A Low-Pressure Oxygen Storage System for Oxygen Supply in Low-Resource Settings

Rassool, Roger; Sobott, B. A.; Peake, D. J.; Mutetire, Bagayana S; Moschovis, Peter P.; Black, Jim Fp

doi:10.4187/respcare.05532

Cited by 18 publications

(23 citation statements)

References 5 publications

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“…This unit has the advantage of storing oxygen at a higher pressure (~500 kPa) using a smaller storage volume that is transportable. Rassool [39] developed a low pressure (~16 kPa) bladder system that utilizes the pressure generated from the concentrator outlet to lift water from a lower bladder to a second bladder placed at some height above. The water applies a pressure to oxygen captured in the lower bladder to drive flow during a power outage.…”

Section: Discussionmentioning

confidence: 99%

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Assessment of a storage system to deliver uninterrupted therapeutic oxygen during power outages in resource-limited settings

Calderon¹,

Morgan²,

Kuiper³

et al. 2019

PLoS ONE

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Access to therapeutic oxygen remains a challenge in the effort to reduce pneumonia mortality among children in low- and middle-income countries. The use of oxygen concentrators is common, but their effectiveness in delivering uninterrupted oxygen is gated by reliability of the power grid. Often cylinders are employed to provide continuous coverage, but these can present other logistical challenges. In this study, we examined the use of a novel, low-pressure oxygen storage system to capture excess oxygen from a concentrator to be delivered to patients during an outage. A prototype was built and tested in a non-clinical trial in Jinja, Uganda. The trial was carried out at Jinja Regional Referral Hospital over a 75-day period. The flow rate of the unit was adjusted once per week between 0.5 and 5 liters per minute. Over the trial period, 1284 power failure episodes with a mean duration of 3.1 minutes (range 0.08 to 1720 minutes) were recorded. The low-pressure system was able to deliver oxygen over 56% of the 4,295 power outage minutes and cover over 99% of power outage events over the course of the study. These results demonstrate the technical feasibility of a method to extend oxygen availability and provide a basis for clinical trials.

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Section: Discussionmentioning

confidence: 99%

“…There have been several attempts to store oxygen on site at relatively low pressures (< 10 bar). One commercially available oxygen storage system (Oxygen Reservoir Filling System, Diamedica, UK) can be filled from a concentrator and, more recently, a low-pressure oxygen storage bladder prototype has been tested in Uganda [39].…”

Section: Introductionmentioning

confidence: 99%

Assessment of a storage system to deliver uninterrupted therapeutic oxygen during power outages in resource-limited settings

Calderon¹,

Morgan²,

Kuiper³

et al. 2019

PLoS ONE

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“…Previous studies have assessed the use of high-pressure and low-pressure oxygen storage reservoirs in pre-clinical studies [ 12 , 13 , 26 ]. In hospitals where there is a reliable supply chain from an oxygen plant, high-pressure oxygen cylinders are the standard.…”

Section: Discussionmentioning

confidence: 99%

“…Problems with low-pressure oxygen cylinders are associated with the size of the reservoir. Space requirements are considerable, and often lead to the relocation of the low-pressure reservoir outside the hospital ward [ 13 ]. In contrast, the MPR was maneuverable and integrated well in the clinical workflow.…”

Section: Discussionmentioning

confidence: 99%

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A feasibility study evaluating a reservoir storage system for continuous oxygen delivery for children with hypoxemia in Kenya

et al. 2021

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Background Supplemental oxygen is an essential treatment for childhood pneumonia but is often unavailable in low-resource settings or unreliable due to frequent and long-lasting power outages. We present a novel medium pressure reservoir (MPR) which delivers continuous oxygen to pediatric patients through power outages. Methods An observational case series pilot study assessing the capacity, efficacy and user appraisal of a novel MPR device for use in low-resource pediatric wards. We designed and tested a MPR in a controlled preclinical setting, established feasibility of the device in two rural Kenyan hospitals, and sought user feedback and satisfaction using a standardized questionnaire. Results Preclinical data showed that the MPR was capable of bridging power outages and delivering a continuous flow of oxygen to a simulated patient. The MPR was then deployed for clinical testing in nine pediatric patients at Ahero and Suba Hospitals. Power was unavailable for 2% of the total time observed due to 11 power outages (median 4.6 min, IQR 3.6–13.0 min) that occurred during treatment with the MPR. Oxygen flowrates remained constant across all 11 power outages. Feedback on the MPR was uniformly positive; all respondents indicated that the MPR was easy to use and provided clinically significant help to their patients. Conclusion We present a MPR oxygen delivery device that has the potential to mitigate power insecurity and improve the standard of care for hypoxemic pediatric patients in resource-limited settings.

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Oxygen insecurity and mortality in resource‐constrained healthcare facilities in rural Kenya

Otiangala

Agai

Olayo

et al. 2020

Pediatric Pulmonology

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Introduction Pneumonia is the leading cause of death globally in children. Supplemental oxygen reduces mortality but is not available in many low‐resource settings. Inadequate power supply to drive oxygen concentrators is a major contributor to this failure. The objectives of our study were to (a) assess the availability of therapeutic oxygen; (b) evaluate the reliability of the electrical supply; and (c) investigate the effects of suboptimal oxygen delivery on patient outcomes in selected healthcare facilities in rural Kenya. Materials and Methods A cross‐sectional descriptive study on oxygen availability and descriptive case series of Kenyan children and youth hospitalized with hypoxemia. Results Two of 11 facilities had no oxygen equipment and nine facilities had at least one concentrator or cylinder. Facilities had a median of seven power interruptions per week (range: 2‐147). The median duration of the power outage was 17 minutes and the longest was more than 6 days. The median proportion of time without power was out 7% (range: 1%‐58%). Fifty‐seven patients hospitalized with hypoxemia (median oxygen saturation 85% [interquartile range {IQR}: 82‐87]) were included in our case series. Patients received supplemental oxygen for a median duration of 4.6 hours (IQR: 3.0‐7.8). Eighteen patients (32%) faced an oxygen interruption of the median duration of 11 minutes (IQR: 9‐20). A back‐up cylinder was used in 5/18 (28%) cases. The case fatality rate was 11/57 (19%). Conclusion Mortality due to hypoxemia remains unacceptably high in low‐resource healthcare facilities and may be associated with oxygen insecurity, related to lack of equipment and/or reliable power.

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A Low-Pressure Oxygen Storage System for Oxygen Supply in Low-Resource Settings

Cited by 18 publications

References 5 publications

Assessment of a storage system to deliver uninterrupted therapeutic oxygen during power outages in resource-limited settings

Assessment of a storage system to deliver uninterrupted therapeutic oxygen during power outages in resource-limited settings

A feasibility study evaluating a reservoir storage system for continuous oxygen delivery for children with hypoxemia in Kenya

Oxygen insecurity and mortality in resource‐constrained healthcare facilities in rural Kenya

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