Over the past decade, there have been incredible strides in long term oxygen therapy options. Portable oxygen concentrators are a game-changer for delivering oxygen on the go. With a portable concentrator in tow, people on oxygen can go whenever and wherever their hearts desire. We used to speak of home oxygen use, but now people can leave the house to travel, exercise, and do all the things that bring them joy.
Portable oxygen concentrators are the little brothers to the larger, stationary oxygen concentrators used at home. Stationary and portable concentrators work on the same principle of operation. They both "manufacture" oxygen by pulling in air from the environment. The air passes through filters and a sieve bed that scrubs out the nitrogen. The air around us is 21% oxygen, 78% nitrogen, and 1% a mix of argon and carbon dioxide (and some other trace gases). By eliminating the nitrogen, the concentrator continually collects concentrated oxygen.
Portable concentrators generally do not replace the stationary concentrators for at-home use. The stationary concentrators are more robust and generate oxygen about ten times as fast as most portable units.
Medical grade oxygen delivered from tanks or liquid systems at home or in the hospital is close to 99% oxygen. Stationary and portable concentrators provide oxygen-enriched gas that is closer to 85%-95% oxygen. The reduced oxygen percent is because the scrubbing of nitrogen is not 100% perfect. The actual efficiency of the scrubbing depends on how high the flow rate is and the patient’s breathing rate. When the demand is higher, the machine pushes it through the filter faster, which decreases the concentration.
Due to these operational differences, a patient may need a slightly higher flow rate from a concentrator than required in the hospital or from a tank of oxygen. Oxygen users must also think about flow rate settings differently with an oxygen concentrator. Hospital oxygen devices and oxygen from a tank typically provide a continuous flow rate. Concentrators can deliver continuous flow oxygen as well, but they also have pulse dose flow settings. Pulse dosing only delivers supplementary oxygen when the patient inhales. Pulse dosing conserves the supplemental oxygen for use when it is needed. Settings for the pulse dose rates are device-specific. The pulse dose setting on one concentrator does not equate to the same pulse dose setting on another model of oxygen concentrator. The pulse dose setting a patient needs on their stationary concentrator may not be the same on their portable concentrator.
When choosing the best portable oxygen concentrator for the oxygen user's needs, it is necessary to evaluate the device characteristics along with the user's oxygen requirements. Indeed, the priority in the decision-making process must be to verify that the portable oxygen concentrator meets the user's needs during all types of activities (sitting, walking, driving, exercising). The decision should also factor in changes in oxygen needs over time. A device that barely meets a user's peak needs now may need to be replaced if the disease state progresses. The Caire SeQual Eclipse 5 weighs in at 15 pounds but has 9 pulse dose settings and can deliver a pulse bolus of up to 192 ml, giving it an impressive range of flow capabilities.
Portable and stationary oxygen concentrators require electricity. Portable units, however, can operate off both AC and DC power. Many portable units can run off the 12V port in a car. Portable units often have internal battery packs allowing use away from any electrical outlets. Many portable devices have optional external battery pack chargers. It is a best practice always to keep a fully charged battery along.
Portable units are much lighter weight than stationary units. Some, like the Philips Respironics SimplyGo Mini, weigh as little as five pounds and fit in the hand. Size and weight bring trade-offs, however. Smaller, lighter concentrators have better battery life than larger concentrators, but larger units produce oxygen faster and deliver at higher flow rates. The Philips Respironics SimplyGo weighs twice as much as the SimplyGo Mini, but it can deliver up to twice as much flow to a patient as the SimplyGo Mini at maximum settings.
Oxygen users who plan to fly should verify that their portable oxygen device meets the FAA requirements. All portable oxygen concentrators currently for sale at CPAPman are FAA approved. Portable oxygen concentrators sold after 2016 that are FAA approved have a red label indicating they are safe for use on aircraft. A list of older models that are FAA approved can be found here.
Forethought and planning make the outing or activity safer and more enjoyable for the oxygen user. Packing should include power supplies for AC and DC connections, a fully charged extra battery, a spare nasal cannula, and any other needed adapters.
Monitoring the user for appropriate levels of blood oxygen is also a vital part of a safe, enjoyable trip. Since pulse dose flow settings vary from device to device, the optimal flow rate on a stationary concentrator may not match the optimal setting on a portable oxygen concentrator. A pulse oximeter helps determine whether the patient has the right flow setting for them.
Pulse oximeters fit over the finger and measure the levels of oxygen in the blood. The pulse oximeter reports a value known as the SpO2 or oxygen saturation level. The physician should tell the patient and caregivers what an appropriate pulse oximetry value is for that patient. Oxygen saturation levels may drop during activity and sleep. Consequently, some people need higher flows or pulse dose settings during those times.
Pulse oximetry is a vital tool in monitoring oxygen efficacy. Signs that a patient may need extra oxygen are changes in the effort of breathing, cognition, dizziness, and fatigue.
Packing list for a trouble-free excursion:
CPAPman sells a variety of supplies needed to keep oxygen delivery safe and trouble-free while on the go, including batteries, power supplies, nasal cannulas, oxygen tubing, pulse oximeters, and other types of adapters.