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Ventilators are widely needed when the COVID-19 is a global outbreak, and they are used to provide mechanical ventilation for patients who are physically unable to breathe, or breathe insufficiently. A ventilator tester is an instrument used to verify and calibrate ventilation parameters of ventilators like gas flow, tidal volume, frequency. As a measuring device, the ventilator tester also needs to be calibrated periodically. And different parameters are usually calibrated with different devices. In order to improve calibration efficiency and accuracy, a novel multi-parameter calibrator for ventilator tester based on reciprocating plunger is proposed in this work. The system composition is introduced and mathematical models are deduced. According to calibrating regulation, different calibrating modes are simulated and realized. © FLOMEKO 2022.All rights reserved
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Aim To explore the impact of coronavirus-2019 disease (COVID-19) pandemic on emergency reper-fusion characteristics in patients with ST-segment elevation myocardial infarction (STEMI) from non-epicenter. Methods This was a retrospective study involved STEMI patients undergoing primary percutaneous coronary intervention (PPCI), who admitted to chest pain center in our hospital during the pandemic ( from January 23 to March 29 in 2020) and the same period in 2019, excluding the patients with COVID-19. Clinical characteristics and reperfusion parameters were compared between the two groups. Results A total of 64 STEMI patients undergoing PPCI were enrolled in our study, including 13 patients during the pandemic and 51 patients during the same period in 2019. No differences occurred in admission signs, GRACE scores, arrival periods, transferred patterns,the period from door to troponin,and the period from first medical contact to dual antiplatelet between the two groups ( P>0. 05). As compared with 2019, STEMI patients undergoing PPCI had an apparent reduction. Meanwhile, significant delays appeared in reperfusion parameters, in-cluding the period from symptom onset to first medical contact (10 h vs. 3. 0 h, P<0. 001), the period from first medical contact to electrocardiogram (6 min vs. 3 min, P<0. 001), the period from door to troponin (15 min vs. 12 min, P = 0. 048), the period from door to device (76 min vs. 62 min, P = 0. 017), the period from telephone to catheter activated (15 min vs. 5 min, P<0. 001) and the period from catheter arrival to device (52 min vs. 41 min, P = 0. 033). Conclusion Even in non-epicenter, the COVID-19 outbreak still delayed mechanical reperfusion significantly. © 2022, Editorial Office of Chinese Journal of Arteriosclerosis. All rights reserved.
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Analgesia and sedation are basic parts of the treatment in the intensive care. Nevertheless, deep sedation during mechanical ventilation has many adverse effects. In last decades the trend towards mild titrated sedation is seen. It enables early weaning from mechanical ventilation and shortening the stay in the intensive care setting and hospital. In this article pharmacology of main drugs used for analgesia/sedation nad strategy of sedation in mechanically ventilated patients are described. The last section of this article is dedicated to sedation of patients with acute respiratory distress syndrome of common"and COVID -19 etiology. These patients usually suffer from critical respiratory failure and agressive ventilatory support, prone positioning and other invasive techniques are needed. That is why deep sedation or even paralysis is sometimes necessary, but also in these patients lower sedation and weaning attempts should be tried as soon as possible.Copyright © 2022 TIGIS Spol. s.r.o.. All rights reserved.
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Background: Coronavirus in 2019 was recognized as one of the leading causes of death worldwide. According to reports, the mortality rate in people who need mechanical ventilation varies from 50 to 97 percent. The aim of this study was to evaluate the outcome of Covid-19 disease based on different characteristics in patients and mechanically ventilated variables. Method(s): This descriptive-analytical study was conducted on 160 patients with a definite diagnosis of Covid-19 who were under mechanical ventilation and admitted to the intensive care unit of Alzahra Hospital in Isfahan from March 2020 to March 2021. Data was collected by checklist. The checklist included demographic information, including age, gender, as well as information such as underlying diseases, disease outcome, length of hospitalization, etc. After collecting the data, they were analyzed in SPSS software version 22 and at a significance level of less than 0.05. Result(s): In this study, the overall mortality rate among mechanically ventilated patients was 62.5%. The mean age of patients was 69.99+/-17.87 years and the mean duration of hospitalization in surviving patients was 15.47+/-11.73 days and for deceased ones was 55.21+/-69.14 days. The mean age of the deceased group (65.71+/-16.59) was significantly higher than the surviving group 53+/-21.17 was (P=0.0001). The length of hospital stay in the deceased group was significantly longer than the surviving group (P=0.005). As a result, ventilator mode and inotropic agent intake during treatment increased the chance of mortality in patients under mechanical ventilation (P=0.001). There was a significant relationship between underlying diseases of hypertension, kidney disease and autoimmune disease with mortality in patients (P<0.05). Conclusion(s): Various factors including the length of stay in the hospital, comorbidities such as hypertension, renal disease and autoimmunity may affect the outcome of critically ill ICU patients under mechanical ventilation. Patients who require long-term invasive ventilation and the use of inotropic drugs to maintain their cardiovascular status while hospitalized in the ICU are at higher risk for mortality.Copyright © 2022 Shetabi et al. Published by Tehran University of Medical Sciences.
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PurposeThis study aims to focus on the preparation and characterization of the silver nanowire (AgNWs), as well as their application as antimicrobial and antivirus activities either with incorporation on the waterborne coating formulation or on their own.Design/methodology/approachPrepared AgNWs are characterized by different analytical instruments, such as ultraviolet-visible spectroscope, scanning electron microscope and X-ray diffraction spectrometer. All the paint formulation's physical and mechanical qualities were tested using American Society for Testing and Materials, a worldwide standard test procedure. The biological activities of the prepared AgNWs and the waterborne coating based on AgNWs were investigated. And, their effects on pathogenic bacteria, antioxidants, antiviral activity and cytotoxicity were also investigated.FindingsThe obtained results of the physical and mechanical characteristics of the paint formulation demonstrated the formulations' greatest performance, as well as giving good scrub resistance and film durability. In the antimicrobial activity, the paint did not have any activity against bacterial pathogen, whereas the AgNWs and AgNWs with paint have similar activity against bacterial pathogen with inhibition zone range from 10 to 14 mm. The development of antioxidant and cytotoxicity activity of the paint incorporated with AgNWs were also observed. The cytopathic effects of herpes simplex virus type 1 (HSV-1) were reduced in all three investigated modes of action when compared to the positive control group (HSV-1-infected cells), suggesting that these compounds have promising antiviral activity against a wide range of viruses, including DNA and RNA viruses.Originality/valueThe new waterborne coating based on nanoparticles has the potential to be promising in the manufacturing and development of paints, allowing them to function to prevent the spread of microbial infection, which is exactly what the world requires at this time.
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The conventional methods used for the diagnostics of viral infection are either expensive and time-consuming or not accurate enough and dependent on consumable reagents. In the presence of pandemics, a fast and reagent-free solution is needed for mass screening. Recently, the diagnosis of viral infections using infrared spectroscopy has been reported as a fast and low-cost method. In this work a fast and low-cost solution for corona viral detection using infrared spectroscopy based on a compact micro-electro-mechanical systems (MEMS) device and artificial intelligence (AI) suitable for mass deployment is presented. Among the different variants of the corona virus that can infect people, 229E is used in this study due to its low pathogeny. The MEMS ATR-FTIR device employs a 6 reflections ZnSe crystal interface working in the spectral range of 2200-7000 cm-1. The virus was propagated and maintained in a medium for long enough time then cell supernatant was collected and centrifuged. The supernatant was then transferred and titrated using plaque titration assay. Positive virus samples were prepared with a concentration of 105 PFU/mL. Positive and negative control samples were applied on the crystal surface, dried using a heating lamp and the spectrum was captured. Principal component analysis and logistic regression were used as simple AI techniques. A sensitivity of about 90 % and a specificity of about 80 % were obtained demonstrating the potential detection of the virus based on the MEMS FTIR device. © 2023 SPIE.
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The COVID-19 pandemic has caused a severe global problem of ventilator shortage. Placing multiple patients on a single ventilator (ventilator sharing) or dual patient ventilation has been proposed and conducted to increase the cure efficiency for ventilated patients. However, the ventilator-sharing method needs to use the same ventilator settings for all the patients, which cannot meet the ventilation needs of different patients. Therefore, a novel multivent system for non-invasive ventilation has been proposed in this study. The close loop system consists of the proportional valve and the flow-pressure sensor can regulate the airway pressure and flow for each patient. Multiple ventilation circuits can be combined in parallel to meet patients’ventilation demands simultaneously. Meanwhile, the mathematical model of the multivent system is established and validated through experiments. The experiments for different inspired positive airway pressure (IPAP), expired positive airway pressure (EPAP), inspiratory expiratory ratio (I:E), and breath per minute (BPM) have been conducted and analyzed to test the performance of the multivent system. The results show that the multivent system can realize the biphasic positive airway pressure (BIPAP) ventilation mode in non-invasive ventilation without interfering among the three ventilation circuits, no matter the change of IPAP, EPAP, I:E, and BPM. However, pressure fluctuation exists during the ventilation process because of the exhaust valve effect, especially in EPAP control. The control accuracy and stability need to be improved. Nevertheless, the novel designed multivent system can theoretically solve the problem of ventilator shortage during the COVID-19 pandemic and may bring innovation to the current mechanical ventilation system. Author
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Philippines is one of the highest electricity prices in the ASEAN where harnessing renewable energy using wasted human effort is necessary. The global pandemic COVID-19 is spreading and because of this, establishments have required sanitation. The study's main objective is to Develop a Rotational Electromagnetic Induction Flywheel using Foot Pedal as Actuation to Harvest Renewable Energy. T-test was used to validate the results using the battery percentage of a power bank as the parameter, where there is a significant difference between single and multiple actuations with an attached mechanical dispenser and without. The system was able to harness an average of 0.30992 Watt-hour and 6.11476 Watt-hour in 5 daily trials for single and multiple controlled set-ups without mechanical dispenser respectively. An average of 0.2441 Watt-hour and 5.0027 Watt-hour for single and multiple controlled set-ups with mechanical dispenser correspondingly. Lastly, an average of 3.2924 Watt-hour in 5 daily trials for uncontrolled set-up. © 2023 IEEE.
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Introduction:Non-invasive mechanical ventilation is a ventilatory alternative for COVID-19 cases. Background:To describe the characteristics and evolution of non-invasive mechanical ventilation (NIMV) in patients discharged from Provisional Center for moderate COVID-19 patients in Figali, Panama. Methods:A descriptive, retrospective, longitudinal stu was carried out in all adult patients discharged from June to July 2021 and who received non-invasive mechanical ventilation. A questionnaire was used using the digital individual medical record as primary source. Descriptive statistics techniques were used. Results:35.9% of the patients (78/217) who were admitted required non-invasive mechanical ventilation on the ninth day of symptoms and the second day after admission. 62.8% (49/78) were obese and 29.5% (23/78) hypertensive. The respiratory rate 30 and the decrease in the PaO2/FiO2 ratio decided the begining of non-invasive mechanical ventilation in 56.4% (78/217) of those admitted. 62.8% (49/78) had moderate-severe acute respiratory distress syndrome, and the severity was related to ventilation failure out of the total number of ventilated patients. Ventilation was successful in 65.4% (51/78). PaO2/FiO2 <150 (62.9%), respiratory rate 30 (55.6%) and physical exhaustion (51.85%) decided ventilation failure. Conclusions:Non-invasive mechanical ventilation is an effective procedure in COVID-19 patients and moderate or severe respiratory distress;although its success is related to the less severe forms. Low PaO2/FiO2, together with symptoms, were key indicators to assess the begining, success or failure of NIMV;not so the values of PaO2, PaCO2 and SpO2.
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Considering the commonality of the pathogenetic links of the critical forms of COVID-19 and influenza AH1N1pdm09 (cytokine over-release syndrome), the question arises: will the predictors of an unfavorable outcome in patients on mechanical ventilation and, accordingly, the universal tactics of respiratory support in these diseases be identical? Objective. In a comparative aspect, to characterize patients with influenza AH1N1pdm09 and COVID-19 who were on mechanical ventilation, to identify additional clinical and laboratory risk factors for death, to determine the degree of influence of respiratory support (RP) tactics on an unfavorable outcome in the studied category of patients. Patients and methods. Patients treated on the basis of resuscitation and intensive care departments of the State Budgetary Healthcare Institution "SKIB" in Krasnodar and the State Budgetary Healthcare Institution "IB No 2" in Sochi were studied: group 1 - 31 people with influenza AH1N1pdm09 (21 people died - subgroup 1A;10 people survived - subgroup 1B) and group 2 - 50 people with COVID-19 (29 patients died - subgroup 2A;21 people survived - subgroup 2B). All patients developed hypoxemic ARF. All patients received step-by-step tactics of respiratory support, starting with oxygen therapy and ending with the use of "traditional" mechanical ventilation. Continuous variables were compared in subgroups of deceased and surviving patients for both nosologies at the stages: hospital admission;registration of hypoxemia and the use of various methods of respiratory therapy;development of multiple organ dysfunctions. With regard to the criteria for which a statistically significant difference was found (p < 0.05), we calculated a simple correlation, the relative risk of an event (RR [CI 25-75%]), the cut-off point, which corresponded to the best combination of sensitivity and specificity. Results. Risk factors for death of patients with influenza AH1N1pdm09 on mechanical ventilation: admission to the hospital later than the 8th day of illness;the fact of transfer from another hospital;leukocytosis >=10.0 x 109/l, granulocytosis >=5.5 x 109/l and LDH level >=700.0 U/l at admission;transfer of patients to mechanical ventilation on the 9th day of illness and later;SOFA score >=8;the need for pressor amines and replacement of kidney function. Predictors of poor outcome in ventilated COVID-19 patients: platelet count <=210 x 109/L on admission;the duration of oxygen therapy for more than 4.5 days;the use of HPNO and NIV as the 2nd step of RP for more than 2 days;transfer of patients to mechanical ventilation on the 14th day of illness and later;oxygenation index <=80;the need for pressors;SOFA score >=8. Conclusion. When comparing the identified predictors of death for patients with influenza and COVID-19 who needed mechanical ventilation, there are both some commonality and differences due to the peculiarities of the course of the disease. A step-by-step approach to the application of respiratory support methods is effective both in the case of patients with influenza AH1N1pdm09 and patients with COVID-19, provided that the respiratory support method used is consistent with the current state of the patient and his respiratory system, timely identification of markers of ineffectiveness of the respiratory support stage being carried out and determining the optimal moment escalation of respiratory therapy.Copyright © 2022, Dynasty Publishing House. All rights reserved.
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The rapid response to the COVID-19 pandemic has resulted in increased municipal waste in the form of used face masks (FMs), which pose a global threat to the environment. To mitigate this, the study explores the applicability of shredded FMs as alternative reinforcing material in sands. Laboratory-grade Ottawa sand and naturally collected sea sand are adopted as the base sands for testing. The primary physical properties of the base materials and the FMs are first examined, and the soil particles are imaged via scanning electron microscopy. Thirty consolidated undrained (CU) triaxial compression tests were conducted to evaluate the effects of the weight fraction of FM, FM length, and the initial effective mean stress on the undrained shear strength parameters of the sands. The experimental results proved that FM inclusion can lead to a substantial improvement in the undrained shear strength of the sands;however, such improvement was sensitive to the initial effective mean stress, with higher undrained shear strength gains associated with lower initial effective mean stress. For a given FM content, the critical state ratio and angle of friction at the critical state increased with the FM length. Finally, the results revealed that FM-reinforced sands exhibit dilative and strain-hardening behaviors.
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Introduction: Several factors may influence mortality in patients hospitalized with COVID-19. Objective: This research aimed to determine mortality and associated factors in adults with COVID-19 hospitalized in the intensive care unit of a Third Level Hospital in Paraguay. Methodology: Observational, descriptive of crossassociation, cross-sectional, and retrospective study. We included medical records of adult patients, of both sexes, who had a confirmed diagnosis (by antigen and/or PCR test) of SARS-CoV-2 infection and who were hospitalized in the intensive care unit of a Third Level General Hospital in Paraguay. Results: We included 116 patients, 54% of whom were male. The mean age was 57 ± 12.9 years. Of participants, 51% had hypertension and 29% diabetes mellitus. Mechanical ventilation was required in 85% of the patients. Of ventilated patients, 75% had a fatal outcome. A statistically significant association was found between the presence of bacterial infections and hemodialysis requirement and fatal outcome (p=0.0074 and p=0.00011, respectively). The mean age of the deceased patients was 59.5 years, while the group of patients discharged from the intensive care unit had a mean age of 54.2 years. The difference between these ages in relation to death was significant, with a p<0.05. Discussion: Overall mortality due to COVID-19 was more than 6 per 10 patients, being higher in those patients with ventilation. Those patients who presented bacterial superinfection or required hemodialysis during hospitalization had a worse outcome compared to patients who did not present this type of complications. © 2023, Faculty of Medical Sciences, Santa Rosa del Aguaray Branch, National University of Asuncion. All rights reserved.
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This paper presents the procedure followed to conduct two various experiments as part of the ‘Mechanical Laboratory' course of the Mechanical Engineering department, at Aristotle University of Thessaloniki, during the Covid-19 period. Adapting to the personal contact restrictions imposed by the health issue outbreak, a remote experimental method is proposed. In the first experiment, the students had to generate the operational map of a cooling computer fan while on the second one the characteristic parameters of a symmetric airfoil needed to be measured. Multifunctional control panel interfaces were introduced to the students. Through these applications, the student had the opportunity to run the experiments, assess the raw data, monitor all the necessary flow parameters and acquire the important variables. The students had to post-process the results and submit two reports, one for each experiment. This teaching method provided the students with the experience of real research project and guided them to use modern tools to enhance the quality of their future work. This publication focuses on the address of the challenges, arose during the automation of the experiments. The remote experimental sessions indicated some advantages in learning procedure which was also reflected on the assignment grades. The development of the procedure has been successfully implemented and tested over a couple of years while the quarantine measure have been in place. Furthermore, the experience gained will be used to implement modern communication protocols in the experimental set-ups.
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The outbreak of the Covid-19 virus prompted many engineers and researchers around the world to seek to develop mechanical ventilation devices and make them easy to use and affordable. This paper presents a simulation model for a group of medical sensors and gives very accurate results. This model contributes to the development and improvement of the artificial breathing system by comparing the results between the simulation model and the realistic response of the human lung. © 2023 IEEE.
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Aim of the study. To study the experience of using focused transthoracic echocardiography in patients with COVID-19 in prone position (fEchoPr) in intensive care units (ICU). Materials and methods. The retrospective observational study included 53 patients (period from 15 April to 31 December 2020). Inclusion criteria: confirmed diagnosis of COVID-19, availability of fEchoPr data, outcome certainty (discharge/death). We analyzed electronic medical records. The fEchoPr was performed in patients in the prone position with a bolster under the left side of the chest and left arm raised ('swimmer's position'). We assessed the systolic function of the right ventricle (RV) (tricuspid annular plane systolic excursion (TAPSE)), RV size, RV/LV ratio, systolic function of the left ventricle (LV) (left ventricular outflow tract velocity time integral. (LVOT VTI)), and pulmonary hypertension (PH) (tricuspid regurgitation peak gradient (PGTR). Depending on the results, the patients were divided into 2 groups: informative (+fEchoPr) and non-informative (-fEchoPr) examinations. Results. There was no statistically significant difference in the groups (+fEcho n = 35 vs -fEcho n = 18) by age (65.6 +/- 15.3 vs 60.2 +/- 15.8, p > 0.05), by gender (male: 23 (65.7%) vs 14 (77.8%), p > 0.05), by body mass index (31.3 +/- 5.3 kg/m2 vs 29.5 +/- 5.4 kg/m2, p > 0.05), by mechanical ventilation support (24 (68.6%) vs 17 (94.4%), p = 0.074), by NEWS scale indicators (6.9 +/- 3.7 vs 8.5 +/- 3.5 points), by mortality (82.8% vs 94.4%, p > 0.05). Correlation analysis revealed a moderate inverse relationship between being on mechanical ventilation and the informative value of the study (Spearman's r = -0.30 at p = 0.033). In the +fEchoPr group, the correct measurement of TAPSE and RV/LV was carried out in 100%: a decrease in RV systolic function was recorded in 5 patients (14%), expansion of the RV in 13 patients (37%). Signs of PH were detected in 11 patients (31%), PGTR could not be measured in 10 patients (28%). LV systolic dysfunction was detected in 7 patients (20%). No pathology was detected in 16 patients (46%). One patient was diagnosed with infective endocarditis of native mitral valve, which was later confirmed by autopsy. Conclusion. In 66% of cases, fEchoPr examinations were informative, especially in terms of assessing the state of the right heart. fEchoPr examination is an affordable, valid and reproducible method to assess and monitor the state of the heart in ICU patients.Copyright © 2021 VIDAR Publishing House. All Rights Reserved.
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Objectives This article observes the mean daily dose of fentanyl required for adequate sedation in critically ill, mechanically ventilated children randomized to receive dexmedetomidine or placebo.Methods We conducted Dexmedetomidine Opioid Sparing Effect in Mechanically Ventilated Children (DOSE), a multicenter, double-blind, randomized, placebo-controlled, dose-escalating trial. We enrolled children aged 35 weeks postmenstrual to 17 years (inclusive) admitted across 13 pediatric multidisciplinary and cardiac intensive care units. Adequate sedation was based on a State Behavioral Score and Richmond Agitation-Sedation Scale of -1 or lower. Only the first two dexmedetomidine dosing cohorts opened for enrollment, due to early trial closure during the coronavirus 2019 pandemic. Thirty children were randomized over 13 months and included in the analyses.Results Demographic and baseline characteristics were not different between dexmedetomidine and placebo cohorts. Similarly, mean daily fentanyl use was not different, using an unadjusted mixed regression model that considered treatment, time, and a treatment-by-time interaction. Adverse events and safety events of special interest were not different between cohorts.Conclusion The DOSE trial revealed that dexmedetomidine added to fentanyl does not impact safety and may not spare fentanyl use in critically ill children, although the trial did not meet its recruitment goals, due to early closure during the coronavirus 2019 pandemic. More rigorous inpatient pediatric trials like DOSE that study critically ill, mechanically ventilated children are needed. Despite the many obstacles faced, the DOSE trial presents challenges from which the greater research community can learn and use to optimize future therapeutic trials in children.
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Wearable sensor technologies have improved people's daily lives through their applications in almost every field. Sensor technologies of inventive kinds are used in an extensive variety of applications in lifestyle, healthcare, fitness, manufacturing, etc. There have also been crucial issues in making significant improvements to the actual mechanical, electrical, and optical sensing methods mainly in upgrading the precision of identification of wearable sensors to various stimuli. With an extensive study of the basic demands in wearable device technology as of now, the road map becomes clearer for creating greater innovations in the future. This is a review that gives an outline of types of wearable sensors by the score that is utilized in daily life. © 2023 IEEE.
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Objective. The prognosis value of fibrosis-4 score (FIB-4) in COVID-19 is controversial. Hence, we conducted a systematic review and meta-analysis to investigate the association between the FIB-4 index and COVID-19 disease progression. Methods. We performed meta-analysis using the PubMed, Embase, and Cochrane databases. A fixed- or random-effects model was used for evaluating heterogeneity. Results. Thirteen studies were included. The meta-analysis of unadjusted results showed that compared to lower FIB-4 index, patients with higher FIB-4 index had increased odds of mortality (OR=5.1, 95%CI 3.67-7.09;P<0.001), ICU admission (OR=2.32, 95%CI: 1.65-3.25, P<0.00001) and need for mechanical ventilator support (OR=3.51, 95%CI: 2.1-5.85, P<0.001). In addition, the meta-analysis of adjusted results showed patients with higher FIB-4 index was associated with increased risk of mortality (OR=3.01, 95%CI: 2.21-4.09, P<0.001) and need for mechanical ventilator support (OR=3.76, 95%CI: 2.08-6.82, P<0.001) compared to patients with lower FIB-4 index. Conclusion. This meta-analysis indicated that high FIB-4 index score was associated with the severity and mortality in COVID-19 infected patients.Copyright © 2022 by the Association of Clinical Scientists, Inc.
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Introduction: It is thought of as a necessary service to provide high-quality care during pregnancy, labour, and the postpartum period. The fields of obstetrics/midwifery and neonatology, which are generally referred to as perinatology, have reduced maternal and newborn mortality and morbidity globally, but the COVID-19 pandemic brought on by the SARS-CoV-2-related COVID-19 virus posed a threat to the security of healthcare. Material(s) and Method(s): A prospective comparative study was conducted in a tertiary care hospital, Bisha city. I want to compare the outcome for 2 years (July 2020-June 2022) after shifting to the new unit with previous 2 years before shifting (July 2018-June 2020) in different aspect: The days on the mechanical ventilation, The IVH rate, The Mortality rate. In this study, I want to compare neonatal services outcomes (for preterm babies less than 37 weeks gestational age) after developing the infrastructure, manpower, Supplies and Policies after the shifting to the new department. Result(s): This is a prospective comparative study conducted in the department of neonatology, in a tertiary care hospital, Bisha city. Mean gestational age in before shifting to new unit, after shifting were 31, 33.34 respectively. Average weight were 1496, 1565 in before shifting to new unit, after shifting respectively. In our study, Average days on the mechanical ventilation were 14.78 days in before shifting to new unit group. Average days on the mechanical ventilation were 4.33 days in after shifting to new unit group. Conclusion(s): The provision of high quality and evidence-based perinatal care must remain a priority, even in the face of a pandemic. Restructuring in health care facility with New advance mechanical ventilators supporting Volume-targeted ventilation, 9 single rooms isolation for septic babies, T-piece resuscitator (in all OR suits, Delivery suits and ER), Total parental nutrition and also the all NICU policies updated especially for Caffeine citrate and fluconazole administration to preterm babies according to the AAP guidelines. Also all the department stuff completed the NRP and STABLE provider course as mandatory requirement to work in the NICU department. IVH rate, mortality rate was drastically reduced after shifting to the new unit than before shifting to new unit. Hence hospital restructuring in neonatology plays a crucial role to reduce mortality rate.Copyright © 2021 Muslim OT et al.
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Introduction: ARDS is a type of lung injury that causes inflammation and makes it harder for oxygen to get into the bloodstream. Some treatments have been suggested, such as using less air with each breath, increasing pressure when breathing out, and using special positions or machines to help the lungs. But it's not clear how much these treatments can improve outcomes for patients with ARDS. So far, no studies have looked specifically at whether using more or less mechanical power to help patients breathe affects their chances of survival or other important measures of health. Objectives: This research aimed to investigate how the use of mechanical ventilation affects the likelihood of death in patients who are severely ill with COVID-19. Methods: This study adopts a cross-sectional design and retrospective analysis, observing critically ill patients who are being treated in the Special Isolation Ward of Dr. Soetomo Hospital's intensive care unit. The population for this study consists of critically ill patients who meet the inclusion and exclusion criteria. The research sample is obtained through randomized sampling, where all eligible individuals meeting the criteria are included in the sample size. Results: The study findings reveal a correlation between mechanical ventilation power and mortality among COVID-19 patients with ARDS. The mechanical power of ventilation is identified as a significant variable in this study, with a cut-off point of 17.4. Patients above this cut-off point are at 3.65 times higher risk of death compared to those below it. Moreover, there is evidence of a relationship between the mechanical power of ventilation variable and the P/F Ratio, as a higher mechanical power is associated with a decrease in the P/F Ratio. Conclusions: The study has identified a correlation between the P/F Ratio variable and mortality in COVID-19 patients with ARDS. On the other hand, there is no evidence of a relationship between the compliance variable and mortality in COVID-19 patients with ARDS. © 2023, Journal for ReAttach Therapy and Developmental Diversities. All Rights Reserved.