<p>Respiratory distress syndrome is a major cause of mortality among pre-term and term neonatal population. To overcome the limitations of current therapies, a new form of respiratory support termed the, “Artificial Placenta” has been proposed. The Artificial Placenta is a type of oxygenator that is attached postnatally via the umbilical vessels to provide pumpless respiratory support to pre-term and term neonates. To develop this concept, our group previously reported on a novel polycarbonate membrane lung assist device (LAD). To build upon its development, the objectives of this thesis are to determine the optimal interface for gas exchange, and characterize the gas exchange properties of the LAD under ambient and oxygen rich atmosphere. Subsequently, its feasibility was determined by studying the effects of extracorporeal flow rates on cardiovascular parameters and gas exchange performance was assessed in a newborn piglet model.</p> <p>In vitro testing demonstrated that PDMS based membrane is the optimal interface for gas exchange in the LAD. In vitro testing of the LAD demonstrated 2.4 µL/min/cm² -3.8 µL/min/cm² and 6.4 µL/min/cm²- 10.1 µL/min/cm² of O₂ and CO₂ transfer respectively under ambient air and oxygen rich atmospheric conditions. Based on these results, the LAD theoretically could provide 6-11% of metabolic O₂ while eliminating 18-26% of CO₂in a newborn healthy pre term infant. Experiments in newborn piglet models achieved pumpless configuration with flow rates up to 60.9ml/kg/min without presenting decompensation. Preliminary, in vivo gas exchange experiments demonstrated O₂ transfer of 3ul/min/cm², which matches closely to in vitro data.</p> <p>A novel pumpless LAD is reported, which provides sufficient respiratory support. High extracorporeal flow rates with stable cardiovascular parameters demonstrate feasibility of the artificial placenta concept. This novel LAD could potentially serve as a rescue device when all other therapies such as nasal continuous positive airway and mechanical ventilation fail.</p> / Master of Applied Science (MASc)

This report outlines developing a mechanism for a relatively low in price, portable, and mechanical ventilator prototype designed to bridge the gap in ventilator access brought about the COVID-19 pandemic. The key goal is to create a portable and easy to use device which will be capable of providing constant and effective respiratory support in areas having limited resources. The ventilator uses the Oscillating Cylinder Mechanism (OCM), which makes the ventilation smoothly and continuously. This eliminates the need for the user to put maximum effort and the patient benefits. Different ideas about designs were being put forward, concentrating on the portability, functionality, reliability, safety, and effectiveness. The OCM was selected because of its ventilation parameter adjustment ability to accommodate patient-specific needs, thereby functioning in a variety of clinical settings. Although upfront complexity and cost are developed, long-term perks such as lower user fatigue and maintenance expenses compensate for the financial investment. The end design will help in the emergency medical care especially in demand emergency situations, in ambulances, and in intensive care.

Made available in DSpace on 2016-12-08T16:52:00Z (GMT). No. of bitstreams: 1 115851.pdf: 5043658 bytes, checksum: faee06c2fc5aeaf5108f5858aac5fd14 (MD5) Previous issue date: 2014-03-31 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This research is about the articulation of my experience applied at the workshops Voice and Voice Action, from Carlos Simioni and From the Voice and the Body to the Kinetic Composition from Jorge Parente and Tiago Porteiro and the search of other references beyond the learned and incorporated ones to discuss the main question suggested: the central region of the body, the Base Energy Center, comprising the area of the hip and the venter. The fundamental objective of this studies is to investigate the relation in different practices and speeches about vocal support, understood here as the Base Energy Center, which can give support to the poetic voicing of the performer, from a theoretical framework that references in the literature and in some specific Eastern and Western cultural practices. This paper argues about how psychophysical exercises can increase consciousness of the performer on its Base Energy Center, and consequently improve the perception of his/her voice as a body production. / Essa pesquisa trata da articulação da minha experiência encarnada nas oficinas Voz e Ação Vocal, de Carlos Simioni e Do Corpo e da Voz à Composição Cinética de Jorge Parente e Tiago Porteiro e a busca de outras referências além das apreendidas e incorporadas para discutir a principal questão nela surgida: a de que a região central do corpo, seu Centro de Energia de Base, que compreende o quadril e o baixo ventre - desempenha influência determinante na corporeidade da voz nas ações vocais. O objetivo fundamental dos estudos é investigar a relação em diferentes práticas e discursos sobre o apoio vocal, aqui entendido como um Centro de Energia de Base, no qual pode se apoiar a vocalidade poética do performer, a partir de um arcabouço teórico que o referencie na literatura e em algumas práticas culturais ocidentais e orientais específicas. Esta dissertação argumenta que exercícios psicofísicos podem ampliar a consciência do performer sobre o seu Centro de Energia de Base, e consequentemente melhorar a percepção deste/desta da voz como uma produção corporal.

Aim: Despite the lack of evidence, current resuscitation guidelines recommend tactile stimulation in apneic infants within the first minutes of life. The aim was to investigate whether timing, duration or intensity of tactile stimulation influences the extent of non-invasive respiratory support in extremely preterm infants during neonatal resuscitation. Methods: In an observational study, we analyzed 47 video recordings and physiological parameters during postnatal transition in preterm infants below 320/7 weeks of gestational age. Infants were divided into three groups according to the intensity of respiratory support. Results: All infants were stimulated at least once during neonatal resuscitation regardless of their respiratory support. Only 51% got stimulated within the first minute. Rubbing the feet was the preferred stimulation method and was followed by rubbing or touching the chest. Almost all very preterm infants were exposed to stimulation and manipulation most of the time within their first 15 min of life. Tactile stimulation lasted significantly longer but stimulation at multiple body areas started later in infants receiving prolonged non-invasive respiratory support. Conclusion: This observational study demonstrated that stimulation of very preterm infants is a commonly used and easy applicable method to stimulate spontaneous breathing during neonatal resuscitation. The concomitant physical stimulation of different body parts and therefore larger surface areas might be beneficial.