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Monday, October 29, 2012

On Oxygen Concentrator

Dr Amit Panjwani
Consultant Pulmonary Medicine,
SevenHills Hospital, Mumbai

Oxygen concentrator is cost effective and, therefore, the most frequently used stationary oxygen source. It is an electrical device that employs a sieve that absorbs nitrogen, carbon dioxide, and other trace gases from the air, so that only oxygen is delivered to the patient. It is, therefore, important that the device is kept in a clean, dry, and well-ventilated space. Oxygen concentrators are available as stationary units, which can be employed at homes as well as in a hospital setting as portable devices. Most of the available concentrators can deliver 85-90 percent of oxygen at flow rates of up to 4 L/min. The polymeric membrane concentrators can deliver 30-40 percent oxygen at flow rates of up to 10 L/min. Oxygen produced from concentrators at more than 88 percent delivered in continuous flow is clinically equivalent to 99.6 percent traditional compressed oxygen. These devices produce noise and heat that may be bothersome to some patients. It is a good practice to have a back-up oxygen cylinder should there be a power failure or a mechanical defect in the device.
Recently, portable oxygen concentrators and concentrators that are able to refill small cylinders have become available. Originally, portable concentrators were marketed for short-term ambulation and travel applications only. Some portable concentrator manufacturers market both a portable and a stationary oxygen concentrator as a system. They typically recommend that the stationary concentrator be used while the patient is sleeping or sedentary and the portable unit be used to ambulate around the home and while traveling. Single-source systems that provide for both stationary and ambulatory needs have brought long-term oxygen therapy (LTOT) to a new level. Oxygen delivered by these concentrators may be delivered either on continuous flow basis or in pulse doses. Not all portable concentrators can deliver continuous flow of oxygen. SFAR 106 (Special Federal Air Regulation) Ruling in the USA allows patients to use portable concentrators during flight.
Oxygen technology is changing. Future improvements in concentrators depend upon improved battery technology, improvement in compressor technology, and improved or new oxygen extraction/generation mechanisms. Consumer-driven LTOT care is new to the industry and creates opportunities and challenges for clinicians.

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