Supplemental oxygen is always used with inhalational agents to prevent hypoxia, even when air is used as the carrier gas. The concentration of oxygen in inspired anaesthetic gases is usually at least 30%, but oxygen should not be used for prolonged periods at a greater concentration than is necessary to prevent hypoxaemia. After prolonged administration, concentrations greater than 80% have a toxic effect on the lungs, which presents initially as a mild substernal irritation progressing to pulmonary congestion, exudation and atelectasis. Use of unnecessarily high concentrations of oxygen in incubators causes retrolental fibroplasia and permanent blindness in premature infants.
Oxygen is supplied under pressure in cylinders, when it remains in the gaseous state. In most hospitals a vacuum insulated evaporator is used to store oxygen in liquid form. This provides for huge volumes of gaseous oxygen and will supply all the piped oxygen outlets in the hospital.
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