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What is an Oxygen Concentrator and How Does It Work?

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Thanks to the field of medicine’s great advancements, the oxygen concentrators today are compact, small, quiet and lightweight, but still provide the utmost compliance and high performance. Older oxygen concentrators are bulky and heavy, making it difficult for patients requiring oxygen therapy while traveling or outside their home.

Today, you can choose from at home stationary concentrators and portable oxygen concentrators (POCs), which can go wherever you go easily.

What is an Oxygen Concentrator?

Oxygen concentrator definition: An oxygen concentrator is a type of medical device used for delivering oxygen to individuals with breathing-related disorders. Individuals whose oxygen concentration in their blood is lower than normal often require an oxygen concentrator to replace that oxygen.

Generally, you can’t buy an oxygen concentrator over the counter. A doctor must prescribe it after they’ve completed a thorough medical evaluation. The doctors will also typically show the patients how to effectively use these concentrators while traveling and in their home.

Oxygen concentrators filter surrounding air, compressing it to the required density and then delivering purified medical grade oxygen into a pulse-dose delivery system or continuous stream system to the patient.

It’s also equipped with special filters and sieve beds which help remove Nitrogen from the air to ensure delivery of completely purified oxygen to the patient. These devices also come with an electronic user interface so you can adjust the levels of oxygen concentration and delivery settings. You then inhale the oxygen through the nasal cannula or special mask.

You generally measure the oxygen concentrator output in LPM (liters per minute). Your doctor will determine what level of oxygen you need, which may vary at rest, during sleep, and when you exercise.

What are the Uses and Reasons for an Oxygen Concentrator?

There are many reasons for an oxygen concentrator and doctors can recommend oxygen therapy to their patients for various medical conditions. Typically, your lungs absorb the air’s oxygen, transferring it into your bloodstream.

If you’ve had bloodwork or pulse oximetry recently performed to assess your oxygen saturation levels, and you were found to have low levels of blood oxygen, your doctor may recommend short-term or long-term oxygen therapy.

You’re probably wondering what is an oxygen concentrator used for? Acute conditions usually require short-term oxygen therapy. These conditions normally run for a short period of time. They may have a sudden onset of symptoms versus chronic conditions where things occur gradually. However, some respiratory or chronic conditions require long-term oxygen supplementation.

Acute Conditions Requiring an Oxygen Concentrator

A few examples of acute conditions where you would need the use of an oxygen concentrator for short-term oxygen therapy are:

Asthma: This condition is where your airways become inflamed and begin producing a lot of mucus, which makes it harder to breathe. While there are a number of pharmaceuticals that can treat and control asthma, an oxygen concentrator can pump high levels of oxygen into the bloodstream of the patient while they’re having or have already had an asthma attack.

Pneumonia: Pneumonia is an infection where you develop inflammation in either one or both of your lungs’ air sacs and in many cases, fill them up with fluid. Many pneumonia patients have been prescribed oxygen therapy and have seen good clinical outcomes.

Respiratory distress syndrome (RDS): RDS is a breathing disorder mostly affecting newborns, particularly those who are born six or more weeks before their delivery date. Newborns suffering from RDS don’t create enough surfactant (a lung coating liquid), causing their lungs to collapse and making them work harder to breathe. Oxygen therapy using oxygen concentrators help pump oxygen into the babies’ blood stream and lungs to reduce further complications.

Bronchopulmonary dysplasia (BPD): Newborns suffering from RDS also have a higher risk of developing BPD. This is a severe lung condition requiring long-term breathing support.

In some cases, after surgery, you may need oxygen for a short period of time.

Chronic Diseases that Require Oxygen Therapy

Some chronic conditions requiring long-term oxygen concentrator uses are:

Chronic obstructive pulmonary disease (COPD): COPD affects around 16 million people, but an oxygen concentrator can be an effective treatment. When you have COPD, you have chronic lung damage which makes it difficult for your lungs to absorb enough oxygen. As a result, you can have difficulty breathing, and oxygen therapy through a concentrator can help.

Cystic fibrosis: You inherit this life-threatening condition. It causes digestive system and lung damage. It’s a rare condition that affects the body’s cells responsible for producing mucus, sweat and digestive juices. The fluids are changed which result in a stickier, thicker solution that plugs the ducts, tubes, and passageways of the individual infected.

Sleep Apnea: Sleep apnea is a sleeping disorder that can be serious and cause the individual’s breathing to sporadically stop and start during their sleep. Usually, treatment for this condition is continuous positive airway pressure (CPAP), weight loss and physical exercise, though some people with sleep apnea may require oxygen therapy.

How Does an Oxygen Concentrator Work?

Think of an oxygen concentrator as a window air conditioner — it takes air in, changes it and delivers it in a different form. The oxygen concentrator takes air in and purifies it for use by individuals who require medical oxygen because of low levels of oxygen in their blood.
It works by:

  1. Compressing air as the cooling mechanism keeps the concentrator from becoming overheated
  2. Taking air in from its surroundings
  3. Using an electronic interface to adjust delivery settings
  4. Removing nitrogen from the air through sieve beds and a filter
  5. Delivering purified oxygen through a mask or nasal cannula

Patients who required oxygen therapy in the past mainly relied on pressurized oxygen tanks. Even though these tanks are extremely effective, they’re also fairly inefficient with the suppliers having to visit the patients regularly to replenish their oxygen supply in their tank.

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

Did you know that around 21 percent of the air in the atmosphere is oxygen? No wonder there is enough for all the 7 billion people and billions of other animals to breathe. However, many people live with breathing disorders like lung cancer, asthma, and COVID-19, and can’t get adequate oxygen naturally. Such individuals need supplemental oxygen or oxygen therapy.

Before the advent of COVID-19 at the end of 2019, terms like oxygen concentrator or pulse oximeter were rarely used in daily conversation. Today, the story is different. People ask questions about what these machines or devices do because the situation is closer home. Most of us know someone who needed oxygen therapy in the last year or so.

We have created this article to answer the most frequently asked questions about oxygen therapy and its different types. We focus on the questions around who needs oxygen therapy, symptoms of low oxygen, and oxygen therapy indicators. We then look at pulse oximeters and provide information on the basic facts about these devices.

Oxygen Therapy

What Is Oxygen Therapy?
Oxygen therapy, sometimes called supplemental oxygen, is a medical treatment that delivers extra oxygen to the body when an individual cannot absorb adequate levels. This type of therapy is only administered based on a prescription from a health professional or paramedic.

Several medical conditions could make it difficult for individuals to absorb enough oxygen, including asthma attacks, COVID-19 complications, or other chronic diseases that reduce oxygen levels in the blood.

Oxygen therapy can be managed at home or within the hospital setting. It can be administered in several ways. In instances where 100% oxygen is required, the patient must wear a tight face mask. In some cases, a small tube is placed through a hole in the front of the neck. In most COVID-19 cases, oxygen is delivered to the patient through a support system known as a ventilator.

Who Needs Oxygen Therapy?
Oxygen therapy is essentially useful for people that have insufficient oxygen levels in their blood. The U.S. National Library of Medicine’s MedlinePlus.gov provides a list of some of the conditions that may lead people to require oxygen therapy:

  • Chronic obstructive pulmonary disease
  • Respiratory fibrosis
  • Heart failure
  • COVID-19
  • Chronic long-term asthma
  • Sleep apnea
  • Respiratory hypertension
  • Cystic fibrosis
  • Pneumonia
What Are the Symptoms of Low Oxygen

What Are the Symptoms of Low Oxygen?
Two dangerous health conditions can result from the body not getting adequate oxygen levels: hypoxemia and hypoxia. ClevelandClinic.org defines hypoxemia as “when levels of oxygen in the blood are lower than normal.” Hypoxia refers to a situation where the low oxygen levels are concentrated in particular cells or a specific organ.
Symptoms of low blood levels in the body can differ from one individual to the next. The American online publisher of news and information relating to human health and well-being, WebMD.com, lists some common symptoms:

  • Skin color changes
  • Confusion
  • Headache
  • Cough
  • Visual disorder
  • An abnormally fast or slow heartbeat
  • Agitation
  • Hurried breathing or shortness of breath
  • Sweating

It’s important to note that this is only a list of some symptoms and not an attempt to provide a definitive diagnosis of low oxygen in the body. People with persistent symptoms must consult a doctor for a proper diagnosis.

What Are the Types of Oxygen Therapy?
There are different types of oxygen therapies. The devices used in the therapy can be categorized under variable devices, which deliver oxygen based on how much the patient needs, or fixed performance devices, which deliver a consistent flow of oxygen. The specific therapy prescribed by the health professional will depend on the condition of the patient.

Oxygen Concentrators
An oxygen concentrator is a medical device that takes the air around it and compresses it so that the patient receives a more concentrated form of oxygen. This device delivers a continuous supply of oxygen when connected to a power source.

One of the main advantages of oxygen concentrators is that they require low maintenance, making them cost-effective. The concentrator has to remain in one place; it can come with long tubes (around 15 meters) that allow the user to move around without moving the device.

To buy an oxygen concentrator, a prescription is required. The U.S. Food and Drug Administration provides some guidelines for people using an oxygen concentrator:

  • Do not use close to an open flame or while smoking.
  • Use in an open space to avoid failure from overheating.
  • Vents must not be blocked for optimum performance.
  • Occasionally check for alarms to ensure you’re receiving enough oxygen.

Liquid and Gas Oxygen
Liquid oxygen, which is more highly concentrated, makes it possible for more oxygen to be stored in smaller tanks. This provides a solution for more active people who need to move around. Usually, the smaller device is refilled from a bigger stationary tank filled by the oxygen supplier once or twice a month.

Oxygen gas is also known as compressed gas systems. In the same way as the liquid oxygen therapy, the gas can be stored in portable tanks to allow for more effortless movement.

girl patient lying hyperbaric chamber

Hyperbaric Oxygen Therapy
According to Johns Hopkins Medicine, “hyperbaric oxygen therapy, or HBOT, is a type of treatment used to speed up healing of carbon monoxide poisoning, gangrene, stubborn wounds, and infections in which tissues are starved for oxygen.”

This therapy happens inside a special chamber where patients breathe pure oxygen. This is done to fill the blood with adequate oxygen to facilitate the repair of damaged tissue. The pressure in the chamber is increased to between 1.5 and 3 times the normal levels.

How Much Oxygen Can a Patient Be Given?
In an article published by the publication focused on education for respiratory professionals, Breathe, experts Binita Kane, Samantha Decalmer, and Ronan O’Driscoll warn against giving a patient too much oxygen. They note that the “common misconception is that one ‘can’t give too much oxygen’ and there is general lack of appreciation for the dangers of ‘hyperoxaemia’ (higher than normal arterial oxygen levels).”

The amount of oxygen to be given to an individual should be determined by the healthcare provider, who should prescribe the flow rate and the number of hours each day. Suppose a patient’s oxygen level is lower when they are active than when they are at rest. In that case, the healthcare provider may prescribe different oxygen flows for the patient when they are at rest and when active.

Oxygen Therapy Indications
In the medical field, the term “indication” denotes a valid reason to use any medication, test, surgery, or procedure. In almost all cases, oxygen therapy is indicated for hypoxemia. However, the British-registered non-profit knowledge resource for physiotherapists, Physiopedia, lists other indicators:
1. Increased breathing rate: A respiratory rate of over 20 breaths per minute when at rest
2. Myocardial infarction: A heart attack
3. Pulmonary hypertension: High blood pressure in the lung’s arteries and heart’s right side
4. Pre-oxygenation in induction and intubation difficulty: Increasing oxygen stores in the body if oxygen shortage is anticipated later.
5. Pre and post suctioning: Following the cleaning of the airway of excess mucus.
6. Postoperative oxygenation: To prevent hypoxemia following surgery.
7. Decompression sickness: Injury or sickness triggered by a rapid change in air pressure, resulting in nitrogen dissolving in the blood.
8. Carbon monoxide poisoning: A buildup of carbon monoxide in the bloodstream.
9. Anemic Hypoxia: A decrease in the blood’s ability to carry oxygen.

What Are the Benefits of Oxygen Therapy?
The American Lung Association reports that “many people living with a lung disease find that oxygen helps them stay active, sleep better and have more energy to do the things they like.”


What Are the Risks of Oxygen Therapy?
The U.S. Department of Health & Human Services’ National Heart, Lung, and Blood Institute reports that “oxygen therapy is generally safe.” However, like with any treatment, there are some risks that patients on oxygen therapy should be aware of.

Here are a few listed by MedlinePlus.gov:

  • Causes a dry nose, drowsiness, and daybreak headaches.
  • Highly inflammable and poses a fire risk, so smoking or use of flammable materials should be avoided when oxygen is used.
  • If the container falls and gets damaged, it can explode and cause injury to people, and damage property.

How Are Oxygen Levels Monitored?
To monitor the oxygen levels, two types of tests can be done:

Arterial blood gas
This blood test measures the blood’s oxygen level and determines the level of other gases in the blood. To conduct the test, blood is drawn from an artery instead of a vein. This is because the pulse is easier felt in arteries than in veins, and oxygenated blood is in arteries.

Pulse oximeter
The pulse oximeter is a painless and noninvasive (placed outside the body) device that measures the amount of oxygen in the blood. This is done by directing infrared light into the capillaries in the finger or toe, which then estimates the volume of light reflected off the gases. A reading shows the percentage of saturated oxygen in the blood.

Generally, a pulse oximeter reading has a 2 percent error chance; meaning readings would be 2 percent higher or lower than the actual level of oxygen in the blood. This test can be done independently.

Can Pulse Oximeters Be Used To Monitor COVID-19 at Home?
The provider of health services in Texas, Houston Methodist, advises that, for anyone with a mild case of COVID-19, and who is self-treating at home, an oximeter is a helpful tool for inspecting oxygen levels. It can help detect low oxygen levels early.

However, it is crucial to underline the fact that the pulse oximeter cannot be used to diagnose COVID-19. The World Health Organization (WHO) advises, “Stay home and self-isolate even if you have minor symptoms such as cough, headache, mild fever, until you recover. Call your health care provider or hotline for advice.”

 

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