Technical results from a trial of the FREO2 Low-Pressure Oxygen Storage system, Mbarara Regional Referral Hospital, Uganda

Abstract

Increased access to reliable medical oxygen would reduce the global burden of pneumonia. Oxygen concentrators have been shown to be an effective solution, however they have significant drawbacks when used in low-resource environments where pneumonia burden is the heaviest. Low quality grid power can damage oxygen concentrators and blackouts can prevent at-risk patients from receiving continual oxygen therapy. Gaps in prescribed oxygen flow can result in acquired brain injuries, extended hypoxemia and death. The FREO2 Low-Pressure Oxygen Storage (LPOS) system consists of a suite of improvements to a standard oxygen concentrator which address these limitations. This study reports the technical results of a field trial of the system in Mbarara, Uganda. During this trial, oxygen supplied from the LPOS system was distributed to four beds in the paediatric ward of Mbarara Regional Referral Hospital. Over a three-month period, medical-grade oxygen was made available to patients 100% of the time. This period was sufficient to quantify the ability of the LPOS system to deal with blackouts, maintenance, and an unscheduled repair to the LPOS store.

Technology to improve reliable access to oxygen in Western Uganda: study protocol for a phased implementation trial in neonatal and paediatric wards

“…image reprinted from Peake et al, and inspired by a similar illustration by David Woodroffe. 20 and need for oxygen, is defined as oxygen saturation by pulse oximetry (SpO 2 ) <90%, based on WHO clinical guidelines. 22 Oxygen administration will follow local guidelines, based on WHO recommendations.…”

“…To study the risk of technology failure on oxygen availability, the FREO2 oxygen system has been trialled in Mbarara Regional Referral Hospital. 20 It has proven safe and reliable. To add further layers of safety, embedded within the system is a back-up oxygen cylinder, and an automatic mechanism to shift between oxygen supplies.…”

“…This system has been recently field tested at the Mbarara Regional Referral Hospital in Uganda. 20 The FREO 2 oxygen system is designed to require a minimum of maintenance and no direct input from the health workers (other than controlling the flow rate of oxygen to individual patients).…”

“…The oxygen concentrator is connected to a PROTECT device, that conditions the mains power to meet the specific electrical requirements of the concentrator. This system has been recently field tested at the Mbarara Regional Referral Hospital in Uganda 20…”

“…FREO 2 oxygen system, consisting of an oxygen concentrator (A), PROTECT—power conditioning system (B), Prioritiser—pneumatic switch that automatically controls oxygen source (C), back-up cylinder (D), low-pressure oxygen storage (E), patient flow-metres (F) and Stack Lamp—traffic light display that communicates the status of the system (G). image reprinted from Peake et al , and inspired by a similar illustration by David Woodroffe 20…”