https://www.cdc.gov/coronavirus/mers/downloads/Isolation2007.pdf

2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings.

Introduction: Ventilator-induced Lung Injury: Not Only Air Leaks Ventilation-induced Pulmonary Edema and Related Findings: A Historical Perspective Ventilation-induced Pulmonary Edema: Hydrostatic or Permeability Edema? Experimental Evidence for Increased Vascular Transmural Pressure Evidence for Alterations in Alveolar–Capillary Permeability Contributions of the Static and Dynamic Lung Volume Components to Ventilator-induced Edema High-volume Lung Edema Low Lung Volume Injury Effects of High-volume Ventilation on Abnormal Lungs Effects of High-volume Ventilation on Injured Lungs Interaction between Severe Alveolar Flooding and Mechanical Ventilation Effects of Resting the Lung on Ventilator-induced Lung Injury Possible Mechanisms of Ventilation-induced Lung Injury Mechanisms of Increased Vascular Transmural Pressure Mechanisms of Altered Permeability Clinical Relevance

Ventilator-induced lung injury: lessons from experimental studies.

Critical Care Medicine : Organizing and Staffing Intensive Care Units

Sleep-induced apnea and disordered breathing refers to intermittent, cyclical cessations or reductions of airflow, with or without obstructions of the upper airway (OSA). In the presence of an anat...

Pathophysiology of Sleep Apnea

The health-care facility environment is rarely implicated in disease transmission, except among patients who are immunocompromised. Nonetheless, inadvertent exposures to environmental pathogens (e.g., Aspergillus spp. and Legionella spp.) or airborne pathogens (e.g., Mycobacterium tuberculosis and varicella-zoster virus) can result in adverse patient outcomes and cause illness among health-care workers. Environmental infection-control strategies and engineering controls can effectively prevent these infections. The incidence of health-care--associated infections and pseudo-outbreaks can be minimized by 1) appropriate use of cleaners and disinfectants; 2) appropriate maintenance of medical equipment (e.g., automated endoscope reprocessors or hydrotherapy equipment); 3) adherence to water-quality standards for hemodialysis, and to ventilation standards for specialized care environments (e.g., airborne infection isolation rooms, protective environments, or operating rooms); and 4) prompt management of water intrusion into the facility. Routine environmental sampling is not usually advised, except for water quality determinations in hemodialysis settings and other situations where sampling is directed by epidemiologic principles, and results can be applied directly to infection-control decisions. This report reviews previous guidelines and strategies for preventing environment-associated infections in health-care facilities and offers recommendations. These include 1) evidence-based recommendations supported by studies; 2) requirements of federal agencies (e.g., Food and Drug Administration, U.S. Environmental Protection Agency, U.S. Department of Labor, Occupational Safety and Health Administration, and U.S. Department of Justice); 3) guidelines and standards from building and equipment professional organizations (e.g., American Institute of Architects, Association for the Advancement of Medical Instrumentation, and American Society of Heating, Refrigeration, and Air-Conditioning Engineers); 4) recommendations derived from scientific theory or rationale; and 5) experienced opinions based upon infection-control and engineering practices. The report also suggests a series of performance measurements as a means to evaluate infection-control efforts.

Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC)

Determinants of maximal expiratory flow from the lungs.

Infectiousness of air from a tuberculosis ward. Ultraviolet irradiation of infected air: comparative infectiousness of different patients.

In excised lungs of dogs, the static pressure-volume characteristics of the vascular bed were determined with the vessels filled with dextran and again after replacement of the dextran with kerosen...

Effect of inflation of the lung on different parts of pulmonary vascular bed

The effect of epinephrine on peripheral circulation was studied in ten anesthetized open-chest dogs. Blood flow and right atrial pressure were independently controlled by a right heart bypass; changes in blood volume could be precisely determined from the changes occurring in the bypass reservoir. At constant blood flow and right atrial pressure, a constant infusion of epinephrine (5.8 µg/kg min-1) decreased blood volume by an average of 208 ml. During epinephrine infusion, the ratio of changes in blood volume to changes in blood flow measured at constant right atrial pressure, (ΔV/ΔQ·)Pra, decreased from 0.226 minutes to 0.153 minutes and the ratio of changes in blood volume to changes in right atrial pressure at constant blood flow, the vascular compliance, decreased from 27.1 ml/cm H2O to 20.7 ml/cm H2O. Transient changes in blood volume following a step decrease in right atrial pressure at constant blood flow showed that blood was draining from two vascular compartments with different time constants: ...

Effect of Epinephrine on Pressure, Flow, and Volume Relationships in the Systemic Circulation of Dogs

In the 1940s and 1950s, both the potential and the problems of interrupting transmission of airborne infection with ultraviolet (UV) light were demonstrated William F Wells first introduced the concept of droplet nuclei as the vehicles of airborne transmission and later showed that these nearly naked, suspended organisms were highly susceptible to inactivation by UV light of 254 nm wavelength (1, 2) Of the many infectious organisms that are susceptible to UV, most attention has been focused on measles and tuberculosis (TB) because of their importance as airborne infections and because each has characteristics favorable for epidemiologic study In his classic experiment of 1942, Wells used UV light in schools to prevent the epidemic spread of measles (3) However, the inability of others to repeat Wells' success led to disillusionment (4, 5) Antiultraviolet sentiment was further fueled by concern about ozone production (negligible with current 254 nm wavelength bulbs) and by concerns about skin and eye

Richard L. Riley

Papers

Determinants of maximal expiratory flow from the lungs.

Infectiousness of air from a tuberculosis ward. Ultraviolet irradiation of infected air: comparative infectiousness of different patients.

Effect of inflation of the lung on different parts of pulmonary vascular bed

Effect of Epinephrine on Pressure, Flow, and Volume Relationships in the Systemic Circulation of Dogs

Clearing the Air: The Theory and Application of Ultraviolet Air Disinfection