Medical Oxygen: A Lifesaving Drug During the COVID-19 Pandemic—Source and Distribution

Abstract

Oxygen is an essential lifesaving medicine used for several indications at all levels of health care. The COVID-19 pandemic and its recent second wave have resulted in a surge in demand for necessary resources, including trained staff, hospital beds, and medical supplies like oxygen. Limited availability of these resources resulted in added risk of adverse outcomes. Also, the widespread unregulated use of oxygen by the general public in household settings poses safety concerns. This review focuses on sources of medical oxygen like cryogenic oxygen plants, pressure swing adsorption, oxygen concentrators, and oxygen cylinders. Their specifications, storage, distribution within healthcare settings, regulation, and safety concerns have been considered. Resources needed for calculating oxygen demand, surge planning, identifying the suitable source, and distribution systems for different settings have been detailed. This review aims to help the hospital administrators, biomedical engineers, and clinicians plan and rationalize oxygen usage in low-and middle-income countries during the COVID-19 pandemic.

Oxygen Consumption with High-Flow Nasal Oxygen versus Mechanical Ventilation— An International Multicenter Observational Study in COVID–19 Patients (PROXY–COVID)

“…Therefore, a full liquid oxygen tank of, for example, 10 K liters, which equals 8,500 K liters of gaseous oxygen, will be sufficient for $40 days of oxygen support for an ICU with 10 COVID-19 patients receiving exclusively HFNO, and $200 days of oxygen support for an ICU with 10 COVID-19 patients exclusively receiving noninvasive or invasive ventilation. 11 A pressure swing adsorption plant could be more attractive, although it should be noted that output is affected by altitude. 18 A plant that produces 1,000 L per minute is sufficient for oxygen support in $70 patients or more receiving HFNO, and more than 330 patients receiving noninvasive or invasive ventilation in case of uninterrupted production.…”

“…Furthermore, it could help hospitals in decisions regarding the source of medical oxygen (e.g., liquid oxygen or pressure swing adsorption plant, oxygen concentrators or oxygen cylinders) as well as the infrastructure (e.g., oxygen concentrators, oxygen cylinders, or piped oxygen). [11][12][13] To improve our understanding of oxygen consumption with HFNO versus mechanical ventilation, we conducted a study, "Oxygen Consumption with High-Flow Nasal Oxygen versus Mechanical Ventilation-An International Multicenter Observational Study in COVID-19 patients" (PROXY-COVID). PROXY-COVID was a substudy of a larger observational study in ICU patients with acute hypoxemic respiratory failure due to COVID-19.…”

Medical oxygen: Sources and regulatory guidelines

“…As a result, only the components in cryogenic distillations with very low boiling points are selectively distilled at low temperatures. [8] Steps in cryogenic distillation of Air [9,10] : Here are a few steps involved in the cryogenic distillation of air which includes: 1. Pre-treatment, compressing, and cooling of incoming air 2.…”

Methodological Approach for Optimizing Production of Oxygen by Adsorption of Nitrogen from Air using Zeolite Li-LSX

“…ere was a desorption process that completed one cycle of operation after each adsorption process. e desorption process was necessary to regenerate the zeolite by inducing vacuum pressure through the bed at −0.9 bar for 2 minutes to remove N 2 molecules from the zeolite surface [14].…”