Oxygen devices and delivery systems

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Abstract

Oxygen use has extended from inpatient to outpatient settings for patients with chronic pulmonary diseases and complications of hypoxaemia. This article presents an overview of oxygen devices (oxygen concentrators, compressed gas cylinders and liquid oxygen) and delivery systems (high- and low-flow). The indications, advantages and disadvantages of each device and delivery system are presented, aiming to offer updated knowledge to the multidisciplinary team members managing patients with respiratory failure, and therefore allowing appropriate selection of devices and delivery systems that are tailored to the needs of each patient.

Abstract

Consolidated knowledge of all oxygen devices and delivery systems is essential to devise tailored patient-based plans for oxygen therapy http://bit.ly/2kh5f2G

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Most cited references 33

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Continuous or nocturnal oxygen therapy in hypoxemic chronic obstructive lung disease: a clinical trial. Nocturnal Oxygen Therapy Trial Group.

WA Conway, EO Coates, PA Kvale (1980)

At six centers, 203 patients with hypoxemic chronic obstructive lung disease were randomly allocated to either continuous oxygen (O2) therapy or 12-hour nocturnal O2 therapy and followed for at least 12 months (mean, 19.3 months). The two groups were initially well matched in terms of physiological and neuropsychological function. Compliance with each oxygen regimen was good. Overall mortality in the nocturnal O2 therapy group was 1.94 times that in the continuous O2 therapy group (P = 0.01). This trend was striking in patients with carbon dioxide retention and also present in patients with relatively poor lung function, low mean nocturnal oxygen saturation, more severe brain dysfunction, and prominent mood disturbances. Continuous O2 therapy also appeared to benefit patients with low mean pulmonary artery pressure and pulmonary vascular resistance and those with relatively well-preserved exercise capacity. We conclude that in hypoxemic chronic obstructive lung disease, continuous O2 therapy is associated with a lower mortality than is nocturnal O2 therapy. The reason for this difference is not clear.

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Early activity is feasible and safe in respiratory failure patients.

Louise Bezdjian, Jaime Rodriquez, Alan Bailey … (2006)

To determine whether early activity is feasible and safe in respiratory failure patients. Prospective cohort study. From June 1, 2003, through December 31, 2003, we assessed safety and feasibility of early activity in all consecutive respiratory failure patients who required mechanical ventilation for >4 days admitted to our respiratory intensive care unit (RICU). A majority of patients were treated in another intensive care unit (ICU) before RICU admission. We excluded patients who required mechanical ventilation for 200 mm Hg, systolic blood pressure 200 mm Hg, systolic blood pressure 100 feet at RICU discharge. Early activity is a candidate therapy to prevent or treat the neuromuscular complications of critical illness.

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British Thoracic Society guidelines for home oxygen use in adults.

Maxine Hardinge, Joe Annandale, Simon Bourne … (2015)

The British Thoracic Society (BTS) Home Oxygen Guideline provides detailed evidence-based guidance for the use of home oxygen for patients out of hospital. Although the majority of evidence comes from the use of oxygen in patients with chronic obstructive pulmonary disease, the scope of the guidance includes patients with a variety of long-term respiratory illnesses and other groups in whom oxygen is currently ordered, such as those with cardiac failure, cancer and end-stage cardiorespiratory disease, terminal illness or cluster headache. It explores the evidence base for the use of different modalities of oxygen therapy and patient-related outcomes such as mortality, symptoms and quality of life. The guideline also makes recommendations for assessment and follow-up protocols, and risk assessments, particularly in the clinically challenging area of home oxygen users who smoke. The guideline development group is aware of the potential for confusion sometimes caused by the current nomenclature for different types of home oxygen, and rather than renaming them, has adopted the approach of clarifying those definitions, and in particular emphasising what is meant by long-term oxygen therapy and palliative oxygen therapy. The home oxygen guideline provides expert consensus opinion in areas where clinical evidence is lacking, and seeks to deliver improved prescribing practice, leading to improved compliance and improved patient outcomes, with consequent increased value to the health service.

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Author and article information

Journal

Journal ID (nlm-ta): Breathe (Sheff)

Journal ID (iso-abbrev): Breathe (Sheff)

Journal ID (publisher-id): BREATHE

Journal ID (hwp): breathe

Title: Breathe

Publisher: European Respiratory Society

ISSN (Print): 1810-6838

ISSN (Electronic): 2073-4735

Publication date (Print): September 2019

Volume: 15

Issue: 3

Pages: e108-e116

Affiliations

[1 ]10th Dept of Respiratory Medicine, Athens Chest Diseases Hospital “Sotiria”, Athens, Greece

[2 ]Dept of Thoracic Surgery, General Hospital “Sismanogleio”, Athens, Greece

[3 ]Dept of Respiratory Medicine, University of Leipzig, Leipzig, Germany

[4 ]Integrated Research and Treatment Center (IFB) Adiposity Diseases, University Medical Center Leipzig, Leipzig, Germany

[5 ]The Royal Marsden, NHS Foundation Trust, London, UK

[6 ]1st Dept of Tuberculosis and Respiratory Diseases, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic

Author notes

E-mail: georgiahardavella@ 123456hotmail.com

Article

Publisher ID: EDU-0204-2019

DOI: 10.1183/20734735.0204-2019

PMC ID: 6876135

PubMed ID: 31777573

SO-VID: 392a8bd8-5d39-471d-87a1-553c30e1d682

License:

Breathe articles are open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.

Oxygen devices and delivery systems

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Most cited references 33

Continuous or nocturnal oxygen therapy in hypoxemic chronic obstructive lung disease: a clinical trial. Nocturnal Oxygen Therapy Trial Group.

Early activity is feasible and safe in respiratory failure patients.

British Thoracic Society guidelines for home oxygen use in adults.

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