Oxygen Therapy - Long Term Oxygen Therapy

The benefits of oxygen therapy for long periods of time are well known and its use has been widely accepted. In recent years the machines that are used in respiratory or oxygen therapy, have been improved is various ways, specially that affecting design and so are able to accommodate the diversity of lifestyles and medical needs. 

Long Term Oxygen Therapy: 

We breathe air into our lungs so as to be able to absorb the oxygen we need and pass it on to our blood. Once in the bloodstream, it must be distributed and reach all the cells in our body.

This function of gas exchange is one of the most important aspects of the whole respiratory process as oxygen is necessary for cells to function properly and carry out their work as they should.

Oxygen is our fuel and so becomes the equivalent of gasoline every vehicle needs to function. Without sufficient oxygen our cells cannot function properly.

As well as absorbing oxygen and distributing it to our bloodstream the lungs must also remove and exhale carbon dioxide. Cells, in order to work properly, also produce waste and this waste must be expelled and this is also a function of the respiratory system.

When Is Oxygen Diagnosed?

The most common diseases are: pulmonary emphysema, pulmonary fibrosis and chronic bronchitis. These chronic diseases, prevent the blood getting the oxygen it needs.

Pulmonary emphysema and chronic bronchitis are known as chronic obstructive pulmonary disease (COPD). 80% to 90% of cases are attributed to smoking.

The most common symptoms include chronic cough, shortness of breath, rapid breathing and short, limited physical activity as well as heart strain, headache and tiredness.

What Options Do You Have For Oxygen Delivery?

Basically you have 3 options for oxygen therapy: oxygen concentrators, oxygen cylinders and high pressure liquid oxygen tanks. Which one is best for you will depend on the amount of oxygen you require and the need to move (in or out of the house). 

Oxygen Concentrators

If you are housebound due to your health limitations, your best option is a stationary oxygen concentrator.

One advantage of the type of oxygen delivery system is that it allows the patient to move in and around the home. You can receive oxygen in your room, in the living room, kitchen etc.

A home unit allows you to have visitors come over and even attend a meetings at the home of a relative or friend. All you need is an outlet nearby.

For more active life styles a portable oxygen concentrator is a practical option.

One limitation is that patient does not require more than 5 liters per minute, which is the maximum flow that the concentrator can provide. Furthermore, it is not designed for spraying, so if the patient need this, you can purchase an electric nebulizer to help the complete therapy.

A portable oxygen concentrator is small, lightweight, easy to carry and very pleasing to the eye. But the main advantage is that it can be on 24 hours a day, which translates into significant savings compared to oxygen cylinders.

Another advantage oxygen concentrators have is that as oxygen is extracted from ambient air, not stored, you do not need to call your local supplier for refills. Maintenance is minimal, (you should obviously follow the instructions) but basically it just needs a proper filter cleaning once a month.

As a safety precaution you should have a reserve oxygen cylinder together with the concentrator to prevent any possibility of interruptions in electricity supply.

Oxygen Cylinders (Compressed Oxygen)

There are both stationary and portable cylinders. A stationary oxygen cylinder will yield many hours of use but does limit mobility as they are large and heavy. These are the recommended option for patients who do not need to travel and require flows greater than 5 liters per minute.

The portable cylinders are useful if you need oxygen for short periods of time - when you have to leave home, go to church, shopping, visiting the doctor, go to your clinic etc. these are portable systems and so easier to carry (due to both weight and size).

Just remember that they are storing oxygen so always check how much oxygen you have before leaving home.

These units are small and light and hold between an hour and three hours of oxygen, depending on the size and capacity of the cylinder, as well as the flow rate you need.

As mentioned portable oxygen cylinders are smaller and yield a limited number of hours of oxygen.

However, there is a very interesting solution:

• Oxygen conserving devices, which increase oxygen duration by up to 100%.
• Conventional regulators supply oxygen continuously, a continuous flow rate of oxygen whether you breathe in or out.
• Conserving devices regulate the oxygen flow to coincide when the patient is inhaling. As you breathe out oxygen is not being supplied, until the next inhalation thus forming the economy cycle.

Liquid Oxygen Tanks

For normal activities, for example visiting family and friends, going shopping, going for walks and so on, portable liquid oxygen tanks is another option.

This equipment is composed of a home stationary unit and a smaller portable tank, both of which hold liquid oxygen as opposed to compressed gas in cylinders. The unit has an oxygen evaporator that transforms the oxygen from a liquid state to gas during use. The stationary cylinder is used to within the house and to fill the portable unit.

This type of oxygen supply unit´s main advantage is that it stores oxygen as a liquid and this means a much greater amount of oxygen is in the tank than the equivalent sized cylinder with oxygen in gaseous form - the end result is a much greater number of hours of use between each refill.

More active and mobile patient´s find this system to be a very good alternative for their daily activities.

Advantages of liquid oxygen tanks:

• They consume no electricity, no heat is generated and they provide a higher oxygen (100%) purity .

To recap an oxygen supply based on liquid oxygen tanks include a stationary unit with liquid oxygen for home use and portable unit for mobility. A portable unit weighs approximately 3 ½ kg and provides 6 hours of oxygen. If you require oxygen just 3 hours away from home, the handset can be partially filled and hence its weight decreases to 3 kg.

General Recommendations For Long Term Oxygen Therapy:

• Monitoring and medical control of patients undergoing home oxygen therapy should be conducted by specialists in respiratory medicine.
• They should provide the patient ease of contact for a fast, agile and efficient response to answer questions that may arise in the course of oxygen therapy program.
• Once oxygen therapy begins monthly checks should be scheduled and performed during the first three months.
• • The aim of these controls is to evaluate:
  • • the effect of the oxygen therapy
    • the patient´s compliance with the treatment
    • their adaptation to the oxygen delivery technology
    • to reassess the adequacy of the prescription
    • and at the same time to offer psychological support to patients
    • and provide the necessary information to help adjust to the life changes all patients go through as they start long term oxygen.
• After the first three months of monitoring and medical control these can be reduced to one control after three months and six monthly periods thereafter, depending on the patient´s needs.

Basic Patient Guide For Long Term Oxygen Therapy

• Oxygen should be maintained as long as possible but never less than 16 hours a day.
• Oxygen administration should be consider essential at the following times:
• • During sleep, after meals, or exercise and unusually in cases of anxiety and mental turmoil.
• If possible, interrupting periods of oxygen administration should not exceed 90 to 120 minutes.

These break periods are not necessary but listed for your convenience. To get the most benefit, stay with your oxygen therapy 24 hours a day, whenever possible.

What Benefit Do You Get With Oxygen?

Oxygen therapy will allow your lungs and heart to function as they do in a healthy person.

In other words not having to work harder to carry oxygenated blood throughout the body, because the oxygen that you are receiving externally will complement what your lungs can not do.

This prevents your heart from getting tired and overworked which can cause heart failure. When there is a decrease of oxygen in the body, the heart has to work faster and pump harder to carry oxygenated blood throughout the body.

The above information is provided as a guide and in no way is meant to replace your physician´s instructions. Always refer to your doctor´s advice.

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