Home Oxygen Delivery Devices

By John Bottrell, RRT

3 min read

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.

Lung Diseases

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.

Nasal Cannula

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.

Bubblers

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.

Flow

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

Stable COPD

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.

Low flow

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.

Unstable 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.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The COPD.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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ladypersephone Member
I have been using a oxygen concentrator in my home for about a year, yes its easy to use, but I am wondering if wearing it all the time, can make you feel tired? My doctor says use it whenever you feel you need it. But can using it all the time, keep you from trying to make your lungs a little stronger? In other words, make them 'lazy' I know its a good thing, just wondering about this. Thanks
1. Leon Lebowitz, RRT Member
 Hi ladypersephone and thanks for your post and inquiry. While we cannot provide medical advice or diagnostics over the internet (for your own safety), your concern certainly warrants a reply. Supplemental oxygen therapy, when prescribed, is designed to make one feel more comfortable when using it. In the most general of terms, using the oxygen should not make you feel tired. If using the oxygen however, is keeping you sedentary, that could be of concern. As you may know, staying active, exercising (to the extent one can for their particular condition), and even pulmonary rehabilitation programs are all positive ways to keep oneself physically conditioned and help to manage COPD. Using supplemental oxygen therapy should not preclude the patient from being physically active. What do you think about this for yourself? We'll be happy to discuss this further and/or you may want to ask your physician about some of these concerns as well. Warm regards, Leon (site moderator)
ajschulte Member
I read about your fear of going walking and all of a sudden needing to use the bathroom, so what I started doing is mostly on good weather days is go early (7) in the morning and walk in a mall, I found out that I was not the only one out there lots of people on oxygen and seniors go there for the same reason, malls usually have at least one bathroom per floor with several stalls so your chances of fear would vanish as mine have I promise you.
1. John Bottrell, RRT Moderator & Contributor
 ajschulte. That is a great idea! Glad you are able to get your walking in. John. Author/ Site Moderator.
2. Leon Lebowitz, RRT Member
 Hi again, ajschulte and thanks so much for adding your post in reply to John's article. What a great idea - going early to the mall!! And, for all the very practical reasons you mentioned! It's interesting to know that others are doing the very same thing at the mall in the early hours. I'm sure others will read what you've written and get some ideas for themselves to use. All the best, Leon (site moderator)

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