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Oxygen independence in practice for hospitals in LMICs

Article-Oxygen independence in practice for hospitals in LMICs

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Compression systems address vulnerabilities and may resolve concerns around the availability of on-site medical oxygen in low- and middle-income countries.

Healthcare facilities in the US and much of Europe consider medical oxygen an entitlement. Oxygen resources fluctuate easily to meet patient needs, and systems, auxiliary units, and even tertiary backups ensure oxygen flows as needed. It is never a question that oxygen is available at a patient’s bedside or during a surgical procedure. Stored liquid or bulk oxygen, onsite oxygen plants, and filled cylinders ensure ready supplies as well as a mobility and availability advantage in patient care.

In more remote areas, a Pressure Swing Adsorption (PSA) or Vacuum Pressure Swing Adsorption (VPSA) oxygen plant provides an important foundation to oxygen delivery even though it may still be considered a nice-to-have option. Instead, pre-filled cylinders delivered by a gas supplier or hospital partner may be the primary and only means of acquiring oxygen for facilities in less-developed parts of the world.

Not only are these facilities ultimately forced to pay a premium for oxygen cylinder by cylinder instead of being able to invest in smarter and more effective options, but they also face a range of supply chain challenges that simply do not happen in the developed world. If the weather takes out a road or a rebel insurgence prevents the safe passage of hospital deliveries – or a global pandemic lands unexpectedly – patients may die. COVID-19 put a spotlight on the problem, and the Global Fund and others are stepping in to help solve the challenge – addressing a slate of real-world factors that weigh heavily on onsite oxygen infrastructure.

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Compressors are key to LMICs’ O2 infrastructure

Even if a PSA or VPSA is implemented, healthcare facilities in low- to middle-income countries (LMICs) face any number of risks in accessing medical oxygen. The power grid is unreliable, and direct pipelines from the oxygen plant into the hospital are highly susceptible to failure due to routine power interruptions.

Remote and rural environments commonly face unsustainable power grids and are all too familiar with power outages occurring at daily intervals. Any oxygen generator running on grid power is immediately affected – and while diesel generators often provide backup power during grid outages, they are not always sized to meet all of a hospital’s needs. Administrators might have to choose between generating oxygen and keeping operating room equipment up and running. Unlike more urban areas, local militia or unofficial forces may control the supply of diesel, siphoning it for their own purposes or limiting its delivery, increasing the jeopardy of grid outages for rural healthcare facilities.

An onsite oxygen compressor addresses many of these risks and must be considered an essential component of any oxygen plant, particularly in LMICs. Like other systems, power is required to run the compressor. However, its capacity for onsite cylinder filling creates a foundation for a ready oxygen supply.

The ideal sizing of an oxygen plant must consider supporting the average consumption rate, and then be deployed to deliver slightly higher volumes. In this scenario, a system supporting facility needs of 500 litres of oxygen per minute should be strategically programmed to generate 700 litres per minute.

The system’s integrated compressor would designate the spare 200 liters per minute to cylinder filling capacity, routing oxygen to fill 10, 20, 100, or more tanks depending on the facility’s size, needs, and resources. Tanks filled and stored are accessible on demand — a power source is not needed, and once connected, oxygen in a high-pressure tank just flows.

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Flexible, onsite cylinder filling is essential in LMIC healthcare settings. Even during a power outage, high-pressure cylinders can provide a continuous supply of oxygen to patients who require it for critical care, respiratory support, or emergencies. The resulting oxygen portability is particularly beneficial during power crises, ensuring continuous oxygen therapy even when patients may require ambulance transport or when medical procedures are performed in field areas without a power supply.

Oxygen independence means hospitals can reduce their reliance on external sources, maintain their oxygen reserves, and mitigate the risk of supply shortages or disruptions. These are critical improvements in the LMIC realm and can be directly tied to onsite cylinder-filling capabilities. It is a first-world advantage that must apply globally, potentially lowering healthcare operational costs over the long term and ensuring consistent delivery of safe and reliable oxygen to patients in need.

Doug Richmond is the sales manager at RIX Industries.

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