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Objective To explore the effect of multi-disciplinary team (MDT) combined with bundle management on prevention and control of multidrug-resistant organism (MDRO) infection in the intensive care unit(ICU).Methods Patients who were admitted to the ICU in a tertiary first-class hospital from January 2013 to December 2015 were studied,MDT combined with bundle management has been applied in the prevention and control of MDRO infection in ICU since January 2014,continuous quality improvement program was performed one year later,isolation of MDROs from specimens of ICU patients before implementation(in the year of 2013),after implementation(in the year of 2014),and after continuous quality improvement(in the year of 2015) was compared.Results The infection rates of MDROs in ICU patients before implementation,after implementation,and after continuous quality improvement were 26.55％ (154/580),17.13％ (117/683),and 12.01％ (77/641) respectively,showing a downward trend,with a significant difference (x2 =44.030,P＜0.001);the total isolation rates of MDROs in ICU patients were 64.44％(154/239),63.59％(117/184),and 43.26％ (77/178) respectively,showing a downward trend,with a significant difference (x2 =22.284,P＜0.001).The main MDROs in ICU were multidrug-resistant (MDR) and pandrug resistant(PDR) Acinetobacterbaumannii (44.54％).Conclusion MDT combined with bundle management can decrease MDRO infection rate and isolation rate in ICU.
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Respirator breathing resistance impacts performance of wearers during constant work load. However, it is less clear as to how breathing resistance affects the tolerant capacity of users during graded work load. The present study investigated the tolerant capacity of 8 individuals during incremental work load. The 8 subjects were required to wear two matched respirators (respirators I and II which were designed to have different breathing resistances and the same dead space) respectively on separate days and then work to end points. Minute ventilation (V(E)), breathing frequency (BF), oxygen consumption (VO(2)) and heart rate (HR) were recorded during exercise, while tolerant time, response time and breathing discomfort were measured at the end of each test trial. The test variables were compared between the two respirators by using matched-pairs t-test. The results showed that the tolerant time was significantly reduced for the respirator I with higher level of breathing resistance when compared with its counterpart with lower breathing resistance (respirator II) (P<0.05). The same changes occurred for response time. Results also showed a significant increase in V(E) and BF for respirator I wearers when the work load was above 125 W. The O(2) consumption was similar under the two breathing resistance conditions. These findings suggested that the respiratory resistance caused by self-contained breathing apparatus (SCBA) has an impact on the tolerant capacity of users.
Subject(s)
Humans , Male , Young Adult , Airway Resistance , Physiology , Exercise , Physiology , Exercise Tolerance , Physiology , Oxygen Consumption , Physiology , Physical Exertion , Physiology , Respiration, Artificial , Methods , Respiratory Mechanics , PhysiologyABSTRACT
Respirator breathing resistance impacts performance of wearers during constant work load. However, it is less clear as to how breathing resistance affects the tolerant capacity of users during graded work load. The present study investigated the tolerant capacity of 8 individuals during incremental work load. The 8 subjects were required to wear two matched respirators (respirators I and II which were designed to have different breathing resistances and the same dead space) respectively on separate days and then work to end points. Minute ventilation (V(E)), breathing frequency (BF), oxygen consumption (VO(2)) and heart rate (HR) were recorded during exercise, while tolerant time, response time and breathing discomfort were measured at the end of each test trial. The test variables were compared between the two respirators by using matched-pairs t-test. The results showed that the tolerant time was significantly reduced for the respirator I with higher level of breathing resistance when compared with its counterpart with lower breathing resistance (respirator II) (P<0.05). The same changes occurred for response time. Results also showed a significant increase in V(E) and BF for respirator I wearers when the work load was above 125 W. The O(2) consumption was similar under the two breathing resistance conditions. These findings suggested that the respiratory resistance caused by self-contained breathing apparatus (SCBA) has an impact on the tolerant capacity of users.
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<p><b>AIM</b>To investigate the sweat regulation mechanism of human body.</p><p><b>METHODS</b>Arm muscular work was performed on bicycle ergometer by eight healthy male subjects on 20 W and 40 W work loads lasting 10 min or 20 min in 16 degrees C and 21 degrees C ambient temperature. Sweat, metabolic rate and corresponding skin and core temperature changes were measured during different periods.</p><p><b>RESULTS</b>Sweat varied directly with ambient temperature and there were the corresponding changes in mean skin temperature, rectal temperature and metabolic rate. And when the work load was elevated, the skin temperature at chest and metabolic rate increased as sweat increased. There were no differences in the physiological indices between 20 W 20 min and 20 W 10 min, but mean skin temperature and sweat rate during 40 W 20 min work were higher than 40 W 10 min while metabolic rate did not change. The time when chest temperature arrived at the threshold was in correspondence with obvious sweat onset. Both local skin temperature at chest and metabolic rate were significantly correlated with sweat, but the latter was stronger. The regression equation relating metabolic rate and sweat rate was compound function.</p><p><b>CONCLUSION</b>Skin temperature was important for sweat onset, and the sweat predicted model based on the metabolic rate or ambient temperature was more suitable and practical.</p>
Subject(s)
Adult , Humans , Male , Body Temperature Regulation , Physiology , Energy Metabolism , Environment , Sweating , Physiology , TemperatureABSTRACT
Objective To explore a space craft precooling temperature at which excessive thermal stress on the crew member could be prevented or reduced in an overheated launch or reentry module. Method Five young male volunteers wearing a space suit participated in 25 tests at sea level.The space suit was either ventilated in a volume air flow rate of 100 L/min (STPD) with ambient air at temperatures (Ta) of 15℃,10℃,and 5℃,respectively,or not ventilated. Rectal (Tr),mean skin (Tsk) and mean body (Tb) temperatures were measured. Result At Ta 15℃,Tr decreased without significance (from 37.0±0.2℃to 36.7±0.3℃) in 120-min tests,whereas Tsk and Tb decreased significantly,and subjects had local cold strain whether the space suit was ventilated or not; while at Ta 10℃,Tr decreased from 37.0±0.3℃ to 36.3±0.3℃(P<0.05),subjects had a whole body cold strain,and both Tsk and Tb dropped continuously and significantly. Conclusion Ambient temperature 15℃,at which the thermal comfort states of crew was not significantly degraded,was acceptable after precooling in a space craft.