Ultra-Clean-Air (UCA) operating theatres aim to minimise surgical instrument contamination and wound infection through high flow rates of ultra-clean air, reducing the presence of Microbe Carrying Particles (MCPs). This study investigates the airflow patterns and ventilation characteristics of a UCA operating theatre (OT) under standard ventilation system operating conditions, considering both empty and partially occupied scenarios. Utilising a precise computational model, quasi-Direct Numerical Simulations (qDNS) were conducted to delineate flow velocity profiles, energy spectra, distributions of turbulent kinetic energy, energy dissipation rate, local Kolmogorov scales, and pressure-based coherent structures. These results were also complemented by a tracer gas decay analysis following ASHRAE standard guidelines. Simulations showed that contrary to the intended laminar regime, the OT’s geometry inherently fosters a predominantly turbulent airflow, sustained until evacuation through the exhaust vents, and facilitating recirculation zones irrespective of occupancy level. Notably, the occupied scenario demonstrated superior ventilation efficiency, a phenomenon attributed to enhanced kinetic energy induced by the additional obstructions. The findings underscore the critical role of UCA-OT design in mitigating MCP dissemination, highlighting the potential to augment the design to optimise airflow across a broader theatre spectrum, thereby diminishing recirculation zones and consequently reducing the propensity for Surgical Site Infections (SSIs). The study advocates for design refinements to harness the turbulent dynamics beneficially, steering towards a safer surgical environment.

Anatomical airways parameters, such as length, diameter and angles, have a strong effect on the flow dynamics. Aiming to explore the effect of variations of the bifurcation angle (BA) and carina rounding radius (CRR) of lower human airways on respiratory processes, numerical simulations of airflow during inhalation and exhalation were performed using synthetic bifurcation models. Geometries for the airways models were parameterized based on a set of different BA’s and several CRR’s. A range of Reynolds numbers (Re), relevant to the human breathing process, were selected to analyze airflow behavior. The numerical results showed a significant influence of BA and the CRR on the development of the airflow within the airways, and, therefore, affecting the following relevant features of the flow: the deformation of velocity profiles, alterations of pressure drop, flow patterns, and, finally, enhancement or attenuation of wall shear stresses (WSS) appearing during the regular respiratory process. The numerical results showed that increases in the bifurcation angle value were accompanied by pressure increases of about 20%, especially in the regions close to the bifurcation. Similarly, increases in the BA value led to a reduction in peak shear stresses of up to 70%. For the ranges of angles and radii explored, an increase in pressure of about 20% and a reduction in wall shear stress of more than 400% were obtained by increasing the carina rounding radius. Analysis of the coherent structures and secondary flow patterns also revealed a direct relationship between the location of the vortical structures, the local maxima of the velocity profiles and the local vorticity minima. This relationship was observed for all branches analyzed, for both the inhalation and exhalation processes of the respiratory cycle.

Anatomical airways parameters as length, diameter and angles have a strong effect on the flow dynamics. Aiming to explore the effect of variations of the bifurcation angle (BA) and carina rounding radius (CRR) of lower human airways on the respiratory processes, numerical simulations of airflow during inhalation and exhalation were performed using a synthetic bifurcation models. Geometries for the airways models were parameterized based on a set of different BA's and several CRR's. A range of Reynolds numbers (\Reyn) relevant to the human breathing process were selected to analyzed the airflow behaviour. The numerical results show a significant influence of BA and the CRR on the development of the airflow within the airways, and therefore affecting some relevant features of the flow, namely the deformation of velocity profiles, alterations of pressure drop, the flow patterns, and finally enhance or attenuation of wall shear stresses (WSS) appearing during the regular respiratory process. Numerical results show that increases in the bifurcation angle value are accompanied by pressure increases of about 20\%, especially in the regions close to the bifurcation. Similarly, increases in the BA value lead to a reduction in peak shear stresses of up to 70\%. For the ranges of angles and radii explored, an increase in pressure of about 20\% and a reduction in wall shear stress of more than 400\% were obtained by increasing the carina rounding radius. Analysis of the coherent structures and secondary flow patterns also revealed a direct relationship between the location of the vortical structures, the local maxima of the velocity profiles and the local vorticity minima. This relationship was observed for all branches analysed, for both the inhalation and exhalation processes of the respiratory cycle.