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A patient's perspective
of POC's, Portable Oxygen Concentrators
By Roxlyn G. Cole
"Lyn" Age 69. I was diagnosed with COPD on
Valentine's Day 2003. Components included small amount
of bronchitis & asthma, but the largest factor is
bullous emphysema. Categorized as borderline
mild/moderate obstruction: FEV1/FVC ratio = 57%, DLCO
-diffusion, circa 60%. That means obstructed airways AND
trouble getting oxygen from the lungs into the blood.
Supplemental O2 24/7 = my energy and lifeline.
Last summer 2007, as a volunteer working for a
magazine, I accepted the assignment to evaluate several
portable oxygen concentrators, they were generously on
loan from Respironics and Inogen Inc. The third one, a
SeQual Technologies Eclipse, belonged to me. The FAA had
recently approved use of these newly developed portable
oxygen concentrators. I tested this collection of
POC's, using them with several oxygen delivery systems:
cannulas, Oxyview Glasses
www.oxyview.com , and also with a
TTO Scoop, (delivery of supplemental O2 through the neck
direct into the trache)
www.tto2.com ) I was able to close off
my tto and use a cannula for testing purposes. Since
I live at almost 5500 ft elevation, my oxygen
needs are generally higher (as would patients needs be
greater on an airplane pressurized to 8500 ft.
My recommendations:
Hold off! Delay purchase of these big ticket items
until you can try them out while walking, or better
yet, while exercising. Be sure the machine of your
choice provides the Oxygen necessary to maintain your O2
saturation at an adequate level while you go up in
altitude. Testing at lower altitudes will not
demonstrate how well a machine will work for you in an
airplane, where generally the cabin air is pressurized
between 5500-8500 ft.
Consider your needs. Consult with your doctor
about sleeping with pulse dose delivery. Do you use a
CPAP or Bipap? These do require constant flow, and
do you need a humidifier bottle? I do especially with a
TTO. It is said one can sleep on pulse mode, but in my
experience, this disturbed my sleep.
Settings are just a number, we shouldn't
expect the same results from a number on the dial of a
different type machine. Setting numbers on POC's
do not mean liters like on your liquid or compressed gas
O2 portables. POC's deliver around 90 % (+/-3%)
oxygen...and Liquid O2 or compressed gas O2 is 99% pure.
Only the Eclipse has a setting equal to liters on its
constant flow setting.
POC'S help MANY patients, but there are Exceptions:
If a patient requires 3 L at sea level just to sit,
oxygen needs might not be met with moving
around on the airplane/at altitude.. I believe from
my experiences in Colorado altitude, that if a patient
requires 3 liters per minute for slow moving or sitting,
they should be certain that the # 4-5-6 settings will
work for them as they move about. If 4-6 barely works at
sea level it is probably NOT going to keep one at
adequate O2 saturation levels at 8500 ft altitude.
Keep in mind this major factor; my tests were done at
altitude.
Also realize you might have very different results in
the oxygen saturation levels you achieve.
Patient's all have different oxygen saturations because
of individual differences /components of their disease.
OBSERVE the TREND of the delivery numbers in my
charts that show more or less for each machine and note
the number setting. # 1 or # 2 didn't do much for me.
Two Nonin oximeters were used during testing: Medical
prescription "Onyx II" and the "Sportstat" for mountain
climbing. Both read out the same or within 1 % point.
Charts e-mailed upon request:
roxlyngcd@comcast.net
or they can be viewed on my Pulmonary Rehab Advocate
blog.
http://360.yahoo.com:80/roxlyngcd
Instruction manuals: There is much to remember,
many signs/symbols to recognize, and certain warning
alarms sounds that must be understood. The
conditions of operation must be recognized, too cold or
too hot to use, all machines are different. Bob
McCoy of Valley Inspired Products put it the right way
by saying these machines like to be in the same
environment that YOU prefer. Chilling or roasting in a
car is "detrimental" to its operation. Each POC has a
different temperature range for use or storage, and a
warm-up time for building up to their max level of
oxygen purity for delivery.
Warm up times can be as little as 5
minutes for the Eclipse, 10 minutes for the
Evergo, and up to 30 minutes for the Inogen. That
30 minutes surprised me, so an additional plan is to
have it warmed up before you leave the house in order
for it to provide oxygen delivery up to specs. ALWAYS
have a manual with you.
Weight: NONE of these POC's would easily be
carried in hand for any *appreciable* length
of time... at least I wouldn't want to carry
them. All were best in their carts, 12+ lbs gets heavy
fast. Lifting the Eclipse (close to 20 lbs including its
cart) in and out of the car wasn't difficult for me. The
Inogen with accessories in the attached bags is around
the same weight. The Evergo is some what easier to lift
into the car. A frail patient might have difficulty
lifting these into a car. Just one more good reason to
exercise with small weights to build strength.
The Inogen One: pulse only, has an extra accessory to
allow 100 ft. of tubing. This "satellite conserver"
boosts the oxygen for the longer tube length and may
cost an additional $295.00 to $495.00. It
attaches to one's belt or hangs around the neck. I found
it a nuisance, it would slip off its belt clip, but, it
did work extremely well in delivering the oxygen 100 ft.
With a TTO, this satellite "booster" had such a hard
pulse as to be a tiring pulse impact in my neck.
Professional test charts indicate the Inogen One
delivers the lowest quantity of O2 per pulse. Currently
it is the most expensive POC. In this group it is the
quietest one.
The Evergo: pulse only, will work with 30 foot tubing
without any extra accessory. . It is a great rugged
little machine, easy to use. Holding 2 batteries
internally it lasts longer without battery changing (up
to 8 hours on #2), and delivers a better quantity of
oxygen per pulse. It is lighter weight, and much less
expensive than the Inogen. If I didn't need the constant
flow at night I would seriously consider this machine.
If I had a constant flow oxygen source at my destination
I would use the Evergo, because of the smaller, more
compact size, easier to store under the seat on an
airplane. I even carried it in a backpack, but it is
somewhat noisy for that close up to it.
The Eclipse: both PULSE and constant flow, can use 50
ft. tubing without any special accessory, just a press
to change to its CONSTANT FLOW setting, and, it delivers
1- 3 full Liters CONSTANT flow - whether on a 7 ft.
cannula or 50 feet of tubing. Pulse setting 1-6, will
conserve oxygen use, making battery operation last
longer, however, I found that on # 6 Pulse dose the
battery lasted approximately the same duration of time
as on 3 L on constant flow.
This machine has the largest and best quantity of
oxygen per pulse. It is the least expensive in this
group, and the cart design with large wheels allows it
to go where the other small wheels drag. Its only
drawback is larger size and weight, which with wheels,
it doesn't matter. It will deliver more oxygen to
maintain better blood oxygen saturation (sats).
WONDERFUL for me! It hums on different settings, fits in
with room sounds.
All POC's offer the wonderful option of recharging
when there is access to an A/C-wall plug, or while
in your car on the car battery. This is
FREEDOM, because you can be in a traffic jam, delayed
waiting for an appointment, or just change plans and
stay over night with the portable oxygen
concentrator…the POC, really is a package of freedom.
Some potential problems would include: inability
to recharge it, a long electrical outage, no wall plug
or car battery handy, or malfunction.
HAVE BACKUP Oxygen available even with these
POC's. I store a few compressed gas E cylinders in my
car, and a small over the shoulder sling carrier with a
small compressed gas bottle. The beauty of compressed
gas O2 is it doesn't evaporate.
I found that after a while, I only used the POC unit
for travel or a very long day out of the home, when I
was uncertain of return time. Small Liquid or compressed
portables are more quiet, lighter weight, but they do
run out, and they aren't allowed on air planes. Thus,
the need for FAA approved POC's for air travel. These
machines in my opinion qualify as a luxury item, unless
you travel very frequently.
At home my preference is to use my liquid oxygen
reservoir. It is quiet, cool and doesn't increase my
electric bill. The POC's do run more efficiently than
the larger older stay at home concentrators.
I am so glad I have one, for ground travel and just
in case I fly someday.
Lyn
Roxlyn G Cole,
roxlyngcd@comcast.net
http://360.yahoo.com:80/roxlyngcd
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