Guidelines for ICU Planning and Designing in India

Heating, ventilation and air conditioning (HVAC) in intensive care unit

“…Regarding filtration, there is wide variation, with the Australian recommendations suggesting progressive filtration with general (G4) followed by fine filter (F8), which is equivalent to Minimum Efficiency Reporting Value (MERV) 7 and 8 ASHRAE, whereas German recommendations suggest filtration through fine filter (F9), which is equivalent to MERV 15-16 [5,6]. Indian guidelines mention filtration up to 99% efficiency till 5 μm, which is similar to the UK standards of using fine filtration with F7 [7,8,[10][11][12]. The use of HEPA filtration was recommended only by Dubai Health Authority in general ICU [9].…”

“…( Table 4). Recommendations and standards from American Institute of Architects (AIA), American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE), Centers for Disease Control and Prevention (CDC), Department of Health Estates and Facilities Division, Health Technical Memorandum (HTM 2025) and Healthcare Infection Control Practices Advisory Committee (HICPAC) are being followed in the construction and maintenance of the majority of healthcare systems [5][6][7][8][9][10][11][12][13][14][15]. Only a few of these mention ICU standards for HVAC system, which are presented and compared in Table 4.…”

“…There is a wide variation in the recommended temperature from 16°C to 25°C in general ICUs [5][6][7][8][9][10][11][12][13][14][15]. Australian, UAE and US recommendations mention the temperature of 21-24°C; whereas the UK recommends 18-25°C and India recommends 16-25°C, German recommendations are silent on this aspect.…”

“…Australian, UAE and US recommendations suggest relative humidity (RH) of 30% to 60% whereas the UK recommends 40-60% [5][6][7][8][9][10][11][12][13][14][15]. German and Indian recommendations are silent on this crucial aspect.…”

“…The objective of this article is to review various worldwide available standards, guidelines and recommendations on HVAC system which mentions required standards in the ICU (Table 1) [5][6][7][8][9][10][11][12][13][14][15]. In order to understand the terminology used in describing the HVAC system, we also described the basic types and constituents of HVAC system along with the maintenance and monitoring of its function [3].…”