Performance of ventilation system in a non-standard operating room

The ventilation system of a hospital operating room is to provide a comfortable and healthy environment for the patient and the surgical team. Thermal comfort can be achieved by controlling the temperature, the humidity, and the air movement. A healthy environment can be achieved by minimizing the risk of contamination through appropriate filtration and air distribution scheme. The design and construction of operating rooms in Hong Kong, including the upgrading of the older ones, have been based on the UK Health Building Notes and Health Technical Memoranda. Observations and field measurements in a case study found that the airflow and some design features were not fully complied with the specified requirements. A CFD analysis supported by field measurements was made to simulate the temperature distribution, airflow pattern and the contaminant dispersion. The study placed an emphasis on the health risk of the airborne bacteria released from the surgical team on the patient, and vice versa.     

Optimization of a hospital room by means of CFD for more efficient ventilation

This paper analyses the ventilation airflow pattern in a two-bedded hospital room. The whole space of the room is divided in modules by means of curtains and internal partition walls. This configuration has many advantages from the point of view of comfort and medical assistance, but it implies an important restriction as far as ventilation is concerned. The ventilation system consists of an induction unit placed inside the hall ceiling blowing into the room and an exhaust fan in the bathroom. Numerical model solves mass, momentum and mean age of air equations assuming isothermal and stationary flow. Ventilation is evaluated analysing the age of air and the velocity fields inside the room. The results with the initial architectural design of the room show a very deficient ventilation at the patients site. Alternative configurations have been studied, allowing for correct ventilation without renouncing to the assistance advantages. Finally, the optimum configuration of the room is provided, regarding both the comfort of the patients and the cost of execution.     

香港某医院手术室内通风效果的数值研究

医院手术室对室内的速度场、温度场及有害气体和细菌的分布有严格的要求。应用商用软件对某手术室的通风效果作了数值模拟。计算采用RNG K-ε紊流模型,使用现场测量数值作为边界条件,求解了三维速度场、温度场及空气龄,研究表明,使用数值方法可以得出通风空间内每一点的详细情况,可对整体通风效果进行全面评价,对此类有严格要求的通风系统的设计及验收具有一定的意义。     

Evaluating emergency ventilation strategies under different contaminant source locations and evacuation modes by efficiency factor of contaminant source (EFCS)

Emergency ventilation plays an important role in protecting occupants when a hazardous contaminant is released indoors. A number of studies have been conducted to better understand how to protect indoor occupants with effective ventilation strategies. However, little attention has been paid to the impact of the non-uniform and time-dependent distribution of occupants during evacuation. A new concept, Efficiency Factor of Contaminant Source (EFCS), has recently been proposed to evaluate the performance of emergency ventilation by comprehensively considering the spatial and temporal distributions of both the contaminant and occupants. This paper aims to: (1) propose and demonstrate a procedure for determining an optimal ventilation strategy by using EFCS; (2) examine the effects of source locations, ventilation modes, and evacuation modes on the performance of emergency ventilation. One hundred cases with ten ventilation modes, two evacuation modes, and five source locations were investigated numerically. The results show that the EFCS concept can provide a reasonable way to evaluate the performance of emergency ventilation. The threats of different source locations may vary over a large range, and certain measures should be taken to monitor and prevent the releases at high threat locations. A system equipped with multiple ventilation modes is necessary since no universal ventilation mode can successfully mitigate all hazardous situations. The effects of an evacuation mode may be more significant than that of a ventilation mode under certain situations.     

Simulation-based feasibility study of improved air conditioning systems for hospital operating room

The goal of the air distribution inside a hospital operating room (OR) is to protect the patient and staff from cross-infection while maintaining occupant comfort and not affecting the facilitation of surgical tasks. In ORs, HEPA-filtered air and vertical (downward) laminar airflow are often used to achieve a unidirectional flow of fresh air from ceiling, washing over the patient and flowing out of exhaust vents on the side walls, near the floor. However, previous research has shown that this method does not necessarily achieve the desired unidirectional flow pattern or adequately achieve optimal air asepsis. The results from this study show that maximizing the area of the laminar flow diffusers remedies this issue and provides very low contamination levels. The use of air curtains as specified by manufacturers of commercial products may not provide satisfactory results, with noticeable contamination levels at the wound site.     

洁净手术室气流组织的CFD数值模拟研究

以Ⅲ级手术室为研究对象,结合CFD数值模拟的方法,对手术室的气流组织进行了研究,重点分析了送风口的尺寸和回风口的位置及尺寸对手术室气流组织的影响,以期为手术室的设计提供参考。     

医院洁净手术部工程设计和施工中的注意事项

简述了洁净手术部工程的基本概况以及质量要求，探讨了医院洁净手术部工程设计和施工中存在的某些问题，阐明了施工全过程中质量控制的重要性，以供业主、设计及施工单位参考。     

对当前医院手术室建设中一些问题的思考

依据在京津穗等地对医院手术室建设现状的调研,以及对一些手术室检测结果的分析,对照国外有关手术室空调净化系统的新规范、新标准,对当前国内医院手术室建设、改造中的一些问题提出了个人看法。     

洁净手术部的净化空调系统设计理念与方法

许多医院洁净手术室的设计在很大程度上受到工业洁净技术的影响,片面强调净化级别、依赖大风量或滥用层流技术等,造成洁净手术部投资和运行费用高昂。从污染控制思路出发,介绍洁净手术部净化空调系统的设计理念与方法,认为净化只是一种保障手段,无菌程度才是控制的目的和结果的体现;应该强调手术室细菌控制的综合措施,强调全过程控制以及完善的保证体系,以真正有效地消防交叉感染的隐患。     

Influence of movements on contaminant transport in an operating room

The influence of persons' movements on contaminant transport during an orthopedic surgical operation is examined. Orthopedic surgical operations require an ultra clean environment usually provided by a LAF device (laminar airflow). During hip replacements bone cement is sometimes applied. Due to practical reasons cement mixing is performed outside the LAF area. During the cement transport from the mixing location to the surgeon there is a potential risk of bacterial transport to the clean zone. This phenomenon is examined by smoke visualization and computational fluid dynamics (CFD). The movements are modeled by CFD using distributed momentum sources as well as a turbulent kinetic energy source. A significant risk of contaminant transport from the less clean zone to the ultra clean zone is found. The results indicate that it is possible to simulate the influence of movements using a relatively simple CFD model that considers the significant influence of a transient phenomenon in an approximate way. PRACTICAL IMPLICATIONS: In real-life ventilated enclosures like operating rooms movements take place. Persons' movements may influence the local flow field as well as the contaminant field substantially. Most often movements are ignored in simulations due to the complexity of the phenomenon. This paper presents an indirect and simple method to consider the influence of movements that may enable modelers to include this important phenomenon in the engineering application of CFD. This may improve practical risk assessment--for instance risk assessment of unintended transport of bacteria during orthopedic surgical operations that may jeopardize the hygiene.     

CFD study of exhaled droplet transmission between occupants under different ventilation strategies in a typical office room

This paper investigated the transmission of respiratory droplets between two seated occupants equipped with one type of personalized ventilation (PV) device using round movable panel (RMP) in an office room. The office was ventilated by three different total volume (TV) ventilation strategies, i.e. mixing ventilation (MV), displacement ventilation (DV), and under-floor air distribution (UFAD) system respectively as background ventilation methods. Concentrations of particles with aerodynamic diameters of 0.8 μm, 5 μm, and 16 μm as well as tracer gas were numerically studied in the Eulerian frame. Two indexes, i.e. intake fraction (IF) and concentration uniformity index R_C were introduced to evaluate the performance of ventilation systems. It was found that without PV, DV performed best concern protecting the exposed manikin from the pollutants exhaled by the polluting manikin. In MV when the exposed manikin opened RMP the inhaled air quality could always be improved. In DV and UFAD application of RMP might sometimes, depending on the personalized airflow rate, increase the exposure of the others to the exhaled droplets of tracer gas, 0.8 μm particles, and 5 μm particles from the infected occupants. Application of PV could reduce R_C for all the three TV systems of 0.8 μm and 5 μm particles. PV enhanced mixing degree of particles under DV and UFAD based conditions much stronger than under MV based ones. PV could increase the average concentration in the occupied zone of the exposed manikin as well as provide clean personalized airflow. Whether inhaled air quality could be improved depended on the balance of pros and cons of PV.     

An experimental study on ventilation efficiency of isolation room

This paper presents an experimental modeling of contaminant dispersion in a mock-up isolation room with different negative pressure differentials and ventilation rates. A hypothetical contaminant (sulfur hexafluoride, SF₆) is emitted from a patient lying on a bed in the mock-up isolation room. The impacts of ventilation rates 12 and 24 h⁻¹ and pressure differentials −2.5, −5.0, −8.0, and −15.0 Pa on the ventilation effectiveness in the room are evaluated quantitatively. A local air quality index and an exposure index for healthcare workers are introduced in the research to evaluate the ventilation efficiency of the isolation room. Based on the results of our experiment, the ventilation efficiency of the isolation room ranks the highest at −15.0 Pa/24 h⁻¹, followed, respectively, by −15.0 Pa/12 h⁻¹, −8.0 Pa/24 h⁻¹, −5.0 Pa/24 h⁻¹, −2.5 Pa/24 h⁻¹, −8.0 Pa/12 h⁻¹, −5.0 Pa/12 h⁻¹, and −2.5 Pa/12 h⁻¹.     

Development of ventilation design strategy for effective removal of pollutant in the isolation room of a hospital

This paper investigates the airflow and pollutant distribution patterns in a “negative pressure” isolation room by means of objective measurement and computational fluid dynamics (CFD) modeling based on three ventilation strategies. An effective ventilation system is crucial to protect doctors, nurses and other health-care workers from patients with infectious disease. In the preliminary study with Strategy 1, the isolation room has two air supply diffusers and two extract grilles mounted on the ceiling. Strategy 2 retains the air supply diffusers in Strategy 1 but relocates the two extract grilles to the wall behind the bed at 0.3 m above the floor level. Strategy 3 has the same layout as Strategy 2 except the ceiling diffusers are replaced by supply grilles and relocated closer to the wall behind the bed.     

Numerical simulation on a horizontal airflow for airborne particles control in hospital operating room

Provision of downward unidirectional clean air has been prevalent for decades in modern hospital operating rooms (ORs) to protect patients and surgeons from infectious airborne particles and has been found to be effective in reducing Surgical Site Infection (SSI), however, its shortcomings are inevitable. In this study we investigated an alternative of horizontal airflow pattern and the airflow performance in an OR with a dimension of 300 cm long, 296 cm wide and 240 cm high. We also evaluated the effectiveness of the horizontal unidirectional airflow to control infectious airborne particles through onsite test and computational fluid dynamics (CFD) simulation method. The investigation was focused mainly on the influence of the medical lamps and the thermal plume with different airflow patterns around the critical zone under the horizontal air supply system. Ultraclean air was supplied from a fan-filter unit. The patient and surgeon were assumed to be releasing 200 and 400 particles per minute, respectively. The results show that when the air supply and return facilities are installed on the same lateral wall to keep a state of horizontal flow ventilation in the OR, medical lamps and the thermal plume have no obvious influence on the horizontal airflow patterns around the critical zone in the OR, and performance of the air supply system is highly related to the relative position of the source to the wound.     

医院手术室供电可靠性探讨

本文介绍了医院手术室供配系统的配电可靠性方案,对医院手术室供配电系统可靠性进行探讨。     

Numerical analysis of particle deposition in ventilation duct

This paper adopts computational fluid dynamics (CFD) to numerically analyze particle deposition in the ventilation duct. A three-dimensional drift-flux model combined with particle deposition boundary conditions for wall surfaces is presented. The numerical method is used to analyze the particle deposition velocity and deposited particle mass flux in the ventilation duct after validation. Twelve groups of particle size, two average air speeds in ducts are investigated to understand the particle deposition in the straight ventilation duct, which ensures a fully developed turbulent duct flow. And then, the particle accumulation by deposition in the ventilation duct is analyzed according to the cleaning code for air duct system in heating, ventilation and air conditioning (HVAC) systems of China. The cases with or without air filter installed are studied by assuming that the duct inlet particle concentration is that of outdoor air in Beijing city, China.     

回风口对Ⅰ级洁净手术室乱流度的影响

采用高雷诺数K—ε二方程模型，在保证Ⅰ级洁净手术室工作区洁净度、送风速度的前提下，对Ⅰ级洁净手术室中回风口大小对其乱流度的影响进行了数值模拟，得出了可用回风口大小的范围，为Ⅰ级洁净手术室的设计提供了依据。     

操作窗口对排风柜污染物控制效果影响的实验研究

为提升排风柜的控污能力,在排风柜性能测试实验台上,采用示踪气体测试法和正交试验法,研究了操作窗口竖直开度、水平开度、面风速和操作窗口位置对排风柜前呼吸区污染物控制效果的影响。极差分析和方差分析结果表明:各因素对呼吸区污染物控制效果影响的强弱顺序依次为竖直开度、水平开度、面风速、操作窗口位置;操作窗口水平开度、竖直开度增大,排风柜对呼吸区的污染物控制效果减弱;面风速增大,控制效果增强;水平开度与竖直开度对控制浓度的影响存在较大的相关性,这2个因素对控制浓度的影响仅在另一因素达到一定水平后才能体现。     

Assessing ventilation system performance in isolation rooms

In this paper numerical transient simulations were used to investigate the air flow patterns, distribution and velocity, and the particulate dispersion inside an existing typical hospitalization room equipped with an advanced Heating Ventilation Air Conditioning (HVAC), with Variable Air Volume (VAV) primary air system designed for immune-suppressed patients never modelled before. The three-dimensional models of the room consider different, most typical, positions of the patients. Results indicate the best conditions for the high induction air inlet diffuser and the scheme of pressures imposed in the room to provide the effective means of controlling flows containing virus droplets. We believe that our work exemplifies the usefulness of numerical investigations of HVAC performances in real situations and provides important recommendations towards disease control and careful design and optimization of ventilation in hospital settings.