Medical Oxygen
Oxygen and the aerobic metabolism is the fundamental basis for all human life. The medical world has known for a long while that it is not only an adequate oxygen fraction that is necessary but also an adequate partial oxygen pressure to ensure the proper transport from the lung into the blood. Medical oxygen is also a fundamental part of the fresh gas flow during general anesthesia and in combinations with either nitrous oxide or air in proportions of 1:2 l/min. It is used in operating theaters throughout the world. Medical oxygen is the standard of care for certain CO intoxications. Normo-baric high flow oxygen therapy or in severe cases hyperbaric oxygen therapy is today the gold standard of care for carbon monoxide poisoning.
Medical Nitrous Oxide
Medical nitrous oxide has well-known and well-documented dose-dependent analgesic and mild anesthetic effects. Nitrous oxide is not sufficiently strong to create general anesthesia as a sole agent. Medical nitrous oxide is relatively inexpensive and certainly far more so than most other commonly-used anesthetics/analgesics. Taking its clinical features, rapid on-set of action, minimal cardio-respiratory effects and rapid off-set, emergence into account as well as its low cost, medical nitrous oxide is an interesting cost-effective choice in modern anesthesia. Improving spontaneous respiration during surgical laryngeal mask anesthetic procedures (lasting an ever-increasing number of days) shortens emergence and brings early recovery, facilitating a rapid patient turnover in the operating theatre. A long and highly extensive record of medicinal nitrous oxide in clinical use is also worthy of consideration. The contraindications for patients for whom the use of nitrous oxide could cause side effects are well recognized and easily identified. There is scarcely any other drug in use today that has been used so widely and so safely with such a vast number of patients.
Medical Air
Medical air is used mainly for ventilation and inhalation therapy as well as a carrier gas for narcotic substances in inhalation-al anesthesia. Pulmonary nebulizer machines or "nebulizers" are used to give routine medication treatments of inhaled bronchodilators to very young children who have problems using metered dose inhalers and spacers. Medical air is used to drive room air through tubing to the nebulizer. The nebulizer converts the liquid medication into a mist that can then be inhaled directly into the lungs.
Medical Nitrogen
Liquid nitrogen provides temperatures as low as -196°C and it can be used for cryobiology and cryogenic therapy. The low temperature is used in cryogenic conservation for the long term preservation of blood, blood components, other cells, body fluids or tissue samples. In cryosurgery, medical nitrogen can be used, for example, for minor surgical procedures such as the obliteration of warts in dermatology. It is also used as a component in many gas mixtures and as a displacement medium for sterile equipment, non-oxidizing displacement medium in pharmaceutical vials and as a propellant in pressurized aerosol dispensers. Medical nitrogen provides a source of pneumatic pressure for powering gas-operated medical devices and as a coolant for carbon dioxide surgical lasers.
Medical Carbon Dioxide
Medical carbon dioxide is used for various medical purposes such as: Insufflation gas for minimal invasive surgery (laparoscopy, endoscopy, and arthroscopy) to enlarge and stabilize body cavities for better visibility of the surgical field. In its liquid phase, where it provides temperatures of down to – 76o C, for cryotherapy or for local analgesia by external application onto the skin surface.
Medical Helium
Gaseous helium is utilized in intra-aortic balloon pumps during myocardial infarction. Liquid helium is utilized extensively in MRI testing laboratories.
In medicine Heliox (Helium/Oxygen mixtures) generally refers to a mixture of 21% O2 (the same as air) and 79% Helium, although other combinations are available. Heliox generates less airway resistance than air and thereby requires less mechanical energy to ventilate the lungs. "Work of Breathing" (WOB) is reduced. It does this by two mechanisms: increased tendency to laminar flow and reduced resistance in turbulent flow. In the large airways where flow is turbulent, resistance is proportional to density, so Heliox has a significant effect. Heliox has been used medically since the early 1930s. It was the mainstay of treatment in acute asthma before the advent of bronchodilators. Currently, Heliox is mainly used in conditions of large airway narrowing (upper airway obstruction from tumors or foreign bodies and vocal cord dysfunction). There is also some use of Heliox in conditions of the medium airways (croup, asthma and chronic obstructive pulmonary disease). Patients with these conditions may suffer a range of symptoms including dyspnea (breathlessness), hypoxemia (below-normal oxygen content in the arterial blood) and eventually a weakening of the respiratory muscles due to exhaustion, which can lead to respiratory failure and require intubation and mechanical ventilation. Heliox may reduce all these effects, making it easier for the patient to breathe. Heliox has also found utility in the weaning of patients off mechanical ventilation, and in the nebulization of inhalable drugs, particularly for the elderly. Research has also indicated advantages in using helium–oxygen mixtures in delivery of anesthesia.
Industrial helium is used for filling balloons.
Calibration Gases
Several medical devices such as blood gas analyzers for the exact determination of the content of pO2, pCO2 and pH in arterial blood samples need to be calibrated from time to time to deliver reliable and exact values of the relevant parameters. Gas mixtures produced with high accuracy and purity according to the specifications of device manufacturers serve as essential components for this important step in the operation of medical devices.
Medical Cardio-pulmonary Testing Gases
Medical cardio-pulmonary test gases (also called medical lung function test gases) are used for in-vivo diagnostic testing to measure either alveolar diffusion capacity in the lung (pulmonary function with CO as the investigative compound) or lung blood flow to give cardiac output (cardiopulmonary function with C2H2 or CO2 as the investigative compound). The medical lung function test gases, which are inhaled, consist of gas mixtures containing a tracer gas. The exhaled gas is analyzed and differences in the concentration of the tracer gas can be used to diagnose different lung diseases.
Regulations
For decades medical gases have been regarded by the healthcare community as low value commodities, delivered to the hospital and reordered when necessary. However, things are evolving rapidly. The most significant change is the classification from medical gases to pharmaceutical quality products. The shift promises to be of major benefit to doctors in their effort to treat patients. We document the quality, safety and efficacy of our gases. Regulations help with increasing patient safety.