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Continuous distending pressure for respiratory distress syndrome in preterm infants

Ho JJ, Subramaniam P, Henderson-Smart DJ, Davis PG

Cochrane Database Syst Rev, 2002.
PMID: 12076445

BACKGROUND: Respiratory distress syndrome (RDS) is the single most important cause of morbidity and mortality in preterm infants (Greenough 1998, Bancalari 1992). Intermittent positive pressure ventilation (IPPV) with surfactant is the standard treatment for the condition. The major difficulty with IPPV is that it is invasive, resulting in airway and lung injury and contributing to the development of chronic lung disease.
OBJECTIVES: In spontaneously breathing preterm infants with RDS, to determine if continuous distending pressure (CDP) reduces the need for IPPV and associated morbidity without adverse effects.
SEARCH STRATEGY: The standard search strategy of the Neonatal Review group was used. This included searches of the Oxford Database of Perinatal Trials, Cochrane Controlled Trials Register (The Cochrane Library, Issue 1, 2002), MEDLINE (1966-January 2002), and EMBASE (1980-January 2002), previous reviews including cross references, abstracts, conference and symposia proceedings, expert informants, journal hand searching mainly in the English language.
SELECTION CRITERIA: All trials using random or quasi-random allocation of preterm infants with RDS were eligible. Interventions were continuous distending pressure including continuous positive airway pressure (CPAP) by mask, nasal prong, nasopharyngeal tube, or endotracheal tube, or continuous negative pressure (CNP) via a chamber enclosing the thorax and lower body, compared with standard care.
DATA COLLECTION AND ANALYSIS: Standard methods of the Cochrane Collaboration and its Neonatal Review Group were used, including independent assessment of trial quality and extraction of data by each author.
MAIN RESULTS: CDP is associated with a lower rate of failed treatment (death or use of assisted ventilation) [summary RR 0.70 (0.55, 0.88), RD -0.22 (-0.35, -0.09), NNT 5 (3, 11)], overall mortality [summary RR 0.52 (0.32, 0.87), RD -0.15 (-0.26, -0.04), NNT 7 (4, 25)], and mortality in infants with birthweights above 1500 g [summary RR 0.24 (0.07, 0.84), RD -0.281 (-0.483, -0.078), NNT 4 (2, 13)]. The use of CDP is associated with an increased rate of pneumothorax [summary RR 2.36 (1.25, 5.54), RD 0.14 (0.04, 0.23), NNH 7 (4, 24)].
REVIEWER'S CONCLUSIONS: In preterm infants with RDS the application of CDP either as CPAP or CNP is associated with benefits in terms of reduced respiratory failure and reduced mortality. CDP is associated with an increased rate of pneumothorax. The applicability of these results to current practice is difficult to assess, given the intensive care setting of the 1970s when four out of five of these trials were done. Where resources are limited, such as in developing countries, CPAP for RDS may have a clinical role. Further research is required to determine the best mode of administration and its role in modern intensive care settings

Matched MeSH terms: Intermittent Positive-Pressure Ventilation/adverse effects
Continuous distending airway pressure for respiratory distress syndrome in preterm infants

Ho JJ, Subramaniam P, Henderson-Smart DJ, Davis PG

Cochrane Database Syst Rev, 2000.
PMID: 10908543

Respiratory distress syndrome (RDS) is the single most important cause of morbidity and mortality in preterm infants (Greenough 1998, Bancalari 1992). Intermittent positive pressure ventilation (IPPV) with surfactant is the standard treatment for the condition. The major difficulty with IPPV is that it is invasive, resulting in airway and lung injury and contributing to the development of chronic lung disease.

Matched MeSH terms: Intermittent Positive-Pressure Ventilation/adverse effects
Fulltext Spirometry and flow-volume in Malay adults

Ismail Y, Zurkurnain Y

Med J Malaysia, 1992 Dec;47(4):261-6.
PMID: 1303477

Respiratory function testing was done using a portable electronic spirometer in 223 normal Malay subjects between the ages of 15 to 75 years. Tests of FEV1, FVC, PEFR, and MMF were recorded using standard forced expiratory maneuvers. Malay adults have lower respiratory function values compared to Caucasians and other Asians.

Matched MeSH terms: Pulmonary Ventilation*
Continuous distending pressure for respiratory distress syndrome in preterm infants

Ho JJ, Subramaniam P, Henderson-Smart DJ, Davis PG

Cochrane Database Syst Rev, 2000.
PMID: 11034747

BACKGROUND: Respiratory distress syndrome (RDS) is the single most important cause of morbidity and mortality in preterm infants (Greenough 1998, Bancalari 1992). Intermittent positive pressure ventilation (IPPV) with surfactant is the standard treatment for the condition. The major difficulty with IPPV is that it is invasive, resulting in airway and lung injury and contributing to the development of chronic lung disease.
OBJECTIVES: In spontaneously breathing preterm infants with RDS, to determine if continuous distending pressure (CDP) reduces the need for IPPV and associated morbidity without adverse effects.
SEARCH STRATEGY: The standard search strategy of the Neonatal Review group was used. This included searches of the Oxford Database of Perinatal Trials, Cochrane Controlled Trials Register, MEDLINE (1966-Jan. 2000), previous reviews including cross references, abstracts, conference and symposia proceedings, expert informants, journal hand searching mainly in the English language.
SELECTION CRITERIA: All trials using random or quasi-random patient allocation of newborn infants with RDS were eligible. Interventions were continuous distending pressure including continuous positive airway pressure (CPAP) by mask, nasal prong, nasopharyngeal tube, or endotracheal tube, or continuous negative pressure (CNP) via a chamber enclosing the thorax and lower body, compared with standard care.
DATA COLLECTION AND ANALYSIS: Standard methods of the Cochrane Collaboration and its Neonatal Review Group, including independent assessment of trial quality and extraction of data by each author, were used.
MAIN RESULTS: CDP is associated with a lower rate of failed treatment (death or use of assisted ventilation), overall mortality, and mortality in infants with birthweights above 1500 g. The use of CDP is associated with an increased rate of pneumothorax.
REVIEWER'S CONCLUSIONS: In preterm infants with RDS the application of CDP either as CPAP or CNP is associated with some benefits in terms of reduced respiratory failure and reduced mortality. CDP is associated with an increased rate of pneumothorax. The applicability of these results to current practice is difficult to assess, given the outdated methods to administer CDP, low use of antenatal corticosteroids, non-availability of surfactant and the intensive care setting of the 1970s when these trials were done. Where resources are limited, such as in developing countries, CPAP for RDS may have a clinical role. Further research is required to determine the best mode of administration and its role in modern intensive care settings

Matched MeSH terms: Intermittent Positive-Pressure Ventilation/adverse effects
Thirteen years of invasive and noninvasive home ventilation for children in a developing country: A retrospective study

Nathan AM, Loo HY, de Bruyne JA, Eg KP, Kee SY, Thavagnanam S, et al.

Pediatr Pulmonol, 2017 04;52(4):500-507.
PMID: 27712049 DOI: 10.1002/ppul.23569

INTRODUCTION: Home ventilation (HV) for children is growing rapidly worldwide. The aim was to describe (1) the sociodemographic characteristics of children on HV and (2) the indications for, means and outcome of initiating HV in children from a developing country.
METHODOLOGY: This retrospective study included patients sent home on noninvasive or invasive ventilation, over 13 years, by the pediatric respiratory unit in a single center. Children who declined treatment were excluded.
RESULTS: Seventy children were initiated on HV: 85.7% on noninvasive ventilation, 14.3% on invasive ventilation. There was about a threefold increase from 2001-2008 (n = 18) to 2009-2014 (n = 52). Median (range) age of initiating HV was 11 (1-169) months and 73% of children were <2 years old. Common indications for HV were respiratory (57.2%), chest/spine anomalies (11.4%), and neuromuscular (10.0%). Fifty-two percent came off their devices with a median (interquartile range) usage duration of 12 (4.8, 21.6) months. Ten children (14.3%) died with one avoidable death. Children with neuromuscular disease were less likely to come off their ventilator (0.0%) compared to children with respiratory disease (62.1%). Forty-one percent of parents bought their equipment, whereas 58.6% borrowed their equipment from the medical social work department and other sources.
CONCLUSION: HV in a resource-limited country is possible. Children with respiratory disease made up a significant proportion of those requiring HV and were more likely to be weaned off. The mortality rate was low. The social work department played an important role in facilitating early discharge. Pediatr Pulmonol. 2017;52:500-507. © 2016 Wiley Periodicals, Inc.

Matched MeSH terms: Noninvasive Ventilation/utilization
Fulltext The correlation of Acanthamoeba from the ventilation system with other environmental parameters in commercial buildings as possible indicator for indoor air quality

Ooi SS, Mak JW, Chen DK, Ambu S

Ind Health, 2017 Feb 07;55(1):35-45.
PMID: 27476379 DOI: 10.2486/indhealth.2015-0218

The free-living protozoan Acanthamoeba is an opportunistic pathogen that is ubiquitous in our environment. However, its role in affecting indoor air quality and ill-health of indoor occupants is relatively unknown. The present study investigated the presence of Acanthamoeba from the ventilation system and its correlation with other indoor air quality parameters, used in the industry code of practice and its potential as an indicator for indoor air quality. Indoor air quality assessments were carried out in nine commercial buildings with approval from the building management, and the parameters assessed were as recommended by the Department of Occupational Safety and Health. The presence of Acanthamoeba was determined through dust swabs from the ventilation system and indoor furniture. Logistic regression was performed to study the correlation between assessed parameters and occupants' complaints. A total of 107 sampling points were assessed and 40.2% of the supplying air diffuser and blowing fan and 15% of the furniture were positive for cysts. There was a significant correlation between Acanthamoeba detected from the ventilation system with ambient total fungus count (r=0.327; p=0.01) and respirable particulates (r=0.276; p=0.01). Occupants' sick building syndrome experience also correlated with the presence of Acanthamoeba in the ventilation system (r=0.361; p=0.01) and those detected on the furniture (r=0.290; p=0.01). Logistic regression showed that there was a five-fold probability of sick building syndrome among occupants when Acanthamoeba was detected in the ventilation system.

Matched MeSH terms: Ventilation*
Fulltext Selection of an appropriate left-sided double-lumen tube size for one-lung ventilation among Asians

Ideris SS, Che Hassan MR, Abdul Rahman MR, Ooi JS

Ann Card Anaesth, 2017 Jan-Mar;20(1):28-32.
PMID: 28074791 DOI: 10.4103/0971-9784.197824

CONTEXT: Selecting an appropriate size double-lumen tube (DLT) for one-lung ventilation has always been a challenge as most choose it based on experience or using the existing guidelines based on gender and height.

AIMS: The aim of this study was to determine if the appropriate choice of this tube could be based on the patients' height, weight, tracheal diameter (TD), or the left main stem bronchus diameter (LMBD) and also to determine the relationship between height and depth of insertion among Asians.

SUBJECTS AND METHODS: This was a retrospective review of 179 patients who were intubated with a left-sided DLT and also had a posterior-anterior view of a digital chest radiograph for tracheal and left main bronchus diameter measurements. Additional data collected included patients' demographics and DLT size used.

RESULTS: There were 123 (68.7%) males and 56 (31.3%) females with an overall mean age of 33.3 ± 16.3 years. Majority of the males (48.8%) used a size 39 Fr while females (46.4%) used a 35 Fr. There were weak correlations between DLT size with height (male: R2 = 0.222; female: R2 = 0.193), DLT size with weight (male: R2 = 0.109; female: R2 = 0.211), DLT size with TD (male: R2 = 0.027); female: R2 = 0.016), and DLT size with LMBD (male: R2 = 0.222; female: R2 = 0.193). There was a good correlation between depth of DLT inserted with patient's height for both genders.

CONCLUSION: The appropriate size of the left-sided DLT could not be predicted based on patients' height, weight, tracheal or left main bronchus diameter alone in Asians; however, the depth of insertion of the tube was dependent on the height in both genders.

Matched MeSH terms: One-Lung Ventilation/instrumentation*
Pulmonary Embolism in an Asymptomatic COVID-19 Patient Detected on Ventilation/Perfusion SPECT/CT

Mahaletchumy T, Muhamad M, Mohammad Kazmin NE, Kori N, Periyasamy P

Clin Nucl Med, 2021 Jul 01;46(7):e360-e362.
PMID: 33443945 DOI: 10.1097/RLU.0000000000003513

Severe COVID-19 infection is associated with significant coagulopathy. We would like share a case of an asymptomatic 26-year-old man who tested positive for COVID-19 and had elevated d-dimer levels. Because of inconclusive CTPA findings, V/Q (ventilation/perfusion) SPECT/CT was performed, which confirmed the presence of pulmonary embolism. This case highlights the fact that pulmonary embolism should not be overlooked in a COVID-19 patient who has raised d-dimer levels, even in the absence of symptoms. It also highlights the importance of performing a V/Q study when CTPA results are inconclusive or when there are contraindications for iodinated contrast media.

Matched MeSH terms: Ventilation-Perfusion Ratio*
Randomized clinical trial comparing helmet continuous positive airway pressure (hCPAP) to facemask continuous positive airway pressure (fCPAP) for the treatment of acute respiratory failure in the emergency department

Adi O, Via G, Salleh SH, Chuan TW, Rahman JA, Muhammad NAN, et al.

Am J Emerg Med, 2021 Nov;49:385-392.
PMID: 34271286 DOI: 10.1016/j.ajem.2021.06.031

STUDY OBJECTIVE: To determine whether non-invasive ventilation (NIV) delivered by helmet continuous positive airway pressure (hCPAP) is non-inferior to facemask continuous positive airway pressure (fCPAP) in patients with acute respiratory failure in the emergency department (ED).
METHODS: Non-inferiority randomized, clinical trial involving patients presenting with acute respiratory failure conducted in the ED of a local hospital. Participants were randomly allocated to receive either hCPAP or fCPAP as per the trial protocol. The primary endpoint was respiratory rate reduction. Secondary endpoints included discomfort, improvement in Dyspnea and Likert scales, heart rate reduction, arterial blood oxygenation, partial pressure of carbon dioxide (PaCO2), dryness of mucosa and intubation rate.
RESULTS: 224 patients were included and randomized (113 patients to hCPAP, 111 to fCPAP). Both techniques reduced respiratory rate (hCPAP: from 33.56 ± 3.07 to 25.43 ± 3.11 bpm and fCPAP: from 33.46 ± 3.35 to 27.01 ± 3.19 bpm), heart rate (hCPAP: from 114.76 ± 15.5 to 96.17 ± 16.50 bpm and fCPAP: from 115.07 ± 14.13 to 101.19 ± 16.92 bpm), and improved dyspnea measured by both the Visual Analogue Scale (hCPAP: from 16.36 ± 12.13 to 83.72 ± 12.91 and fCPAP: from 16.01 ± 11.76 to 76.62 ± 13.91) and the Likert scale. Both CPAP techniques improved arterial oxygenation (PaO2 from 67.72 ± 8.06 mmHg to 166.38 ± 30.17 mmHg in hCPAP and 68.99 ± 7.68 mmHg to 184.49 ± 36.38 mmHg in fCPAP) and the PaO2:FiO2 (Partial pressure of arterial oxygen: Fraction of inspired oxygen) ratio from 113.6 ± 13.4 to 273.4 ± 49.5 in hCPAP and 115.0 ± 12.9 to 307.7 ± 60.9 in fCPAP. The intubation rate was lower with hCPAP (4.4% for hCPAP versus 18% for fCPAP, absolute difference -13.6%, p = 0.003). Discomfort and dryness of mucosa were also lower with hCPAP.
CONCLUSION: In patients presenting to the ED with acute cardiogenic pulmonary edema or decompensated COPD, hCPAP was non-inferior to fCPAP and resulted in greater comfort levels and lower intubation rate.

Matched MeSH terms: Noninvasive Ventilation/instrumentation; Noninvasive Ventilation/methods
Fulltext Anaesthetic management in a patient requiring one lung ventilation during COVID-19 pandemic

Teah MK, Yap KY, Ismail AJ, Yeap TB

BMJ Case Rep, 2021 Feb 17;14(2).
PMID: 33597165 DOI: 10.1136/bcr-2020-241148

Placement of a double-lumen tube to achieve one lung ventilation is an aerosol-generating procedure. Performing it on a patient with COVID-19 will put healthcare workers at high risk of contracting the disease. We herein report a case of its use in a patient with traumatic diaphragmatic rupture, who was also suspected to have COVID-19. This article aims to highlight the issues, it presented and ways to address them as well as the perioperative impact of personal protective equipment.

Matched MeSH terms: One-Lung Ventilation/instrumentation; One-Lung Ventilation/standards*
The potential risk from 222radon posed to archaeologists and earth scientists: reconnaissance study of radon concentrations, excavations, and archaeological shelters in the Great Cave of Niah, Sarawak, Malaysia

Gillmore G, Gilbertson D, Grattan J, Hunt C, McLaren S, Pyatt B, et al.

Ecotoxicol Environ Saf, 2005 Feb;60(2):213-27.
PMID: 15546638

This reconnaissance study of radon concentrations in the Great Cave of Niah in Sarawak shows that in relatively deep pits and trenches in surficial deposits largely covered by protective shelters with poor ventilation, excavators are working in a micro-environment in which radon concentrations at the ground surface can exceed those of the surrounding area by a factor of > x 2. Although radon concentrations in this famous cave are low by world standards (alpha track-etch results ranging from 100 to 3075 Bq m(-3)), they still may pose a health risk to both excavators (personal dosemeter readings varied from 0.368 to 0.857 mSv for 60 days of work) and cave occupants (1 yr exposure at 15 h per day with an average radon level of 608 Bq m(-3) giving a dose of 26.42 mSv). The data here presented also demonstrate that there is considerable local variation in radon levels in such environments as these.

Matched MeSH terms: Ventilation
Anthropometric and physiological profiles of active blind Malaysian males

Singh R, Singh HJ

J Sports Med Phys Fitness, 1993 Dec;33(4):378-82.
PMID: 8035586

Cardiopulmonary capacities of twelve adults (aged between 14 to 44 years) with varying degrees of blindness engaged in regular recreational activities were compared with twelve age-matched normal sighted healthy males (control group) who were also involved in regular recreational activities. Maximum oxygen consumption (VO2max) was measured directly during exhaustive exercise test on a cycle ergometer. Forced vital capacity, leg strength and power were determined by spirometry, standing long jump and vertical jump respectively. No significant differences in VO2max, forced vital capacity and leg strength and power were observed between the blind and the control groups. No anthropometric differences were evident between the two groups. The results show therefore that the visually handicapped who are active can have a similar level of physical fitness, lung function and explosive leg strength as those of their active sighted counterparts.

Matched MeSH terms: Pulmonary Ventilation
Association between indoor microbiome exposure and sick building syndrome (SBS) in junior high schools of Johor Bahru, Malaysia

Fu X, Norbäck D, Yuan Q, Li Y, Zhu X, Hashim JH, et al.

Sci Total Environ, 2021 Jan 20;753:141904.
PMID: 32890872 DOI: 10.1016/j.scitotenv.2020.141904

Sick building syndrome (SBS) is a collection of nonspecific syndromes linked with the built environment. The occurrence of SBS is associated with humidity, ventilation, moulds and microbial compounds exposure. However, no study has reported the association between indoor microbiome and SBS. In this study, 308 students were surveyed for SBS symptoms from 21 classrooms of 7 junior high schools from Johor Bahru, Malaysia, and vacuum dust from floor, desks and chairs was collected. High throughput amplicon sequencing (16S rRNA gene and ITS region) and quantitative PCR were conducted to characterize the absolute concentration of bacteria and fungi taxa. In total, 326 bacterial and 255 fungal genera were detected in dust with large compositional variation among classrooms. Also, half of these samples showed low compositional similarity to microbiome data deposited in the public database. The number of observed OTUs in Gammaproteobacteria was positively associated with SBS (p = 0.004). Eight microbial genera were associated with SBS (p

Matched MeSH terms: Ventilation
Fulltext Ventilation flow evaluation system for sustainable housing development

Nur Azfahani Ahmad, Zuraihana Ahmad Zawawi, Nazhatulzalkis Jamaludin, Khairulliza Ahmad Salleh

Jurnal Inovasi Malaysia, 2019;2(2):55-70.
MyJurnal

A 1984 World Health Organization (WHO) Committee report highlighted that up to 30 per cent of buildings may have to face problems related to Indoor Air Quality (IAQ). Insufficient ventilation will lead to stagnant air and can cause stuffiness in buildings. This will then leads to a bigger problem, known as the Sick Building Syndrome (SBS). It is important to note that sick building syndrome may cause various illnesses including allergies, acute respiration problem, feeling of discomfort and other psychological impacts. The “Ventilation Flow Evaluation System for Sustainable Housing Development” is a PC-based database tool developed to access and measure ventilation flow in a new or remodelled building in order to prevent or mitigate this problem. The purpose of the system is to provide resources for building designers in solving Indoor Air Quality (IAQ) issues especially related to ventilation flow based on regulations provided in Malaysian Standard (MS 1525). The system will allow readily building plan to be measured and analysed based on ventilation data collected at site, in order to allow buildings to obtain healthy and sufficient air for breathing and comfort purposes. The system will also recommend suitable layout plan in the building to meet the ventilation purposes, namely cross-ventilation and stack-effect ventilation.

Matched MeSH terms: Ventilation
Fulltext A rare cause of unilateral tinnitus

Nik Mohd Syukra Nik Abd Ghani, Nik Adilah Nik Othman, Amran Mohamad

International Medical Journal Malaysia, 2018;17(1):145-148.
MyJurnal

Tinnitus is not a disease per se but it is a symptom. It can be either subjective or objective type and the
underlying cause varies such as tumour, infection, vascular abnormality or Meniere’s disease. Foreign body in the external ear is a common presentation especially in children. However, foreign body in the middle ear manifested with only symptom of tinnitus is a rare and unexpected presentation. Foreign body in the middle ear are commonly due to iatrogenic cause such as complication of myringotomy and ventilation tube insertion surgery. There are reported cases of complications of myringotomy and ventilation tube insertion, and they typically presented with the ear infection manifestation, myringosclerosis or permanent perforation of tympanic membrane. Currently, there are only few reported cases in literatures of foreign body in the middle ear following complication of medial migration of ventilation tube into a middle ear with intact tympanic membrane.

Matched MeSH terms: Middle Ear Ventilation
Baska mask versus endotracheal tube in laparoscopic cholecystectomy surgery: a prospective randomized trial

Ng CC, Sybil Shah MHB, Chaw SH, Mansor MB, Tan WK, Koong JK, et al.

Expert Rev Med Devices, 2021 Feb;18(2):203-210.
PMID: 33322949 DOI: 10.1080/17434440.2021.1865796

Background: Supraglottic airway devices have increasingly been used as the airway technique of choice in laparoscopic surgeries. This study compared the efficacy and safety of the Baska Mask with endotracheal tube (ETT) in patients undergoing elective laparoscopic cholecystectomy.Research design and methods: This single-center, prospective, randomized controlled trial recruited 60 patients aged 18-75 years with American Society of Anesthesiologists' classifications I to III. The time taken to achieve effective airway, number of attempts, ease of insertion, ventilation parameters, hemodynamics data, and pharyngolaryngeal complications were recorded.Results: The time taken to achieve effective airway was shorter for the Baska group (26.6 ± 4.7 vs. 47.2 ± 11.8 s; p

Matched MeSH terms: Pulmonary Ventilation
Otological outcome in cleft lip and palate children with middle ear effusion

Azman A, Manuel AM

Int J Pediatr Otorhinolaryngol, 2020 Nov;138:110274.
PMID: 32836138 DOI: 10.1016/j.ijporl.2020.110274

OBJECTIVE: To evaluate the factors contributing to middle ear pathology, hearing and speech development among cleft palate children treated for middle ear effusion.
METHOD: A prospective cross-sectional otoscopic and audiological analysis was conducted on 102 cleft palate children (204 ears) aged 1-18 years old who were treated for middle ear effusion at our centre. Retrospective chart review was done to determine patient characteristics and prior patient management. The aim was to assess the effect of ventilation tube insertion (VTI) on hearing, speech and chronic otitis media; comparing the timing and number of ventilation tubes per ear and determining other factors affecting the short-term and long-term outcome.
RESULTS: 68 children or 130 ears (63% of all cases) were selectively treated with ventilation tube insertion. Repeat procedures (more than 2) were performed in 41 ears. Among children with VTI performed, the incidence of chronic otitis media in children after the age of 4 was 17%. Overall, abnormal tympanic membrane findings and hearing loss were detected in nearly half the cases who were previously treated with VTI. Early ventilation tube insertion at less than 1 year of age, resulted in a better middle ear and hearing outcome in children less than 4 years old (p

Matched MeSH terms: Middle Ear Ventilation
Fulltext High Frequency Oscillating Ventilation (HFOV) in Severe Acute Respiratory Distress Syndrome (ARDS): A Case Report.

Azrina, M.R., Basri, M.N., Abdul Hadi, M., Fahmi, M.L., Asmarawati, M.Y., Ariff, O.

International Medical Journal Malaysia, 2010;9(1):51-53.
MyJurnal

High frequency oscillating ventilation (HFOV) provides a rescue therapy for patients with refractory hypoxaemia in severe acute respiratory distress syndrome (ARDS). HFOV utilizes high mean airway pressures to maintain an open lung and low tidal volumes at a high frequency that allows for adequate ventilation while at the same time preventing alveolar overdistension. This seems to be an ideal lung protective ventilation strategies to prevent ventilator-induced lung injury (VILI)2. We reported a case of severe extrapulmonary ARDS secondary to acute lymphoblastic leukaemia responding to the use of HFOV.

Matched MeSH terms: High-Frequency Ventilation
Causes of chronic oxygen dependency in new borns in a tertiary level neonatal unit

Jacqueline, H.O.

Malaysian Journal of Child Health, 1992;4(1):20-22.
MyJurnal

A retrospective survey was carried out in a neonatal unit to identify babies who required oxygen for more than the first 28 days of life and to determine the cause of their oxygen dependency. A total of 9173 neonates were admitted over a three year period. Approximately 750 were ventilated. Fifteen required oxygen for more than the first 28 days. Ten (67%) of these were due to bronchopulmonary dysplasia. 2 had upper airway complications of mechanical ventilation, one had recurrent apnoea, one had recurrent pneumonia, and one who did not require ventilation had chronic oxygen dependency of unknown cause. Bronchopulmonary dysplasia was the commonest cause of chronic oxygen dependency. The incidence was 1.5% of ventilated babies.

Matched MeSH terms: Ventilation
A study of the effectiveness of local exhaust ventilation (LEV) using computational fluid dynamics (CFD) approach

Ng, C. S., Leman, A. M., N. Asmuin

Journal of Occupational Safety and Health, 2012;9(3):1-8.
MyJurnal

Local exhaust ventilation (LEV) is used in industries to capture contaminants such as gases, dusts, mists, vapours or fumes out of workstations to protect occupants’ exposure to contaminants. LEV is allocated and installed by employers, however it doesn’t work accordingly. LEV design is often overlooked and underappreciated. Effectiveness of LEV system can be achieved if more attention is focused to proper design of LEV system. To solve this issue, computational fluid dynamics (CFD) can be performed. CFD is a software tool to predict and simulate fluid dynamic phenomena. CFD is used to forecast or reconstruct the behaviour of an engineering product under assumed or measure boundary conditions. However, CFD is just a prediction tool, which can lead to inaccuracy of predicting airflow due to problems with pre-processing, solver and post-processing with parameter from actual experimental results. Therefore, validation is needed to help minimizing percentage error of CFD methods. In this research, measurements of airflow parameter of LEV system at National Institute of Occupational Safety and Health (NIOSH) Bangi, Selangor were conducted. Control Speed panel found at NIOSH Bangi, which is used to increase or decrease speed of fan, was performed using Control Speed of 20%, 40% 60% and 80%. Upon validation, average absolute error obtained from four different control speeds ranges from 3.372% to 4.862%. Validity of CFD modelling is acceptable, which is less than 5% and good agreement is achieved between actual experimental results and CFD simulation results. Therefore, it can be concluded that CFD software tool can be performed to simulate air velocity in LEV system. CFD methods can save labour costs and time consumption when it is used during earliest stage of LEV design, before actual construction is implemented. The outcome of this paper can be used as a baseline for factories equipped with LEV system to protect occupants’ exposure to contaminants.

Matched MeSH terms: Ventilation

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