Some of the Acute Conditions Requiring an Oxygen Concentrator:

Asthma: Asthma is an inflammatory disease of the airways to the lungs. it is a condition in

which your airways narrow and swell and may produce extra mucus. This can make
breathing difficult and trigger coughing, a whistling sound (wheezing) when you breathe
out and shortness of breath. While there are a number of pharmaceuticals that can treat
and control asthma, an oxygen concentrator can pump high levels of oxygen into the
bloodstream of the patient while they’re having or have already had an asthma attack.

Pneumonia: Pneumonia is an infection where you develop inflammation in either one or

both of your lungs’ air sacs (alveoli) and in many cases, fill them up with fluid. Symptoms
typically include some combination of productive or dry cough, chest pain, fever and
difficulty breathing. Pneumonia is usually caused by infection with viruses or bacteria and
less commonly by other microorganisms, certain medications or conditions such as
autoimmune diseases. Many pneumonia patients have been prescribed oxygen therapy and
have seen good clinical outcomes.

Respiratory distress syndrome (RDS): RDS is a breathing disorder which mostly affects

newborns, particularly those who are born prematurely. Newborns suffering from RDS
don’t create enough surfactant (a lung coating liquid), causing their lungs to collapse and
making them work harder to breathe. Oxygen therapy is given using oxygen concentrators
help pump oxygen into the babies’ blood stream and lungs to reduce further complications.

Bronchopulmonary dysplasia (BPD): Newborns suffering from RDS also have a higher

risk of developing BPD. This is a severe lung condition requiring long-term breathing
support.
In some cases, after surgery, you may need oxygen for a short period of time.

Some Chronic Diseases that Require Oxygen Therapy

Chronic obstructive pulmonary disease (COPD): COPD affects around 16 million people,

but an oxygen concentrator can be an effective treatment. COPD leads to chronic lung
damage which makes it difficult for your lungs to absorb enough oxygen. As a result, you
can have difficulty breathing, and oxygen therapy through a concentrator can help.

Cystic fibrosis: You inherit this life-threatening condition. It causes digestive system and
lung damage. It’s a rare condition that affects the body’s cells responsible for producing
mucus, sweat and digestive juices. The fluids are changed which result in a stickier, thicker
solution that plugs the ducts, tubes, and passageways of the individual infected.

Sleep Apnea: Sleep apnea is a sleeping disorder that can be serious and cause the
individual’s breathing to sporadically stop and start during their sleep. Usually, treatment
for this condition is continuous positive airway pressure (CPAP), weight loss and physical
exercise, though some people with sleep apnea may require oxygen therapy.

Is the Portable Oxygen Concentrator Good for Day and Night?

A typical Portable oxygen concentrators have two settings for receiving oxygen: pulse
dose and continuous flow.

The pulse flow oxygen concentrator:

The pulse dose mode is usually used for daytime use, as it delivers air via the cannula when
you inhale. Portable concentrators with pulse flow oxygen are designed for people with an
active or ever-changing lifestyle who require freedom of movement. It is recommended for
patients with a low oxygen requirement of up to 2 LPM (liters per minute). Pulse flow
oxygen is based on your breathing rate, and focuses on the amount and intensity of each
breath you take.

Pulse technology detects when you are about to inhale and delivers a bolus (pulse dosage)
of oxygen at the start of your breath. After supplying you with a burst of oxygen to breathe,
the concentrator will rest and wait for your next breath. This is made possible due to the
device’s built-in oxygen conserver. With pulse flow technology, oxygen can be stored in the
conserver to be saved for when your breathing rate increases, you become suddenly active,
or whatever the case may be. Concentrators with pulse dose technology also are more
compact in design and offer a longer battery life. Hence, pulse flow is much more efficient.

the continuous flow oxygen concentrator:

The continuous flow mode delivers a constant air flow via the tubes. For people who need
oxygen while they sleep, this mode is the best option. If the person’s activity level is very
minimal throughout the day/during the night, using a continuous flow concentrator is
more suitable. These devices don’t feature any breath detection technology like a pulse
dose concentrator would, but instead delivers a constant, steady stream of oxygen to the
person. Continuous flow devices are mostly stationary, home concentrators that remain
plugged in to keep producing oxygen, but there are some portable devices that offer it
along with a pulse dose setting. portable oxygen concentrators run on battery life which
depletes more quickly on a continuous flow setting as opposed to pulse flow.

A patient is usually prescribed continuous flow oxygen if their oxygen requirements are 5
LPM or greater. If you breathe through your mouth more than your nose, you might also
find this to be the better option for you. The reason why pulse dose devices are not
recommended for 24/7 usage is because sometimes during sleep, shallow breathing might
be an issue. Pulse technology can’t always detect a shallow breath during sleep, resulting in
an alarm being set off that wakes the user several times a night. Patients with sleep apnea
should address this with a doctor when deciding what oxygen concentrator to use.
Continuous flow concentrators can be used with a CPAP or BiPAP during sleep if needed.
Unlike the pulse dose devices, continuous flow devices do not have an oxygen conserver to
store excess oxygen. Oxygen is still being produced even if you aren’t taking a breath.

Advantages of Oxygen Concentrators

 Oxygen concentrators are much less dangerous than traditional oxygen

cylinders, which can, if ruptured or leaking, cause a fire.
 In todays world portable oxygen concentrators that produce their own
oxygen have become more popular and widely used than old-fashioned
oxygen tanks.
 Portable oxygen concentrators provide the necessary oxygen anywhere the
user goes, even on airplanes. Hence, the ease and increased ability to be
mobile with oxygen.
 The FAA (Federal Aviation Administration) has ruled that all passengers who
require oxygen must be allowed to bring FAA-approved portable oxygen
concentrators on all U.S. aircraft with more than 19 seats. Foreign airlines
must also allow portable oxygen concentrators on all flights to and from U.S
soil.
 Easy to Use: it’s important to use a device that’s user-friendly. An easy-to-
understand and clean control panel allows you to monitor your liter flow and
battery life easily. It also makes adjustments as simple as pressing one button
on the touch screen control display
 A Better Night’s Sleep: While you’re sleeping, your oxygen saturation levels
tend to drop, even in individuals with healthy lungs. If a person suffers from
COPD or another type of chronic lung disease, they may suffer with transient
nocturnal desaturation which can interfere in their good night’s sleep,
leading to substantial health issues.
  Customized to Meet the individual’s Needs: Whether an individual suffers
from chronic bronchitis, emphysema or chronic obstructive pulmonary
disease, they’ll have different needs than the next person who needs oxygen
therapy. And, this is why it’s essential the POC is more than a one-size-fits all
device.
 Independent Lifestyle: POCs make independence obtainable. Individuals can
often lead energetic and active lives. Machines are made for mobility and
carrying cases, wheeled carts and many other accessories are available to
make it easier to get around.

Portable Oxygen Concentrator Limitations

 POCs aren’t cheap and even the most basic device can cost more than $2,300.
Medicare or Medicaid (health insurances) may not cover this high upfront
cost because of the industry’s preference for the less expensive supplemental
oxygen tanks.
 Noise and battery life are also a drawback but these are negligible compared
to the services offered by the concentrators.

History of oxygen concentrators

Early models weighed about 10 pounds and worked on a battery or electrical

current. In the more recent history of portable oxygen, the heavy metal oxygen
tanks were used. These were not really motivational or practical regarding activity.
But all this have changed tremendously with the introduction to the portable oxygen
concentrators (POC). It was Finally Cleared by FAA in 2005.

The oxygen in the original tanks and the liquid-oxygen devices was most flammable
and its use was strictly controlled by the airlines. The portable oxygen concentrators
of today create their oxygen by removing the nitrogen from the room air. This does
not create any hazardous material. The two units that were first cleared by the FAA
were the AirSep Lifestyle and the Inogen One.

Pulse-Dose and Continuous Flow

There are two main types of portable oxygen concentrators, the pulse-dose and the
continuous flow units.
The continuous flow system delivers a non-stop flow of oxygen. Because of this
continuous flow, these units are larger.
The pulse dose unit only delivers oxygen in fixed increments, delivering oxygen
when it senses your inhalations. This sensor monitoring of changes in your
breathing rate is most efficient, as it delivers more oxygen at times you need it the
most. Because it does not deliver a continuous flow, the pulse-dose units conserve
the oxygen and it lasts for longer periods.

Today's Portable Oxygen Concentrators

1. AirSep Focus: In contrast to the AirSep Lifestyle mentioned above, one of the
newest models from AirSep called the AirSep Focus, weighs only 1.75
pounds. Using two interior batteries and adding the AirSep AirBelt (attaches
around your waist) you can extend your use time up to 4 hours.
2. Inogen One G3: The Inogen One G3 will allow you to travel most any
international flight with its 16 cell battery. You get 8-12 hours of therapy
with the 16 cell battery. It can be used for both daytime and night time
therapy as it is able to adjust to your needs when sleeping.
3. SeQual eQuinox: The SeQual eQuinox portable oxygen concentrator delivers
both the pulse-dose and continuous flow therapy. It is a powerful unit that
also includes an Advanced Voice Module Interface. This interface announces
each button press or function change which can be most helpful in lowlight
situations.

Technical specifications for oxygen concentrators

(as per World Health Organization)

Background and scope of technical specifications

The WHO technical specifications for oxygen concentrators both comply with
relevant International Standards Organization (ISO) requirements (based on ISO
80601-2-69:2014, which supersedes EN ISO 8359:2009/A1:2012)
Figure 1Comparison of oxygen cylinders and concentrators as the basis for oxygen systems
Figure 2 process flow diagram of the oxygen concentrator
Figure 3 Typical components and their function within an oxygen concentrator

Technical specifications for oxygen concentrators

Oxygen concentration

 The oxygen concentrator shall be capable of delivering a continuous flow at a

concentration of oxygen greater than 82%.
 Most concentrators currently available produce an oxygen concentration between
82% and 96% volume fraction when operated within manufacturer specifications.
 The minimum oxygen concentration shall be maintained at the maximum rated flow
rate, at 40 °C, 95% relative humidity (RH) and atmospheric pressure representing
an altitude of 2000 m above sea level.
Flow control

 The oxygen concentrator shall be equipped with at least one built-in flowmeter with
flow-rate control. If the oxygen concentrator is equipped with more than one
flowmeter, each shall incorporate independent flow-rate control.
 For pediatric use, the flowmeter shall be capable of providing a minimum flow rate
of at least 0.5 LPM. The maximum rated flow should depend on the oxygen needs.
 The oxygen concentrator shall be prevented from providing a flow rate greater than
the maximum rated flow rate. As Drawing a higher flow rate than intended by the
manufacturer can reduce sieve-bed performance with resultant oxygen
concentration dropping too low. It can also result in an earlier than usual
replacement of sieve beds, which will need to be performed by trained technical
personnel.
 The flowmeter shall provide continuous flow-rate control, with markings from 0
LPM to the maximum rated flow-rate, at a minimum of 0.5 LPM intervals.
 The oxygen concentrator shall be capable of generating at least 55 kPa at all flows,
up to the maximum rated flow.This is to overcome pressure drops due to long
oxygen delivery tubing. In clinical practice, back pressure is added when accessories
such as flow splitters and oxygen administration tubing accessories are connected
to the oxygen concentrator outlet

Indicators and alarms

 The oxygen monitor shall indicate when the oxygen concentration is less than 82%.

 The oxygen concentrator shall incorporate alarms for alerting the user of fault
conditions such as: low oxygen concentration (<82%)

 There shall be alarms/ indicators in case of: no flow, high/low pressure, low battery,
power supply failure and high temperature.

 The oxygen concentrator shall incorporate a time meter that records the cumulative
hours of device operation.

Outlets
 The oxygen concentrator shall have at least one oxygen outlet for direct attachment
of oxygen delivery tubing.
 The outlets shall be barbed fittings and should be recessed or made out of materials
that will not be easily bent or broken to avoid damage.

Enclosure

 The oxygen concentrator shall incorporate gross particle filters to prevent dust and
grime from entering the enclosure and air inlet.
  All user-removable filters shall be cleanable. Cleaning instructions for filters shall be
included in the instructions for use.
 The enclosure shall have wheels to allow for movement of the oxygen concentrator
between rooms. A lightweight device, weighing less than 27 kg, is recommended
based on the average weight of current devices. Brakes are also ideal to prevent free
rolls.
 The oxygen concentrator shall produce no more than 50 dB(A) of noise when
operating.

Power

 The oxygen concentrator shall have a power efficiency of ≤70 W/LPM.

 Stationary oxygen concentrators consume a significant amount of power, ranging
from about 300–600 W. This amounts to significant energy demands if the
concentrator is used continuously over several days or even weeks.
 The oxygen concentrator shall have an electrical plug that is compatible with the
power outlets of the clinical facility and country where it will be installed.
 Electrical input requirements should be labelled on the device since concentrators
are available for different ranges of voltage and frequency. Procurement-related
documents should also specify these requirements, including the voltage, frequency
and type of plug needed.