Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Temperature ( C)
Operating Theatres
17 ~ 27
45 ~ 55
24 ~ 27
30 ~ 60
24
30 ~ 60
24 ~ 27
30 ~ 60
Wards (airconditioned)
Isolation Ward
As Hospital Leaders continue to seek ways to improve quality and reduce errors, it is
critical that they look around their own physical environment with the goal of
ensuring the hospital contributes to, rather than impedes, the process of healing.
- Carolyn Clancy, M.D.US Director
Temperature
Relative Humidity
Bacterial count
Supply air velocity at the operating table
Fresh air (recirculation is optional)
Total number of air changes
Pressurization
Filtration efficiency
Supply air discharge area
General
0
20 1 C
55 5%
<35 cfu/m3
0.38 m/s
20 air changes / hour
20 air changes / hour
+25 Pa
99.997% at terminal
2.4m x 1.8m
Ultra-clean
20 1 0C
55 5%
<10 cfu/m3
0.38 m/s
20 air changes / hour
20 air changes / hour
+25 Pa
99.997% at terminal
2.8m x 2.8m
Hospital Operating Rooms. The operating theatres are categorised as general and ultraclean, with Ultra-clean OTs, used for
specialized procedures, such as, organ transplant, orthopedic surgery, neurosurgery, etc., where bacterial contamination is
relatively much more critical. Operating rooms should be at a low relative humidity (35-55 % RH) and cool (600 - 680F) / (150 200C). This is an excellent application for CDQ. The improved latent capacity not only reduces the required cooling needed but the
supply-air dew points can eliminate the need for a secondary refrigeration coil or a heat-regenerated active desiccant system.
Because active desiccant systems provide hot air (which would then require a significant amount of post-cooling), using a CDQ
system can result in significant energy savings.
The OR Microclimate
Operating Rooms....the most critical enviroment that requires the highest level of humidity and temperature control, require:
Sterile and controlled enviroments
Adhere to codes/Standards
Reliable systems
By providing cooler, drier air, doctors complaints can be greatly reduced with improved space conditions. The need to provide a
colder surgery suite has become The expectation of doctors.
Cooler temperatures decrease bleeding and improve the patient outcomes.
Drier air delivered to the space results in drier ductwork on the outside and inside of the ductwork. Moisture inside the duct work
becomes a breeding ground for mold. Moisture on the outside of the ductwork drips on to ceilings and into the space.
By keeping moisture out of the space, breeding grounds for mold and nosocomial infections are reduced. They both need dirt and
moisture. Controlling to lower humidity levels reduces the presence of one of the main ingredients for mold growth.
If the dew point in the space is higher then the surface temperature of any of the equipment, condensate will form on those
surfaces.
The importance of temperature control in Operating Theatres
A hospitals physical environment is linked to the health of patients and caregivers, and it can have a direct impact on the
satisfaction of both. the modern surgical suite is prime example of how the environment directly affects both patient health and
caregiver satisfaction.
Many countries encounter high surgical site infection (SSI) rates in their hospitals. Besides economical effects, such
infections can have major impact on the health and recovery of the patient. The incidence of SSI depends on many variables,
including the type of surgery performed and the type of ventilation system. The air is one of the transfer routes for
microbiological contamination, therefore high performance requirements are set with respect to the ventilation system
applied. Besides, the ventilation system in an operating theatre affects, e.g., the thermal comfort of the personnel,
hypothermia of the patient, drying out of the wound, etc.
Comparatively, over time, the temperature in operating rooms has been driven to lower levels for a number of very practical
reasons:
Cooler temperatures slow down the metabolic rates of exposed organs and minimize bleeding during surgery.
Less blood loss and a slowed metabolism places less stress on the patient, which can improve patient health
outcomes. But again, operating room temperatures should not be allowed to go too low. Temperature sensors and
controls are crucials to maintaining the optimum temperature for patients and caregivers.
The increased desire by surgical teams to minimize exposure to airborne contaminants and the transfer of bodily
fluids has led to more complete gowning of the surgical team. This extra gowning traps more heat and results in the
need for lower temperatures in the surgery suite to minimize perspiration. Doctors and nurses do not
want to sweat during critical procedures.
In orthopedic procedures, which require the use of cements and glues to set joints, the drying rate of the adhesives
is crucial to improved patient outcomes. If the operating room temperature is too warm, the adhesives set too
quickly. Colder temperature allow adequate time for proper setting of the joints.
68-73
(20-23)
62-80
(17-27)
relative
room
humidity
air
%
changes
outdoor
air
changes
%
outdoor
air
30-60
15
20
45-55
15
15
100
ASHRAE design
manual (2003)
68-75
(20-24)
30-60
25
20
ASHRAE Standard
170P (Sep 2006)
68-75
(20-24)
30-60
20
20
ASHRAE Handbook
(2007)
62-80
(17-27)
68-75
(20-24)
70-75
(21-24)
FGI
(2010)
Class B&C
Class A
25C
77oF(25oC) 50% RH
Unoccupied Mode 50% Airflow
+ve Pa
o
o
Warm 72 F(22 C)
50%RH
30-60
20
20
30-60
20
20
o
o
Cold 66 F(19 C)
50%RH
30-60
18
15
17C
o
o
Coldest 62 F(17 C)
50%RH
19C
but trend is for colder temperatures (65F, 62F (18C, 16C), or even colder)
The need to control the temperature and humidity of surgical suites is clear - patients and caregivers need a cool, dry surgical environment to support
them in the sometimes tension-fraught atmosphere of the operating room. In some even more challenging operations, whereby the surgical staffs might
want to rise the room temperature to a warmer conditions as they go through a series of various stages of operating procedures and yet, maintain the
relative humity within control. This poses a very challenging design to any airside equipment. Temperature and humidity ranges, and minimum
air-change rates are often prescribed by local codes or by industry-accepted guidelines.
HEALTHCARE
how it works
high
typical
mixed-air
conditions
(MA)
ability to
hold water
vapor
low
0
20
40
60
80
relative humidity, %
100
Air leaving a cooling coil (CA on the previous slides) is generally at a very high relative
humidity (often greater than 90%). At this condition, the series desiccant wheel will
have a high affinity for water vapor and absorb it from the air that leaves the cooling
coil. When the wheel rotates into the mixed air stream (MA on the previous slides),
it will be exposed to air that is at a much lower relative humidity (typically 40% to
60%). At this lower relative humidity, the desiccant will have have a much lower
affinity for water vapor, and it will release water vapor into the air stream.Unlike
traditional desiccant dehumidification applications, the regeneration air stream does
not need to be hot in order to drive the process. It is driven by the characteristic of the
desiccant specifically chosen for this application, which allows the wheel to be
regenerted at low temperatures.
Innovative CDQ
TM
dehumidification
Trane CDQ
wheel
peak DB
RA
62F(16.7oC) DB
55% RH
MA
69.6F(21.1oC) DB
53.2 gr/lb(7.6g/kg)
MA'
66.3F(19oC) DB
62.8 gr/lb(9g/kg)
CA
52F(11.1oC) DB
51.6 gr/lb(7.4g/kg)
SA
55.3F (12.9oC)DB
41.9 gr/lb(6g/kg)
40(4.4)
30(-1)
C)
80%
F(
,
re
u
t
ra 70(21)
pe
m
te
SA
RA
180(25.7)
160(22.9)
colder
warmer
140(20)
drier
b
ul 60(15.6)
-b
t
e
w
MA'
50(10)
CA
60%
wetter
80(26.7)
40%
120(17.1)
100(14.3)
OA
20%
80(11.4)
60(8.6)
MA
coil loads:
2.2 tons(7.7Kw) (cooling)
0 MBh(Kw) (reheat)
40(5.7)
20(2.9)
30
40
50
60
70
80
90
100
110
(-1)
(4.4)
(10)
(15.6)
(21)
(26.7)
(32.2)
(37.8)
(43.3)
OA
100F(38oC) DB
74F(23oC) WB
MA'
CA
MA
RA
SA
Control
Trane offers as standard, Trane propriety controls on all CDQ projects.
Trane provides a single source solution to the entire cooling and dehumification. The
AHU with the coil and CDQ wheel, the sensors and the controller. Single source
supply implies single source responsibility and accountability.
Economics
As an overall comparison:
y The basic constant-volume system is unable to meet both the temperature and
humidity requirements of the surgery room. This system requires the use of
reheat, even at full-load conditions.
y If the cooling equipment serving the surgery rooms are to be separate from the
existing chiller plant (i.e., standalone), then the split dehumidification unit or
CDQ system are typically preferred because they require no reheat at full load,
and therefore require less overall cooling capacity (about 20% less cooling
capacity in our example).
y In the CDQ system, the existing chiller plant might be able to provide all of
the cooling capacity because the temperature of the air leaving the cooling coil is
only 520 F (11.10C), which can likely be achieved with proper coil selection. This
system is able to achieve a lower supply-air humidity ratio (drier) without requiring
the use of a lower leaving-coil temperature.