162 HVAC DESIGN MANUAL FOR HOSPITALS AND CLINICS

Figure 8-7 Sources of Operating Room Cooling Loads

and maintenance of pressurization. Many hospitals have decided that

the problems and risks of setback exceed the benefits.

8.3.2 Air Distribution A simple way to save energy in ORs is to maintain constant air
volume, but reduce room setpoint during unoccupied periods. This
will reduce reheat and often satisfy a surgeons desire for a cold room.
This strategy should be discussed with the clinical staff.

Current recommendations for air distribution design are based

heavily on the work on Memarzadeh and Manning (2002), which
included an analysis of air change rates as well as air velocity. The air
velocity recommendations are based on the theory of a small thermal
plume radiating up from an open surgical site. This plume, while not
necessarily aseptic, will, in theory, contain only the microbes that are
already present on or in the patient. If the thermal plume is undisturbed,
particles from the air supply and/or from the staff will be diverted and
not directly impact the surgical site. Thus, Memarzadeh and Manning
recommended a maximum face velocity of 25 to 30 fpm [0.13 to
0.15 m/s] so that the supply air will not disrupt the plume. This air
velocity is specified in ANSI/ASHRAE/ASHE Standard 170-2008.
Ongoing ASHRAE research project RP-1397, which is investigating
hospital operating room air distribution to verify CFD predictions of
conditions that sustain the thermal plume, indicates that wound
temperatures in orthopedic surgery are relatively low (80F [26.7C]).
These researchers, therefore, question if a thermal plume could be
created at such a low temperature. This research thus far indicates