (49.1%) with abnormal perfusion 12 (21.1%), with altered sensitivity 11 (19.3%) and a high risk of ulcer on the scale of Braden 37 (65%). The admission diagnosis was respiratory failure 33 (57.3%) and had different backgrounds. We used reused mask 53 (93.0%), the average time of NIV was 7.1 days (1-28), 4.8 days of hospitalization (1-18) and an average of 7.8 IPAP pressure. 11 (19.3%) of the participants developed face ulcer pressure.Conclusions: The NIV is used in patients with advanced age, obesity, respiratory failure and high risk of face ulcer development.

Analysis and improvement of the envelope, heating and ventilation of a low energy building with district heating

In this thesis project, a building in Vegagatan 12, Gävle has been analysed in order to see why it does consume more energy than it was expected. This building is a low energy building certified by Miljöbyggnad and it should use less than 55kWh/m2 year and nowadays it is using 62.23 kWh/m2. To get the needed data, some information about the building has been gathered, some measurements have been done in the building and some calculations have been done with those measurements. Finally, some possible solutions have been offered to reduce the energy use of the building. Insulating the floor, the pipes and the walls, reducing the indoor temperature in winter... All of these changes need the help of environmentally friendly attitudes, which is a very important fact in low energy buildings.

Évaluation de la biomasse fongique dans les systèmes de ventilation

Le nettoyage des systèmes de Chauffage, Ventilation et Climatisation de l’Air est important pour assurer une bonne qualité d’air intérieur. Le déclenchement de leur nettoyage est basé sur une inspection visuelle qui ne tient pas compte du contenu en moisissures, lesquelles ont des effets sur le système respiratoire. Cette recherche vise à proposer une méthode d’évaluation du contenu en moisissures afin d’aider les gestionnaires d’immeuble. Cinq générations de poussières ont été effectuées pour simuler un conduit de ventilation. Une cassette modifiée 37 mm et un filtre CPV pré-pesés ont utilisés pour collecter les poussières déposées avec une pompe calibrée à 15L/min. Les pourcentages de collecte des cassettes et des filtres ont été calculés pour 54 échantillons. Dix générations supplémentaires de poussières ont été effectuées concomitamment avec la génération de spores. Soixante échantillons ont été analysés selon quatre méthodes : culture, comptage direct des spores par microscopie (CDSM), dosage de β-N-acétylhexosaminidase (NAHA), 18S-q-PCR. La limite de détection (LD), la réplicabilité, la répétabilité, le nombre de spores et le coefficient de corrélation (r) ont été déterminés. Les récupérations de poussières étaient supérieures à 84%. Selon la méthode analytique, les concentrations médianes de spores/100 cm² allaient de 10 000 à 815 000. Les LD variaient dépendamment de la méthode de 120 à 218 000 spores/100 cm² et r de -0,08 à 0,83. La réplicabilité et la répétabilité étaient de 1% et 1% pour PCR; 5% et 10% pour CDSM; 6% et 15% pour NAHA; 12% et 11% pour culture. La méthode de collecte a démontré une excellente efficacité de récupération. La PCR est la méthode analytique recommandée pour l’évaluation fongique des systèmes de ventilation. Une validation terrain est en cours.

Le mode de ventilation neurally adjusted ventilatory assist (NAVA) est faisable, bien toléré, et permet la synchronie entre le patient et le ventilateur pendant la ventilation non invasive aux soins intensifs pédiatriques : étude physiologique croisée

Introduction: La ventilation non invasive (VNI) est un outil utilisé en soins intensifs pédiatriques (SIP) pour soutenir la détresse respiratoire aigüe. Un échec survient dans près de 25% des cas et une mauvaise synchronisation patient-ventilateur est un des facteurs impliqués. Le mode de ventilation NAVA (neurally adjusted ventilatory assist) est asservi à la demande ventilatoire du patient. L’objectif de cette étude est d’évaluer la faisabilité et la tolérance des enfants à la VNI NAVA et l’impact de son usage sur la synchronie et la demande respiratoire. Méthode: Étude prospective, physiologique, croisée incluant 13 patients nécessitant une VNI dans les SIP de l’hôpital Ste-Justine entre octobre 2011 et mai 2013. Les patients ont été ventilés successivement en VNI conventionnelle (30 minutes), en VNI NAVA (60 minutes) et en VNI conventionnelle (30 minutes). L’activité électrique du diaphragme (AEdi) et la pression des voies aériennes supérieures ont été enregistrées pour évaluer la synchronie. Résultats: La VNI NAVA est faisable et bien tolérée chez tous les enfants. Un adolescent a demandé l’arrêt précoce de l’étude en raison d’anxiété reliée au masque sans fuite. Les délais inspiratoires et expiratoires étaient significativement plus courts en VNI NAVA comparativement aux périodes de VNI conventionnelle (p< 0.05). Les efforts inefficaces étaient moindres en VNI NAVA (résultats présentés en médiane et interquartiles) : 0% (0 - 0) en VNI NAVA vs 12% (4 - 20) en VNI conventionnelle initiale et 6% (2 - 22) en VNI conventionnelle finale (p< 0.01). Globalement, le temps passé en asynchronie a été réduit à 8% (6 - 10) en VNI NAVA, versus 27% (19 - 56) et 32% (21 - 38) en périodes de VNI conventionnelle initiale et finale, respectivement (p= 0.05). Aucune différence en termes de demande respiratoire n’a été observée. Conclusion: La VNI NAVA est faisable et bien tolérée chez les enfants avec détresse respiratoire aigüe et permet une meilleure synchronisation patient-ventilateur. De plus larges études sont nécessaires pour évaluer l’impact clinique de ces résultats.

An Evaluation of Carbon Concentrations Associted with Biodiesel Particulate Matter in an Underground Metal Mine

Exposure to diesel particulate matter from diesel exhaust has been shown to have adverse health effects in humans. In 2012 The International Agency for Research on Cancer classified diesel exhaust as a group 1 know human carcinogen. Because of the associated health effects, there has been a strong push to reduce the amount of diesel exhaust present in the mining industry. Biodiesel is one to the more common and promising control options used to reduce the amount of diesel particulate matter that is generated during fuel combustion. The use of biodiesel over petroleum diesel has been shown to reduce not only particulate matter, but hydro carbon and carbon monoxide mass emissions as well. Personal and area samples were collected at an underground metal mine in the northwestern United States to evaluate the current blend of B70 biodiesel. The objective of this research was to evaluate the carbon levels associated with diesel particulate matter generated from the combustion of a B70 biodiesel. Data was also compared to past studies on which diesel particulate matter from petroleum diesel was evaluated. Samples were taken on four separate four day campaigns between March and October of 2014. Area samples were taken from 7 different areas in the mine and personal samples were taken from a 20 person cohort. The equipment used for sampling was compliant with the NIOSH 5040 method. Statistical analysis of the results was done using Minitab 17 software. The statistical analysis showed that the total carbon concentrations from biodiesel were well below the MSHA exposure limit. Results also showed that organic/elemental carbon ratios were consistent with past studies as the concentrations of organic carbon were significantly higher than those of elemental carbon.

More favorable combination of circumstances could hardly have been desired : a bottom to top examination of the Pittsburgh and Boston Mining Company's Cliff Mine

The Cliff Mine, an archaeological site situated on the Keweenaw Peninsula of Michigan, is the location of the first successful attempt to mine native copper in North America. Under the management of the Pittsburgh & Boston Mining Company from 1845-1879, two-third of the Cliff’s mineral output was in the form of mass copper, some pieces of which weighed over 5 tons when removed from the ground. The unique nature of mass copper and the Cliff Mine’s handling of it make it one of the best examples of early mining processes in the Keweenaw District. Mass copper only constituted 2% of the entire product of the Lake Superior copper districts, and the story of early mining on the Peninsula is generally overshadowed by later, longer running mines such as the Calumet & Helca and Quincy Mining Companies. Operating into the mid-twentieth century, the size and duration of these later mines would come to define the region, though they would not have been possible without the Cliff’s early success. Research on the Cliff Mine has previously focused on social and popular history, neglecting the structural remains. However, these remains are physical clues to the technical processes that defined early mining on the Keweenaw. Through archaeological investigations, these processes and their associated networks were documented as part of the 2010 Michigan Technological Archaeology Field School’s curriculum. The project will create a visual representation of these processes utilizing Geographic Information Systems software. This map will be a useful aid in future research, community engagement and possible future interpretive planning.

Évaluation de la biomasse fongique dans les systèmes de ventilation

Le nettoyage des systèmes de Chauffage, Ventilation et Climatisation de l’Air est important pour assurer une bonne qualité d’air intérieur. Le déclenchement de leur nettoyage est basé sur une inspection visuelle qui ne tient pas compte du contenu en moisissures, lesquelles ont des effets sur le système respiratoire. Cette recherche vise à proposer une méthode d’évaluation du contenu en moisissures afin d’aider les gestionnaires d’immeuble. Cinq générations de poussières ont été effectuées pour simuler un conduit de ventilation. Une cassette modifiée 37 mm et un filtre CPV pré-pesés ont utilisés pour collecter les poussières déposées avec une pompe calibrée à 15L/min. Les pourcentages de collecte des cassettes et des filtres ont été calculés pour 54 échantillons. Dix générations supplémentaires de poussières ont été effectuées concomitamment avec la génération de spores. Soixante échantillons ont été analysés selon quatre méthodes : culture, comptage direct des spores par microscopie (CDSM), dosage de β-N-acétylhexosaminidase (NAHA), 18S-q-PCR. La limite de détection (LD), la réplicabilité, la répétabilité, le nombre de spores et le coefficient de corrélation (r) ont été déterminés. Les récupérations de poussières étaient supérieures à 84%. Selon la méthode analytique, les concentrations médianes de spores/100 cm² allaient de 10 000 à 815 000. Les LD variaient dépendamment de la méthode de 120 à 218 000 spores/100 cm² et r de -0,08 à 0,83. La réplicabilité et la répétabilité étaient de 1% et 1% pour PCR; 5% et 10% pour CDSM; 6% et 15% pour NAHA; 12% et 11% pour culture. La méthode de collecte a démontré une excellente efficacité de récupération. La PCR est la méthode analytique recommandée pour l’évaluation fongique des systèmes de ventilation. Une validation terrain est en cours.

Le mode de ventilation neurally adjusted ventilatory assist (NAVA) est faisable, bien toléré, et permet la synchronie entre le patient et le ventilateur pendant la ventilation non invasive aux soins intensifs pédiatriques : étude physiologique croisée

Introduction: La ventilation non invasive (VNI) est un outil utilisé en soins intensifs pédiatriques (SIP) pour soutenir la détresse respiratoire aigüe. Un échec survient dans près de 25% des cas et une mauvaise synchronisation patient-ventilateur est un des facteurs impliqués. Le mode de ventilation NAVA (neurally adjusted ventilatory assist) est asservi à la demande ventilatoire du patient. L’objectif de cette étude est d’évaluer la faisabilité et la tolérance des enfants à la VNI NAVA et l’impact de son usage sur la synchronie et la demande respiratoire. Méthode: Étude prospective, physiologique, croisée incluant 13 patients nécessitant une VNI dans les SIP de l’hôpital Ste-Justine entre octobre 2011 et mai 2013. Les patients ont été ventilés successivement en VNI conventionnelle (30 minutes), en VNI NAVA (60 minutes) et en VNI conventionnelle (30 minutes). L’activité électrique du diaphragme (AEdi) et la pression des voies aériennes supérieures ont été enregistrées pour évaluer la synchronie. Résultats: La VNI NAVA est faisable et bien tolérée chez tous les enfants. Un adolescent a demandé l’arrêt précoce de l’étude en raison d’anxiété reliée au masque sans fuite. Les délais inspiratoires et expiratoires étaient significativement plus courts en VNI NAVA comparativement aux périodes de VNI conventionnelle (p< 0.05). Les efforts inefficaces étaient moindres en VNI NAVA (résultats présentés en médiane et interquartiles) : 0% (0 - 0) en VNI NAVA vs 12% (4 - 20) en VNI conventionnelle initiale et 6% (2 - 22) en VNI conventionnelle finale (p< 0.01). Globalement, le temps passé en asynchronie a été réduit à 8% (6 - 10) en VNI NAVA, versus 27% (19 - 56) et 32% (21 - 38) en périodes de VNI conventionnelle initiale et finale, respectivement (p= 0.05). Aucune différence en termes de demande respiratoire n’a été observée. Conclusion: La VNI NAVA est faisable et bien tolérée chez les enfants avec détresse respiratoire aigüe et permet une meilleure synchronisation patient-ventilateur. De plus larges études sont nécessaires pour évaluer l’impact clinique de ces résultats.

Natural ventilation and indoor air quality in educational buildings: experimental assessment and improvement strategies

Indoor environmental conditions in classrooms, in particular temperature and indoor air quality, influence students’ health, attitude and performance. In recent years, several studies regarding indoor environmental quality of classrooms were published and natural ventilation proved to have great potential, particularly in southern European climate. This research aimed to evaluate indoor environmental conditions in eight schools and to assess their improvement potential by simple natural ventilation strategies. Temperature, relative humidity and carbon dioxide concentration were measured in 32 classrooms. Ventilation performance of the classrooms was characterized using two techniques, first by fan pressurization measurements of the envelope airtightness and later by tracer gas measurements of the air change rate assuming different envelope conditions. A total of 110 tracer gas measurements were made and the results validated ventilation protocols that were tested afterward. The results of the ventilation protocol implementation were encouraging and, overall, a decrease on the CO2 concentration was observed without modifying the comfort conditions. Nevertheless, additional measurements must be performed for winter conditions.

Design of a Novel Auto-Rotating UAV Platform for Underground Mine Cavity Surveying

The purpose of this paper is to investigate the potential for use of UAVs in underground mines and present a prototype design for a novel autorotating UAV platform for underground 3D data collection.

Inhibition of nitro-oxidative stress attenuates pulmonary and systemic injury induced by high-tidal volume mechanical ventilation

Mechanisms contributing to pulmonary and systemic injury induced by high tidal volume (VT) mechanical ventilation are not well known. We tested the hypothesis that increased peroxynitrite formation is involved in organ injury and dysfunction induced by mechanical ventilation. Male Sprague-Dawley rats were subject to low- (VT, 9 mL/kg; positive end-expiratory pressure, 5 cmH2O) or high- (VT, 25 mL/kg; positive end-expiratory pressure, 0 cmH2O) VT mechanical ventilation for 120 min, and received 1 of 3 treatments: 3-aminobenzamide (3-AB, 10 mg/kg, intravenous, a poly adenosine diphosphate ribose polymerase [PARP] inhibitor), or the metalloporphyrin manganese(III) tetrakis(1-methyl-4-pyridyl)porphyrin (MnTMPyP, 5 mg/kg intravenous, a peroxynitrite scavenger), or no treatment (control group), 30 min before starting the mechanical ventilation protocol (n = 8 per group, 6 treatment groups). We measured mean arterial pressure, peak inspiratory airway pressure, blood chemistry, and gas exchange. Oxidation (fluorescence for oxidized dihydroethidium), protein nitration (immunofluorescence and Western blot for 3-nitrotyrosine), PARP protein (Western blot) and gene expression of the nitric oxide (NO) synthase (NOS) isoforms (quantitative real-time reverse transcription polymerase chain reaction) were measured in lung and vascular tissue. Lung injury was quantified by light microscopy. High-VT mechanical ventilation was associated with hypotension, increased peak inspiratory airway pressure, worsened oxygenation; oxidation and protein nitration in lung and aortic tissue; increased PARP protein in lung; up-regulation of NOS isoforms in lung tissue; signs of diffuse alveolar damage at histological examination. Treatment with 3AB or MnTMPyP attenuated the high-VT mechanical ventilation-induced changes in pulmonary and cardiovascular function; down-regulated the expression of NOS1, NOS2, and NOS3; decreased oxidation and nitration in lung and aortic tissue; and attenuated histological changes. Increased peroxynitrite formation is involved in mechanical ventilation-induced pulmonary and vascular dysfunction.