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1.
J Cardiovasc Electrophysiol ; 27(4): 428-34, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26725742

RESUMO

INTRODUCTION: Totally thoracoscopic (TT) epicardial ablation combined with endocardial catheter ablation is an emerging treatment for persistent AF. The effects of timing of the TT and endocardial portion on AT/AF recurrence are not known. METHODS: We retrospectively analyzed patients undergoing TT staged versus simultaneous hybrid AF ablation at our institution. Arrhythmia-free outcome was compared using time to recurrence (AF or AT greater than 30 seconds after a 3-month blanking period from endocardial ablation) at 12 months. All subjects had continuous ILR or PM monitoring. RESULTS: Eighty-three patients (52 same-day, 31 staged) underwent TT hybrid AF ablation. Recurrence was observed in 23 (29%) patients at a median time of 147 days (IQR 91,238). In univariate analysis, a staged approach significantly increased the likelihood of detecting incomplete PVI (OR 6 [95% CI 2-17] P = 0.001). However, only longstanding persistent AF (LSP-AF) status predicted recurrence (HR 4 [95% CI 1.4-12] P = 0.01). Neither a staged approach (HR 1.0 [95% CI 0.4-2.4] P = 0.9), nor detection of incomplete PVI (HR 0.9 [95% CI 0.4-2.3] P = 0.8) predicted time to first AF/AT recurrence. CONCLUSIONS: Staged hybrid ablation of AF significantly increases the likelihood of discovering incomplete PVI at the time of endocardial mapping versus a same-day procedure. However, the staged approach did not improve time to first AT/AF recurrence.


Assuntos
Fibrilação Atrial/epidemiologia , Fibrilação Atrial/cirurgia , Ablação por Cateter/métodos , Ablação por Cateter/estatística & dados numéricos , Toracoscopia/métodos , Toracoscopia/estatística & dados numéricos , Idoso , Fibrilação Atrial/diagnóstico , Doença Crônica , Terapia Combinada/métodos , Terapia Combinada/estatística & dados numéricos , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Recidiva , Reoperação/métodos , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Risco , Tennessee/epidemiologia , Resultado do Tratamento
2.
J Cardiovasc Electrophysiol ; 25(6): 617-21, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24446764

RESUMO

INTRODUCTION: Transvenous pacemaker or implantable cardioverter defibrillator (ICD) lead extraction via mechanical or excimer laser sheath is typically safe and effective. Longer duration from implant, presence of large vegetations or thrombi, fractured leads, and prior failed extraction are risk factors predicting higher complication rates or incomplete or failed lead removal. Techniques developed for minimally invasive valve surgery were used in conjunction with laser extraction to refine a "hybrid" technique for lead extraction. We assessed the outcomes of high-risk lead extraction using this hybrid lead extraction technique. METHODS AND RESULTS: Retrospective assessment of clinical parameters and procedural outcomes in patients undergoing planned hybrid lead extraction from February 2008 to September 2012 was performed. We report 8 cases of hybrid lead extraction performed at our institution. We extracted 21 leads with average lead age of 13.8 years since implant. All leads were removed with complete clinical and radiographic success. There were no intraprocedure complications. One patient died of continued sepsis and 1 other had symptoms consistent with pulmonary embolism. CONCLUSIONS: Hybrid lead extraction using this technique is a safe and effective approach for removal of high-risk chronic pacemaker or ICD leads. This method extends the range of approachable leads resulting in complete removal without median sternotomy. Hybrid lead extraction can be scheduled electively facilitating complete lead removal with a low complication rate and short postoperative recovery time, mitigating the risks inherent in midline sternotomy or emergent cardiac surgical rescue.


Assuntos
Angioplastia a Laser/métodos , Desfibriladores Implantáveis , Remoção de Dispositivo/métodos , Falha de Equipamento , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Toracotomia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Desfibriladores Implantáveis/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento
3.
Crit Care Med ; 40(10): 2805-12, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22824930

RESUMO

OBJECTIVE: This study tested the hypothesis that interruption of the renin-angiotensin system with either an angiotensin-converting enzyme inhibitor or a mineralocorticoid receptor antagonist will decrease the prevalence of atrial fibrillation after cardiac surgery. DESIGN: Randomized double-blind placebo-controlled study. SETTING: University-affiliated hospitals. PATIENTS: Four hundred forty-five adult patients in normal sinus rhythm undergoing elective cardiac surgery. INTERVENTIONS: One week to 4 days prior to surgery, patients were randomized to treatment with placebo, ramipril (2.5 mg the first 3 days followed by 5 mg/day, with the dose reduced to 2.5 mg/day on the first postoperative day only), or spironolactone (25 mg/day). MEASUREMENTS: The primary endpoint was the occurrence of electrocardiographically confirmed postoperative atrial fibrillation. Secondary endpoints included acute renal failure, hyperkalemia, the prevalence of hypotension, length of hospital stay, stroke, and death. MAIN RESULTS: The prevalence of atrial fibrillation was 27.2% in the placebo group, 27.8% in the ramipril group, and 25.9% in the spironolactone group (p=.95). Patients in the ramipril (0.7%) or spironolactone (0.7%) group were less likely to develop acute renal failure than those randomized to placebo (5.4%, p=.006). Patients in the placebo group tended to be hospitalized longer than those in the ramipril or spironolactone group (6.8±8.2 days vs. 5.7±3.2 days and 5.8±3.4 days, respectively, p=.08 for the comparison of placebo vs. the active treatment groups using log-rank test). Compared with patients in the placebo group, patients in the spironolactone group were extubated sooner after surgery (576.4±761.5 mins vs. 1091.3±3067.3 mins, p=.04). CONCLUSIONS: Neither angiotensin-converting enzyme inhibition nor mineralocorticoid receptor blockade decreased the primary outcome of postoperative atrial fibrillation. Treatment with an angiotensin-converting enzyme inhibitor or mineralocorticoid receptor antagonist was associated with decreased acute renal failure. Spironolactone use was also associated with a shorter duration of mechanical ventilation after surgery.


Assuntos
Inibidores da Enzima Conversora de Angiotensina/administração & dosagem , Fibrilação Atrial/prevenção & controle , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Ramipril/administração & dosagem , Receptores de Mineralocorticoides/metabolismo , Espironolactona/administração & dosagem , Idoso , Inibidores da Enzima Conversora de Angiotensina/efeitos adversos , Fibrilação Atrial/epidemiologia , Fibrilação Atrial/etiologia , Pressão Sanguínea , Método Duplo-Cego , Eletrocardiografia , Feminino , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Sistema Renina-Angiotensina/efeitos dos fármacos
4.
Surg Clin North Am ; 102(3): 365-391, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35671762

RESUMO

This article focuses on the guideline-directed evaluation and management of cardiac dysrhythmias, particularly as they are important to the practice of a noncardiac surgeon. The focus is on atrial fibrillation (AF) as the most common arrhythmia encountered by surgeons. The authors discuss the importance of AF as a risk factor for perioperative morbidity and mortality. They pay particular attention to topics such as postoperative AF and options for its acute treatment and perioperative anticoagulation management. They discuss nonpharmacologic left atrial appendage management and nonpharmacologic AF management, including catheter-based therapy, surgical-based therapy, and hybrid therapies.


Assuntos
Fibrilação Atrial , Ablação por Cateter , Fibrilação Atrial/terapia , Humanos , Fatores de Risco , Resultado do Tratamento
5.
Ann Surg ; 254(4): 606-11, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21946219

RESUMO

BACKGROUND: A simplified minimally invasive mitral valve surgery (MIMVS) approach avoiding cross-clamping and cardioplegic myocardial arrest using a small (5 cm) right antero-lateral incision was developed. We hypothesized that, in high-risk patients and in patients with prior sternotomy, this approach would yield superior results compared to those predicted by the Society of Thoracic Surgeons (STS) algorithm for standard median sternotomy mitral valve surgery. METHODS: Five hundred and four consecutive patients (249 males/255 females), median age 65 years (range 20-92 years) underwent MIMVS between 1/06 and 8/09. Median preoperative New York Heart Association function class was 3 (range 1-4). Eighty-two (16%) patients had an ejection fraction ≤35%. Forty-seven (9%) had a STS predicted mortality ≥10%. Under cold fibrillatory arrest (median temperature 28°C) without aortic cross-clamp, mitral valve repair (224/504, 44%) or replacement (280/504, 56%) was performed. RESULTS: Thirty-day mortality for the entire cohort was 2.2% (11/504). In patients with a STS predicted mortality ≥ 10% (range 10%-67%), the observed 30-day mortality was 4% (2/47), lower than the mean STS predicted mortality of 20%. Morbidity in this high-risk group was equally low: 1 of 47 (2%) patients underwent reexploration for bleeding, 1 of 47 (2%) patients suffered a permanent neurologic deficit, none had wound infection. The median length of stay was 8 days (range 1-68 days). CONCLUSIONS: This study demonstrates that MIMVS without aortic cross-clamp is reproducible with low mortality and morbidity rates. This approach expands the surgical options for high-risk patients and yields to superior results than the conventional median sternotomy approach.


Assuntos
Doenças das Valvas Cardíacas/cirurgia , Valva Mitral/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Procedimentos Cirúrgicos Cardíacos/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos , Fatores de Risco , Adulto Jovem
6.
Front Bioeng Biotechnol ; 9: 659609, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34041230

RESUMO

Porcine reproductive and respiratory syndrome virus (PRRSV) infections cause significant economic losses to swine producers every year. Aerosols containing infectious PRRSV are an important route of transmission, and proper treatment of air could mitigate the airborne spread of the virus within and between barns. Previous bioaerosol studies focused on the microbiology of PRRSV aerosols; thus, the current study addressed the engineering aspects of virus aerosolization and collection. Specific objectives were to (1) build and test a virus aerosolization system, (2) achieve a uniform and repeatable aerosol generation and collection throughout all replicates, (3) identify and minimize sources of variation, and (4) verify that the collection system (impingers) performed similarly. The system for virus aerosolization was built and tested (Obj. 1). The uniform airflow distribution was confirmed using a physical tracer (<12% relative standard deviation) for all treatments and sound engineering control of flow rates (Obj. 2). Theoretical uncertainty analyses and mass balance calculations showed <3% loss of air mass flow rate between the inlet and outlet (Obj. 3). A comparison of TCID50 values among impinger fluids showed no statistical difference between any two of the three trials (p-value = 0.148, 0.357, 0.846) (Obj. 4). These results showed that the readiness of the system for research on virus aerosolization and treatment (e.g., by ultraviolet light), as well as its potential use for research on other types of airborne pathogens and their mitigation on a laboratory scale.

7.
J Heart Valve Dis ; 19(2): 236-43, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20369510

RESUMO

BACKGROUND AND AIM OF THE STUDY: The study aim was to determine the safety and benefits of minimally invasive mitral valve surgery without aortic cross-clamping for mitral valve surgery after previous cardiac surgery. METHODS: Between January 2006 and August 2008, a total of 90 consecutive patients (38 females, 52 males; mean age 66 +/- 9 years) underwent minimally invasive mitral valve surgery after having undergone previous cardiac surgery. Of these patients, 80 (89%) underwent mitral valve replacement and 10 (11%) mitral valve repair utilizing a small (5 cm) right lateral thoracotomy along the 4th or 5th intercostal space under fibrillatory arrest (mean temperature 28 +/- 2 degrees C). The predicted mortality, calculated using the Society of Thoracic Surgeons (STS) algorithm, was compared to the observed mortality. RESULTS: The mean ejection fraction was 45 +/- 13%, mean NYHA class 3 +/- 1, while 66 patients (73%) had previous coronary artery bypass grafting and 37 (41%) had previous valve surgery. Twenty-six patients (29%) underwent non-elective surgery. Cardiopulmonary bypass was instituted through axillary (n = 19), femoral (n = 70) or direct use aortic (n = 1) cannulation. Operative mortality was 2% (2/90), lower than the STS-predicted mortality of 7%. Three patients (3%) developed acute renal failure postoperatively, one patient (1%) required new-onset hemodialysis, and one (1%) developed postoperative stroke. No patients developed postoperative myocardial infarction. The mean postoperative packed red blood cell transfusion requirement at 48 h was 2 +/- 3 units. CONCLUSION: Minimally invasive right thoracotomy without aortic cross-clamping is an excellent alternative to conventional redo-sternotomy for reoperative mitral valve surgery. The present study confirmed that this technique is safe and effective in reducing operative mortality in high-risk patients undergoing reoperative cardiac surgery.


Assuntos
Valva Mitral/cirurgia , Esternotomia , Toracotomia , Idoso , Aorta/fisiologia , Procedimentos Cirúrgicos Cardíacos , Constrição , Feminino , Implante de Prótese de Valva Cardíaca , Humanos , Masculino , Procedimentos Cirúrgicos Minimamente Invasivos , Complicações Pós-Operatórias , Reoperação
8.
Circulation ; 118(16): 1619-25, 2008 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-18824641

RESUMO

BACKGROUND: Postoperative atrial fibrillation (AF), a frequent complication after cardiac surgery, causes morbidity and prolongs hospitalization. Inotropic drugs are commonly used perioperatively to support ventricular function. This study tested the hypothesis that the use of inotropic drugs is associated with postoperative AF. METHODS AND RESULTS: We evaluated perioperative risk factors in 232 patients who underwent elective cardiac surgery. All patients were in sinus rhythm at surgery. Sixty-seven patients (28.9%) developed AF a mean of 2.9+/-2.1 days after surgery. Patients who developed AF stayed in the hospital longer (P<0.001) and were more likely to die (P=0.02). Milrinone use was associated with an increased risk of postoperative AF (58.2% versus 26.1% in nonusers; P<0.001). Older age (63.4+/-10.7 versus 56.7+/-12.3 years; P<0.001), hypertension (P=0.04), lower preoperative ejection fraction (P=0.03), mitral valve surgery (P=0.02), right ventricular dysfunction (P=0.03), and higher mean pulmonary artery pressure (27.1+/-9.3 versus 21.8+/-7.5 mm Hg; P=0.001) also were associated with postoperative AF. In multivariable logistic regression, age (P<0.001), ejection fraction (P=0.02), and milrinone use (odds ratio, 4.86; 95% confidence interval, 2.31 to 10.25; P<0.001) independently predicted postoperative AF. When only data from patients with pulmonary artery catheters were analyzed and pulmonary artery pressure was included in the model, age, milrinone use (odds ratio, 4.45; 95% confidence interval, 2.01 to 9.84; P<0.001), and higher pulmonary artery pressure (P=0.02) were associated with an increased risk of postoperative AF. Adding other potential confounders or stratifying analysis by mitral valve surgery did not change the association of milrinone use with postoperative AF. CONCLUSIONS: Milrinone use is an independent risk factor for postoperative AF after elective cardiac surgery.


Assuntos
Fibrilação Atrial/induzido quimicamente , Fibrilação Atrial/epidemiologia , Procedimentos Cirúrgicos Cardíacos/estatística & dados numéricos , Cardiotônicos/efeitos adversos , Milrinona/efeitos adversos , Complicações Pós-Operatórias/induzido quimicamente , Complicações Pós-Operatórias/epidemiologia , Adulto , Idoso , Doença das Coronárias/tratamento farmacológico , Doença das Coronárias/cirurgia , Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Feminino , Humanos , Hipertensão/epidemiologia , Tempo de Internação , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Insuficiência da Valva Mitral/epidemiologia , Insuficiência da Valva Mitral/cirurgia , Análise Multivariada , Pressão Propulsora Pulmonar , Fatores de Risco
9.
J Air Waste Manag Assoc ; 59(6): 683-94, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19603736

RESUMO

This paper describes techniques used to determine airflow rate in multiple emission point applications typical of animal housing. An accurate measurement of building airflow rate is critical to accurate emission rate estimates. Animal housing facilities rely almost exclusively on ventilation to control inside climate at desired conditions. This strategy results in building airflow rates that range from about three fresh-air changes per hour in cold weather to more than 100 fresh-air changes per hour in hot weather. Airflow rate measurement techniques used in a comprehensive six-state study could be classified in three general categories: fan indication methods, fan rotational methods, and airspeed measurement methods. Each technique is discussed and implementation plans are noted. A detailed error analysis is included that estimated the uncertainty in airflow rate between +/-5 and +/-6.1% of reading at a building operating static pressure, air temperature, relative humidity, and barometric pressure of 20 Pa, 25 degrees C, 50%, and 97,700 Pa, respectively.


Assuntos
Movimentos do Ar , Abrigo para Animais , Ventilação/instrumentação , Ventilação/métodos , Poluentes Atmosféricos/química , Poluição do Ar/prevenção & controle , Animais , Galinhas , Odorantes , Suínos
10.
Animals (Basel) ; 9(11)2019 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-31752265

RESUMO

Pre-weaning morality (PWM) is attributed to a poor creep area microclimate and causes major economic and productivity losses for the US swine industry. Piglets need supplementary heat to overcome a high surface area to body weight ratio and minimal thermoregulation. A pilot-scale study was conducted to evaluate a semi-enclosed heated microclimate (SEHM) as a supplementary heat source for farrowing creep areas over six farrowing cycles (from January to July 2019) in two rooms with 24 farrowing stalls in each room. Six SEHMs (each SEHM covers two stalls) were randomly distributed to each room and compared to heat lamps (HLs) for productivity and electricity usage. Data from 113 (SEHM) and 101 litters (HL) showed no significant difference between treatments in average daily gain (p = 0.26), 252.4 ± 8.0 g hd-1 d-1 (SEHM) and 260.3 ± 8.1 g hd-1 d-1 (HL) and PWM (p = 0.08), 9.67% ± 0.82% (SEHM) and 12.04% ± 0.87% (HL). However, a significant difference (p = 0.02) was noted in the PWM attributed to over-lay mortalities, 4.05% ± 0.76% (SEHM) compared to 6.04% ± 0.78% (HL). The SEHM electricity averaged 3.25 kWh d-1 (2.91, 3.59 kWh d-1; 95% CI), which was significantly different (p < 0.01) from the HL equivalent (125 W bulb; 6 kWh d-1).

11.
Bioresour Technol ; 99(16): 7767-80, 2008 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-18455390

RESUMO

A pilot-scale mobile biofilter was developed where two types of wood chips (western cedar and 2 in. hardwood) were examined to treat odor emissions from a deep-pit swine finishing facility in central Iowa. The biofilters were operated continuously for 13 weeks at different air flow rates resulting in a variable empty bed residence time (EBRT) from 1.6 to 7.3 s. During this test period, solid-phase microextraction (SPME) PDMS/DVB 65 microm fibers were used to extract volatile organic compounds (VOCs) from both the control plenum and biofilter treatments. Analyses of VOCs were carried out using a multidimentional gas chromatography-mass spectrometry-olfactometry (MDGC-MS-O) system. Results indicated that both types of chips achieved significant reductions in p-cresol, phenol, indole and skatole which represent some of the most odorous and odor-defining compounds known for swine facilities. The results also showed that maintaining proper moisture content is critical to the success of wood-chip based biofilters and that this factor is more important than media depth and residence time.


Assuntos
Cromatografia Gasosa-Espectrometria de Massas/métodos , Microquímica/métodos , Odorantes/análise , Microextração em Fase Sólida/métodos , Madeira/análise , Movimentos do Ar , Animais , Filtração/instrumentação , Filtração/métodos , Compostos Orgânicos/análise , Projetos Piloto , Olfato , Suínos , Fatores de Tempo , Volatilização
12.
J Environ Qual ; 37(2): 521-34, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18396537

RESUMO

Swine manure is associated with emissions of odor, volatile organic compounds (VOCs) and other gases that can affect air quality on local and regional scales. In this research, a solid phase microextraction (SPME) and novel multidimensional gas chromatography-mass spectrometry-olfactometry (MDGC-MS-O) system were used to simultaneously identify VOCs and related odors emitted from swine manure. Gas samples were extracted from manure headspace using Carboxen/polydimethylsiloxane (PDMS) 85-microm SPME fibers. The MDGC-MS-O system was equipped with two columns in series with a system of valves allowing transfer of samples between columns (heartcutting). The heartcuts were used to maximize the isolation, separation, and identification of compounds. The odor impact of separated compounds was evaluated by a trained panelist for character and intensity. A total of 295 compounds with molecular weights ranging from 34 to 260 were identified. Seventy one compounds had a distinct odor. Nearly 68% of the compounds for which reaction rates with OH* radicals are known had an estimated atmospheric lifetime <24 h.


Assuntos
Poluentes Atmosféricos/análise , Esterco , Odorantes/análise , Compostos Orgânicos/análise , Animais , Monitoramento Ambiental , Cromatografia Gasosa-Espectrometria de Massas , Humanos , Olfato , Microextração em Fase Sólida , Suínos , Volatilização
13.
J Air Waste Manag Assoc ; 58(12): 1571-8, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19189755

RESUMO

It is vital to forecast gas and particle matter concentrations and emission rates (GPCER) from livestock production facilities to assess the impact of airborne pollutants on human health, ecological environment, and global warming. Modeling source air quality is a complex process because of abundant nonlinear interactions between GPCER and other factors. The objective of this study was to introduce statistical methods and radial basis function (RBF) neural network to predict daily source air quality in Iowa swine deep-pit finishing buildings. The results show that four variables (outdoor and indoor temperature, animal units, and ventilation rates) were identified as relative important model inputs using statistical methods. It can be further demonstrated that only two factors, the environment factor and the animal factor, were capable of explaining more than 94% of the total variability after performing principal component analysis. The introduction of fewer uncorrelated variables to the neural network would result in the reduction of the model structure complexity, minimize computation cost, and eliminate model overfitting problems. The obtained results of RBF network prediction were in good agreement with the actual measurements, with values of the correlation coefficient between 0.741 and 0.995 and very low values of systemic performance indexes for all the models. The good results indicated the RBF network could be trained to model these highly nonlinear relationships. Thus, the RBF neural network technology combined with multivariate statistical methods is a promising tool for air pollutant emissions modeling.


Assuntos
Poluição do Ar/estatística & dados numéricos , Previsões , Modelos Teóricos , Redes Neurais de Computação , Análise Multivariada , Análise de Componente Principal , Fatores de Tempo
14.
J Air Waste Manag Assoc ; 58(6): 806-11, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18581810

RESUMO

Standard protocols for sampling and measuring odor emissions from livestock buildings are needed to guide scientists, consultants, regulators, and policy-makers. A federally funded, multistate project has conducted field studies in six states to measure emissions of odor, coarse particulate matter (PM(10)), total suspended particulates, hydrogen sulfide, ammonia, and carbon dioxide from swine and poultry production buildings. The focus of this paper is on the intermittent measurement of odor concentrations at nearly identical pairs of buildings in each state and on protocols to minimize variations in these measurements. Air was collected from pig and poultry barns in small (10 L) Tedlar bags through a gas sampling system located in an instrument trailer housing gas and dust analyzers. The samples were analyzed within 30 hr by a dynamic dilution forced-choice olfactometer (a dilution apparatus). The olfactometers (AC'SCENT International Olfactometer, St. Croix Sensory, Inc.) used by all participating laboratories meet the olfactometry standards (American Society for Testing and Materials and European Committee for Standardization [CEN]) in the United States and Europe. Trained panelists (four to eight) at each laboratory measured odor concentrations (dilution to thresholds [DT]) from the bag samples. Odor emissions were calculated by multiplying odor concentration differences between inlet and outlet air by standardized (20 degrees C and 1 atm) building airflow rates.


Assuntos
Poluentes Ocupacionais do Ar/análise , Criação de Animais Domésticos , Animais Domésticos , Monitoramento Ambiental/normas , Odorantes/análise , Animais , Interpretação Estatística de Dados , Monitoramento Ambiental/métodos , Humanos , Controle de Qualidade , Olfato , Suínos
15.
JACC Clin Electrophysiol ; 3(12): 1356-1365, 2017 12 11.
Artigo em Inglês | MEDLINE | ID: mdl-29759664

RESUMO

OBJECTIVES: This study sought to assess long-term left atrial appendage (LAA) closure efficacy of the Atriclip applied via totally thoracoscopic (TT) approach with computed tomographic angiography. BACKGROUND: LAA closure is associated with a low risk for atrial fibrillation-related embolic stroke. The Atriclip exclusion device allows epicardial LAA closure, avoiding the need for post-operative oral anticoagulation. Previous data with Atriclip during open chest procedures show a high efficacy rate of closure >95%. METHODS: Three-dimensional volumetric 2-phase computed tomographic angiography ≥90 days post-implantation was independently assessed by chest radiology for complete LAA closure on all consented subjects identified retrospectively as having had a TT-placed Atriclip at Vanderbilt University Medical Center from June 13, 2011, to October 6, 2015. RESULTS: Complete LAA closure (defined by complete exclusion of the LAA with no exposed trabeculations, and clip within 1 cm from the left circumflex artery) was found in 61 of 65 subjects (93.9%). Four cases had incomplete closure (6.2%). Two clips were placed too distally, leaving a large stump with exposed trabeculae. Two clips failed to address a secondary LAA lobe. No major complications were associated with TT placement of the Atriclip. Follow-up over 183 patient-years revealed 1 stroke in a patient with complete LAA closure and no thrombus (hypertensive cerebrovascular accident). CONCLUSIONS: Angiographic LAA closure efficacy with a TT-placed Atriclip is high (93.9%). The clinical significance of a remnant stump is unknown. Confirmation of complete LAA occlusion should be made before cessation of systemic anticoagulation.


Assuntos
Apêndice Atrial/cirurgia , Embolia Intracraniana/patologia , Toracoscopia/métodos , Idoso , Apêndice Atrial/diagnóstico por imagem , Fibrilação Atrial/complicações , Procedimentos Cirúrgicos Cardíacos/métodos , Angiografia por Tomografia Computadorizada/métodos , Ecocardiografia Transesofagiana , Feminino , Humanos , Embolia Intracraniana/etiologia , Embolia Intracraniana/prevenção & controle , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Estudos Retrospectivos , Instrumentos Cirúrgicos , Oclusão Terapêutica/instrumentação , Trombose/etiologia , Resultado do Tratamento , Técnicas de Fechamento de Ferimentos/instrumentação
16.
J Chromatogr A ; 1102(1-2): 60-72, 2006 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-16297922

RESUMO

Swine operations can affect air quality by emissions of odor, volatile organic compounds (VOCs) and other gases, and particulate matter (PM). Particulate matter has been proposed to be an important pathway for carrying odor. However, little is known about the odor-VOCs-PM interactions. In this research, continuous PM sampling was conducted simultaneously with three collocated TEOM 1400a analyzers inside a 1000-head swine finish barn located in central Iowa. Each TEOM was fitted with total suspended particulate (TSP), PM-10, PM-2.5 and PM-1 preseparators. Used filters were stored in 40 mL vials and transported to the laboratory. VOCs adsorbed/absorbed to dust were allowed to equilibrate with vial headspace. Solid-phase microextraction (SPME) Carboxen/polydimethylsiloxane (PDMS) 85 microm fibers were used to extract VOCs. Simultaneous chemical and olfactometry analyses of VOCs and odor associated with swine PM were completed using a gas chromatography-mass spectrometry-olfactometry (GC-MS-O) system. Fifty VOCs categorized into nine chemical function groups were identified and confirmed with standards. Five of them are classified as hazardous air pollutants. VOCs were characterized with a wide range of molecular weight, boiling points, vapor pressures, water solubilities, odor detection thresholds, and atmospheric reactivities. All characteristic swine VOCs and odorants were present in PM and their abundance was proportional to PM size. However, the majority of VOCs and characteristic swine odorants were preferentially bound to smaller-size PM. The findings indicate that a significant fraction of swine odor can be carried by PM. Research of the effects of PM control on swine odor mitigation is warranted.


Assuntos
Cromatografia Gasosa-Espectrometria de Massas/métodos , Odorantes , Compostos Orgânicos/análise , Animais , Volatilização
18.
J Air Waste Manag Assoc ; 56(10): 1472-83, 2006 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17063869

RESUMO

Comprehensive field studies were initiated in 2002 to measure emissions of ammonia (NH3), hydrogen sulfide (H2S), carbon dioxide (CO2), methane (CH4), nonmethane hydrocarbons (NMHC), particulate matter <10 microm in diameter, and total suspended particulate from swine and poultry production buildings in the United States. This paper focuses on the quasicontinuous gas concentration measurement at multiple locations among paired barns in seven states. Documented principles, used in air pollution monitoring at industrial sources, were applied in developing quality assurance (QA) project plans for these studies. Air was sampled from multiple locations with each gas analyzed with one high quality commercial gas analyzer that was located in an environmentally controlled on-farm instrument shelter. A nominal 4 L/min gas sampling system was designed and constructed with Teflon wetted surfaces, bypass pumping, and sample line flow and pressure sensors. Three-way solenoids were used to automatically switch between multiple gas sampling lines with > or =10 min sampling intervals. Inside and outside gas sampling probes were between 10 and 115 m away from the analyzers. Analyzers used chemiluminescence, fluorescence, photoacoustic infrared, and photoionization detectors for NH3, H2S, CO2, CH4, and NMHC, respectively. Data were collected using personal computer-based data acquisition hardware and software. This paper discusses the methodology of gas concentration measurements and the unique challenges that livestock barns pose for achieving desired accuracy and precision, data representativeness, comparability and completeness, and instrument calibration and maintenance.


Assuntos
Poluentes Atmosféricos/análise , Monitoramento Ambiental/métodos , Abrigo para Animais , Amônia/análise , Animais , Dióxido de Carbono/análise , Monitoramento Ambiental/instrumentação , Hidrocarbonetos/análise , Sulfeto de Hidrogênio/análise , Metano/análise , Controle de Qualidade , Estados Unidos
19.
J Air Waste Manag Assoc ; 56(12): 1642-8, 2006 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17195483

RESUMO

Federally funded, multistate field studies were initiated in 2002 to measure emissions of particulate matter (PM) < 10 microm (PM10) and total suspended particulate (TSP), ammonia, hydrogen sulfide, carbon dioxide, methane, nonmethane hydrocarbons, and odor from swine and poultry production buildings in the United States. This paper describes the use of a continuous PM analyzer based on the tapered element oscillating microbalance (TEOM). In these studies, the TEOM was used to measure PM emissions at identical locations in paired barns. Measuring PM concentrations in swine and poultry barns, compared with measuring PM in ambient air, required more frequent maintenance of the TEOM. External screens were used to prevent rapid plugging of the insect screen in the PM10 preseparator inlet. Minute means of mass concentrations exhibited a sinusoidal pattern that followed the variation of relative humidity, indicating that mass concentration measurements were affected by water vapor condensation onto and evaporation of moisture from the TEOM filter. Filter loading increased the humidity effect, most likely because of increased water vapor adsorption capacity of added PM. In a single layer barn study, collocated TEOMs, equipped with TSP and PM10 inlets, corresponded well when placed near the inlets of exhaust fans in a layer barn. Initial data showed that average daily mean concentrations of TSP, PM10, and PM2.5 concentrations at a layer barn were 1440 +/- 182 microg/m3 (n = 2), 553 +/- 79 microg/m3 (n = 4), and 33 +/- 75 microg/m3 (n = 1), respectively. The daily mean TSP concentration (n = 1) of a swine barn sprinkled with soybean oil was 67% lower than an untreated swine barn, which had a daily mean TSP concentration of 1143 +/- 619 microg/m3. The daily mean ambient TSP concentration (n = 1) near the swine barns was 25 +/- 8 microg/m3. Concentrations of PM inside the swine barns were correlated to pig activity.


Assuntos
Poluentes Atmosféricos/análise , Criação de Animais Domésticos , Monitoramento Ambiental/métodos , Abrigo para Animais , Sulfeto de Hidrogênio/análise , Material Particulado/análise , Amônia/análise , Animais , Dióxido de Carbono/análise , Monitoramento Ambiental/instrumentação , Filtração , Umidade , Hidrocarbonetos/análise , Metano/análise , Odorantes/análise , Aves Domésticas , Controle de Qualidade , Projetos de Pesquisa , Suínos , Fatores de Tempo
20.
J Air Waste Manag Assoc ; 56(5): 581-90, 2006 May.
Artigo em Inglês | MEDLINE | ID: mdl-16739794

RESUMO

It is a common practice in the midwestern United States to raise swine in buildings with under-floor slurry storage systems designed to store manure for up to one year. These so-called "deep-pit" systems are a concentrated source for the emissions of ammonia (NH3), hydrogen sulfide (H2S), and odors. As part of a larger six-state research effort (U.S. Department of Agriculture-Initiative for Future Agriculture and Food Systems Project, "Aerial Pollutant Emissions from Confined Animal Buildings"), realtime NH3 and H2S with incremental odor emission data were collected for two annual slurry removal events. For this study, two 1000-head deep-pit swine finishing facilities in central Iowa were monitored with one-year storage of slurry maintained in a 2.4 m-deep concrete pit (or holding tank) below the animal-occupied zone. Results show that the H2S emission, measured during four independent slurry removal events over two years, increased by an average of 61.9 times relative to the before-removal H2S emission levels. This increase persisted during the agitation process of the slurry that on average occurred over an 8-hr time period. At the conclusion of slurry agitation, the H2S emission decreased by an average of 10.4 times the before-removal emission level. NH3 emission during agitation increased by an average of 4.6 times the before-removal emission level and increased by an average of 1.5 times the before-removal emission level after slurry removal was completed. Odor emission increased by a factor of 3.4 times the before-removal odor emission level and decreased after the slurry-removal event by a factor of 5.6 times the before-removal emission level. The results indicate that maintaining an adequate barn ventilation rate regardless of animal comfort demand is essential to keeping gas levels inside the barn below hazardous levels.


Assuntos
Poluição do Ar em Ambientes Fechados/análise , Amônia/análise , Sulfeto de Hidrogênio/análise , Esterco , Suínos , Poluição do Ar em Ambientes Fechados/prevenção & controle , Criação de Animais Domésticos , Animais , Monitoramento Ambiental , Abrigo para Animais , Humanos , Iowa , Exposição Ocupacional , Odorantes/análise , Ventilação
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