Home Oxygen Delivery Devices
Last updated: February 2019
Some people with COPD have low oxygen levels. This may require them to need oxygen at home. If you require oxygen, you’ll need some form of delivery device to deliver it.
Terms to know regarding home oxygen delivery devices
Fraction of Inspired Oxygen (FiO2)
The percentage of oxygen in the air we inhale. In-room air, the FiO2 is 21%. Under normal conditions, this is more than enough oxygen. Our lungs are very efficient at getting to arterial blood to maintain normal oxygen levels.
Some diseases may cause changes inside your lungs. This may make it so they are less efficient at getting oxygen to your arterial blood. This may cause oxygen levels to diminish. When this happens, supplemental oxygen may prove useful. It may be delivered by any of the following devices.
It was invented in the 1950s. It’s very easy to use and is well tolerated by most people who need it.1 These allow you to inhale a low flow of supplemental oxygen.
They consist of plastic tubing. One end is attached to a flowmeter and oxygen source. On the other end, the tubing splits in two and consists of two nasal prongs. The prongs fit securely in your nostrils. The tubing then goes over your cheeks and is secured behind your ears.
A disadvantage is that the oxygen flow may dry out and irritate nasal passages. This may cause nosebleeds in some. The remedy for these is nasal ear covers and humidity.
These are mini humidification systems. They consist of small, plastic bottles that contain sterile water. Some are square, others are round. So, they come in all shapes and sizes, depending on the brand. They attach to the flowmeter. The nasal cannula is then attached to the bubbler.
A flow of oxygen passes over the water in the bubbler and picks up humidity. This helps to reduce nasal irritation. Usually, they are only needed with higher flows (4-6 LPM). But, they can be used with lower flows also.
Nasal Cannula Ear Covers
These are just soft covers that fit over the part of the cannula that fits over your ears. The covers are soft and prevent the cannula from causing skin breakdown there. Some people prefer to use cotton or gauze.
Nasal cannulas allow for delivery of a low flow of oxygen. Two studies performed during the 1960s showed that 2-3 LPM is perfect for most people with stable COPD.2 This low flow of oxygen is very tolerable for most people. So, if you have home oxygen for COPD, chances are you only use 2-3 LPM.3
Transtracheal Oxygen (TTO)
I have had some patients who really, really like these. A small opening is made into your trachea. A small catheter is inserted into the opening. The catheter is secured around your neck in a similar fashion to how a cannula does. Tubing is connected to a flowmeter and oxygen source. This allows the person to inhale oxygen. These are particularly ideal for people who require 24-hour oxygen and who like to stay active.4-6
There are some nice advantages to this. For one, you don’t have to wear a nasal cannula. It won't dry out your nose or irritate your ears. Another nice advantage is that oxygen is directly applied to your airway. This makes it so you need less oxygen. This is ideal for staying active, as portable oxygen lasts a lot longer. A disadvantage is it requires a surgical procedure.4-6
To receive home oxygen therapy, you must have stable COPD. This means your rate and depth of breathing must be within an acceptable range. This is because nasal cannula and TTO are both low flow oxygen devices.
This basically means that the device does not give you all the air/oxygen you inhale. It allows you to inhale room air. Obviously, nasal cannulas also allow you to inhale room air. So, this room air may dilute the FiO2 delivered to you.7 Low flow oxygen devices usually work just fine for stable COPD.
This is basically when you're having flare-ups. Your rate and depth of breathing may increase. This can make it so you inhale more room air with your nasal cannula. When this happens, a nasal cannula cannot maintain a FiO2 high enough to maintain good oxygen levels.
What to make of this?
So, these are your oxygen delivery devices. They are all actually pretty simple and easy to use. I've also thrown in some basic related terms. Hopefully, these help you better understand why we use what we use.
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