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Table 2 Studies associated with HVAC use

From: Health effects of heating, ventilation and air conditioning on hospital patients: a scoping review

Publication,
Title
Type of Study Objective (I) Intervention/ HVAC Specification (if given: mean temperature)
(C) Control
(if given: mean temperature)
(S) Setting
(D) Duration of Intervention
Study Population Health Effects of HVAC Use/ Results/Findings Comments
Price et al. 2003, [37],
“Cooling strategies for patients with severe cerebral insult in ICU”
Clinical trial Analysis of the efficacy of different cooling strategies for patients with cerebral insult and elevated body temperature (I) -Group a) paracetamol and depending on the clinical course: Continuation of paracetamol and additional “fanning” [portable rotary fans were preferably used]
-Group b) no paracetamol and depending on the clinical course: Continuation with no intervention or additional “fanning”
(C) -Group a) paracetamol and depending on the clinical course: Continuation of paracetamol alone or paracetamol and additional other cooling methods (e.g. ice packs)
• -Group b) no paracetamol and depending on the clinical course: Continuation with no intervention or use of other cooling methods (e.g. ice packs)
(S) Intensive care unit
(D) Criteria to end the procedure were not stated; it is referred to temperature measurements over 24 h
N total = 67
Intervention:
-Group a) paracetamol and fanning:
n = 12
-Group b) no paracetamol and fanning:
n = 16
Control:
-Group a) paracetamol and another cooling strategy:
n = 25
-Group b) no paracetamol and another cooling strategy:
n = 14
• Physical cooling strategies (fanning) do not add to body cooling regardless of paracetamol use
• Use of fan is negatively associated with a reduction in body temperature
• Report of hygiene problems associated with fan use
• Uneven patient allocation to different cooling methods
• “Fanning” could not be specified
Ferguson & Martin 1991, [38],
“A study of skin temperatures, sweat rate and heat loss for burned patients”
Clinical trial Analysis of the influence of the thermal environment on heat loss/ evaporation of patients with severe burns
- Intensive care unit: Measurement of skin temperature of volunteers; measurement of wound temperatures, evaporation from burn wounds and sweating rates of burned patients
- General ward: Measurement of sweating rates of patients
(I) - Intensive care unit: Clean air unit: Small box with ultra-flow clean air system with uniform heated airflow (cf. 41)
(28 °C – 38 °C);
- General ward: Additional heating
(C) Not fully applicable
(S) Intensive care unit, general ward
(D) Few days/until wounds dried off
Intervention 1 (intensive care unit):
n = 12, volunteers:
n = 6
Intervention 2 (general ward), temperature not specified:
n = 7
• During the first 3 days wound temperature was cooler than intact skin; after that time wound temperature was higher
• Evaporation rate from wounds varied between 100 and 700g/m2/h
• With a higher percentage of burned surface, room temperature could be higher without initiating sweating
• Radiation and convection loss is lower in ICU (higher temperature). Losses from burn wounds were lower in the first few days (lower wound temperature). Overall convective losses: Similar in ICU and general ward.
• Difficult to identify participants in intervention groups
• Healthy volunteers were enrolled
• Clean air unit shows features of air conditioning but reported maximum room temperatures are outside the thermal comfort range
Johnston et al. 2006, [39],
“Body temperature management after severe traumatic brain injury: methods and protocols used in the United Kingdom and Ireland”
Cross-sectional Survey on “methods and protocols used in the management of body temperature in patients with severe TBI“ (I) Convection fan and other methods
(C) Not fully applicable
(S) Intensive care unit
(D) Up to 48 h
• 33 centres • Besides fans, a variety of methods is used for temperature management
• Only 2 out of 33 intensive care units have a convection fan implemented as the first-line method
• If the first-line method failed to lower body temperature, mostly a combination of direct body cooling methods was used
• Fan use was mentioned as an adjunct to first-line treatment
• The survey was conducted with intensive care nurses
• “Convection fan” could not be specified
De Vries & Feix 2018, [40],
“Fever burden, septic screening, and cooling therapies in brain injury patients on a regional neurosciences intensive care unit”
Cross-sectional Analysis of fever incidence and adherence to fever management protocols in the intensive care unit (I) “Cold air humidification”, “fan” and other physical and medical cooling methods
(C) Not applicable
(S) Intensive care unit
(D) Not specified
N = 38 • Temperature burden in febrile patients was high
• Besides screening for fever causes, 9 patients were treated with paracetamol alone, 9 patients had two or more cooling methods, 5 febrile patients were not treated
• Outcomes according to different methods are not reported
• The analysis deals with adherence to fever treatment protocols
• Most patients (n = 29) had a subarachnoid haemorrhage
• Interventions are part of a bundle of cooling strategies including medical treatment (e.g. paracetamol)
• Frequencies for use of “cold air humidification” or “fan” are not specified
• “Fan” could not be specified
  1. TBI: traumatic brain injury