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Procedia
Procedia Engineering
Engineering 00
00 (2017)
(2017) 000–000
000–000
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Procedia Engineering 205 (2017) 4129–4134

10th
10th International
International Symposium
Symposium on
on Heating,
Heating, Ventilation
Ventilation and
and Air
Air Conditioning,
Conditioning, ISHVAC2017,
ISHVAC2017, 19-
19-
22 October 2017, Jinan, China
22 October 2017, Jinan, China

The Status of Research on Clean Air Conditioning System in
Hospital Operation Room
Zhiqiang
Zhiqiang Kang
Kang1,*,, Yubo
1,*
Yubo Zhang
Zhang1,, Jiannan
1
Jiannan Dong
1
Dong1 ,, Xiaocong
1
Xiaocong Cheng
Cheng1,, Guohui
1
Guohui Feng
Feng1
1
1 School
School of
of Municipal
Municipal and
and Environmental
Environmental Engineering,
Engineering, Shenyang
Shenyang Jianzhu
Jianzhu University,
University, Shenyang,
Shenyang, China
China 110168
110168

Abstract
Abstract

With
With the
the gradual
gradual improvement
improvement of of medical
medical level,
level, the
the influence
influence ofof the
the operating
operating room
room environment
environment on on surgical
surgical results
results is
is becoming
becoming
more
more and more obvious. This paper reviews the current situation and significance of clean air conditioning systems in
and more obvious. This paper reviews the current situation and significance of clean air conditioning systems in different
different
operating rooms
operating rooms of
of hospitals,
hospitals, and
and explores
explores the
the application
application ofof environmental
environmental control
control technology
technology in in the
the operating
operating room,
room, such
such as
as the
the
form
form ofof airflow
airflow in
in the
the operating
operating room,
room, the
the selection
selection ofof air-conditioning
air-conditioning system
system and
and equipment,
equipment, indoor
indoor heat
heat and
and humid
humid air
air
treatment
treatment process,
process, control
control of
of pollutant
pollutant concentration,
concentration, and
and soso on,
on, which
which reveals
reveals the
the important
important impact
impact of
of the
the operating
operating room
room
airflow environment
airflow environment onon surgery
surgery and
and forecasts
forecasts the
the application
application ofof clean
clean air-conditioning
air-conditioning system
system in
in the
the hospital
hospital operating
operating room.
room.
© 2017 The Authors. Published by Elsevier
© 2017 The Authors. Published by Elsevier Ltd. Ltd.
© 2017 The Authors.
Peer-review Published by
under responsibility
responsibility of Elsevier Ltd. committee of the 10th International Symposium on Heating, Ventilation and Air
the scientific
scientific
Peer-review under of the committee of the 10th International Symposium on Heating, Ventilation and Air
Peer-review
Conditioning. under responsibility of the scientific committee of the 10th International Symposium on Heating, Ventilation and
Conditioning.
Air Conditioning.
Keywords: Operating
Keywords: Operating room;
room; Clean
Clean air
air conditioning;
conditioning; Airflow
Airflow organization;
organization; Pollutant
Pollutant concentration
concentration

1.
1. Introduction
Introduction

With
With the
the rapid
rapid development
development of of China's
China's economy
economy in in recent
recent years,
years, people's
people's living
living standard
standard has has been
been greatly
greatly
enhanced,
enhanced, and higher demands for medical treatment have been pursued, which will further push forward
and higher demands for medical treatment have been pursued, which will further push forward thethe
improvement
improvement for for the
the construction
construction level
level of
of medical
medical facilities.
facilities. Therefore,
Therefore, clean
clean operation
operation room,
room, especially
especially senior
senior
clean
clean operation
operation room,
room, will
will give
give full
full play
play to
to aa more
more and
and more
more important
important role.
role. It
It is
is known
known to to us
us that
that the
the cleanness
cleanness ofof
an
an operation room is a key link in controlling infection, which will directly influence the infection rate after
operation room is a key link in controlling infection, which will directly influence the infection rate after the
the
operation.
operation. Therefore,
Therefore, the the requirement
requirement forfor clean
clean air
air conditioning
conditioning technology
technology isis gradually
gradually increasing[1].
increasing[1].
In GB50333-2002
In GB50333-2002 Specifications
Specifications for
for the
the Construction
Construction Technology
Technology of of Clean
Clean Hospital
Hospital Operation
Operation Rooms
Rooms published
published
and implemented
and implemented in in 2002[2],
2002[2], operation
operation rooms
rooms were
were divided
divided into
into four
four levels,
levels, including
including especially
especially clean
clean operation
operation
rooms,
rooms, standard
standard clean
clean operation
operation rooms,
rooms, generally
generally clean
clean operation
operation rooms,
rooms, andand to-be
to-be clean
clean operation
operation rooms.
rooms. Their
Their
leveling
leveling standards
standards and
and indicators
indicators are
are shown
shown inin Table
Table 1.
1.

*
* Corresponding
Corresponding author.
author. Tel.:
Tel.: +86-13840541633.
+86-13840541633.
E-mail address: kangzhiqiang101915@163.com
E-mail address: kangzhiqiang101915@163.com

1877-7058
1877-7058 ©© 2017
2017 The
The Authors.
Authors. Published
Published by
by Elsevier
Elsevier Ltd.
Ltd.
Peer-review
Peer-review under responsibility of the scientific committee
under responsibility of the scientific committee of
of the
the 10th
10th International
International Symposium
Symposium on
on Heating,
Heating, Ventilation
Ventilation and
and Air
Air Conditioning.
Conditioning.

1877-7058 © 2017 The Authors. Published by Elsevier Ltd.
Peer-review under responsibility of the scientific committee of the 10th International Symposium on Heating, Ventilation and
Air Conditioning.
10.1016/j.proeng.2017.10.152

which can effectively protect the operating area from being distracted by external environment. Standards states that clean air conditioning system shall ensure the overall .75(25/m3) 1. thus cleaning the air. [7] from Nanjing Tech University have studied the effect of air curtain device on the air distribution in operating room.5(50/m3) 5/m3 1000 10000 room general clean operating Ⅲ 2(75/m3) 4(150/m3) 5/m3 10000 100000 room Ⅳ quasi clean operating room 5(175/m3) 5/m3 300000 2. but it is not favorable for the running of clean operating rooms. the dust concentration and bacterial colony number obtained from work can completely meet the cleanliness requirement of 100-level clean operation room. verified the indoor cleanliness. What’s more. / Procedia Engineering 205 (2017) 4129–4134 2 Zhiqiang Kang et al. Meanwhile. Key parts shall be especially protected and bacteria control measures are required to ensure a set of sterile protection system to ensure a smooth and effective operation. and found that the air curtain not only has buffer function. As a result. Air distribution mode The airflow state in a clean operation room plays a vital role in controlling the pollutants in a clean room. Air conditioning system and cold and heat sources Design concept of an air conditioning system in the hospital clean operating room is different from the general industrial clean room. the principle of non-unidirectional airflow is to dilute the concentration of indoor pollutants by mixing the clean airflow sent to the room and the indoor air. but also has strong resistance to external disturbance when it reaches to breaking wind speed. et al. Deng [6] et al. et al. the blowing-in speed of air may be increased.4130 Zhiqiang Kang et al. Stand-alone systems are served for one operating room or 2 to 3 operating rooms [9].30m/s. American scholar Farhad Memarzadeh[3. the width of the clean room shall be reduced as much as possible. foreign researchers have studied on the air distribution in clean operation rooms by making use of CFD (Computational Fluid Dynamics) simulation technology. and evaluated the distribution of all kinds of particles during the operation process through mathematical models. the result of which shows that the vortex area of clean operation rooms may be increased with the decreasing size of air supply outlet. [8] from Harbin Institute of Technology have studied the characteristics of concentrated air supply and return air on both sides in unstable triangle eddy in unidirectional-flow clean room. Yan et al. which can be divided into non-unidirectional airflow and unidirectional airflow in line with the level of the clean room.Wei. to seek out the optimal systematic mode. Clean operating room air-conditioning system features Air distribution mode 2. 2. they obtained the conclusion that with the air supply velocity of 0. At present. studied the airflow mode in operating rooms by combining CFD value simulation. to achieve certain dynamic balance.2. Upon the requirements. as well as the requirements of the design. Recently.2(5/m3) 0. Taking Level III operating rooms as the research object.4(10/m3) 5/m3 100 1000 room standard clean operating Ⅱ 0. hoping to get more reasonable air distribution mode.25- 0. and simulated personnel’s influence on the cleanliness of operating rooms. namely 0. On the other hand. The results show that the height of the air outlet has a close relation to the width of the triangle eddy.1. clean air conditioning system is divided into stand-alone system and multi-machine system.48m/s.4] simulated the air distribution of different systematic modes by applying CFD. / Procedia Engineering 00 (2017) 000–000 Table1. Unidirectional airflow gradually squeezes the dirty air and discharges it to the return air outlet by means of piston displacement. Liang. it could meet the requirement of the velocity in cross section of operating rooms in the Standards. Standard of clean operation room The largest average Air cleanliness level concentration Classification of the The maximum density of surface Level operating room forms pollution Operating surrounding Operating surrounding zone zone zone zone special clean operating Ⅰ 0. [5] simulated the designed air quantity of operating rooms by making use of CFD technology.

because different operating rooms of different level have different heat and moisture load.1 Multicomputer system As the operating room is relatively independent in use. as shown in Figure. reliable and easy to operate when the operating room is not fully used. and the cooling dehumidification and reheating system will cause cold and heat counteract and unreasonable energy use. is energy-saving. and there are heating from indoor lighting.0. the commonly used cold and heat sources of air conditioning is the ordinary air source heat pump unit and auxiliary electric heating systems. compared with the traditional ones. personnel and a variety of medical equipment. So. Zhiqiang Kang et al. The COP is up to 7. At present. a variety of cold and heat source combinations have been adapted to satisfy the different heating (cooling) demand under different climatic conditions in different regions. Since the clean operating room has good leakprofness and heat insulation. and each operating room has separate exhaust. et al. . / Procedia Engineering 205 (2017) 4129–4134 4131 Zhiqiang Kang et al. Yan [13] has studied the cold and heat source all-in-one machine technology applied in the clean operating room. This system uses a three-stage fan to increase the indoor air circulation to increase the ventilation coefficient and reduce the indoor bacteria concentration [10]. It is also adapted for different heating and cooling conditions. [14] have studied the modular air-cooled heat pump unit applied in small and medium-sized clean operating room. Yang. and also keep the clean operating room to be in flexible use. / Procedia Engineering 00 (2017) 000–000 3 control of the clean operating room. with significant energy-saving effects. The air supply parameters are also different. and has high performance. have optimized the ordinary unidirectional flow clean air conditioning system. The present Joubret operating room air conditioning system has been formed after several improvements. Joubret. Clean operating room of level I and II shall use separated clean air conditioning system. and found that it can supply cold and heat at the same time all year around.Wu [11] has shown in the study of clean operation area that 2-3 clean operating rooms of level I and II usually can share a clean air conditioning system. et al. and found that modular air-cooled heat pump unit. water chilling unit and boiler system [12]. cold and heat sources of air conditioning in the operating room shall not be shared with the hospital's cold and heat source.1. cooling system is operated all year around. Fig. Thus. The air cooled heat pump unit can hardly supply heating and cooling at the same time. operating rooms of different level shall have separated air conditioning units.0 to 9. and the air conditioning units shall be in correspondence with the operating room.

According to the design and operating experience on the hospital operating room in recent years. The principle of the air conditioning system is that the fresh air undertakes full humidity load. the air supply temperature shall be raised to the air supply point in order to maintain the indoor temperature and humidity. and then sent to the room. bacteria and certain gases. the two air handling system is not necessary to be in series [15]. This system is simple and has low energy consumption. Control of pollutants Indoor pollutants mainly include the dust particles. Secondary heating thus counteracts the heat loss. In recent years. but also high operating costs. and we can use high temperature cold water to control indoor temperature to achieve temperature and humidity independent control [17]. and centrally processed to the machine dew point (L) of each operating room. Judging from most temperature and humidity requirements. more and more scholars and engineering and technical personnel have begun to study the temperature and humidity independent control air conditioning system. In the early time. Fig.4. the payback period is long. and sent to the pressurized filter unit in operating room and secondary mixed with the rest indoor air (N2) to indoor air state point (O). Fig. The air treatment solution of secondary return air reheating and the primary and secondary air return is shown in Figure 2 and Figure 3. and a number of operating rooms can share the same air treatment unit. which can be widely used in many areas. and the system is complicated. For the clean operating . and sent to the pressurized filter unit in operating room and mixed with indoor air (N) to indoor air state point (O). so that the fan coils in the end can run under dry conditions. 2.2 Primary return air system The fresh air (W) is centrally processed to the middle value of dew point (L). while the practice has proved that the system has not only high construction cost.4132 Zhiqiang Kang et al. / Procedia Engineering 205 (2017) 4129–4134 4 Zhiqiang Kang et al. and then sent to the room. high dehumidification capacity adjustment range and precise control. The reason is that when primary mixed air is treated to the dew point. there are many problems in practice. the initial investment is high. Related problems will be resolved in the follow up research. Indoor air conditioning treatment process There are a variety of air treatment solutions for operating room in summer. Zhao [16] has studied the hospital operation department in Beijing and found that primary return air reheating system in will expend much more energy than the second return air and other solutions. the preferred solution for the summer is that the fresh air takes full heat and humidity load. For example.3 Secondary return air systems Fresh air (W) is mixed with the return air (N1) to M. the model of fresh air conditioner in series connection with the operating room air conditioner has been rapidly developed.3. suitable for different regions and conditions. microbes. / Procedia Engineering 00 (2017) 000–000 2. Although the air conditioning system has the advantages of high air supply quality.

4. Contamination Control and Air-conditioning Technology. But for the large surgery hospital. and the door causes airflow when opened and closed. Using a return air system resulting in severe heat and cold offset. [2] Z L. so how to ensure that the air flow according to the ideal way need to be further studied. which has its advantages in special circumstances. ensure the air quality in the operating room with low energy consumption. Results and discussion Different levels of operation room use different forms of air flow in line with the "standard". Conclusions Surgery is an indispensable part of the medical process. . which make it difficult to control cross-infection. References [1] J M. there is also need for a more in-depth study of the humidity independent control system. Purification issues related to air conditioning system can be avoided by reasonable design and management mechanism of air conditioning and purification system. But multi system complementary operation in the process of running system and how to realize the automatic control to restrict energy consumption at the lowest level are main problems of present research. we analyze the common heat and moisture treatment process in operation room. S1(2006) 1-6. J. Under the permission of the construction area. Chen [18] has studied the layout of operating room and found that the single channel system in operating room is more in line with people's daily habits. / Procedia Engineering 00 (2017) 000–000 5 room. The implementation of multi system complementary operation in line with the "standard". Medical workers and necessary staff shall completely be purified before enter the clean operating room. Scientific research projects in Liaoning province department of education No. personnel bring in pollutants when they come in and out of the operation room. Zhiqiang Kang et al. Shen. the difference of indoor air quality and positive pressure control instability due to the operating room partially opened or stopped caused by a single system. Concept and feature of China code for clean operating room. 2015. China's hospital operating room is gradually in line with the world. 51401133. the two air return system is difficult to meet the requirements of a large number of fresh air. Heating Ventilating Air Conditioning. A ring gallery can differentiate the clean area and accurate clean area to ensure that sterile supplies will not be cross-infected. SJZUBSH201620. Class Ⅰ operating room air flow organization should use vertical unidirectional flow. J. The medical workers and patients shall have separate routes to avoid cross-infection. ‘Fresh air to bear all wet load system’ can accurately control the temperature and humidity of the air and the energy saving effect is obvious. medical workers. to ensure the operation smoothly. and supplies will enter in by the same channel. focusing on reducing the concentration of contaminants in the surgical area. Sun [19] has pointed out that sterile supply gallery can separate sterile supplies. Clean operating room requires small temperature difference in air supply and large amount of fresh air. / Procedia Engineering 205 (2017) 4129–4134 4133 Zhiqiang Kang et al. 20141074. At present. Science and technology fund in Liaoning province No. the most important thing is to control the distribution and dissemination. and the quality of the air in the operating room will affect the results and quality of the operation. optimizing the quality of the air in the operating room and reducing the energy consumption while meeting the operating room environmental standards will be an important research direction. The main sources of pollutants in the operating room are that the air conditioning system is not completely purified. the domestic hospital at present stage generally adopts the single channel mode. ensuring the quality of air in the operating room is one of the important conditions for the implementation of the operation. reducing energy consumption while ensuring indoor air quality. Therefore. In this paper. staff and equipment will make great impact on vertical air flow organization. Xu. improve energy waste. but in this case the patients. L2014230 and Shenyang Jianzhu University Postdoctoral Foundation No. New thinking and characteristic in the standard of hospital clear operating department. and also powerful guarantee for medical research. 3. Acknowledgements This research was supported by National Nature Science Foundation of China No. Subject to the construction area restrictions.

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