Narrow Results

Background: In developing countries, lower respiratory tract infection is a major cause of death in children, with severely ill patients being admitted to the critical-care unit. While physical therapists commonly use the manual hyperinflation (MHI) technique for secretion mass clearance in critical-care patients, its efficacy has not been determined in pediatric patients.

Objective: This study investigated the effects of MHI on secretion mass clearance and cardiorespiratory responses in pediatric patients undergoing mechanical ventilation.

Methods: A total of 12 intubated and mechanically ventilated pediatric patients were included in this study. At the same time of the day, the patients received two randomly ordered physical therapy treatments (MHI with suction and suction alone) from a trained physical therapist, with a washout period of 4h provided between interventions.

Results: The MHI treatment increased the tidal volume [$V_t$; 1.2mL/kg (95% CI, 0.8–1.5)] and static lung compliance [$C_{\mathrm{\text{stat}}}$; 3.7mL/cmH₂O (95% CI, 2.6–4.8)] immediately post-intervention compared with the baseline ($p<0.05$). Moreover, the MHI with suction induced higher $V_t$ [1.4mL/kg (95% CI, 0.8–2.1)] and $C_{\mathrm{\text{stat}}}$ [3.4mL/cmH₂O (95% CI, 2.1–4.7)] compared with the suction-alone intervention. In addition, the secretion mass [0.7g (95% CI, 0.6–0.8)] was greater in MHI with suction compared with suction alone ($p<0.05$). However, there was no difference in peak inspiratory pressure, mean airway pressure, respiratory rate, heart rate, blood pressure, mean arterial blood pressure or oxygen saturation ($p>0.05$) between interventions.

Conclusions: MHI can improve $V_t$, $C_{\mathrm{\text{stat}}}$ and secretion mass without inducing adverse hemodynamic effects upon the pediatric patients requiring mechanical ventilation.

The unsteady flow over a continuously shrinking sheet with wall mass suction in a nanofluid is numerically studied. The governing boundary layer equations are transformed into a set of nonlinear ordinary differential equations by using similarity transformation. The resulting similarity equations are then solved by the shooting method for three types of nanofluid: copper-water, alumina-water and titania-water to investigate the effect of nanoparticle volume fraction parameter ɸ to the flow in nanofluid. The skin friction coefficient and velocity profiles are presented and results show that dual solutions exist for a certain range of unsteadiness parameter A. It is also found that the nanoparticle volume fraction parameter ɸ and types of nanofluid play an important role to significantly determine the flow behaviour.

A skin is an indispensible organ for humans because it contributes to metabolism using its own biochemical functions and protects the human body from external stimuli. Recently, mechanical properties such as a thickness, a friction and an elastic coefficient have been used as a decision index in the skin physiology and in the skin care market due to the increased awareness of wellbeing issues. In addition, the use of mechanical properties is known to have good discrimination ability in the classification of human constitutions, which are used in the field of an alternative medicine. In this study, a system that measures mechanical properties such as a friction and an elastic coefficient is designed. The equipment consists of a load cell type (manufactured by the authors) for the measurements of a friction coefficient, a decompression tube for the measurement of an elastic coefficient. Using the proposed system, the mechanical properties of human skins from different constitutions were compared, and the relative repeatability error for measurements of mechanical properties was determined to be less than 2%. Combining the inspection results of medical doctors in the field of an alternative medicine, we could conclude that the proposed system might be applicable to a quantitative constitutional diagnosis between human constitutions within an acceptable level of uncertainty.