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Hakan Oral - One of the best experts on this subject based on the ideXlab platform.
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conversion of Positive Pressure cardiac catheterization and electrophysiology laboratories to a novel 2 zone negative Pressure system during covid 19 pandemic
Journal of Cardiovascular Electrophysiology, 2020Co-Authors: Monica Truesdell, Paul Guttman, Barbara Clarke, Sherryl Wagner, Jim Bloom, Jeff Dushane, Linda Richardson, Kristen Vanderelzen, Stanley Chetcuti, Hakan OralAbstract:: During COVID-19 pandemic, there continues to be a need to utilize cardiac catheterization and electrophysiology laboratories for emergent and urgent procedures. Per infection prevention guidelines, and hospital codes, catheterization and electrophysiology laboratories are usually built as Positive Pressure ventilation rooms to minimize the infection risk. However, patients with highly transmissible airborne diseases such as COVID-19 are best cared in negative ventilation rooms to minimize the risk of transmission. From mechanical and engineering perspective, Positive Pressure ventilation rooms cannot be readily converted to negative Pressure ventilation rooms. In this report, we describe a novel, quick, readily implantable and resource friendly approach on how to secure air quality in catheterization and electrophysiology laboratories by converting a Positive Pressure ventilation room to a 2-zone negative ventilation system to minimize the risk of transmission. This article is protected by copyright. All rights reserved.
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conversion of Positive Pressure cardiac catheterization and electrophysiology laboratories to a novel 2 zone negative Pressure system during covid 19 pandemic
Journal of Cardiovascular Electrophysiology, 2020Co-Authors: Monica Truesdell, Paul Guttman, Barbara Clarke, Sherryl Wagner, Jim Bloom, Jeff Dushane, Linda Richardson, Kristen Vanderelzen, Stanley Chetcuti, Hakan OralAbstract:During coronavirus disease-2019 (COVID-19) pandemic, there continues to be a need to utilize cardiac catheterization and electrophysiology laboratories for emergent and urgent procedures. Per infection prevention guidelines and hospital codes, catheterization and electrophysiology laboratories are usually built as Positive-Pressure ventilation rooms to minimize the infection risk. However, patients with highly transmissible airborne diseases such as COVID-19 are best caredfor in negative ventilation rooms to minimize the risk of transmission. From a mechanical and engineering perspective, Positive-Pressure ventilation rooms cannot be readily converted to negative-Pressure ventilation rooms. In this report, we describe a novel, quick, readily implantable, and resource-friendly approach on how to secure air quality in catheterization and electrophysiology laboratories by converting a Positive-Pressure ventilation room to a two-zone negative ventilation system to minimize the risk of transmission.
Brian P Kavanagh - One of the best experts on this subject based on the ideXlab platform.
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relative effects of negative versus Positive Pressure ventilation depend on applied conditions
Intensive Care Medicine, 2012Co-Authors: Doreen Engelberts, Atul Malhotra, James P Butler, George P Topulos, Stephen H Loring, Brian P KavanaghAbstract:Purpose Comparisons of negative versus Positive Pressure ventilation have imperfectly matched the Pressure–time profile or the lung volume history, or have incompletely applied in vivo negative Pressure to include the complete thoracic wall and abdomen.
Monica Truesdell - One of the best experts on this subject based on the ideXlab platform.
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conversion of Positive Pressure cardiac catheterization and electrophysiology laboratories to a novel 2 zone negative Pressure system during covid 19 pandemic
Journal of Cardiovascular Electrophysiology, 2020Co-Authors: Monica Truesdell, Paul Guttman, Barbara Clarke, Sherryl Wagner, Jim Bloom, Jeff Dushane, Linda Richardson, Kristen Vanderelzen, Stanley Chetcuti, Hakan OralAbstract:: During COVID-19 pandemic, there continues to be a need to utilize cardiac catheterization and electrophysiology laboratories for emergent and urgent procedures. Per infection prevention guidelines, and hospital codes, catheterization and electrophysiology laboratories are usually built as Positive Pressure ventilation rooms to minimize the infection risk. However, patients with highly transmissible airborne diseases such as COVID-19 are best cared in negative ventilation rooms to minimize the risk of transmission. From mechanical and engineering perspective, Positive Pressure ventilation rooms cannot be readily converted to negative Pressure ventilation rooms. In this report, we describe a novel, quick, readily implantable and resource friendly approach on how to secure air quality in catheterization and electrophysiology laboratories by converting a Positive Pressure ventilation room to a 2-zone negative ventilation system to minimize the risk of transmission. This article is protected by copyright. All rights reserved.
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conversion of Positive Pressure cardiac catheterization and electrophysiology laboratories to a novel 2 zone negative Pressure system during covid 19 pandemic
Journal of Cardiovascular Electrophysiology, 2020Co-Authors: Monica Truesdell, Paul Guttman, Barbara Clarke, Sherryl Wagner, Jim Bloom, Jeff Dushane, Linda Richardson, Kristen Vanderelzen, Stanley Chetcuti, Hakan OralAbstract:During coronavirus disease-2019 (COVID-19) pandemic, there continues to be a need to utilize cardiac catheterization and electrophysiology laboratories for emergent and urgent procedures. Per infection prevention guidelines and hospital codes, catheterization and electrophysiology laboratories are usually built as Positive-Pressure ventilation rooms to minimize the infection risk. However, patients with highly transmissible airborne diseases such as COVID-19 are best caredfor in negative ventilation rooms to minimize the risk of transmission. From a mechanical and engineering perspective, Positive-Pressure ventilation rooms cannot be readily converted to negative-Pressure ventilation rooms. In this report, we describe a novel, quick, readily implantable, and resource-friendly approach on how to secure air quality in catheterization and electrophysiology laboratories by converting a Positive-Pressure ventilation room to a two-zone negative ventilation system to minimize the risk of transmission.
Nicholas S Hill - One of the best experts on this subject based on the ideXlab platform.
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noninvasive Positive Pressure ventilation in critical and palliative care settings understanding the goals of therapy
Critical Care Medicine, 2007Co-Authors: Randall J Curtis, Nicholas S Hill, Sean P Keenan, Deborah J Cook, Tasnim Sinuff, Douglas B White, Joshua O Benditt, Robert M Kacmarek, Karin T Kirchhoff, Mitchell M LevyAbstract:Objective:Although noninvasive Positive Pressure ventilation (NPPV) is a widely accepted treatment for some patients with acute respiratory failure, the use of NPPV in patients who have decided to forego endotracheal intubation is controversial. Therefore, the Society of Critical Care Medicine charg
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noninvasive Positive Pressure ventilation for respiratory failure after extubation
The New England Journal of Medicine, 2004Co-Authors: Andres Esteban, Nicholas S Hill, Stefano Nava, Fernando Frutosvivar, Niall D Ferguson, Yaseen M Arabi, Carlos Apezteguia, Marco Gonzalez, Scott K Epstein, Marco Antonio SoaresAbstract:background The need for reintubation after extubation and discontinuation of mechanical ventilation is not uncommon and is associated with increased mortality. Noninvasive PositivePressure ventilation has been suggested as a promising therapy for patients with respiratory failure after extubation, but a single-center, randomized trial recently found no benefit. We conducted a multicenter, randomized trial to evaluate the effect of noninvasive Positive-Pressure ventilation on mortality in this clinical setting. methods Patients in 37 centers in eight countries who were electively extubated after at least 48 hours of mechanical ventilation and who had respiratory failure within the subsequent 48 hours were randomly assigned to either noninvasive Positive-Pressure ventilation by face mask or standard medical therapy. results A total of 221 patients with similar baseline characteristics had been randomly assigned to either noninvasive ventilation (114 patients) or standard medical therapy (107 patients) when the trial was stopped early, after an interim analysis. There was no difference between the noninvasive-ventilation group and the standard-therapy group in the need for reintubation (rate of reintubation, 48 percent in both groups; relative risk in the noninvasive-ventilation group, 0.99; 95 percent confidence interval, 0.76 to 1.30). The rate of death in the intensive care unit was higher in the noninvasive-ventilation group than in the standard-therapy group (25 percent vs. 14 percent; relative risk, 1.78; 95 percent confidence interval, 1.03 to 3.20; P=0.048), and the median time from respiratory failure to reintubation was longer in the noninvasive-ventilation group (12 hours vs. 2 hours 30 minutes, P=0.02). conclusions Noninvasive Positive-Pressure ventilation does not prevent the need for reintubation or reduce mortality in unselected patients who have respiratory failure after extubation.
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acute applications of noninvasive Positive Pressure ventilation
Chest, 2003Co-Authors: Timothy N Liesching, Henry Kwok, Nicholas S HillAbstract:Noninvasive Positive-Pressure ventilation (NPPV) has been used increasingly to treat acute respiratory failure (ARF). The best indications for its use are ARF in patients with COPD exacerbations, acute pulmonary edema, and immunocompromised states. For these indications, multiple controlled trials have demonstrated that therapy with NPPV avoids intubation and, in the case of COPD and immunocompromised patients, reduces mortality as well. NPPV is used to treat patients with numerous other forms of ARF, but the evidence is not as strong for its use in those cases, and patients must be selected carefully. The best candidates for NPPV are able to protect their airway, are cooperative, and are otherwise medically stable. Success is optimized when a skilled team applies a well-fitted, comfortable interface. Ventilator settings should be adjusted to reduce respiratory distress while avoiding excessive discomfort, patient-ventilator synchrony should be optimized, and adequate oxygenation should be assured. The appropriate application of NPPV in the acute care setting should lead to improved patient outcomes and more efficient resource utilization.
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leak compensation in Positive Pressure ventilators a lung model study
European Respiratory Journal, 2001Co-Authors: Sangeeta Mehta, F D Mccool, Nicholas S HillAbstract:Leak compensating abilities of six different Positive Pressure ventilators commonly used to deliver noninvasive Positive Pressure ventilation, including the bilevel Positive airway Pressure (BiPAP) S/T-D and Quantum (Respironics Inc, Murrysville, PA, USA), 335 and O'NYX (Mallinckrodt Inc, St Louis, MO, USA), PLV 102 (Respironics), and Siemens Servo 900C (Siemens Inc, Danvers, MA, USA). Using a test lung model, compensatory capabilities of the ventilators were tested for smaller and larger leaks using the assist/control or timed modes. Back-up rate was 20 min(-1), inspiratory Pressure was 18 cmH2O, and expiratory Pressure was 5 cmH2O. It was found that even in the absence of air leaking, delivered tidal volume differed substantially between the ventilators during use of Pressure-targeted modes, depending on inspiratory flows, inaccuracies in set versus delivered Pressures, and inspiratory duration. Also during Pressure-targeted ventilation, increasing the tI/ttot up to, but not beyond, 0.5 improved compensation by lengthening inspiratory duration, whereas use of a sensitive flow trigger setting tended to cause autocycling during leaking, interfering with compensation. Leaking interfered with cycling of the BiPAP S/T, inverting the I:E ratio, shortening expiratory time, and reducing delivered tidal volume. Volume-targeted modes achieved limited compensation for small air leaks, but compensated poorly for large leaks. To conclude, leak-compensating capabilities differ markedly between ventilators but Pressure-targeted ventilators are preferred for noninvasive Positive Pressure ventilation in patients with substantial air leaking. Adequate inspiratory flows and durations should be used, triggering sensitivity should be adjusted to prevent autocycling, and a mechanism should be available to limit inspiratory time and avoid I:E ratio inversion.
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randomized prospective trial of noninvasive Positive Pressure ventilation in acute respiratory failure
American Journal of Respiratory and Critical Care Medicine, 1995Co-Authors: Naomi R Kramer, Thomas J Meyer, Joseph Meharg, Richard D Cece, Nicholas S HillAbstract:Recent studies suggest that noninvasive Positive Pressure ventilation (NPPV) administered by nasal or oronasal mask avoids the need for endotracheal intubation, rapidly improves vital signs, gas exchange, and sense of dyspnea, and may reduce mortality in selected patients with acute respiratory failure, but few controlled trials have been done. The present study used a randomized prospective design to evaluate the possible benefits of NPPV plus standard therapy versus standard therapy alone in patients with acute respiratory failure. Patients to receive NPPV were comfortably fitted with a standard nasal mask connected to a BiPAP ventilatory assist device (Respironics, Inc., Murrysville, PA) in the patient flow-triggered/time-triggered (S/T) mode, and standard therapy consisted of all other treatments deemed necessary by the primary physician, including endotracheal intubation. The need for intubation was reduced from 73% in the standard therapy group (11 of 15 patients) to 31% in the NPPV group (5 of 16 p...
Paul Guttman - One of the best experts on this subject based on the ideXlab platform.
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conversion of Positive Pressure cardiac catheterization and electrophysiology laboratories to a novel 2 zone negative Pressure system during covid 19 pandemic
Journal of Cardiovascular Electrophysiology, 2020Co-Authors: Monica Truesdell, Paul Guttman, Barbara Clarke, Sherryl Wagner, Jim Bloom, Jeff Dushane, Linda Richardson, Kristen Vanderelzen, Stanley Chetcuti, Hakan OralAbstract:: During COVID-19 pandemic, there continues to be a need to utilize cardiac catheterization and electrophysiology laboratories for emergent and urgent procedures. Per infection prevention guidelines, and hospital codes, catheterization and electrophysiology laboratories are usually built as Positive Pressure ventilation rooms to minimize the infection risk. However, patients with highly transmissible airborne diseases such as COVID-19 are best cared in negative ventilation rooms to minimize the risk of transmission. From mechanical and engineering perspective, Positive Pressure ventilation rooms cannot be readily converted to negative Pressure ventilation rooms. In this report, we describe a novel, quick, readily implantable and resource friendly approach on how to secure air quality in catheterization and electrophysiology laboratories by converting a Positive Pressure ventilation room to a 2-zone negative ventilation system to minimize the risk of transmission. This article is protected by copyright. All rights reserved.
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conversion of Positive Pressure cardiac catheterization and electrophysiology laboratories to a novel 2 zone negative Pressure system during covid 19 pandemic
Journal of Cardiovascular Electrophysiology, 2020Co-Authors: Monica Truesdell, Paul Guttman, Barbara Clarke, Sherryl Wagner, Jim Bloom, Jeff Dushane, Linda Richardson, Kristen Vanderelzen, Stanley Chetcuti, Hakan OralAbstract:During coronavirus disease-2019 (COVID-19) pandemic, there continues to be a need to utilize cardiac catheterization and electrophysiology laboratories for emergent and urgent procedures. Per infection prevention guidelines and hospital codes, catheterization and electrophysiology laboratories are usually built as Positive-Pressure ventilation rooms to minimize the infection risk. However, patients with highly transmissible airborne diseases such as COVID-19 are best caredfor in negative ventilation rooms to minimize the risk of transmission. From a mechanical and engineering perspective, Positive-Pressure ventilation rooms cannot be readily converted to negative-Pressure ventilation rooms. In this report, we describe a novel, quick, readily implantable, and resource-friendly approach on how to secure air quality in catheterization and electrophysiology laboratories by converting a Positive-Pressure ventilation room to a two-zone negative ventilation system to minimize the risk of transmission.
