Oxygen

Going on Oxygen: An Introduction

Why Extra Oxygen?

Because it will help you live longer! We have shown that patients with lung disease with oxygen saturation levels of less than 88% (89% with heart failure or high red blood cell counts) at rest will significantly benefit from oxygen therapy. Patients with oxygen levels above 90%, even if abnormal (less than 96%) have not shown any benefit. Not all shortness of breath will be fixed with extra oxygen, but wearing oxygen during exercise for those who qualify at rest may help increase activity. Typically patients are also required to wear oxygen during sleep if they need it at rest or with activity.

How does one take oxygen?

At Home

At home, typically a stationary concentrator with extra-long tubing will allow oxygen use. Oxygen concentrators take oxygen in the air and use electricity to “concentrate” the oxygen and deliver it at the desired rate to the patient.

On the Go:

• Portable Tanks:
  These are cylinders of concentrated oxygen. They can deliver high rates, though heavy and bulky.
  They will be delivered to your home prefilled, at regular intervals typically weekly. Some systems can be filled at home from a concentrator.
  The amount of oxygen you need will determine if you can use the smallest portable tank, a “B- tank” which can be carried in a special backpack or the larger “E-tank” which requires a cart with wheels.

• Liquid Oxygen:
  Less bulky, and more compact, usually lasting less time but are capable of high flows of oxygen than the smallest portable tanks. Due to this they can be slightly heavier. They have to be filled at home by the patient. Liquid nitrogen must be handled with care when refilling as it can cause cold burns. Not every medical supply company carries this option.

• Portable Concentrators:
  Run on their own battery, car battery and electricity. They concentrate oxygen and work as long as the battery goes on or there is access to electricity. Some can generate higher flows of oxygen, others release oxygen only when you breathe in and typically used for patients needing less oxygen.

• Humidifier:
  Will add humidity to the home delivery system so as to not dry nasal passages.

• Delivery to patients from the device:
  Typically, a Nasal Cannula will bring the oxygen to the patient’s nose. These come in many different sizes. Longer tubing up to can be used at home or shorter tubing for portable oxygen. High flow nasal cannulas are available when higher flow oxygen is needed.

• Reservoir tubing:
  These small bags either on the face (Mustache) or a pendant, help increase oxygen delivered (used by patients with greater needs) – also known as Oxymizer. The reservoir concentrates the oxygen between breaths and delivers a bolus of 80-100% oxygen with each breath. This normally allows for a lower flow of oxygen to be used allowing a tank to last longer. These can only be used with continuous flow oxygen.

• How do you select what system is best for you?
  You will typically need a home concentrator and a portable system.
  Medicare and most insurance companies will cover a home concentrator and some type of portable oxygen. The portable oxygen may be a tank, liquid oxygen or a portable concentrator depending on both insurance allowance and the medical supply company’s product availability. The smallest lightweight concentrator is normally the most desirable but not always covered so many patients obtain these on their own.
  Consider the weight of the devices. Smaller concentrators are less heavy and easier to carry but deliver lower rates of oxygen. Portable concentrators can deliver unlimited supply if there is an electric supply, or many hours with extra batteries. Liquid oxygen and larger portable tanks deliver purer oxygen and can be used at higher flows but will only last until reservoir runs out, this varies by size and flow rate. Due to the amount of the oxygen prescribed by your health care professional, many systems may not be available to you simply because they cannot deliver the amount of oxygen needed.

Who can help?

Typically either your care provider or the Durable Medical Equipment Company (DME) can help you select the right combination for you. The DME company that you will be directed to is either selected by your health care provider or one of a few allowed by your insurance company.

You can find here a list of most concentrators and their capabilities, though it is best to find from your DME which one is available to you.

Other Resources

• Videos on how to use concentrators, portable oxygen

• When do you get off Oxygen?

• Pulse Oximeters and Oxygen Concentrators: What to Know About At-Home Oxygen Therapy

• Travelling with Oxygen