Koldo Redondo

Background: There is growing interest in the quality of manual ventilation during cardiopulmonary resuscitation (CPR), but accurate assessment of ventilation parameters remains a challenge. Waveform capnography is currently the reference for monitoring ventilation rate in intubated patients, but fails to provide information on tidal volumes and inspiration–expiration timing. Moreover, the capnogram is often distorted when chest compressions (CCs) are performed during ventilation compromising its reliability during CPR. Our main purpose was to characterize manual ventilation during CPR and to assess how CCs may impact on ventilation quality. Methods: Retrospective analysis were performed of CPR recordings fromtwo databases of adult patients in cardiac arrest including capnogram, compression depth, and airway flow, pressure and volume signals. Using automated signal processing techniques followed by manual revision, individual ventilations were identified and ventilation parameters were measured. Oscillations on the capnogram plateau during CCs were characterized, and its correlation with compression depth and airway volume was assessed. Finally, we identified events of reversed airflow caused by CCs and their effect on volume and capnogram waveform. Results: Ventilation rates were higher than the recommended 10 breaths/min in 66.7% of the cases. Variability in ventilation rates correlated with the variability in tidal volumes and other ventilatory parameters. Oscillations caused by CCs on capnograms were of high amplitude (median above 74%) and were associated with low pseudo-volumes (median 26 mL). Correlation between the amplitude of those oscillations with either the CCs depth or the generated passive volumes was low, with correlation coefficients of −0.24 and 0.40, respectively. During inspiration and expiration, reversed airflow events caused opposed movement of gases in 80% of ventilations. Conclusions: Our study confirmed lack of adherence between measured ventilation rates and the guideline recommendations, and a substantial dispersion in manual ventilation parameters during CPR. Oscillations on the capnogram plateau caused by CCs did not correlate with compression depth or associated small tidal volumes. CCs caused reversed flow during inspiration, expiration and in the interval between ventilations, sufficient to generate volume changes and causing oscillations on capnogram. Further research is warranted to assess the impact of these findings on ventilation quality during CPR.

Integration of wind energy into the grid faces a great challenge regarding power quality. The International Electrotechnical Commission (IEC) 61400-21 standard defines the electrical characteristics that need to be assessed in a Wind Turbine (WT), as well as the procedure to measure the disturbances produced by the WT. One of the parameters to be assessed are voltage fluctuations or flicker. To estimate the flicker emission of a Wind Power Plant (WPP), the standard establishes that a quadratic exponent should be used in the summation of the flicker emission of each WT. This exponent was selected based on studies carried out in WPPs with type I and II WTs. Advances in wind turbine technology have reduced their flicker emission, mainly thanks to the implementation of power electronics for the partial or total management of the power injected into the grid. This work is based on measurements from a WPP with 16 type III WTs. The flicker emission of a single WT and of the WPP were calculated. Low flicker emission values at the Point of Common Coupling (PCC) of the WPP were obtained. The flicker estimation at the PCC, based on the measurement from a single WT, was analyzed using different exponents. The results show that a cubic summation performs better than the quadratic one in the estimation of the flicker emission of a WPP with type III WTs.

Integration of wind energy into the grid faces a great challenge regarding power quality. The International Electrotechnical Commission (IEC)~61400-21 standard defines the electrical characteristics that need to be assessed in a Wind Turbine (WT), as well as the procedure to measure the disturbances produced by the WT. One of the parameters to be assessed are voltage fluctuations or flicker. To estimate the flicker emission of a Wind Power Plant (WPP), the standard establishes that a quadratic exponent should be used in the summation of the flicker emission of each WT. This exponent was selected based on studies carried out in WPPs with type I and II WTs. Advances in wind turbines technology have reduced their flicker emission, mainly thaks to the implementation of power electronics for the partial or total management of the power injected into the grid. This work is based on measurements from a WPP with 16 type III WTs. The flicker emission of a single WT and of the WPP were calculated. Low flicker emission values at the Point of Common Coupling (PCC) of the WPP were obtained. The flicker estimation at the PCC, based on the measurement from a single WT, was analyzed using different exponents. The results show that a cubic summation performs better than the quadratic one in the estimation of the flicker emission of a WPP with type III WTs.

The purpose of the present paper is to evaluate the sensitivity of modern lighting technologies to different types of RVCs. In order to do that, 27 modern lamps—mainly LED—have been subjected to real RVCs and their response has been assessed. The detection of RVCs on the grid has been performed according to the IEC 61000-4-30 detection method, while the response of the lamps has been measured with a light flickermeter and characterized using the instantaneous flicker perception, as defined in IEC 61000-4-15. The obtained results show a high dispersion in the response of the modern lighting technologies and high values of flicker perception, although with a lower sensitivity than the incandescent lamp. The results led the authors to propose the definition of a new immunity test to be added to the lamp immunity protocol IEC TR-61547-1, to ensure that newly produced lamps cause limited irritation to grid users.