Management of driving pressure(ΔP) may contribute to improvement of survival rate of acute respiratory distress syndrome (ARDS). The purpose of this study was to develop a database of ARDS, to analyze the relation of the ΔP and the mortality rate.
We retrospectively identified 32 patients, who sustained from ARDS, using the ventilator data from January 1, 2016 to June 30, 2018. The comparison criteria for ΔP of ARDS were ΔP≦14 cmH2O : low pressure group, ΔP≧15 cmH2O: high pressure group. The secondary end-point was 28-day. Data are presented as percentages and numbers, or median and IQR. The chi-square test was performed to compare proportions in the different groups. The p-value < 0.05 was considered statistically significant.
Among 1845 patients, who were admitted to ICUs, 32 (1.7%) patients were presented as the inclusion criteria for ventilator in ARDS. The median [IQR] of age in low pressure group ranged from 71[58-79] years and 54% was male. Although there was no significant difference in the chi-square test, the low pressure group contributed to the survival rate.
Low pressure of ΔP contributed to the improvement of survival rate in the ARDS. The present study provides information about the current status of ventilator for ARDS. Further studies are needed to investigate the effects of ARDS based on ΔP.
Removing air, which prevents proper steam exposure, is critically important in steam sterilization. Removing internal air from long lumen device is considered to be especially difficult. Hollow load process challenge devices (PCDs) designed to simulate the tubular structure is expected to assure the sterile quality inside the tube-like instruments. However, there have been few reports to test the internal conditions of hollow load PCDs. The same five hollow load PCDs were prepared. Two of them were modified to insert thermocouples to measure the temperature inside the capsule of the PCDs, and for the one of the two PCDs, the hollow part was removed. We ran a steam sterilizer of approximately 500L chamber size under different conditions of pre-vacuum process to examine changes of temperature inside the capsule and chemical indicator color. We demonstrated here that when the highest vacuum point was lowered or the number of the vacuum pulse was decreased, the chemical indicator showed more FAIL results and the temperature rise inside the capsule of the PCD was delayed accordingly. These results demonstrate that the number of the pulse and the reachable pressure of pre-vacuum have a large effect on steam penetration into the hollow PCD.
The purpose of this study was to develop disposable oxygen cylinder residual alarm with the light and sound for the oxygen cylinders as part of the medical engineering collaboration. We co-developed, with two local manufacturing companies, the original alarm device, which is measured in the remaining quantity of the gas stored in an oxygen cylinder and is visually displayed in an LED and sound, and performed verification tests through the oxygen cylinders managing inside the hospital. As a result, we could appropriately monitor the remaining quantity of the oxygen cylinder through the LED and the sound without depending on a visual check of a user, and also could reduce the event of an empty oxygen cylinder and a burden on a monitoring person when simultaneously monitoring the remaining quantity of the oxygen cylinder. This device was thought to improve patient safety during oxygen therapy by successfully establishing a speedy and appropriate process.