Human factors/ergonomics to support the design and testing of rapidly manufactured ventilators in the UK during the COVID-19 pandemic.

Background: This paper describes a rapid response project from the Chartered Institute of Ergonomics & Human Factors (CIEHF) to support the design, development, usability testing and operation of new ventilators as part of the UK response during the COVID-19 pandemic.

Method: A five-step approach was taken to (1) assess the COVID-19 situation and decide to formulate a response; (2) mobilise and coordinate Human Factors/Ergonomics (HFE) specialists; (3) ideate, with HFE specialists collaborating to identify, analyse the issues and opportunities, and develop strategies, plans and processes; (4) generate outputs and solutions; and (5) respond to the COVID-19 situation via targeted support and guidance.

Results: The response for the rapidly manufactured ventilator systems (RMVS) has been used to influence both strategy and practice to address concerns about changing safety standards and the detailed design procedure with RMVS manufacturers.

Effects of hyperoxia on the permeability of 16HBE14o- cell monolayers--the protective role of antioxidant vitamins E and C.

The use of hyperoxia for critically ill patients is associated with adverse impacts resulting in lung injury accompanied by inflammation. The aim of this study was to evaluate aspects of mechanisms that contribute to hyperoxia-induced disruption of the epithelial permeability barrier, and also the protective effects of the antioxidants α-tocopherol and ascorbate. 16HBE14o- cells were cultured as monolayers at an air-liquid interface for 6 days, after which transepithelial electrical resistance reached 251.

Hyperoxia-induced ciliary loss and oxidative damage in an in vitro bovine model: the protective role of antioxidant vitamins E and C.

Although elevated oxygen fraction is used in intensive care units around the world, pathological changes in pulmonary tissue have been shown to occur with prolonged exposure to hyperoxia. In this work a bovine bronchus culture model has been successfully used to evaluate the effects of hyperoxia on ciliated epithelium in vitro. Samples were cultured using an air interface method and exposed to normoxia, 21% O(2) or hyperoxia, 95% O(2).

Elevated oxygen fraction reduces cilial abundance in explanted human bronchial tissue.

The effect of hyperoxia on ciliary abundance in cultured explants of adult human bronchus was investigated. Bronchus samples were removed during surgery from patients receiving pneumonectomy or lobectomy for malignancy. Part or all of each of these samples was used for measurement of cilial abundance by scanning electron microscopy (SEM); in many cases the remainder was subdivided and cultured at 37 degrees C in DMEM medium, maintaining an air interface at the ciliated surface of each segment.

A randomised controlled trial investigating the effects of dopexamine on gastrointestinal function and organ dysfunction in the critically ill.

Objective: To determine whether an infusion of dopexamine for up to 7 days has an effect on gastrointestinal (GIT) absorption and permeability, renal function or organ dysfunction in the critically ill.

Design And Setting: Prospective, randomised controlled clinical trial in two general adult intensive care units.

Patients: 102 critically ill adult patients predicted to require organ support for at least 4 days.