ABSTRACT
ABSTRACT Objective Humidity and temperature are fundamental for the balance in the life cycle of living beings and, consequently, for maintaining the well-being of the human population and reducing the prevalence of infectious diseases. Thus, in order to mitigate the impact of climate change, especially in the period when humidity is not the ideal, it is necessary to adopt some assistance measures. The present experimental study aims to elucidate what would be the recommended option to improve the quality of life of the human being and to clarify which resources (air humidifier, bucket of water or wet towel) will be effective to improve the humidity of the air in times of drought and low moisture. Methods The experimental study was carried out with INKBIRD hygrometers allowing the analysis of the variation of air humidity throughout the day. Three forms of treatment were established: humidifier, wet towel and bucket of water. In each room, two hygrometers were placed equidistant from the occupant of the room and their respective treatment that varied between 1m and 2m away from the headboard indoor each room. In addition, two environments were used as controls, one being an external environment and the other an internal closed environment, totaling five rooms for the study. The rooms were monitored between the end of July and the end of August 2019 in Goiania (GO). Results Although assistance measures are used to significantly improve air pollution in times of extreme drought, there was a significant difference between them. The humidifier and a wet towel had 7.50% and 5.71% more humidity in the external relation (external control), respectively, more efficient. The volume of water, however, did not show significant difference (p>0.05) and, therefore, there was no variation. Conclusion The humidifier and the towel are treatments considered more efficient, and that there was a significant effect of distance on humidity. Therefore, 1m of distance is more efficient in increasing and/or maintaining air humidity, inducing improvements in the populations' health.
RESUMO Objetivo A umidade e a temperatura são fundamentais para o equilíbrio no ciclo da vida dos seres vivos e, consequentemente, para manter o bem-estar da população humana e diminuir a prevalência de doenças infecciosas. Visando mitigar o impacto das alterações climáticas, principalmente no período em que a umidade não é a ideal, é preciso adotar algumas medidas assistencialistas. O presente estudo visa elucidar qual seria a opção mais indicada para melhorar a qualidade de vida do ser humano e esclarecer qual melhor recurso (umidificador de ar, balde com água ou toalha molhada) é eficaz para melhorar a umidade do ar em épocas de seca e baixa umidade. Métodos Estudo experimental realizado com higrômetros INKBIRD que permitiram a análise da variação da umidade do ar ao longo do dia. Foram estabelecidas três formas de tratamento: umidificador, toalha molhada e balde com água. Em cada quarto, foram colocados dois higrômetros equidistantes do ocupante do quarto e seu respectivo tratamento, que variava entre 1m e 2m de distância da cabeceira da cama dentro de cada cômodo. Além disso, dois ambientes foram utilizados como controle, sendo um externo e outro fechado interno, totalizando cinco cômodos para o estudo. Os cômodos foram monitorados entre o final do mês de julho até final do mês de agosto de 2019 em Goiânia (GO). Resultados Apesar de as medidas assistencialistas serem utilizadas para melhora significativa da umidade do ar em épocas de extrema seca, há uma diferença significativa entre elas. O umidificador e a toalha molhada possuíram 7,50% e 5,71% a mais de umidade em relação à área externa (controle externo), respectivamente, sendo considerados mais eficientes. Já o balde de água não se diferenciou significativamente (p>0,05), não havendo variação. Conclusão O umidificador e a toalha foram os tratamentos considerados mais eficientes, com efeito significativo da distância sobre a umidade. Portanto, 1m de distância é mais eficiente no aumento e/ou na manutenção da umidade do ar, induzindo melhorias na saúde da população.
Subject(s)
Humans , Quality of Life , Water , Temperature , HumidityABSTRACT
RESUMO Objetivo: Avaliar as possíveis alterações do volume corrente, volume-minuto e frequência respiratória causadas pela utilização de trocadores de calor e umidade em pacientes submetidos à ventilação mecânica na modalidade pressão de suporte, e quantificar a variação da pressão de suporte necessária para compensar o efeito causado pelo trocador de calor e umidade. Métodos: Os pacientes sob ventilação mecânica invasiva na modalidade pressão de suporte foram avaliados utilizando umidificadores aquecidos e trocadores de calor e umidade. Caso o volume encontrado com uso de trocadores de calor e umidade fosse menor que o achado com o umidificador aquecido, iniciava-se o aumento da pressão de suporte, perante o uso de trocadores de calor e umidade, até ser encontrado um valor de pressão de suporte que possibilitasse ao paciente gerar um valor próximo do volume corrente inicial com umidificador aquecido. A análise foi realizada por meio do teste t pareado, e os valores de incremento foram expressos em porcentagem de aumento necessário. Resultados: Foram avaliados 26 pacientes. O uso de trocadores de calor e umidade aumentou a frequência respiratória, e reduziu o volume corrente e o volume-minuto, quando comparados com o uso do umidificador aquecido. Com o uso de trocadores de calor e umidade, os pacientes precisaram de um incremento de 38,13% na pressão de suporte para manter os volumes prévios. Conclusão: O trocador de calor e umidade alterou os parâmetros de volume corrente, volume-minuto e frequência respiratória, sendo necessário um aumento da pressão de suporte para compensar estas alterações.
ABSTRACT Objective: To evaluate the possible changes in tidal volume, minute volume and respiratory rate caused by the use of a heat and moisture exchanger in patients receiving pressure support mechanical ventilation and to quantify the variation in pressure support required to compensate for the effect caused by the heat and moisture exchanger. Methods: Patients under invasive mechanical ventilation in pressure support mode were evaluated using heated humidifiers and heat and moisture exchangers. If the volume found using the heat and moisture exchangers was lower than that found with the heated humidifier, an increase in pressure support was initiated during the use of the heat and moisture exchanger until a pressure support value was obtained that enabled the patient to generate a value close to the initial tidal volume obtained with the heated humidifier. The analysis was performed by means of the paired t test, and incremental values were expressed as percentages of increase required. Results: A total of 26 patients were evaluated. The use of heat and moisture exchangers increased the respiratory rate and reduced the tidal and minute volumes compared with the use of the heated humidifier. Patients required a 38.13% increase in pressure support to maintain previous volumes when using the heat and moisture exchanger. Conclusion: The heat and moisture exchanger changed the tidal and minute volumes and respiratory rate parameters. Pressure support was increased to compensate for these changes.
Subject(s)
Humans , Male , Female , Aged , Respiration, Artificial/methods , Tidal Volume , Respiratory Rate/physiology , Humidifiers , Prospective Studies , Hot Temperature , Middle AgedABSTRACT
In 2011, a cluster of peripartum patients were admitted to the intensive care unit of a tertiary hospital in Seoul with signs and symptoms of severe respiratory distress of unknown etiology. Subsequent epidemiological and animal studies suggested that humidifier disinfectant (HD) might represent the source of this pathology. Epidemiological studies, animal studies, and dose-response analysis demonstrated a strong association between HD use and lung injuries. The diagnostic criteria for HD-associated lung injury (HDALI) was defined on the basis of the clinical, pathological, and radiological attributes of the patients. The clinical spectrum of HDALI appears to range from asymptomatic to full-blown acute respiratory failure, and some patients have required actual lung transplantation for survival. The overall mortality of the exposed population was not significant, although peripartum patients and children who were admitted to the intensive care unit did show high mortality rates. Persistent clinical findings such as diffuse ill-defined centrilobular nodules and restrictive lung dysfunction were observed in some of the survivors. The findings of this review emphasize the importance of assessment of the level of toxicity of chemical inhalants utilized in a home setting, as well as the need to identify and monitor afflicted individuals after inhalational injury.
Subject(s)
Animals , Child , Humans , Diagnosis , Disinfectants , Epidemiologic Studies , Humidifiers , Intensive Care Units , Lung Injury , Lung Transplantation , Lung , Mortality , Pathology , Peripartum Period , Prognosis , Respiratory Insufficiency , Seoul , Survivors , Tertiary Care CentersABSTRACT
In April 2011 a tertiary hospital located in Seoul, Korea reported several cases of severe respiratory distress of unknown origin in young adults. To find the route of transmission, causative agent and patient risk factors of the outbreak, an investigation of the epidemic was initiated. A hospital based case-control study was conducted to indicate that humidifier detergent use was the cause of the outbreak. This information led the Ministry of Health and Welfare of Korea issued an order that humidifier detergents should be withdrawn from the market. Here, we describe the major events of planning, execution, and interpretation of the study, and discussions between researchers and public authorities following the decision to perform an epidemiologic study, chronologically.
Subject(s)
Humans , Young Adult , Case-Control Studies , Detergents , Disease Outbreaks , Disinfectants , Epidemiologic Studies , Humidifiers , Korea , Lung Diseases , Lung , Republic of Korea , Risk Factors , Seoul , Tertiary Care CentersABSTRACT
OBJECTIVES: As of November 2011, the Korean government recalled and banned humidifier disinfectants (HDs) from the market, because four case-control studies and one retrospective epidemiological study proved the association between HDs and lung injury of unknown cause. The report reviewed the causal role of HDs in lung injury based on scientific evidences. METHODS: A careful examination on the association between the HDs and lung injury was based on the criteria of causality inference by Hill and the US Surgeon General Expert Committee. RESULTS: We found that all the evidences on the causality fulfilled the criteria (strength of association, consistency, specificity, temporality, biologic gradient, plausibility, coherence, experiment, analogy, consideration of alternative explanations, and cessation of exposure), which proved the unknown cause lung injury reported in 2011 was caused by the HDs. In particular, there was no single reported case of lung injury since the ban in selling HDs in November 2011 as well as before the HDs were sold in markets. CONCLUSIONS: Although only a few epidemiological studies in Korea have evaluated the association between lung injury and the use of HDs, those studies contributed to proving the strong association between the use of the HDs and lung injury, based on scientific evidence.
Subject(s)
Case-Control Studies , Disinfectants , Epidemiologic Studies , Evaluation Studies as Topic , Humidifiers , Korea , Lung Injury , Lung , Retrospective Studies , Sensitivity and SpecificityABSTRACT
In the spring of 2011, a cluster of lung injuries caused by humidifier disinfectant (HD) usage were reported in Korea. Many patients required mechanical ventilation, extracorporeal membrane oxygenation, and even lung transplantation (LTPL). However, the long-term course of HD-associated lung injury remains unclear because the majority of survivors recovered normal lung function. Here we report a 33-year-old woman who underwent LTPL approximately four years after severe HD-associated lung injury. The patient was initially admitted to the intensive care unit and was supported by a high-flow nasal cannula. Although she had been discharged, she was recurrently admitted to our hospital due to progressive lung fibrosis and a persistent decline in lung function. Finally, sequential double LTPL was successfully performed, and the patient's clinical and radiological findings showed significant improvement. Therefore, we conclude that LTPL can be a therapeutic option for patients with chronic inhalation injury.
Subject(s)
Adult , Female , Humans , Catheters , Disinfectants , Extracorporeal Membrane Oxygenation , Fibrosis , Humidifiers , Inhalation , Inhalation Exposure , Intensive Care Units , Korea , Lung Injury , Lung Transplantation , Lung , Oxygen Inhalation Therapy , Respiration, Artificial , SurvivorsABSTRACT
In the spring of 2011, a cluster of lung injuries caused by humidifier disinfectant (HD) usage were reported in Korea. Many patients required mechanical ventilation, extracorporeal membrane oxygenation, and even lung transplantation (LTPL). However, the long-term course of HD-associated lung injury remains unclear because the majority of survivors recovered normal lung function. Here we report a 33-year-old woman who underwent LTPL approximately four years after severe HD-associated lung injury. The patient was initially admitted to the intensive care unit and was supported by a high-flow nasal cannula. Although she had been discharged, she was recurrently admitted to our hospital due to progressive lung fibrosis and a persistent decline in lung function. Finally, sequential double LTPL was successfully performed, and the patient's clinical and radiological findings showed significant improvement. Therefore, we conclude that LTPL can be a therapeutic option for patients with chronic inhalation injury.
Subject(s)
Adult , Female , Humans , Catheters , Disinfectants , Extracorporeal Membrane Oxygenation , Fibrosis , Humidifiers , Inhalation , Inhalation Exposure , Intensive Care Units , Korea , Lung Injury , Lung Transplantation , Lung , Oxygen Inhalation Therapy , Respiration, Artificial , SurvivorsABSTRACT
BACKGROUND: Dry and cold anesthetic gas deteriorates patient's respiratory function and body heat balance. We examined whether a humidifier with heated wire circuit might maintain core temperature and humidity of inspired gas in patient undergoing general anesthesia. METHODS: We enrolled forty ASA physical status I, II patients under general anesthesia for this study. We allocated the patients randomly into two groups with (experimental group) or without (control group) Humitube(R) anesthesia circuit, which delivered heated and humidified inspired anesthetic gases. We recorded the temperatures and humidity of the inspired gases throughout the surgery. RESULTS: The temperatures and relative humidity of the inspired gases in experimental group were significantly greater compared to control group (36.2 +/- 0.9degrees C, 89.5 +/- 4.8% vs. 30.4 +/- 1.8degrees C, 37.9 +/- 5.9%, P < 0.05) during anesthesia. The core temperatures in experimental group were significantly greater compared to control group (36.1 +/- 0.3degrees C vs. 35.7 +/- 0.1degrees C, P < 0.05) during anesthesia. CONCLUSIONS: A humidifier with heated wire system for anesthesia breathing circuit is helpful to maintain core temperature and adequate humidity.
Subject(s)
Humans , Anesthesia , Anesthesia, General , Anesthetics, Inhalation , Body Temperature , Cold Temperature , Gases , Hot Temperature , Humidity , RespirationABSTRACT
BACKGROUND: This study aims to obtain basic data regarding the proper maintenance and potential role of humidifiers in the development of nosocomial pneumonia. We investigated into a spectrum of bacteria that grew after disinfection in humidifiers that were used in intensive care units (ICUs). The bacteria were isolated at different time points after disinfection. METHODS: We randomly selected 6 humidifiers that were used in an ICU and conducted a series of bacterial culture studies at 24 hr, 48 hr, 72 hr and 168 hr after disinfecting the six humidifiers. The fluid from the humidifider was cultured in the same manner as the dialysate. RESULTS: No bacteria were isolated in most of the 6 humidifiers 24 hr after the disinfection of the instruments. Gram-negative bacilli such as Acinetobacter baumannii, Burkholderia cepacia, and Stenotrophomonas maltophilia were cultured at 48 hr after disinfection. CONCLUSION: Regular and thorough disinfection of humidifiers is necessary to prevent possible spread of infection via humidifiers in the ICU.
Subject(s)
Acinetobacter baumannii , Bacteria , Burkholderia cepacia , Disinfection , Critical Care , Intensive Care Units , Pneumonia , Stenotrophomonas maltophiliaABSTRACT
Despite many theoretical advantages of humidification of anesthetic gas, the role and method of choice of humidification in anesthesia remains uncertain. With the recent introduction of disposable heat and moisture exchangers (HME), a paueity of information of the specific performance characteristics of various HMEs exists. Using an on-line humidity detector, based on the dry-wet bulb principle, with a fast response temperature sensor (0.l sec), I have reexamined the effectiveness in maintaining humidity and temperature of various commercially available HMEs in clinical settings, and the relationship of the effectiveness of the rate of fresh gas flow. Humid-Vent 2 demonstrated the best result that increased the inspired temperature from 22.78+/-0.2degrees C to 31.35+/-0.89degrees C (absolute humidity; 27.4+/-0.7mg H2O/L). Extreme low fresh gas flow(500ml/min) demonstrated low absolute humidity (18.87+/-1.28 mg H2O/L) that was lower than use of HME.
Subject(s)
Anesthesia , Hot Temperature , HumidityABSTRACT
Despite many theoretical advantages of humidification of anesthetic gas, the role and method of choice of humidification in anesthesia remains uncertain. With the recent introduction of disposable heat and moisture exchangers (HME), a paueity of information of the specific performance characteristics of various HMEs exists. Using an on-line humidity detector, based on the dry-wet bulb principle, with a fast response temperature sensor (0.l sec), I have reexamined the effectiveness in maintaining humidity and temperature of various commercially available HMEs in clinical settings, and the relationship of the effectiveness of the rate of fresh gas flow. Humid-Vent 2 demonstrated the best result that increased the inspired temperature from 22.78+/-0.2degrees C to 31.35+/-0.89degrees C (absolute humidity; 27.4+/-0.7mg H2O/L). Extreme low fresh gas flow(500ml/min) demonstrated low absolute humidity (18.87+/-1.28 mg H2O/L) that was lower than use of HME.