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Ultra-Clean-Air (UCA) operating theatres aim to minimise surgical instrument contamination and wound infection through high flow rates of ultra-clean air, reducing the presence of Microbe Carrying Particles (MCPs). This study investigates the airflow patterns and ventilation characteristics of a UCA operating theatre (OT) under standard ventilation system operating conditions, considering both empty and partially occupied scenarios. Utilising a precise computational model, quasi-Direct Numerical Simulations (qDNS) were conducted to delineate flow velocity profiles, energy spectra, distributions of turbulent kinetic energy, energy dissipation rate, local Kolmogorov scales, and pressure-based coherent structures. These results were also complemented by a tracer gas decay analysis following ASHRAE standard guidelines. Simulations showed that contrary to the intended laminar regime, the OT's geometry inherently fosters a predominantly turbulent airflow, sustained until evacuation through the exhaust vents, and facilitating recirculation zones irrespective of occupancy level. Notably, the occupied scenario demonstrated superior ventilation efficiency, a phenomenon attributed to enhanced kinetic energy induced by the additional obstructions. The findings underscore the critical role of UCA-OT design in mitigating MCP dissemination, highlighting the potential to augment the design to optimise airflow across a broader theatre spectrum, thereby diminishing recirculation zones and consequently reducing the propensity for Surgical Site Infections (SSIs). The study advocates for design refinements to harness the turbulent dynamics beneficially, steering towards a safer surgical environment.
RESUMO
A careful analysis of the typical devices and conditions used during hydrodynamic injection in capillary electrophoresis shows that the Hagen-Poiseuille model for the laminar flow is valid, even during the transitions of pressure. Therefore, the monitoring of pressure becomes a reliable approach to evaluate the effective injected volume, because the volume is proportional to the integral of pressure (IoP) over time. A piezoresistive sensor was used to monitor the air pressure at headspace of the sample vial. A set of 18 injections at 50 mbar and different times were used to evaluate the use of the normalization of the peak areas of the analytes by the IoP to compensate for imperfection during the injection. There was a significant decrease in relative standard deviation (RSD), and the proposed approach presented results similar to the use of internal standard. In addition, a microcontroller was used not only to monitor the pressure but also to command a peristaltic pump and a solenoid valve creating a system that dynamically controls the applied pressure and stops the injection when the desired value of IoP is reached. The system was used in a proof of concept in which different combinations of pressure and time were used: 10 mbar × 50 s, 25 mbar × 20 s, 50 mbar × 10 s, 125 mbar × 4 s, and 250 mbar × 2 s. Despite the constraints posed by the flowrates of the peristaltic pump and the solenoid valve, the microcontroller effectively conducted the injections across this extensive range of conditions, resulting in an IoP RSD of 2.7%.
RESUMO
INTRODUCTION: Medical and nursing care of newborns is predicated on the delicate control and balance of several vital parameters. Closed incubators and open radiant warmers are the most widely used devices for the care of neonates in intensive care; however, several well-known limitations of these devises have not been resolved. The use of laminar flow is widely used in many fields of medicine, and may have applications in neonatal care. OBJECTIVE: To describe the neonatal laminar flow unit, a new equipment we designed for care of ill newborns. METHODS: The idea, design, and development of this device was completed in Sao Paulo, Brazil. The unit is an open mobile bed designed with the objective of maintaining the advantages of the incubator and radiant warmer, while overcoming some of their inherent shortcomings; these shortcomings include noise, magnetic fields and acrylic barriers in incubators, and lack of isolation and water loss through skin in radiant warmers. The unit has a pump that aspirates environmental air which is warmed by electrical resistance and decontaminated with High Efficiency Particulate Air Filter (HEPA) filters (laminar flow). The flow is directed by an air flow directioner. The unit has an embedded humidifier to increase humidity in the infant's microenvironment and a servo control mechanism for regulation of skin temperature. RESULTS: The laminar flow unit is open and facilitates access of care providers and family, which is not the case in incubators. It provides warming by convection at an air velocity of 0.45 m/s, much faster than an incubator (0.1 m/s). The system provides isolation 1000 class (less than 1,000 particles higher than 0.3 micron per cubic feet at all times). This is much more protection than an incubator provides and more than radiant warmers, which have no isolation whatsoever. Additionally, it provides humidification of the newborn's microenvironment (about 60% relative humidity), which is impossible with a radiant warmer, which produces high water body loss. It has no mechanical barriers like acrylic walls, its magnetic field is lower than an incubator (0.25 µt versus 1.2 µt), and the noise is minimal compared to incubators. The unit is also able to provide controlled total body hypothermia, which is not possible with either of the other two units. CONCLUSION: The laminar flow unit for neonatal care is a novel device which we recently developed. The introduction of laminar flow technology represents a real innovation in the neonatal field. We have described the various components of the unit and the potential advantages for management of ill neonates. This will hopefully lead to improved clinical outcomes and more effective neonatal management and safety.