50 research outputs found

    General anaesthetic and airway management practice for obstetric surgery in England: a prospective, multi-centre observational study

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    There are no current descriptions of general anaesthesia characteristics for obstetric surgery, despite recent changes to patient baseline characteristics and airway management guidelines. This analysis of data from the direct reporting of awareness in maternity patients' (DREAMY) study of accidental awareness during obstetric anaesthesia aimed to describe practice for obstetric general anaesthesia in England and compare with earlier surveys and best-practice recommendations. Consenting patients who received general anaesthesia for obstetric surgery in 72 hospitals from May 2017 to August 2018 were included. Baseline characteristics, airway management, anaesthetic techniques and major complications were collected. Descriptive analysis, binary logistic regression modelling and comparisons with earlier data were conducted. Data were collected from 3117 procedures, including 2554 (81.9%) caesarean deliveries. Thiopental was the induction drug in 1649 (52.9%) patients, compared with propofol in 1419 (45.5%). Suxamethonium was the neuromuscular blocking drug for tracheal intubation in 2631 (86.1%), compared with rocuronium in 367 (11.8%). Difficult tracheal intubation was reported in 1 in 19 (95%CI 1 in 16-22) and failed intubation in 1 in 312 (95%CI 1 in 169-667). Obese patients were over-represented compared with national baselines and associated with difficult, but not failed intubation. There was more evidence of change in practice for induction drugs (increased use of propofol) than neuromuscular blocking drugs (suxamethonium remains the most popular). There was evidence of improvement in practice, with increased monitoring and reversal of neuromuscular blockade (although this remains suboptimal). Despite a high risk of difficult intubation in this population, videolaryngoscopy was rarely used (1.9%)

    Eco-efficiency evaluation of a smart window prototype

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    Summarization: An eco-efficiency analysis was conducted using indicators suitably defined to evaluate the performance of an electrochromic window acting as an energy saving component in buildings. Combining the indicators for various parameters (control scenario, expected lifetime, climatic type, purchase cost) significant conclusions are drawn for the development and the potential applications of the device compared to other commercial fenestration products. The reduction of the purchase cost (to 200€/m2) and the increase of the lifetime (above 15 years) are the two main targets for achieving both cost and environmental efficiency. An electrochromic device, implemented in cooling dominated areas and operated with an optimum control strategy for the maximum expected lifetime (25 years), can reduce the building energy requirements by 52%. Furthermore, the total energy savings provided will be 33 times more than the energy required for its production while the emission of 615 kg CO2 equivalent per electrochromic glazing unit can be avoided.Presented on: Science of the Total Environmen

    Eco-efficiency analysis of an electrochromic smart window prototype

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    Summarization: The environmental efficiency of a prototype electrochromic window was studied using eco-efficiency methodology, combined with life cycle assessment. The data obtained on the specified eco-efficiency indicators provide significant information that could be used in decision-making for the optimisation of the window's energy and environmental performance. The energy efficiency of the product is affected by its life expectancy and the climatic zone. It was found that in cooling-dominated areas the energy needs of buildings can be reduced by more than 55%, while the total energy saved can be 30 times the energy consumed during an expected 25 years life cycle. The corresponding CO2 and human toxic emissions reductions were estimated to be 6 times those achieved with a conventional double-glazed unit. An expected retail price of 200 euros per m2 for an electrochromic window would result in a cost of less than 0.10 euros for each kWh saved over a 20-year lifetime. Consequently, purchase cost reduction will be necessary if such devices are to meet market expectations for solar control window products.Παρουσιάστηκε στο: Quantified Eco-Efficienc
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