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Search indexed NASA NTRS and DOE OSTI research on propulsion, heat transfer, battery materials and energy systems. Follow report and document links to the original sources.

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6 records
All sourcesNASA NTRSDOE OSTI
DOE OSTI2020

CPAP Ventilators Needed for Rapid Response to COVID-19 by Modification of CPAP Equipment

Early on in the COVID-19 pandemic, potential ventilator shortages were a critical issue identified by national health care providers. Capacity modeling at the time suggested patient demand may exceed ventilator supply. Thus, the challenge became finding an urgent interim solution to meet health care needs. Our initial hypothesis was that CPAP technology could be modified to provide similar functionality to a ventilator, relieving demand and allowing physicians to decide which patients need high end machines, ultimately saving lives. In conjunction with medical experts and pulmonologists, we were able to identify three key thrusts associated with this research problem: (1) modification of CPAP technology to allow for 02 input that would be capable of providing ventilation; (2) development of an alarming function that would provide real-time audible alarms to alert medical personnel to critical conditions, which would be used inline with CPAP technology; and (3) a method of sterilizing expiratory air from such a system in order to protect medical personnel from biohazard, since CPAPs vent to the atmosphere. We were unable to realize results for thrust 1 (CPAP modification for 02); we identified potential safety issues associated with utilizing medical grade oxygen with a common CPAP device. In order to characterize and mitigate these issues, we would need to partner closely with a device manufacturer; such a partnership could not be achieved in the timeframe needed for this rapid response work. However, we determined that some medical grade BiPAP devices do not need this modification and that the significant progress on thrusts 2 and 3 would be sufficient to buy down risk of a massive ventilator shortage. Our team built a prototype alarm system that can be utilized with any assistive respiratory device to alert on all key conditions identified by medical personnel (high pressure, low pressure, apnea, loss of power, low battery). Finally, our team made significant progress in the rapid prototyping and demonstration of an inline UV air purifier device. The device is cost efficient and can be manufactured at scale with both commercially available and additively manufactured parts. Initial tests with SARS-CoV-2 analog bacteriophage MS2 show 99% efficacy at reducing bioburden. Following a successful demonstration of the prototype device with medical personnel, we were able to obtain follow-on (non-LDRD) funding to provide additional device characterization, validation, and production in order to respond to an immediate regional need.

42 ENGINEERING↗
DOE OSTI2020

Filter Adapters for BI-PAP and CPAP Equipment

Researchers at Los Alamos National Laboratory are researching and designing technology intended to help reduce the exposure of patients and medical staff to pathogens, such as SARS-CoV-2, while providing medical staff the dexterity and flexible work conditions necessary to conduct routine and complex patient care on infected patients. This investigative technology would potentially enable hospitals to adapt, utilize, and repurpose existing Bilevel Positive Airway Pressure (BiPAP) or Continuous Positive Airway Pressure (C-PAP) equipment in the fight against COVID-19, which would potentially save hospitals significant money, reduce exposure to staff and patients, and increase the supply of critically needed devices at a time when supplies are scarce in the market place. A provisional patent has been filed on the technology and we are seeking a commercialization partner to license and further develop the product for commercial purposes, including processing the device through the FDA emergency use authorization or clearance process. One hospital system has indicated that upon FDA authorization or clearance, it would have interest in the product.

42 ENGINEERING↗
DOE OSTI2015

Continuous Positive Airway Pressure for Motion Management in Stereotactic Body Radiation Therapy to the Lung: A Controlled Pilot Study

Objective: To determine the effect of continuous positive airway pressure (CPAP) on tumor motion, lung volume, and dose to critical organs in patients receiving stereotactic body radiation therapy (SBRT) for lung tumors. Methods and Materials: After institutional review board approval in December 2013, patients with primary or secondary lung tumors referred for SBRT underwent 4-dimensional computed tomographic simulation twice: with free breathing and with CPAP. Tumor excursion was calculated by subtracting the vector of the greatest dimension of the gross tumor volume (GTV) from the internal target volume (ITV). Volumetric and dosimetric determinations were compared with the Wilcoxon signed-rank test. CPAP was used during treatment if judged beneficial. Results: CPAP was tolerated well in 10 of the 11 patients enrolled. Ten patients with 18 lesions were evaluated. The use of CPAP decreased tumor excursion by 0.5 ± 0.8 cm, 0.4 ± 0.7 cm, and 0.6 ± 0.8 cm in the superior–inferior, right–left, and anterior–posterior planes, respectively (P≤.02). Relative to free breathing, the mean ITV reduction was 27% (95% confidence interval [CI] 16%-39%, P<.001). CPAP significantly augmented lung volume, with a mean absolute increase of 915 ± 432 cm{sup 3} and a relative increase of 32% (95% CI 21%-42%, P=.003), contributing to a 22% relative reduction (95% CI 13%-32%, P=.001) in mean lung dose. The use of CPAP was also associated with a relative reduction in mean heart dose by 29% (95% CI 23%-36%, P=.001). Conclusion: In this pilot study, CPAP significantly reduced lung tumor motion compared with free breathing. The smaller ITV, the planning target volume (PTV), and the increase in total lung volume associated with CPAP contributed to a reduction in lung and heart dose. CPAP was well tolerated, reproducible, and simple to implement in the treatment room and should be evaluated further as a novel strategy for motion management in radiation therapy.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2023

Neonatal respiratory support strategies—short and long-term respiratory outcomes

Mechanical ventilation (MV), although life-saving, is associated with chronic respiratory morbidity in both preterm and term born infants. New ventilation modes have been developed with the aim of minimising lung injury. These include invasive and non-invasive respiratory support strategies, techniques for less invasive surfactant administration (LISA) and closed-loop automated oxygen control (CLAC) systems. Increasingly, newborn infants with signs of respiratory distress are stabilised on continuous positive airway pressure (CPAP) and receive LISA. Early CPAP when compared to mechanical ventilation reduced the incidence of BPD and respiratory morbidity at 18 to 22 months corrected age. Nasal intermittent positive pressure ventilation reduced treatment failure rates compared to CPAP, but not bronchopulmonary dysplasia (BPD). LISA compared with intubation and surfactant delivery reduced BPD, but there is no evidence from randomised trials regarding long-term respiratory and neurodevelopmental outcomes. Synchronisation of positive pressure inflations with the infant's respiratory efforts used with volume targeting should be applied for infants requiring intubation as this strategy reduces BPD. A large RCT with long term follow up data demonstrated that prophylactic high frequency oscillatory ventilation (HFOV) improved respiratory and functional outcomes at school age, but those effects were not maintained after puberty. CLAC systems appear promising, but their effect on long term clinical outcomes has not yet been explored in randomised trials. Further studies are required to determine the role of newer ventilation modes such as neurally adjusted ventilator assist (NAVA). All such respiratory support strategies should be tested in randomised controlled trials powered to assess long-term outcomes.

Kaltsogianni, Ourania↗
DOE OSTI2019

Efficient and Zero Net Energy-Ready Plug Loads

Plug loads are the devices plugged into common electrical outlets. Modern buildings contain hundreds of these devices which, together, are responsible for at least 25 percent of the energy use in California buildings. Energy consumed by plug loads is increasing because the “Internet of Things” is, to a great extent, the “Internet of Plug Loads.” This project developed technologies that will reduce the energy use of plug loads. Two crosscutting strategies were investigated in detail: (1) technologies to reduce standby power use to near zero, and (2) methods to increase the use of direct current (DC) as a power source. Two new approaches to reduce standby to near zero were developed and have potential applicability to a wide range of devices. Prototype DC appliances were developed to demonstrate energy savings by bypassing power supplies and avoiding other losses. Networks of DC-powered devices can save even more energy and provide other benefits, such as resiliency during power outages. A unique category of energy-using devices was identified that provide life safety, health, and security to building occupants. Their installation or use is dictated by building codes, health providers, insurance companies, and other entities—none of whom would ordinarily prioritize energy efficiency. In the case of ground fault circuit interrupts (GFCIs), savings of 80 percent appear possible, simply by adopting the most efficient designs. Home medical equipment, particularly oxygen concentrators, are a rising category of energy use where significant savings are possible. This report also reviews the codes, standards, and other policies that affect energy use of plug loads.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗