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PATIENT SAFETY


of a patient’s breathing pattern; an adapted version that allows it to function silently; and a feedback loop to control oxygen flow to automatically maintain the oxygen saturation based on the patient’s requirements. This built-in, self-adjusting mechanism addresses a critical unmet need in oxygen delivery, as a recent report by the Healthcare Safety Investigation Branch found that portable oxygen systems currently used across the NHS in England do not provide ‘clear and timely’ feedback that oxygen is flowing to the patient.3 Patient safety in oxygen therapy is an area where there is substantial unmet need. It has been found that oxygen therapy may become unfavourable above the saturation range of 94-96%, a range which can be exceeded with the administration of a liberal supply of oxygen.4 In acute respiratory conditions, a liberal oxygen supply administered to the patient can negatively impact on patient-important outcomes and even increase the risk of mortality. These findings support the need for a more conservative oxygen therapy approach when treating patients and makes the idea of a self-adjusting oxygen supply device even more poignant. Oxygen wastage is also a major concern for the NHS. IMOD would have the potential to reduce wastage as the oxygen supply is only activated by the device if the patient inhales, rather than a continuous supply. This has a two-fold advantage: it allows for significant cost savings through the reduction of waste and increased efficiency; and also an expected oxygen saving of up to 66% compared to continuous supply, allowing oxygen bottles to last up to three times as long.5


A report


conducted by Cambridge University calculated that a 1000-bed hospital could potentially save up to £200,000 per annum on wasted oxygen – up to two- thirds of current expenditure.5


The IMOD hardware can operate from a mains piped supply or oxygen cylinders, which will have an impact on oxygen supplies in the healthcare system, but will also allow patients to use the device in their homes. Similarly, it will also allow ambulances and air ambulances that rely on a limited oxygen supply, to safely treat patients for longer durations. It’s hoped that the device will pave the way for other applications of BAT in respiratory care, especially in devices that require a bespoke form of gas delivery. With this in mind, Camcon Medical is now also investigating a tailored air delivery product designed to help treat patients who have been diagnosed with obstructive sleep apnoea.


Collaboration and applications


BAT in healthcare is in its infancy, yet there are huge ambitions for this technology. This ambition is more profound within the current healthcare climate, where technologies are increasingly being looked


MAY 2019 WWW.CLINICALSERVICESJOURNAL.COM I 65


In the UK, 3000 patients per day receive the incorrect dose of oxygen and 2100 patients per day are over-dosed.


upon to provide solutions that are sustainable and efficient.


The vast potential applications of this technology are apparent, but, as with all medical technology applications in the current environment, the success of this technology will depend hugely on listening to and collaborating with clinicians and industry leaders. The challenge when applying this science in clinical settings will be mapping and prioritising opportunities with the greatest impact.


References


1 Inogen Inc. 2017 Annual Report. 2 British Thoracic Society Emergency Oxygen Audit


Report National Audit Period. Ronan O’Driscoll. 15 August - 1 November 2015 https://www.brit- thoracic.org.uk/document-library/audit-and- quality-improvement/audit-reports/bts-emergency- oxygen-audit-report-2015/


3 Healthcare Safety Investigation Branch – Independent report into the design and safe use of portable oxygen systems (I2017/013) Nov 2018.


CSJ


4 Chu DK, et al. Mortality and morbidity in acutely ill adults treated with liberal versus conservative oxygen therapy (IOTA): a systematic review and meta-analysis. Lancet. 2018 Apr 28;391(10131):1693-1705.


5 IMOS Device: Clinical Insight and Technical Validation Report. Cambridge University Hospitals NHS. June 2014.


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