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When should Oxygen Concentrator be used by COVID-19 patients? Here are all the details

As COVID-19 cases surge and with oxygen cylinders in short supply across several states, the concentrator is among the most sought after devices for o-xygen therapy. So, here’s a quick lowdown on oxygen concentrators.

When should Oxygen Concentrator be used by COVID-19 patients? Here are all the details
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As COVID-19 cases surge and with oxygen cylinders are in short supply across several states, the concentrator is among the most sought after devices for oxygen therapy, especially among patients in home isolation and for hospitals running out of oxygen.

With oxygen deprivation and lung infections becoming common problems faced by patients during the second wave of COVID-19, many patients have been recommended to use oxygen concentrators and cylinders at home to maintain oxygen levels and avoid fatalities. However, with oxygen therapy, one needs to be doubly careful and be aware of the risks and dangers as well, said Dr Sanjay Shah Consultant, General Physician, Fortis Hospital Mulund.

So, what precisely are oxygen concentrators, when would they be required, how are they to be used? or not used? Here’s a quick lowdown on the same.

What is an oxygen concentrator?

An oxygen concentrator is an electronically operated device that separates oxygen from room air. It provides a high concentration of oxygen directly to you through a nasal cannula. These devices can supply a continuous stream of oxygen at flow rates of up to 10 litres per minute. This concentrator is recommended by doctors so that the shortage of oxygen in a person's body is fulfilled.

How does it work?

We know that atmospheric air has roughly 78 per cent nitrogen and 21 per cent oxygen. Oxygen concentrators are simple devices that do precisely what their name promises – they take in ambient air and increase the oxygen concentration, by filtering out and throwing away nitrogen.

"These devices work on the principle of ‘rapid pressure swing absorption’ which is where the nitrogen is removed from the air using zeolite minerals which absorb the nitrogen, leaving other gases to pass through and capturing oxygen as the primary gas. The collected oxygen is 92-95 per cent pure," said Dr Sanjay Shah.

These Oxygen concentrators work the same way in supplying oxygen needed by the body such as oxygen tanks or cylinders, with the use of a cannula, oxygen masks or nasal tubes. The difference is that, while the cylinders need to be refilled, the Oxygen Concentrators can work 24 x 7.

Also, a steady electricity supply is a must. If you live in a place with frequent power cuts, you may want to look for an oxygen cylinder.

Types of oxygen concentrators

There are two types— continuous flow and pulse dose. Continuous flow oxygen will provide the same flow of oxygen every minute unless it is turned off irrespective of whether a patient is breathing it in or not, while the pulse dose oxygen concentrator detects breathing pattern and dispenses oxygen when it detects inhalation. The oxygen dispensed per minute will vary in the second case.

What to check when renting or buying an oxygen concentrator?

A physician’s advice is necessary to decide how many litres per minute of oxygen is required, a pulse oximeter should be handy. Oxygen concentrators can supply between 0.1 litres per minute (LPM) to 5 to 10 LPM. A concentrator has 92-95 per cent pure oxygen.

Can one use oxygen concentrators on their own?

The answer is a strict no. Till you get a bed, Oxygen Concentrator can be beneficial, but not without guidance from a chest physician/internal medicine specialist; depends on patients' pre-existing lung conditions.

Who can use them, and when?

Does this mean that anyone who finds their oxygen level falling below acceptable levels can use a concentrator and help oneself? Absolutely not.

"Oxygenation should be preferred when blood oxygen levels (SpO2) readings drop below 94%. Ideal oxygen levels should be between 95-99%. While no oxygen therapy can instantly boost oxygen levels or restore them to normal, COVID+ patients should aim to achieve a saturation of up to 92 per cent. Experts also advise that achieving 100% saturation shouldn't be done, when the body is sick. More so, this may exhaust your resources quicker - whether it is a concentrator or cylinder that you use," shares Dr Sanjay Shah.

Speaking to PIB on the appropriate usage of concentrators, Professor and Head of Department Anaesthesia, B. J. Medical College, Pune, Prof. Sanyogita Naik said: “Oxygen concentrators can be used only in moderate cases of COVID-19 when the patient experiences drop in oxygen levels, where the oxygen requirement is a maximum of 5 litres per minute."

The professor added that oxygen concentrators are also very useful for patients experiencing post-COVID complications which necessitate oxygen therapy.

What is the price of oxygen concentrators?

The price of oxygen concentrators ranges from INR 40,000 to INR 2,00,000. They are of high value because they are operated by a power function and are portable too.

However, the normal oxygen cylinders are priced from INR 8,000 to INR 9,000, and they require refilling, unlike the oxygen concentrators that are portable and do not require refilling.

How are concentrators different from oxygen cylinders and concentrators?

Oxygen concentrators are the easiest alternatives to cylinders but can only supply 5-10 litres of oxygen per minute (critical patients may need 40-50 litres per minute) and are best suited for moderately ill patients.

Concentrators are portable and unlike LMO that needs to be stored and transported in cryogenic tankers, need no special temperature. And unlike cylinders that require refilling, concentrators only need a power source to draw in ambient air.

"The difference is that a concentrator purifies the air and makes it available for patients who have low oxygen levels in their blood. It just needs to be pulled into a power source. Cylinders accomplish the same, but the oxygen is already compressed within the tank. That supply is gradually reduced until the tank runs out and needs to be refilled or replaced," explained Dr Shah.

Who is Eligible?

Dr Sanjay Shah mentions that only mild to moderately ill patients, who have an oxygen saturation level between 90-94 per cent, should depend on an oxygen concentrator and can use it at home. We must understand that hoarding of such life-saving equipment will only worsen the country’s problem. Anyone with oxygen saturation depleting below 80-85 per cent may need a higher flow of oxygen and will have to switch to a cylinder or liquid medical oxygen supply and may eventually need hospitalization.

Where can you find one? 

The oxygen concentrators are available in online stores. 

List of importers and manufacturers in India

Phillips, BPL Medical Technologies Ltd, Invacare, AirSep corporation, SS Technologies, Oshocorp Global Pvt Ltd, Medtronic, Inogen, Nidek Medical, Chart Industries are some common importers and manufacturers in India.

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