Oxygenation With a Single Portable Pulse-Dose Oxygen-Conserving Device and Combined Stationary and Portable Oxygen Delivery Devices in Subjects With COPD

Abstract

BACKGROUND: Portable oxygen devices simplify and facilitate patient therapy. This study was designed to compare S pO 2 and patient satisfaction with a portable oxygen concentrator or a combined system consisting of a fixed device with continuous-flow oxygen dispensation and a portable device with pulse dispensation for ambulation. METHODS: This crossover trial assessed 25 subjects with COPD (92% men, mean age of 72.2 ؎ 7.4 y, mean FEV 1 of 34.14 ؎ 12.51% of predicted) at 4 hospitals in Madrid. All subjects had previously used the combined system, consisting of a fixed oxygenation system and a portable system for ambulation, with 16 (64%) using stationary and portable concentrators and 9 (36%) using a stationary reservoir and portable liquid oxygen bag. Oxygenation settings at rest and while walking were determined at baseline. Subjects were maintained on the previous combined system for 1 week and then switched to the portable oxygen concentrator for 1 week. Mean S pO 2 over 24 h was calculated using the software in the oximeter, and compliance was monitored (Visionox). RESULTS: Low S pO 2 (< 90%) was significantly more frequent during use of the portable concentrator alone than with the combined system (37.1% vs 18.4%, P < .05). The portable system alone was preferred by 43% of subjects, and the combined system was preferred by 36%, whereas 21% were not sure. CONCLUSIONS: Subjects preferred using a single portable oxygenation system both at home and during ambulation. Portable systems alone, however, did not supply the same levels of oxygenation as the combination of fixed and portable systems. Before the widespread adoption of portable systems as a single device, additional studies are needed to determine best-practice protocols for adjustment of daytime and nighttime oxygenation settings. (ClinicalTrials.gov registration NCT02079753)

Comparison of pulsed versus continuous oxygen delivery using realistic adult nasal airway replicas

“… 3 , 4 A recent study showed that chronic obstructive pulmonary disease (COPD) patients requiring LTOT generally prefer a single source POC over a combined stationary and portable oxygen source both in the home and during activity, citing the practicality of the system as its main advantage. 5 …”

Contemporary portable oxygen concentrators and diverse breathing behaviours -- a bench comparison

“…But as noted by Chatburn et al [24], a key consideration in achieving efficacious therapy of any oxygen therapy “is not whether a person desaturates at night, but why they desaturate”. And despite the controversy, the ambition for the POC category is evolving towards a single-device for home and ambulation, as experience grows with nocturnal pulsed oxygen delivery and in response to user preference [24, 31, 32].…”

An in silico analysis of oxygen uptake of a mild COPD patient during rest and exercise using a portable oxygen concentrator

“…In another study, POCs alone did not supply the same levels of oxygenation as the combination of fixed and portable systems. 17 Furthermore, as described by McCoy 1 and others, 18 it is not clear how the wide variety of models and setting available on modern POCs affect patient oxygenation and adherence. Thus, we believed that a fundamental study of the interaction of patient physiology with the output of a real POC could provide guidance for future developments in device design and patient management.…”