Controlling contamination via proper airflow distribution in an operating room becomes vital to ensure the reliable surgery process. The heating, ventilation, and air conditioning (HVAC) systems significantly influence the operating room environment, including temperature, relative humidity, pressurization, particle counts, filtration, and ventilation rate. A full-scale operating room has been investigated extensively through field measurements and numerical analyses. Computational fluid dynamics (CFD) simulation was conducted and verified with the field measurement data. The simulation was analyzed with three different operating room schemes, including at-rest conditions (case 1), normal operational conditions with personnel (case 2), and actual conditions with personnel inside and some medical equipment blocking the return air (case 3). The concentration decay method was used to evaluate this study. The results revealed that the contamination concentration in case 1 could be diluted quickly with the average value of 404 ppm, whereas the concentration in case 2 slightly increased while performing a surgery with the average value of 420 ppm. The return air grilles in case 3, blocked by obstacles from some medical equipment, resulted in the average concentration value of 474 ppm. Other than that, the contaminant dilution could be obstructed dramatically, which revealed that proper and smooth airflow distribution is essential for contamination control. The ventilation efficiency of case 2 and case 3 dropped around 6% and 17.91% compared to case 1 in the unoccupied and ideal condition. Ventilation efficiency also decreased along with decreasing the air change rate per hour (ACH), while with increasing ACH, the ventilation efficiency in case 3 actually increased, approaching case 2 in the ideal condition.

Negative-pressurized isolation rooms have been approved effectively and applied widely for infectious patients. However, the outbreak of COVID-19 has led to a huge demand for negative-pressurized isolation rooms. It is critical and essential to ensure infection control performance through best practice of ventilation systems and optimum airflow distribution within isolation rooms. This study investigates a retrofitting project of an isolation room to accommodate COVID-19 patients. The field measurement has been conducted to ensure the compliance with the design specification from the CDC of Taiwan. The pressure differentials between negative-pressurized isolation rooms and corridor areas should be at least 8 Pa, while the air change rate per hour (ACH) should be 8–12 times. Computational fluid dynamics (CFD) is applied to evaluate the ventilation performance and contamination control. Different layout arrangements of exhaust air have been proposed to enhance the ventilation performance for infection control. A simple projected air-jet curtain has been proposed in the simulation model to enhance extra protection of medical staff. The resulting ventilation control revealed that the contamination control can be improved through the minor adjustment of exhaust air arrangement and the application of an air-jet curtain.

The COVID-19 pandemic caused by the novel SARS-CoV-2 virus raises alarming concern around the healthcare facilities due to the significant increase in patient inflow. Negative-pressurized isolation rooms have been utilized in various health care facilities to isolate the patients from active community contact. Several studies have highlighted isolation rooms improvement. However, limited knowledge is available regarding the isolation room facilities for pediatric intensive care units (PICU) to accommodate more than one pediatric patient. In this aspect, this study investigates a negative-pressurized isolation facility in PICU with minimal design modifications with the possibility that it can accommodate more than one pediatric patient. The field measurement tests were conducted to ensure the design compliance of Taiwan CDC. Then, computational fluid dynamics (CFD) was further utilized to numerically evaluate the HVAC system role and the ventilation performance towards infection control. A protected air-jet curtain system with a new ventilation layout was proposed through this study to enhance the protection for both pediatric patients and medical staff. The concentration decay was monitored and recorded within 900 s to evaluate the performance. The concentration can be reduced to 504 ppm for case 1, 620 ppm for case 2, 501 ppm for case 3, and 486 ppm for case 4. In addition, the injected bioaerosol particles could be well diluted dealing with two patients presents a good performance. The results revealed that this proposed configuration could feasibly accommodate two patients with a significant contamination control to protect the medical staff and patients.

Hipertiroidisme yang berlanjut menjadi krisis tiroid merupakan salah satu komplikasi yang jarang ditemui. Berbagai faktor dapat mencetuskan krisis tiroid pada tirotoksikosis seperti trauma, pembedahan, emboli paru, infark miokard, gangguan serebrovaskular, infeksi, ketoasidosis diabetikum, toksemia gravidarum, dan ketidakpatuhan mengkonsumsi obat anti tiroid. Angka mortalitas yang tinggi menyebabkan penanganan pada kasus ini harus cepat dan tepat, penyebab kematian tersering pada krisis tiroid ialah kegagalan sistem kardiopulmonal. Apabila mendapat penanganan lebih awal maka angka mortalitas dapat dikurangi, oleh karena itu akan dipresentasikan sebuah kasus seorang perempuan usia 58 tahun dengan struma multinodusa yang mengalami impending krisis tiroid dengan faktor pemicu infeksi pneumonia komunitas. Penilaian dengan skor Burch Wartofsky didapatkan nilai 40, yang menunjukkan kecurigaan akan terjadinya impending krisis tiroid, faktor pencetusnya kemudian ditangani dengan pemberian antibiotika, kemudian untuk kondisi tirotoksikosisnya ditangani dengan pemberian obat anti tiroid, antipiretik, beta bloker dan glukokortikoid, setelah menjalani perawatan, kondisi pasien membaik dan diperbolehkan pulang.

Operating room is a cleanroom that provides thermal comfort and good indoor air quality (IAQ) to support the surgery process. The heating, ventilation, and air conditioning (HVAC) system plays a critical role for the health protection regarding to IAQ, i.e., thermal performance, air changes per hour, pressurization, filtration, air distribution, etc. However, HVAC system in the operating room is operated for 24 hours year-round with intensive energy consumption. Energy-efficient approaches for the HVAC system is also quite challenging in term of contamination control to meet the standards specifications. In this study, a full-scale operating room was carried out through field measurements and numerical analysis extensively. Computational Fluid Dynamic (CFD) simulation has been carried out and verified with field measurement data. Thermal comfort performance along with temperature distribution and velocity profile have been simulated extensively. The energy-efficient approach by reducing the face velocity of the HEPA filter was examined which is done by reducing the velocity from 0.4, 0.3, 0.2 (m/s) for energy-saving concern but still need to meet the thermal performance and minimum contamination control requirement. The results reveal how the potential of HVAC systems to control air contamination, a comfortable thermal environment for occupants and the possibility of energy-efficient approaches in the operating room.