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Perspectives on human movement considerations in indoor airflow assessment: a comprehensive data-driven systematic review

Kek HY, Tan H, Othman MHD, Nyakuma BB, Goh PS, Wong SL, et al.

Environ Sci Pollut Res Int, 2023 Dec;30(58):121253-121268.
PMID: 37979109 DOI: 10.1007/s11356-023-30912-y

Understanding particle dispersion characteristics in indoor environments is crucial for revising infection prevention guidelines through optimized engineering control. The secondary wake flow induced by human movements can disrupt the local airflow field, which enhances particle dispersion within indoor spaces. Over the years, researchers have explored the impact of human movement on indoor air quality (IAQ) and identified noteworthy findings. However, there is a lack of a comprehensive review that systematically synthesizes and summarizes the research in this field. This paper aims to fill that gap by providing an overview of the topic and shedding light on emerging areas. Through a systematic review of relevant articles from the Web of Science database, the study findings reveal an emerging trend and current research gaps on the topic titled Impact of Human Movement in Indoor Airflow (HMIA). As an overview, this paper explores the effect of human movement on human microenvironments and particle resuspension in indoor environments. It delves into the currently available methods for assessing the HMIA and proposes the integration of IoT sensors for potential indoor airflow monitoring. The present study also emphasizes incorporating human movement into ventilation studies to achieve more realistic predictions and yield more practical measures. This review advances knowledge and holds significant implications for scientific and public communities. It identifies future research directions and facilitates the development of effective ventilation strategies to enhance indoor environments and safeguard public health.

Matched MeSH terms: Ventilation
Evaluation of HACOR scale as a predictor of non-invasive ventilation failure in acute cardiogenic pulmonary oedema patients: A prospective observational study

Chong CY, Bustam A, Noor Azhar M, Abdul Latif AK, Ismail R, Poh K

Am J Emerg Med, 2024 May;79:19-24.
PMID: 38330879 DOI: 10.1016/j.ajem.2024.01.044

BACKGROUND AND IMPORTANCE: Acute cardiogenic pulmonary oedema (ACPO) is a common indication for non-invasive ventilation (NIV) in the emergency department (ED). HACOR score of >5 is used to predict NIV failure. The predictive ability of HACOR may be affected by altered physiological parameters in ACPO patients due to medications or comorbidities.
OBJECTIVES: To validate the HACOR scale in predicting NIV failure among acute cardiogenic pulmonary oedema (ACPO) patients.
DESIGN, SETTINGS AND PARTICIPANTS: This is a prospective, observational study of consecutive ACPO patients requiring NIV admitted to the ED.
OUTCOME MEASURE AND ANALYSIS: Primary outcome was the ability of the HACOR score to predict NIV failure. Clinical, physiological, and HACOR score at baseline and at 1 h, 12 h and 24 h were analysed. Other potential predictors were assessed as secondary outcomes.
MAIN RESULTS: A total of 221 patients were included in the analysis. Fifty-four (24.4%) had NIV failure. Optimal HACOR score was >5 at 1 h after NIV initiation in predicting NIV failure (AUC 0.73, sensitivity 53.7%, specificity 83.2%). As part of the HACOR score, respiratory rate and heart rate were not found to be significant predictors. Other significant predictors of NIV failure in ACPO patients were acute coronary syndrome, acute kidney injury, presence of congestive heart failure as a comorbid, and the ROX index.
CONCLUSIONS: The HACOR scale measured at 1 h after NIV initiation predicts NIV failure among ACPO patients with acceptable accuracy. The cut-off level > 5 could be a useful clinical decision support tool in ACPO patient. However, clinicians should consider other factors such as the acute coronary and acute kidney diagnosis at presentation, presence of underlying congestive heart failure and the ROX index when clinically deciding on timely invasive mechanical ventilation.

Matched MeSH terms: Noninvasive Ventilation*
The modification of the tropical environment for comfort and efficiency; engineering aspects

WARD GT

Med J Malaya, 1957 Mar;11(3):185-9.
PMID: 13476995
Matched MeSH terms: Ventilation*
Fulltext Report on post-operative elective ventilation in University Hospital , Kuala Lumpur 1970 – 1980

Delilkan AE, Sannasi RV

Singapore Med J, 1983 Feb;24(1):23-6.
PMID: 6346504

The practice of continuing ventilation into the post·operatlve period in certain poor risk patients resulted in a reduction in morbidity and mortality. So much more surgery can be performed on many patients which otherwise would not be justified without this back·up services provided by the intensive therapy unit. From 1970 - 80, 763 patients were electively ventilated following surgery (both elective and emergency) of which 115 died, giving a mortality incidence of 15.01%

Matched MeSH terms: Intermittent Positive-Pressure Ventilation*
Helmet CPAP in the emergency department: A narrative review

Adi O, Fong CP, Keong YY, Apoo FN, Roslan NL

Am J Emerg Med, 2023 May;67:112-119.
PMID: 36870251 DOI: 10.1016/j.ajem.2023.02.030

BACKGROUND: The choice of correct interface for the right patient is crucial for the success of non-invasive ventilation (NIV) therapy. Helmet CPAP is a type of interface used to deliver NIV. Helmet CPAP improves oxygenation by keeping the airway open throughout the breathing cycle with positive end-expiratory pressure (PEEP).
OBJECTIVE: This narrative review describes the technical aspects and clinical indications of helmet continuous positive airway pressure (CPAP). In addition, we explore the advantages and challenges faced using this device at the Emergency Department (ED).
DISCUSSION: Helmet CPAP is tolerable than other NIV interfaces, provides a good seal and has good airway stability. During Covid-19 pandemic, there are evidences it reduced the risk of aerosolization. The potential clinical benefit of helmet CPAP is demonstrated in acute cardiogenic pulmonary oedema (ACPO), Covid-19 pneumonia, immunocompromised patient, acute chest trauma and palliative patient. Compare to conventional oxygen therapy, helmet CPAP had been shown to reduce intubation rate and decrease mortality.
CONCLUSION: Helmet CPAP is one of the potential NIV interface in patients with acute respiratory failure presenting to the emergency department. It is better tolerated for prolonged usage, reduced intubation rate, improved respiratory parameters, and offers protection against aerosolization in infectious diseases.

Matched MeSH terms: Noninvasive Ventilation*
Natural history and clinical features of ALS in Malaysia

Abdul Aziz NA, Toh TH, Goh KJ, Loh EC, Capelle DP, Abdul Latif L, et al.

Amyotroph Lateral Scler Frontotemporal Degener, 2021 02;22(1-2):108-116.
PMID: 33084408 DOI: 10.1080/21678421.2020.1832121

OBJECTIVE: Studies from multiethnic populations are rarely reported but do indicate differences in phenotypic presentation and survival in amyotrophic lateral sclerosis (ALS). In this study, we aimed to investigate the natural history of a cohort of ALS patients from a multiethnic population. Methods: Data from ALS patients presenting to our multidisciplinary ALS clinic were prospectively collected from January 2015 to June 2020 as part of an ongoing hospital-based patient registry. Kaplan-Meier and Cox regression model were performed to identify potential prognostic factors. Results: A total of 144 ALS patients were recruited. We estimated the crude ALS incidence as 0.53 per 100,000 for 2019 but rises to 2 per 100,000 in patients aged 60-74 years. The majority of patients were of Chinese ethnicity (59.7%), followed by Malay (24.3%), Indian (11.1%), and others (4.9%). Malaysian Indians had a significantly steeper ALSFRS-R slope at diagnosis (p = 0.040). We found a worse prognosis in patients with bulbar-onset (HR = 1.915, p = 0.019), older age (HR = 1.052, p = 0.000), and who were fast-progressors (HR = 1.274, p = 0.000). In contrast, a higher body mass index (HR = 0.921, p = 0.007) and a longer time to diagnosis (HR = 0.967, p = 0.006), noninvasive ventilation (HR = 0.820, p = 0.000) and percutaneous endoscopic gastrostomy insertion (HR = 0.823, p = 0.000) were associated with better survival. On multivariate analysis, diagnostic delay and slow disease progression were associated with better survival. Conclusions: In our cohort, diagnostic delay and a slow disease progression were significantly associated with better survival in ALS. We also found ethnic variation with Chinese preponderance and more rapid disease progression in patients of Indian descent.

Matched MeSH terms: Noninvasive Ventilation*
Outcomes of Long-Term Noninvasive Ventilation Use in Children with Neuromuscular Disease: Systematic Review and Meta-Analysis

AlBalawi MM, Castro-Codesal M, Featherstone R, Sebastianski M, Vandermeer B, Alkhaledi B, et al.

Ann Am Thorac Soc, 2022 01;19(1):109-119.
PMID: 34181865 DOI: 10.1513/AnnalsATS.202009-1089OC

Objectives: To determine whether children with neuromuscular disorders using long-term noninvasive ventilation (NIV), continuous or bilevel positive airway pressure, have improved health outcomes compared with alternative treatment strategies. Data Sources: This systematic review is an extension of a scoping review. The search strategy used Medical Subject Headings and free-text terms for "child" and "noninvasive ventilation." Studies of humans from 1990 onward were searched in MEDLINE (Ovid), Embase (Ovid), CINAHL (Ebsco), Cochrane Library (Wiley), and PubMed. The results were reviewed for articles reporting on neuromuscular disorders and health outcomes including mortality, hospitalization, quality of life, lung function, sleep study parameters, and healthcare costs. Data Extraction: Extracted data included study design, study duration, sample size, age, type of NIV, follow-up period, primary disease, and primary and secondary outcome measures. Studies were grouped by primary disease into three groups: spinal muscular atrophy, Duchenne muscular dystrophy, and other/multiple neuromuscular diseases. Data Synthesis: A total of 50 articles including 1,412 children across 36 different neuromuscular disorders are included in the review. Mortality is lower for children using long-term NIV compared with supportive care across all neuromuscular disease types. Overall, mortality does not differ when comparing the use of NIV with invasive mechanical ventilation, though heterogeneity suggests that mortality with NIV is higher for spinal muscular atrophy type 1 and lower for other/multiple neuromuscular diseases. The impact of long-term NIV on hospitalization rate differed by neuromuscular disease type with lower rates compared with supportive care but higher rates compared with supportive care use for spinal muscular atrophy type 1, and lower rates compared with before NIV for other/multiple neuromuscular diseases. Overall, lung function was unaltered and sleep study parameters were improved from baseline by long-term NIV use. There are few data to assess the impact of long-term NIV use on quality of life and healthcare costs. Conclusions: Long-term NIV for children provides benefit for mortality, hospitalizations, and sleep study parameters for some sub-groups of children with neuromuscular disorders. High risk of bias and low study quality preclude strong conclusions.

Matched MeSH terms: Noninvasive Ventilation*
Indoor thermal comfort study: A case study at higher institution in East Coast of Malaysia

Rosli Abu Bakar, Ahmad Rasdan Ismail, Norfadzilah Jusoh, Abdul Mutalib Leman

Journal of Occupational Safety and Health, 2012;9(3):65-72.
MyJurnal

This paper discuss thermal comfort studies of an under air conditioning in hot and humid climate which at one of the higher institution in East Coast of Malaysia. Indoor thermal environment is important as it affects the health and productivity of building occupants. The paper reports on an experimental investigation of indoor thermal comfort characteristics under the control of air conditioning. Firstly, the well known Fanger’s thermal comfort model was simplified for the current experimental investigation. This is followed by reporting the experimental results of indoor thermal comfort characteristics under the control of temperature, with eight different of temperatures which are 22oC to 29oC. Finally, indoor thermal comfort was merely affected by the increment ventilation and outdoor climate. PMV value was higher when near from the window because of the effects of the wall radiations and the metabolic heat.

Matched MeSH terms: Ventilation
Data on the natural ventilation performance of windcatcher with anti-short-circuit device (ASCD)

Nejat P, Calautit JK, Majid MZ, Hughes BR, Jomehzadeh F

Data Brief, 2016 Dec;9:252-6.
PMID: 27660813 DOI: 10.1016/j.dib.2016.08.042

This article presents the datasets which were the results of the study explained in the research paper 'Anti-short-circuit device: a new solution for short-circuiting in windcatcher and improvement of natural ventilation performance' (P. Nejat, J.K. Calautit, M.Z. Abd. Majid, B.R. Hughes, F. Jomehzadeh, 2016) [1] which introduces a new technique to reduce or prevent short-circuiting in a two-sided windcatcher and also lowers the indoor CO2 concentration and improve the ventilation distribution. Here, we provide details of the numerical modeling set-up and data collection method to facilitate reproducibility. The datasets includes indoor airflow, ventilation rates and CO2 concentration data at several points in the flow field. The CAD geometry of the windcatcher models are also included.

Matched MeSH terms: Ventilation
Fulltext Using computational fluid dynamics in the determination of solar collector orientation and stack height of a solar induced ventilation prototype

Yusoff, W. F. M., Sapian, A. R., Salleh, E., Adam, N. M., Hamzah, Z., Mamat, M. H. H.

Pertanika Journal of Science & Technology, 2014;22(1):273-288.
MyJurnal

Stack ventilation in the hot and humid climate is inherently inefficient due to minimal air temperature differences between indoor and outdoor environment of a naturally ventilated building. Solar induced ventilation is a viable alternative in enhancing this stack ventilation. This paper aims to demonstrate investigations on the effective solar collector orientation and stack height for a solar induced ventilation prototype that utilizes roof solar collector and vertical stack. The orientation of the solar collector is significant as it determines the amount of solar radiation absorbed by the solar collector. Meanwhile, the height of the vertical stack influences the creation of the stack pressure in inducing air movement. Investigations were executed using a simulation modelling software called FloVENT. The validation of the simulation modelling against physical experiment indicated a good agreement between these two results. Analyses were executed on the air temperature increments inside the solar collector. A high increment of the air temperature resulted in the effective orientation. Meanwhile, the air temperature and mass flow rate of the various heights of the vertical stack were also analyzed. The findings concluded that the recommended orientation for the prototype’s solar collector is the west-facing orientation. It was also found that the higher the vertical stack, the lower the air temperature inside the stack would be, but with greater induced mass flow rate.

Matched MeSH terms: Ventilation
Fulltext Energy Optimization Using a Case-Based Reasoning Strategy

González-Briones A, Prieto J, De La Prieta F, Herrera-Viedma E, Corchado JM

Sensors (Basel), 2018 Mar 15;18(3).
PMID: 29543729 DOI: 10.3390/s18030865

At present, the domotization of homes and public buildings is becoming increasingly popular. Domotization is most commonly applied to the field of energy management, since it gives the possibility of managing the consumption of the devices connected to the electric network, the way in which the users interact with these devices, as well as other external factors that influence consumption. In buildings, Heating, Ventilation and Air Conditioning (HVAC) systems have the highest consumption rates. The systems proposed so far have not succeeded in optimizing the energy consumption associated with a HVAC system because they do not monitor all the variables involved in electricity consumption. For this reason, this article presents an agent approach that benefits from the advantages provided by a Multi-Agent architecture (MAS) deployed in a Cloud environment with a wireless sensor network (WSN) in order to achieve energy savings. The agents of the MAS learn social behavior thanks to the collection of data and the use of an artificial neural network (ANN). The proposed system has been assessed in an office building achieving an average energy savings of 41% in the experimental group offices.

Matched MeSH terms: Ventilation
The effect of core stability training with ball and balloon exercise on respiratory variables in chronic non-specific low back pain: An experimental study

Mohan V, Paungmali A, Sitilertpisan P, Henry LJ, Omar FA, Azhar FZ

J Bodyw Mov Ther, 2020 Oct;24(4):196-202.
PMID: 33218511 DOI: 10.1016/j.jbmt.2020.07.007

BACKGROUND: Studies have shown the involvement of respiratory characteristics and their relationship with impairments in non-specific low back pain (NS-LBP). The effects of core stability with a combined ball and balloon exercise (CBB) on respiratory variables had not been investigated.
OBJECTIVE: To evaluate the effectiveness of CBB on respiratory variables among NS-LBP patients.
STUDY DESIGN: pre- and post-experimental study.
PARTICIPANTS: Forty participants were assigned to an experimental group (EG) [n = 20] and control group (CG) [n = 20] based on the study criteria.
INTERVENTIONS: The EG received CBB together with routine physiotherapy and the CG received routine physiotherapy over a period of 8 weeks. Participants were instructed to carry out the exercises for 3 days per week. The training was evaluated once a week and the exercises progressed based on the level of pain.
OUTCOME MEASURES: Primary outcomes were maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP) and maximum voluntary ventilation (MVV). The secondary outcomes were measured in the numeric rating scale (NRS), total faulty breathing scale (TFBS), cloth tape measure (CTM) and lumbo-pelvic stability.
RESULTS: The MIP increased significantly among the EG when compared with that in the CG (p > 0.05).The EG showed a significant increase in MVV (p = 0.04) when compared to the CG (p = 0.0001). There was a significant reduction in pain for both groups. The MEP, TFBS, chest expansion and core stability showed no changes in either group.
CONCLUSION: CBB was effective in improving respiratory variables among NS-LBP patients.

Matched MeSH terms: Maximal Voluntary Ventilation
Fulltext Data Assessment on the relationship between typical weather data and electricity consumption of academic building in Melaka

Ngah Nasaruddin A, Tee BT, Mohd Tahir M, Md Jasman MES

Data Brief, 2021 Apr;35:106797.
PMID: 33614870 DOI: 10.1016/j.dib.2021.106797

Exposure to hot and humid weather conditions will often lead to consuming a vast amount of electricity for cooling. Heating, ventilation, and air conditioning (HVAC) systems are customarily known as the largest consumers of energy in institutions and other facilities which raises the question regarding the impact of the weather conditions to the amount energy consumed. The academic building is a perfect example where a constant fixed daily operating characteristic is measured by the hour, aside from the occasional semester break. Therefore, it can be assumed that the daily HVAC services on an academic facility will operate on a fixed schedule each day, having a similar pattern all year round. This article aims to present an analysis on the relationship between typical weather data by implying the test reference year (TRY) and academic building electricity consumption in an academic building located at Durian Tunggal, Melaka. Typical weather data were generated in representing the weather data between 2010 and 2018 using the Finkelstein-Schafer statistic (F-S statistic) in addition to a data set of electricity consumption. Descriptive analysis and correlation matrix analysis were conducted using JASP software for two sets of sample data; Set A and Set B, with data points of 12 and 108, respectively. The result showed an alternate result with a positive correlation between 1)mean temperature-electricity consumption, and 2)mean rainfall-electricity consumption for data Set A, and a negative correlation between 1)mean temperature-electricity consumption and 2)mean rainfall-electricity consumption for data Set B.

Matched MeSH terms: Ventilation
Fulltext PARTICULATE RESUSPENSION DURING THE USE OF VACUUM CLEANERS ON OFFICE CARPETS IN UNIVERSITI MALAYSIA TERENGGANU

SYAFIQAH ASYIQIN ROHADI, IZAN JAAFAR, ISMANIZA ISMAIL, TENGKU AZMINA IBRAHIM

UMT Journal of Undergraduate Research, 2020;2(2):41-48.
MyJurnal

The household activities such as vacuuming may elevate the concentration of particulate matter in indoor environments. Cleaning workers and occupants inside closed room may be exposed to the fine particulate matter and at risk of developing numerous respiratory symptoms. This study aims to determine the concentration of the particulate matter (PM10 and PM2.5) that might arise during vacuuming activities and estimated the surface compartmental residence time of particulate matter in indoor environment after each vacuuming activities. The PM10 and PM2.5 concentrations throughout vacuuming were measured in forty-seven offices in Universiti Malaysia Terengganu using the TSI Dust Track DRX. Based on the concentrations measured, the surface compartmental residence time was then estimated using standardized equations taken from literature. The result shows that highest particulate matter concentration was nearly eleven times higher than the World Health Organization guidelines of 25 µg/m3 for PM2.5 concentration (PM2.5 was 270 µg/m3, PM10 was 421 µg/m3), while the particulate matter were estimated to remain lingers inside the air for around 1-4 days before being deposited on the surface. In conclusion, the usage of vacuum cleaners may contribute to more particulate matter being released inside the air due to the resuspension phenomenon. Therefore, it is important for the occupants to maintain proper ventilation after each vacuuming activities took place.

Matched MeSH terms: Ventilation
Local exhaust ventilation: past, present, and future

Nor Halim Hasan, Said, M.R., Leman, A.M.

Journal of Occupational Safety and Health, 2013;10(1):9-26.
MyJurnal

Engineering control is a method of controlling the risk of exposure to contaminants. Health effects to industrial workers are more severe whilst high exposure and time exposed to contaminants at workplace. Installation of industrial ventilation or local exhaust ventilation (LEV) system is the proposed method to reduce the risk. This paper discusses the past, present and future relating to LEV system in Malaysia. Current issues related to monitoring reported by Hygiene Technician in compliance with Occupational Safety and Health (Use of Standard Chemical Hazardous to Health Regulation 2000) carried out in several states in Malaysia as a sample. The nanotechnology is a new area at present and future. The involvement of government, employers and employees need to be justified due to the attention to prevent and control of any exposure. It is suggested that using the Computational Fluid Dynamic (CFD) simulation, a new design of LEV system can be upgraded and predicted.

Matched MeSH terms: Ventilation
Fulltext Development and validation of a mathematical model for ventilation rate in crop protection structures

Al-Shamiry, Faisal Mohammed Seif, Desa Ahmad

Pertanika Journal of Science & Technology, 2010;18(1):-.
MyJurnal

Natural ventilation is defined as the number of air exchanges per hour per unit floor area necessary
to reduce high indoor air temperature and humidity. In addition, it maintains the concentration of carbon dioxide. Natural ventilation is preferred in mechanical system as the ventilation opening is built into the greenhouse, with lower construction cost and no energy and maintenance inputs are required. A mathematical model to quantify natural ventilation rates was developed and verified in large-scale greenhouse structures. For this purpose, four Naturally Ventilated Tropical Greenhouse Structures were designed and constructed at the Malaysian Agricultural Research and Development Institute (MARDI). These were single, double, triple, and quadruple span structures with floor areas of 500 m2, 1000 m2, 1500 m2 and 2000 m2, respectively. This paper presents the validation of a mathematical model which was developed to quantify natural ventilation rates which are very crucial to reduce high in-house temperature built up in the tropics. Regression equations of natural ventilation against wind speed were found to be Φw = 0.0632V, Φw= 0.0395V, Φw= 0.0316Vand Φw=0.0276V for the single, double, triple and quadruple spans, respectively. Meanwhile, coefficients of determination showed strong relationships between ventilation rate and wind speed, with R2 = 0.9999 for all structures. Larger floor area was found to have higher in-house temperature than smaller ones. Ventilation rate inside the single-span structure was found to be higher compared to the multi-span structures, which increased linearly with the increasing wind speed at the eaves of structure.

Matched MeSH terms: Ventilation
Fulltext Study on radon emanation from selected building materials in Malaysia

Ahmed, Al-Halemi, Jaafar, M.S.

Journal of Nuclear and Related Technologies, 2010;2010(1):14-20.
MyJurnal

Radon-222 emanation from selected locally produced samples of building materials, used in Malaysia were measured using the Professional Continuous Radon Monitor Model 1027, which is a patented electronic detecting-junction photodiode sensor to measure the concentration of radon gas. Each sample was placed for 72 hours inside a 3.11 x 10 -2 m 3 sealed container. It was found that the average radon concentration Bqm -3 of air for concrete bricks, concrete brick with cemented coatings, concrete brick with cemented coatings and paint samples were, 303.7 Bq/m 3, 436.6 Bqm -3, and 410.7 Bqm -3, respectively. (Bqm -3 ) for brown clay brick, brown clay brick with cemented coatings, brown clay brick with cemented coatings and paint were 166.5 Bqm -3, 166.5 Bqm -3, and 148 Bqm -3, respectively. (Bqm -3 ) for sample of compact ceramic tile was 0 Bqm -3. The findings show that concrete brick samples are important source of radon emanation, while brown clay brick have been accepted as the recommendation of the U.S. Environmental Protection Agency (EPA), and ceramic tiles had no emanation of radon gas due to their compact surface, or the glazed layer created on the tile surface during the manufacturing process, which blocks radon emanation. A positive correlation between radon emanation and radium content has been observed for both brown clay brick and concrete brick samples whereas a negative correlation for ceramic tile has been observed. Consequently from the findings, in order to reduce radon emanation and radon exposure in house dwellings and in addition to EPA recommendation of sealed cracks and established good ventilation, we recommend concrete walls to be painted and concrete floors to be paved with ceramic tiles.

Matched MeSH terms: Ventilation
Fulltext The impact of high frequency oscillatory ventilation on mortality in paediatric acute respiratory distress syndrome

Wong JJ, Liu S, Dang H, Anantasit N, Phan PH, Phumeetham S, et al.

Crit Care, 2020 01 31;24(1):31.
PMID: 32005285 DOI: 10.1186/s13054-020-2741-x

BACKGROUND: High-frequency oscillatory ventilation (HFOV) use was associated with greater mortality in adult acute respiratory distress syndrome (ARDS). Nevertheless, HFOV is still frequently used as rescue therapy in paediatric acute respiratory distress syndrome (PARDS). In view of the limited evidence for HFOV in PARDS and evidence demonstrating harm in adult patients with ARDS, we hypothesized that HFOV use compared to other modes of mechanical ventilation is associated with increased mortality in PARDS.
METHODS: Patients with PARDS from 10 paediatric intensive care units across Asia from 2009 to 2015 were identified. Data on epidemiology and clinical outcomes were collected. Patients on HFOV were compared to patients on other modes of ventilation. The primary outcome was 28-day mortality and secondary outcomes were 28-day ventilator- (VFD) and intensive care unit- (IFD) free days. Genetic matching (GM) method was used to analyse the association between HFOV treatment with the primary outcome. Additionally, we performed a sensitivity analysis, including propensity score (PS) matching, inverse probability of treatment weighting (IPTW) and marginal structural modelling (MSM) to estimate the treatment effect.
RESULTS: A total of 328 patients were included. In the first 7 days of PARDS, 122/328 (37.2%) patients were supported with HFOV. There were significant differences in baseline oxygenation index (OI) between the HFOV and non-HFOV groups (18.8 [12.0, 30.2] vs. 7.7 [5.1, 13.1] respectively; p

Matched MeSH terms: High-Frequency Ventilation/methods; High-Frequency Ventilation/mortality; High-Frequency Ventilation/standards*
Fulltext Retrospective review of grommet insertions for otitis media with effusion in children in Singapore

Nurliza I, Lim LH

Med J Malaysia, 2011 Aug;66(3):227-30.
PMID: 22111445 MyJurnal

Otitis media with effusion is one of the most common childhood infections, and grommet insertions are done for chronic otitis media which have failed medical therapy. The aims of this study were 1) to determine the patient profile of children needing grommet insertion and 2) to determine if grommet insertion is safe and effective. A retrospective review of 105 children with myringotomy and grommet insertions for chronic otitis media with effusion between 2006 and 2008 was performed. Seventy two percent of patients were younger than 6 years old. Male to female ratio was 4:3. Twelve percent of patients were syndromic. In children with otitis media with effusion, hearing and academic performance improved after grommet insertion. Allergic rhinitis and cleft palate are risk factors for chronic middle ear effusion.

Matched MeSH terms: Middle Ear Ventilation*
Grommet insertion using a branula

Raman R, Rahmat O

J Laryngol Otol, 2008 Jul;122(7):735-6.
PMID: 18346289 DOI: 10.1017/S0022215108001928

To develop an easy method of performing myringotomy and grommet insertion, using minimal instruments.
Methods: An ear speculum and a branula were used.
Results: This method was found to be useful.
Conclusion: An easy method of performing myringotomy and grommet insertion is proposed.
Key words: Middle Ear Ventilation; Grommet Insertion; Otitis Media With Effusion

Matched MeSH terms: Middle Ear Ventilation/instrumentation*

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