Oxygen needs in austere environment : French military health service experience

INTRODUCTION Management of Oxygen supplies is a recurring problem for the intensivists and anesthesiologists working in an austere environment. The French military health service has chosen oxygen concentrators (OC) as the primary source of oxygen. OBJECTIVES The main objective was to evaluate the feasibility of using OC as the main source of 0 2 for intensive care patients. We assess the need to use pressurized 0 2 during the ICU hospitalization. The secondary objectives were to identify the causes of the use of pressurized 0 2 . MATERIAL AND METHOD We realize an interventional cohort study at the French role 3 hospitals located in the Republic of Djibouti. The criteria of inclusion were all patients aged over 18 years, requiring oxygen and admitted to intensive care. RESULTS We include 35 patients over 6-month period for 251 days of oxygenation, including 142 days of invasive mechanical ventilation. The population include 21 (60%) men, aged of 35 (30 - 49) years. Twenty-eight (80%) patients benefits of invasive ventilation. Median 0 2 administration duration was 6 (3-10) days, and the median duration of mechanical ventilation was 3 (1-5) days. Nineteen pressurized O2 treatments were required over 251 days of oxygen therapy, or 7.5% of the total oxygen therapy time. The causes of recourse were in 10 cases (52.6%) severe ARDS, in 6 cases (31.6%) an emergency orotracheal intubation and in 3 cases (15.8%) a transfer. Only one OC dysfunction occurred during the study. CONCLUSION OC can be used as a primary source for intensive care patients in an austere environment. The use of pressurized 0 2 remains imperative in the event of an electrical failure and the need to use high Fi0 2 over 60%.