Design and development of air ventilated air bed for hospitalized patients

Abstract

Keywords: Air Ventilated Air Bed; Hospitalized patients; Bedsore; Ventilation

Introduction

The number of patients admitted to hospitals has risen considerably in recent years. Furthermore, the number of individuals hospitalized for weeks or months due to various disorders has increased dramatically [1] . Patients who

tion to keep their skin dry by reducing the sweat. [2]. The medical profession is one where engineering principles and applications can be used to tackle any challenges or difficulties that arise during the process improvement process [3].

*Corresponding author. *E-mail address: prhatte@mitaoe.ac.in, prhatte@gmail.com This paper was recommended for publication in revised form by Regional Editor Omid Mahian Published by Yıldız Technical University Press, İstanbul, Turkey Copyright 2021, Yıldız Technical University. This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/).

One of these types of applications is the proposed solution. The solution entails creating and developing an air-ventilated air bed with several components such as compressors, tube mesh, and a comfortable fabric [4, 5]. The primary goal of air beds is to avoid bedsores in hospitalized patients [6, 7]. Constant pressure and moisture build-up between the bed’s surface and the patient’s body are typical causes of bedsores. Infection from a pressure sore can burrow into joints and bones, causing warmth, redness, and swelling in the affected area. As a result, it is critical to avoid bedsores, which can cause considerable harm to hospitalized patients [8]. Bedsores can be avoided if sufficient ventilation is given. In the regions where it is most needed, an air bed assists in providing good ventilation to hospitalized patients. The patient’s neck and thighs are provided with ventilation [9]. The air bed is designed so that the air is provided from the upper side of the bed through a tube mesh, preventing the patient from developing bedsores [10, 11]. For improved outcomes, a wavy surface is given. Because the compressors utilized here are medical compressors, they don’t make a lot of noise, which is a big advantage [12]. Rubber tubes are used, which do not prick the patients. The Air bed’s surface is wavy, which helps to alleviate pressure between the surface and the hospitalized patients [13, 14]. Other skin problems induced by excessive sweating can be avoided by providing sufficient ventilation to a patient’s bedsore. Patients benefit from enough ventilation due to the air bed’s dual compressors. To begin, compressed air is used to inflate the air bed. The rubber tube mesh is then positioned above the air bed [15]. Holes are drilled into the rubber tube mesh at regular intervals. The air bed takes about 15 to 20 minutes to inflate. After the air bed has been inflated, the compressors are detached and linked to the rubber tube mesh. The air bed is operated in this manner. The operating and installation processes are both simple. The primary aim of this research work is to provide a simple and user-friendly solution for hospitalized patients which can keep the skin dry and avoid bedsores. Bed sores are a global issue and remain a substantial concern for healthcare systems [1]. In the medical field, the most important thing for the prevention of bedsores is by keeping temperature and pressure in control between the surface of hospitalized patients and the bed [2]. One of the major causes of bed sores is hard mattresses used in hospitals [3]. For designing beds for patients these factors are taken into consideration. For better control of pressure, knowing patients’ sleep positions and behaviour is essential [4]. Alternating low-pressure air mattresses can help avoid bedsores [5]. The effect of the air distributor and the upstream air supply system on the airflow in an air bed affects the overall air bed [6]. In constructing an effective mattress for the prevention of bed sore, three required specifications are contact pressure, power of compressed air, and bumpiness of the air mattress. The contact pressure should be low, the air pressure should have enough power, and the bumpiness of the air mattress should be low [7].

In an experiment carried out, an Intelli-Sense bed system was able to reduce sweat produced by patients for 2 hours but could not stand for long hours [8]. By repositioning of mechanically ventilated patients every 2 hours, which requires a higher nursing workload and increases the likelihood of an adverse effect, may offer no significant improvement in bed sore prevention [9]. To monitor the sleep of patients, a differential measurement technique was applied [10]. The use of rubber tubes for the flow of air creates a great advantage in reducing pressure [11]. The operation of air ventilated air bed is also dependent on the patient’s weight, as it is also a factor affecting to the prevention of bed sore [12]. As prolonged bed rest is one of the reasons for bedsores, the air mattress provides a good alternative to normal beds, as the air bed is designed for prolonged use for hospitalized patients [13]. The standard hospital mattress is less effective for avoiding bed sores, whereas air ventilated air bed is specially designed for such cases [14]. Also, the use of air-ventilated air beds can be done in surgeries, as the noise produced by air beds is low as well as it is flexible which helps in operations [15]. Air mattresses can also be designed to inflate and deflate at certain intervals of time. This helps the patients to change their positions on bed automatically when the patient is not able to change the sleeping position due to critical physical condition [16]. Few researchers also focused on the effectiveness of static air mattress overlays to prevent pressure ulcers and proved that mattress overlays are more effective in preventing pressure ulcers compared with the use of a standard mattress [17]. The study shows that the main areas of starting the skin ulcers are pressure points. The pressure points are close to the bone areas. The mattresses are designed according to the bone positions and pressure points [18]. Support surfaces can be created for the patients to provide relief and reduce the chances of pressure ulcers [19]. Along with the support surfaces, bed-integrated local exhaust ventilation system in combination with air cleaning fabric also found to be a very effective solution [20]. Even after various approaches used in bed or mattress design, individual patient care with holistic treatment approach proved to be very effective. It includes dressings of the ulcers, customised beds, individualised pressure conditions of the beds and critical observations [21].

Objectives

The following are the objectives of the present research work:

3. To ventilate the air around the patient’s body.

4. To prevent the patient from bedsores and other skin diseases caused by sweating while resting.

Research Challenges

The research work has provided a unique solution for bedridden patients to provide them comfort. At the same time, during the design and implementation phase following challenges were observed. 1. Unwanted airflow was observed through the pipe junctions. The pipe joints were manually made and did have minor air leakage.

2. Laying the air tubes on the air bed to ventilate the air

bed was initially challenging, as it caused discomfort to the patients. The laying pattern and tube size kept on changing initially to make it comfortable for the patients. 3. At the first stage it was challenging to maintain the airflow uniform throughout the mattress. The proposed solution has two compressors to keep the airflow separate for the bed and tubes.

Methodology

Identification of Problem In the medical field, there are various serious diseases like paralysis, brain hemorrhage, or recent disease like Covid -19. Due to these diseases, patients may suffer from coma, i.e., a condition that limits their ability to change positions or continuous laying in bed without movement of the body. When a patient’s body continuously comes in contact with the bed, due to pressure and temperature difference body tends to sweat on the back side. If sweated body and bed come in contact regularly, then friction between the outer parts of the skin epidermis ruptures, and the inner layer dermis is open. After some time, it may completely damage the patient’s outer skin. In Covid 19 conditions, patients are generally on a ventilator support system to breathe, but some patients are not able to get up from the bed due to the severity of the infection. Hence the body of the patient remains always in contact with the bed. This leads to bed sores. If bed sores happen simultaneously with the other disease, then the body of the patient becomes weak and the percentage of patients surviving decreases. In certain cases, the patient may die. Define Parameters a. Moisture Control Moisture plays a vital role in bedsores. It is very important to control moisture for achieving the goal of reducing bedsores. The main reason behind the bedsore is moisture. It will happen due to the body resting continuously on the bed. Variations in temperature happen according to the

state of body condition. This leads to sweat from the body. It may cause cracking of tissue and bedsores to happen. b. Air Ventilation Generating moisture is controlled by proper air ventilation. When a patient is laying on the bed, the gap between the body and the bed is very negligible and if the air is not properly circulated around the patient’s body it causes moisture generation around the patient’s body. Proper ventilation is provided artificially by using compressed air from the bottom side of the body. c. Air Flow Uniformity It is very necessary to flow the air over the human body. This is possible by providing a rubber tube at the back side of the body. But in some cases, this rubber tube gets pressed and blocked if the patient occupies the bed completely. The back pressure is generated on the system so there is a need for such provision where the tube is not getting pressed and air flows uniformly. Working The two compressors used in setup C1 and C2 as shown in Figure 2, have the same pressure range of 70 – 130 mmHg. The first compressor was connected to the bed for inflation or blowing, and the second compressor was connected to a rubber tube circuit for ventilation. When the C1 compressor is switched on, the pressure regulating valve adjusts the pressure as per the requirements of the patient. The air flows through the compressor to the inlet port of the bed. Two ports are available for the compressor, which works on a cycle having a cycle time of 6 min. In the first 6 min, one layer of the bed inflates, whereas in the next 6 min, the other layer of the bed inflates. To make the system stabilize, 30 to 40 minutes are required. After the complete filling of the air in the bed, the pressure is regulated by the pressure regulating valve. A rubber tube is provided with a small hole on its periphery having a diameter of 2 mm from which the circulation of air takes place. This results in continuous impingement of air in the patient’s body. When the patient is resting on the bed, there is a compression of a rubber tube due to body weight. To avoid this issue, a rubber tube is placed in the gap between two layers, as shown in Figure 1. It will not generate back pressure on the system and air flows uniformly around the body of the patient. Model Designing Figure 1 represents a block diagram utilizing a single compressor for inflating the air bed and for ventilation around the patient’s body. The basic components are the air compressor, Tee connectors, pressure control valve, tube mesh, and air bed. The air compressor is connected to the inlet port of TeeConnector (T1) which one outlet port connection is given to the air bed and another port connection is given to the inlet port of tube mesh. Tee- Connector (T2) is connecting with the air bed from one outlet port and the other outlet

Figure 1. Initial design block diagram - single compressor system.

port is connected to the inlet of tube mesh. Tube mesh is made up of rubber material which is placed in the gap between the air bed layers which contains capillary holes over it. This is a basic structure used for trials to find out whether a single compressor is sufficient for inflating air beds and providing ventilation. Figure 2 represents the block diagram of the complete construction of the air-ventilated air bed system. The basic components that are shown in Figure 2 are air pumps/compressors, pressure control valves, air beds, tube mesh, and connection lines. Here in this block diagram, a separate compressor is utilized for inflation and ventilation purpose. Compressor C1 is connected to the air bed, the pressure is controlled by a pressure control valve 1 for inflating the air

bed. Compressor C2 is connected with tube mesh, the pressure is controlled by a pressure control valve 2 for ventilation around the patient’s body. The tube mesh is also made from a rubber material to avoid any kind of discomfort to the patient. The tube mesh is arranged on an air bed in such a manner that it perfectly fits in the groves of the air bed. As the compressor operates in a cycle, every portion of the tube mesh and air bed is supplied with a sufficient amount of air. Capillary Tube Figure 3 represents the capillary tube that is used for tube mesh: The capillary tube has an inner diameter of 2 mm and an outer diameter of 4 mm. The material used for the capillary tube is rubber. Holes of diameter 1 mm are

Figure 2. Block diagram of system with double compressor-Final design.

outer diameter and an inner diameter is 6 mm. The second tube is a PVC material tube mostly used as a reducer having an outer diameter of 6 mm and an inner diameter of 4 mm. The last tube is a capillary tube made from rubber material which avoids discomfort to the patient.

Figure 3. Rubber tube provided with holes. provided on the tube through which air is ventilated around the patient’s body. The tube is flexible and avoids any kind of discomfort for the patient. Tube Connections Figure 4 shows the tube connections made to form complete airflow lines as well as tube mesh. The connections consist of three different tubes of different dimensions fitted inside each other to avoid any air leakage. The first tube is a compressor tube, directly connected to a compressor outlet, made from a rubber material, and having an 8 mm

Selection of Material a. Air Compressor To maintain silence in the hospital, the compressor should be noise free. Also, air pressure is the main parameter for proper ventilation. The medical compressor should meet all specific requirement characteristics. b. Mattress The alternative solution to reduce bedsores is anti-decubitus mattresses which are widely used in such situations. This ultimately provides comfort to the patient but is not much efficient. It forms a layer when it is completely filled with air. c. Rubber Tube The rubber tube should be selected in such a way that the patient should feel comfortable while lying on the bed and it should not compress by the weight of the patient. Project design Design: As shown in Figure 5 the rubber tubes are placed in between the gaps of the air bed curve. When the load is applied to the bed, the rubber tubes are not compressed easily and the airflow is uninterrupted. Hence the back pressure generated on the compressor reduces by using this design. Calculations A. In this condition air is circulated for ventilation and bed inflates purpose by using a single compressor. Q1 amount of air flowing toward the T connector some of the air passes toward the ventilation system i.e., Q3 and some air passes toward the bed i.e., Q2. For T connector: According to principle of fluid mechanics, Q1 = Q2+ Q3 Q = AV ASSUMPTION: Velocity of air is 5 m/s Neglecting loss in tube due to friction.

Figure 8. Flow rate through separate compressor. Q1= π (r1) 2 * V1 Q1 = 1.4137 * 10 - 4 m3/s But Q2 = Q3 Q2 = Q3 = Q1 * 0.5 Q2 = Q3 = 7.068 * 10 - 5 m3 /s = 0.0706 mm3 /s B. Air flow rate and velocity of valve tube: This arrangement is provided reduce diameter to d3 to d4 for connection of rubber tube. Q3 = Q4 0.0706 = π (2)2 * V4 V4 = 0.022 mm/s Q4 = π (2)2 * 0.022 Q4 = 0.0691 mm3 /s For 10% loss due to eddy Actual air flow rate = 0.9 * 0.0691 = 0.06319 mm3/s C. Air flow rate of separate compressor for ventilation:

After trial-and-error method concluded that single compressor is not sufficient to deliver required pressure hence two compressors are used. Q1 = π (r1) 2 * V1 = π (4*10 -3 ) 2 * 5 Q1 = 2.513*10 - 4 m3 /s Q1 = 0.2513 m3 /s Q1 = Q2 A1V1 = A2V2 0.2513 = π (1) ^2* V2 V2 = 0.0799 mm/s Loss due to sudden contraction = 2.036*10 - 6 mm Actual Velocity = 0.0799 - 2.036*10 - 6 = 0.0798 mm/s Actual discharge = A2 * V Actual = 0.2506 mm3 /s Manufacturing Tube meshing The most important part of manufacturing is manufacturing the tube mesh, as tube mesh is the most important part of the construction of the air bed. The tube mesh consists of rubber tubes with holes at specific intervals for air ventilation. The rubber tubes are inserted in the gaps of the Honeycomb Structure of the air bed. Connections There are some specific connections provided for manufacturing the air bed. The power supply is connected to the two compressors and the compressor tube is connected to the reducer which is connected to the rubber tube. Testing The following procedure is used for testing the setup.

2. Connect the first compressor to the mattress.

The product improves air circulation around the body while maintaining relief and relaxation. For greater ventilation, the airflow/air pressure should be raised. While changing sides, the tube mesh should not slip.

For optimal results, increase the airflow/air pressure. To avoid fungal infection and other skin problems, apply candid dusting powder. For system maintenance, cleaning, and disinfection, a simple method or way should be found.

3. Then connect the rubber tube to the second compressor

and attach the rubber tube to the surface of the mattress. A diamond shape is formed on the surface of the mattress.

4. Start the first compressor. Inflate the mattress. It takes

around 15 to 20 minutes to inflate the mattress. Start the second compressor. Check every connection for any air leakage. Inspect whether the air is properly flowing through the tubes and the holes. Lay on the mattress for checking the ventilation, as well as use the water dipping method. Control the speed of the compressor by the push button present on the compressor. Set it according to the requirement. After testing setup, deflates the mattress.

of the air bed. Here a temperature-measuring thermometer is used for determining the patient body temperature. The new project setup undergoes two different trials; one consists of an empty trial having only an air bed and another where two air compressors are used. Both trials were performed on alternative days in a morning time slot. The temperature readings were taken by two different ways:

2. By body skin temperature (Core temperature).

For both trials, the patient and his bodywear are kept the same.

PROJECT IMPLEMENTATION / TRIALS Because the method is based on reverse engineering, various trials are conducted to arrive at final outcomes. Following a trial using a single air compressor for air beds and tube mesh, doctors and patients offered a variety of suggestions once the system was implemented in the hospital. Taking into account the feedback another compressor is used for mesh without disturbing the original connection

Free Trial This trial was performed in the morning secession in a time slot of 10:00 AM to 12:00 PM. The readings are recorded every 10 minutes time intervals. For the free trial only a single compressor with air bed is used. In conducting the trial, the air bed system has been on a stability condition of 10 to 15 min. Hence the proper air is inflated in the air bed. Here given the information regarding the free trial. Observation Table of Free Trial The following are the observations from Table 2:

2. The second column of the table indicates the time at

which respective readings are recorded in 0F. The third column shows body temperature with body wear while the last column indicates body surface temperature. 3. The temperature is measured with help of infrared thermometer. The air bed temperature is 97.10 F at the end of the trial.

4. While the average temperature of the body with clothes

(body wear) is 96.380 F, the average temperature of the body surface (without body wear) is 97.770 F.

5. The standard deviations of the readings are less than 0.5

and is fairly acceptable. Project Trial This trial was performed in the morning secession in a time slot of 10:00 am to 12:00 pm. The readings are recorded every 10 min. of the time interval. For the setup trial, two compressors were used. One for the air bed and another for rubber tubes for air ventilation. The same way is used for setup trials. The system is kept for 10 to 15 min on to achieve stability condition. Before performing the trial, the tube mesh is checked for air ventilation at different intervals using the water dipping method. Here a trial setup is shown. The air bed temperature is 96.40 F at the end of

the trial. Here the given table shows observations recorded while performing the trials. Where 96.460 F is the average temperature of the body with cloth and 96.340 F is the average temperature of the body without cloth. Observation Table of Project Trial The following are the observations from the table:

2. The second column of the table indicates the time at

which respective readings are recorded in 0 F. The third column shows body temperature with body wear while the last column indicates body surface temperature. 3. The temperature is measured with the help of an infrared thermometer. The air bed temperature is 96.40 F at the end of the trial.

4. While the average temperature of the body with clothes

(body wear) is 96.460 F, the average temperature of the body surface (without body wear) is 96.340 F. Material Testing The same process is followed for validating the air ventilation effect on the system as well environment. Three different types of materials are tested for a time duration of 3 min. Its initial and final temperature is recorded for forming a conclusion and validation of the system’s working.

Uncertainty Analysis

This research work includes the use of a digital infrared non-contact type thermometer. Table 5 shows the specifications of this thermometer and the uncertainty of the same.

Table 5. Thermometer specifications and uncertainty Temperature Instrument

Measuring range: - In body mode: 32°C Weight: 151g (including the ~ 43°C (89.6°F ~ 109.4°F) batteries)

Infrared digital thermometer Unit size: 155 x 100 x 40 mm (L x W x H)

Results And Discussion

Need of Two Compressors For proper ventilation, a single compressor is insufficient. By including two compressors, users get the benefit of both an air mattress and ventilation. The results are improved with compressor staging. The loss due to leakage was minimized, as well as the connection. By lowering the pressure drop, the airflow rate is boosted. The compressor staging is mainly derived from the following parameters i.e., connections in mesh, mostly including joints and bends another parameter is lost due to leakage, air flow rate improvement, controlling air velocity at the outlet, and comparing ventilation with single and double compressor. Analysis As shown in Figure 12, comparative analysis shows that:

1. The time periods during which readings are obtained

are shown on the X-axis. Temperature intervals in degrees Fahrenheit are shown on the Y-axis.

2. The airbed measurements are shown by the red chart

line, which has a temperature range of 97.50 F minimum to 98.10 F maximum. The temperature is rising with a

step after a set time interval, as shown by the chart line. After a 30-minute time delay, a step shape may be seen. 3. The blue chart line depicts the project’s actual execution, with a minimum temperature range of 97.50 F and a maximum temperature range of 97.70 F. If look at the chart line, will notice that the temperature rises at first, and then settles into a steady state. After the process begins, the chart displays a spike or rise at a specific time interval, followed by a return to normal temperature.

4. The project trial yields better outcomes than the free

trial; the system is effective in maintaining the patient’s body temperature. Findings Proper ventilation can help with bedsore therapy. Ventilation aids in the regulation of body temperature. Proper ventilation not only reduces the risk of bedsores but also improves the health of the patient. With certain changes, an air mattress may be used to treat bedsores efficiently. A refrigeration system can be added to the recommended solution to deliver cool air. Engineering ideas and understanding can help with medical difficulties and equipment development. The comfort condition of the patient is improved due to the circulation of air. It also assists in

evaporation of the sweat from the body and reduces the frequency of changing the clothes from the air mattress. Thermodynamic aspects of this air bed can be observed from the perspective of evaporative cooling. The air passing over the body evaporates the sweat from the body which mainly has water contents. This evaporative cooling keeps the skin dry for a longer time and avoids bedsores. Costing The proposed solution is very simple and it can be add-on to the existing air bed. The cost estimation is done for a complete solution of a standard air bed and additional compressor with air tubes. The total cost is ₹6345.

one compressor. This makes the solution simple and user-friendly.

6. The proposed solution is cost-effective at only ₹6345.

The cost of treatment of one day is more than the cost of this solution.

7. The air tubes are replaceable and can be fitted in any of

the existing air mattresses irrespective of the brand and make of the mattress.

Future Scope

This system can be provided for multiple numbers of beds in hospital wards, by replacing the air compressor with a hermetically sealed compressor. It will improve the efficiency of the system. The condenser can be used for cooling of the air before entering the tube for better efficiency of the system. A new chemical composite can be developed in the form of powder which is more efficient in absorbing moisture. This powder can be spread on the mattress. The number of tubes on the bed can be increased for patients with high weight (more than 70 Kg) to provide better comfort. A higher capacity compressor (0.5 to 1 bar pressure) may be used in single for the bed. This may reduce the size required for two compressors.

Nomenclature

Based on the result, it is concluded that this innovation can be utilized to reduce the problem where patients are suffering from bedsores. One of the most important aspects of bedsore prevention is the control of temperature and moisture contained in the backside of the patient’s skin. Providing air ventilation to the bed surface not only aids in the prevention of bed sores but also provides comfort to the patient.

1. Experiments were performed to study the effectiveness

of the developed system. The solution developed served the purpose of providing the cooling effect to reducer the sweat of the patient.

2. The accuracy of the system is increased by using two

separate compressors for inflation and ventilation. Ventilated air operates at a controlled pressure. As a result, venting air around the patient’s body provides additional benefits for recovering from medical issues.

3. The study of implementation offers superior outcomes

than previous strategies. The system is successfully maintaining the patient’s body temperature at a steady level.

4. The maximum variation of body temperature is

observed to be very stable and within 0.20F. The proposed solution makes the patient stable and avoids a rise in the body temperature of the patient.

5. The existing air bed can be modified simply by laying

Cross-sectional area of the tube Air flow rate toward T connector Air flow rate toward air bed Air flow rate toward ventilation Bypass air flow rate Radius of the tube Air velocity

Data Availability Statement

The authors confirm that the data that supports the findings of this study are available within the article. Raw data that support the finding of this study are available from the corresponding author, upon reasonable request.

Conflict Of Interest

The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethics

There are no ethical issues with the publication of this manuscript.

References

1. REFERENCES
2. [1] Jaichandar KS, García EAM. Intelli-Sense Bed Patient Movement Sensing and Anti-Sweating System for Bed Sore Prevention in a Clinical Environment. In: Proceedings of the 2011 8th International Conference on Information, Communications & Signal Processing; 13-16 December 2011; Singapore. IEEE; 2011. [CrossRef]
3. [2] Demarré L, Beeckman D, Vanderwee K, Defloor T, Grypdonck M, Verhaeghe S. Multi-stage versus single-stage inflation and deflation cycle for alternating low pressure air mattresses to prevent pressure ulcers in hospitalised patients: A randomised-controlled clinical trial. Int J Nurs Stud. 2012;49(4):416–426. [CrossRef]
4. [3] Vanderwee K, Grypdonck M, Defloor T. Alternating pressure air mattresses as prevention for pressure ulcers: A literature review. Int J Nurs Stud 2008;45:784–801. [CrossRef]
5. [4] Beeckman D, Serraes B, Anrys C, Van Tiggelen H, Van Hecke A, Verhaeghe S. A multicentre prospective randomised controlled clinical trial comparing the effectiveness and cost of a static air mattress and alternating air pressure mattress to prevent pressure ulcers in nursing home residents. Int J Nurs Stud 2019;97:105–113. [CrossRef]
6. [5] Depypere F, Pieters JG, Dewettinck K. CFD analysis of air distribution in fluidised bed equipment. Powder Technol 2004;145:176–189. [CrossRef]
7. [6] Nair P, Mathur S, Bhandare R, Narayanan G. Bed sore prevention using pneumatic controls. In: Proceedings of the 2020 IEEE International Conference on Electronics, Computing and Communication Technologies (CONECCT); 02-04 July 2020; Bangalore, India. IEEE; 2020. [CrossRef]
8. [7] Barsocchi P. Position recognition to support bedsores prevention. IEEE J Biomed Health Inform 2013;17:53–59. [CrossRef]
9. [8] Manoj R, Kumarasami R, Joseph J, George B, Sivaprakasam M. Continuous weight monitoring system for ICU beds using air-filled mattresses/pads: a proof of concept. In: Proceedings of the 2019 IEEE International Symposium on Medical Measurements and Applications (MeMeA); 2019:1–5. IEEE; 2019. [CrossRef]
10. [9] Walton-Geer PS. Prevention of Pressure Ulcers in the Surgical Patient. AORN J 2009;89:538–552.
11. [10] Shin JH, Chee YJ, Jeong DU, Park KS. Nonconstrained sleep monitoring system and algorithms using air-mattress with balancing tube method. IEEE Trans Inf Technol Biomed 2010;14:147–156. [CrossRef]
12. [11] Rosenthal MJ, Felton RM, Nastasi AE, Naliboff BD, Harker J, Navach JH. Healing of Advanced Pressure Ulcers by a Generic Total Contact Seat: 2 Randomized Comparisons with Low Air Loss Bed Treatments. Arch Phys Med Rehabil 2003;84:1733–1742. [CrossRef]
13. [12] Manzano F, Colmenero M, Pérez-Pérez AM, Roldán D, Jiménez-Quintana MM del M, Mañas MR, et al. Comparison of two repositioning schedules for the prevention of pressure ulcers in patients on mechanical ventilation with alternating pressure air mattresses. Intensive Care Med 2014;40:1679–1687. [CrossRef]
14. [13] Kandha Vadivu P. Design and development of portable support surface and multilayered fabric cover for bed sore prevention. Indian J Surg 2015;77(Suppl 2):576–582. [CrossRef]
15. [14] Takashima A, Misaki A, Takasugi SI, Yamamoto M. Characteristic analysis of an air cell for active air mattress of prevention for pressure ulcer. Adv Robot 2014;28:497–504. [CrossRef]
16. [15] Lv B, Luo Z, Zhang B, Zhao Y, Zhou C, Yuan W. Effect of the secondary air distribution layer on separation density in a dense-phase gas-solid fluidized bed. Int J Min Sci Technol 2015;25:969–973. [CrossRef]
17. [16] Pawaskar P, Khade S, Patil N, Meshram N, Purandare P. Design and Development of Anti-bedsore Air Mattress. Int J Eng Res Mech Civ Eng 2021;6:39–43.
18. [17] Serraes B, van Leen M, Schols J, Van Hecke A, Verhaeghe S, Beeckman D. Prevention of pressure ulcers with a static air support surface: A systematic review. Int Wound J 2018;15:333–343. [CrossRef]
19. [18] Chanpur ML, Rajhans NR. Ergonomic bed to reduce bedsores for bedridden patients. In: Proceedings of the International Conference on Ergonomics and Human Factors, HWWE 2011; Pune, India. 2011.
20. [19] Shi C, Dumville JC, Cullum N. Support surfaces for pressure ulcer prevention: A network meta-analysis. PLoS One 2018;13:e0192707. [CrossRef]
21. [20] Bivolarova MP, Melikov AK, Mizutani C, Kajiwara K, Bolashikov ZD. Bed-integrated local exhaust ventilation system combined with local air cleaning for improved IAQ in hospital patient rooms. Build Environ 2016;100:10–18. [CrossRef]
22. [21] Chaudhari K, Mahajan NP, Pande K, Dadhaniya RR, Jarika A. To study the development of pressure sores in chronically bed ridden patients in a tertiary care centre: observational study. Int J Adv Res 2022;10:292–298. [CrossRef]

Share and Cite