Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Energy modeling and data structure framework for Sustainable Human-Building Ecosystems (SHBE) - a review

This paper contributes an inclusive review of scientific studies in the field of sustainable human building ecosystems (SHBEs). Reducing energy consumption by making buildings more energy efficient has been touted as an easily attainable approach to promoting carbon-neutral energy societies. Yet, despite significant progress in research and technology development, for new buildings, as energy codes are getting more stringent, more and more technologies, e.g., LED lighting, VRF systems, smart plugs, occupancy-based controls, are used. Nevertheless, the adoption of energy efficient measures in buildings is still limited in the larger context of the developing countries and middle income/low-income population. The objective of Sustainable Human Building Ecosystem Research Coordination Network (SHBE-RCN) is to expand synergistic investigative podium in order to subdue barriers in engineering, architectural design, social and economic perspectives that hinder wider application, adoption and subsequent performance of sustainable building solutions by recognizing the essential role of human behaviors within building-scale ecosystems. Expected long-term outcomes of SHBE-RCN are collaborative ideas for transformative technologies, designs and methods of adoption for future design, construction and operation of sustainable buildings