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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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