What is an Oxygen Concentrator?

Oxygen Concentrator is an electronic device that provides Oxygen to the patients by concentrating room air (ambient air) into pure oxygen.

The air we breathe in is mainly comprised of Nitrogen (78%) & Oxygen (21%). This machine takes the room air using a compressor, removes Nitrogen from it, and delivers medical-grade Oxygen up to 95% purity.

Based on the principle of Pressure Swing Adsorption (PSA) technology, these oxygen machines are now widely used in homes for oxygen therapy especially where liquid or pressurized oxygen is too dangerous or inconvenient.

An oxygen concentrator can replicate the function of an Oxygen cylinder; however, the only snag is that it uses electricity even though the power consumption is minimal.

When is it used?
Patients who have respiratory conditions like COPD, ILD, etc. that cause low levels of oxygen in their blood.

An Oxygen Concentrator is used when a patient is prescribed supplemental Oxygen to fulfill the basic Oxygen needs of the body.

The number of hours that the physician prescribes oxygen therapy can vary from 1 to 24 hrs per day depending upon the patient’s condition.

It is highly advised to start using supplemental Oxygen as soon as it is recommended by a physician.

How does it work?
The basic working of an Oxygen Concentrator is simple; it takes room air, removes Nitrogen from it, and gives us medical grade O2 up to 95% purity.

Since Nitrogen and Oxygen are two main components of air with 78% Nitrogen and 21% Oxygen; the air is left with 90-95% pure Oxygen after removing Nitrogen from it.

Working in 4 simple steps:

Room air is taken in the machine

Nitrogen trapped & removed from the air leaving behind O2 as the primary gas

Adjusting the O2 delivery flow in Litres Per Minute (LPM)

90-95% pure Oxygen delivered to the patient through delivery systems like Nasal cannula, mask, etc


Types:
Stationary Oxygen Concentrator:
The stationary concentrator also is known as home oxygen concentrator is the one that works only on AC mains. All stationary Oxygen Concentrators deliver a continuous flow of Oxygen just like a cylinder with standard delivery systems.

It is called stationary because the patient cannot carry it all the time as an Oxygen source with him/her but it can easily be moved in the home as most manufacturers manufacture models that are mounted on wheels and weigh from about 9kg (19 lbs) to 28 kg (61 lbs).

Portable Oxygen Concentrator:
They are similar to home oxygen concentrators but smaller in size, lighter in weight, easy to carry and can work on battery as well as AC mains. Most portable models are pulse flow-based but some have continuous mode as well.

Accessories
Humidifier
The flow of Oxygen through the airways tends to dry them up just like normal air would do to any wet surface. To avoid the dryness in the nose and throat of patients, a humidifier is required.

O2 bubbles through the water in a humidifier bottle and gets moistened. Usually, it is said that humidification is required for flows higher than 3 Litres Per Minute (LPM). Also, note that a humidifier is not required in the pulse flow of a portable oxygen concentrator.

Oxygen Delivery Systems
The most commonly used O2 Delivery Sytems are Nasal Cannula and Simple face Mask. However other than these two, some other less common systems are the non-rebreathing mask, partial rebreathing mask, Trans-tracheal catheter, and Ventury mask.

Nasal Cannula
Oxygen is delivered directly to nostrils through a thin tube called Nasal cannula which is connected to the source by one end and the other end is split into 2 prongs & is placed in nostrils.

 

Face Mask
The simple face mask is a single patient use a plastic mask which is to be placed on the face of the patient covering nose and lips for respiration.


Summary


> Oxygen Concentrator is a machine that takes in room air, removes Nitrogen from it, and provides 90-95% pure Oxygen to patients.

> It is more economic and convenient than using Oxygen cylinders as it doesn't require any refills.

> Used when a patient is prescribed supplemental Oxygen due to low oxygen level in blood.

> Two types: Stationary and Portable

> Accessories used with the machine are: Humidifier to moisten dry Oxygen, Nasal Cannula / Mask to deliver Oxygen to the patient.

> Oxygen Concentrators are increasingly becoming popular across the world. They are much more reliable than cylinders as they don’t run out of the gas and don’t require any refills; Oxygen concentrator is an economic alternative for patients who have to take Oxygen on regular basis as a medical intervention.

 

Guide to buy an Oxygen Concentrator

1. Determine the Flow
Many people go out in the market to buy Oxygen Concentrator (OC) without knowing their flow requirements. The flow is in Litres Per Minute (LPM) and is written on the doctor’s prescription.

There are chances that if you have been recently prescribed Oxygen, then you may need a Home Oxygen Concentrator with flow up to 5 LPM (the most commonly available oxygen concentrator in India).

2. COVID 19 Patients?

Buy only Home Oxygen Concentrator with at least 5 LPM capacity and with built-in flow increase - decrease regulator.

3. Tubing

Oxygen Concentrator should preferably have crush-proof tubes (Pipes).

4. Filters

There are two filters in Home Oxygen Concentrators. Both should last for at least 1000 hours of operation.

5. Other important features which an Oxygen Concentrator should preferably have:

> Total Running Time Display.

> Current Use Time Display.

> Timer for Auto-Off.

> Nebulizer Function.

> Low Oxygen Alarm.

> Circuit Breaker.

> Manual Reset Switch.

IMPORTANT: Residents of J&K should choose an Oxygen Concentrator which can run on Home Inverter during power outages.

Warranty and Service

> Oxygen Concentrators of reputed brands get a warranty of 3 years and paid service post-warranty. You should ask the dealer about the facility of repair and service support available in your town before proceeding with the purchase.

How to Use & Maintain an Oxygen Concentrator?
Every machine needs maintenance and an Oxygen Concentrator is no different although the maintenance required is minimal.

Before learning how to maintain your Oxygen machine properly one should know how to initialize/use it first.

Instructions for using an Oxygen Concentrator
Using an oxygen concentrator is as simple as running a television. The following steps need to be followed:

Switch ‘ON’ main power source where the power cord of the Oxygen Concentrator is connected.

Place the machine in a well-ventilated location preferably 1-2 ft. away from the wall so that the intake and exhaust have clear access.

Connect the humidifier (Usually required for Continuous Oxygen flow more than 2-3 LPM).

Ensure that the particle filter is in place.

Connect the Nasal Cannula/Mask and ensure that the tubing is not kinked.

Turn on the machine by pressing the ‘Power’ button/switch on the machine.

Set the Oxygen flow as prescribed by the physician on the flow-meter.

Bubble out Oxygen by putting the outlet of Nasal Cannula into a glass of water, this would ensure the flow of Oxygen.

Breathe through Nasal Cannula/Mask.

Maintaining your Oxygen Concentrator
There are few things that patients or patient’s caregivers need to keep in mind while using their Oxygen Machines. Some of these things require special attention while some are just basic maintenance practices.

1.Using a Voltage Stabilizer
In J&K, we have usually low and fluctuating voltage, especially during winters. Low and fluctuating voltage is always bad for sensitive electronic equipment like an Oxygen Concentrator.

After a power cut, the electricity returns back with such high voltage that it can damage the compressor. This problem can be solved by using a good quality voltage stabilizer. The voltage stabilizer stabilizes the voltage fluctuation and hence improves the life of the stationary oxygen concentrator.

It is not mandatory to use a voltage stabilizer but it is recommended; after all, you will be spending a lot of money to buy an oxygen concentrator and there is no harm in spending a few more bucks to buy a voltage stabilizer.

2.Placement of the Oxygen Concentrator
An oxygen concentrator can be kept anywhere inside the house; but while operating, it should be kept one foot away from the walls, bed, sofa, etc.

There should be 1-2 ft. of vacant space around the air-inlet of your oxygen concentrator as the compressor inside the machine needs space to take in, sufficient amount of room air which will be concentrated to pure Oxygen inside the machine. (Air-inlet can be on the back, front or sides of the machine – depends on the model).

If enough gap is not provided for the air intake, then there is a possibility that the compressor of the machine might heat up as it won't be able to take in, sufficient amount of ambient air, and the machine will give an alarm.

3. The Dust Factor
The dust in the environment plays a very important role in the early service requirement of the machine.

The air impurities like dust particles get filtered out by the filters of the machine. These filters get choked after few months of usage depending upon the SPM levels inside the room.

When the filter gets choked then the oxygen purity drops. Most of the machines start giving an alarm when this happens. Machine filters need to be replaced periodically in such cases.

Though it is impossible to eliminate dust from the air, you should avoid using your Oxygen Machine in a dusty environment. Precautionary measures should be taken to reduce dust seeping into the machine. 

4. Resting the Machine
Oxygen concentrators are made in such a way that they can run for 24 hours. But at times, they face the problem of heating up and stopping abruptly.

Therefore, after continuous usage of 7-8 hours, the concentrator should be given some rest for 20-30 minutes.

After 20-30 minutes the patient can turn the concentrator on and use it for another 7-8 hours before giving it rest of 20-30 minutes to the machine again.

When the machine is switched off, the patient can use the standby Oxygen Cylinder. This will improve the life of the compressor of the Oxygen Concentrator.

5. Mice in the house
The stationary Oxygen Concentrators face a huge challenge from the mice running around in the house.

In most of the stationary oxygen concentrators, there are vents under or behind the machine.

While the machine is being operated, a mouse cannot get inside the machine.

But when the machine is idling, the mice can get inside the machine and inflict damage to the machine.

6. Filters
In some machines, there are external filter cabinets which can be opened to retrieve the filter easily. This filter should be cleaned once in a week (or more frequently depending upon the operating conditions) with soap water. Filters should be dried completely before putting back into the machine.

The internal filters should be replaced by the authorized service engineer of your equipment provider only. These filters do not require replacement quite often.

7. Humidifier Cleaning practices

Clean drinking water should be used for humidification to avoid any blockages in the holes of the bottle.

The water should not be less or more than the respective min and max water level marks on the bottle

Water in the bottle should be replaced once in 2 days

The bottle should be cleaned from inside once in 2 days.​

8.​ Basic precautionary measures and cleaning practices

> The Oxygen tube should not have any kinks or leakage from the oxygen outlet where it is attached to the nasal prongs.

> Water should not be spilt over the machine

> The machine should not be kept near fire or smoke

> The outside cabinet of the machine should be cleaned with a mild household cleaner applied using a sponge/damped cloth to wipe all the surfaces dry. Do not allow any liquid to get inside the device

> The machine should not be moved on rough surfaces where the wheels of the machine might break. It is highly recommended to lift the machine.


Summary


> Use a good quality voltage stabilizer

> Keep the concentrator 1-2 ft. away from all walls

> Avoid using the machine in a dusty environment

> Get regular performance checks done

> Do not run the machine continuously for long durations. Give it some rest.

> Use clean water in the humidifier and replace it every 2 days.

> All the above-stated measures will improve the life of the oxygen concentrator and reduce your expenditure on repair/service of the machine.

> However, a concentrator can still break down anytime. Therefore, it is highly recommended to keep a standby OxygenCylinder with you always because a service engineer would take some time to reach your home to repair your Oxygen Concentrator. One should ideally keep a backup Oxygen Cylinder that would last for 24 hours.

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