Group of emergency physicians advocates rapid and simple measures to reduce medical oxygen wastage in crisis context of insufficient oxygen.
27 May 2021 – A few simple measures can make a big difference in managing limited medical oxygen supplies to treat severe COVID-19 patients. This is the message from a group of emergency physicians as part of an ad hoc consultation on crisis oxygen management hosted by the COVID-19 Clinical Research Coalition. The consultation was prompted by the medical oxygen shortage in several countries battling rising numbers of COVID-19 cases.
The measures recommended by the group to optimize available oxygen include reducing oxygen leaks and wastage, prioritizing low-flow oxygen devices and those that waste the least amount of oxygen, using the lower end of target oxygen saturation ranges, and regular monitoring of patients’ oxygen saturation to ensure oxygen is started and stopped only as needed.
The group emphasizes that these measures are intended for immediate action in crisis situations only, and they also direct clinicians and policymakers to several sources of existing guidance on oxygen supply and management to help rectify the problem over the longer term.
“What we are sharing here are basic and pragmatic steps that any health facility can take to provide emergency oxygen and to preserve limited supplies where demand is suddenly higher than available supply, which is what many clinicians are facing in low-resource settings,” said Dr Cliff Roberson, Anesthesia and COVID-19 Oxygen Advisor from Médecins Sans Frontières France. “This is about crisis management while more sustainable measures for oxygen supply and management are put in place.”
Oxygen is categorized as an essential medicine by WHO and is one of only a few effective therapeutic tools available for the treatment of severe COVID-19.
Important initiatives are underway to mobilize global oxygen supply, including through a COVID-19 Oxygen Emergency Taskforce established by Wellcome Trust, Unitaid, and WHO as part of the Access to COVID-19 Tools Accelerator, and the Global Fund, which is funding oxygen procurement and supply as part of emergency COVID-19 grants to LMICs.
“What we really need is improved and sustainable oxygen systems in all low-resource settings,” said Dr Marcus Schultz, professor of intensive care medicine at Amsterdam UMC. “This would not only save the lives of people severely ill with COVID-19 but also premature infants, children with pneumonia, and many other people with life-threatening health conditions.”
Oxygen supply was already inadequate before the COVID-19 pandemic in most low- and middle-income countries, where oxygen is often not available for critically ill patients.
About the COVID-19 Clinical Research Coalition
The COVID-19 Clinical Research Coalition brings together individuals and institutions working to accelerate COVID-19 research that will provide evidence on COVID-19 prevention, diagnosis, and case management in resource-limited settings. The coalition was created by DNDi, the Mahidol-Oxford Tropical Medicine Research Unit, and the Infectious Diseases Data Observatory (IDDO). DNDi hosts the coalition’s secretariat.
A not-for-profit research and development organization, DNDi works to deliver new treatments for neglected patients, those living with Chagas disease, sleeping sickness (human African trypanosomiasis), leishmaniasis, filarial infections, mycetoma, paediatric HIV, and hepatitis C. DNDi is also coordinating the ANTICOV clinical trial to find treatments for mild-to-moderate COVID-19 cases in Africa. DNDi hosts the secretariat of the COVID-19 Clinical Research Coalition.
Frédéric Ojardias (Switzerland)
+41 79 431 62 16
Image credit: Kenny Mbala-DNDi