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What Is an Oxygen Concentrator and How to Shop for One?

Some health conditions affect breathing, and the usual course of action is to employ medical devices to sort this problem. One of these devices is an oxygen concentrator. What is it, and how does oxygen concentrator differ from other similar machines? Where and how to buy one? Read on to get answers to these questions.

What is an oxygen concentrator?

An oxygen concentrator is a medical device created specifically to deliver extra oxygen to patients with breathing-related conditions. Patients with lower-than-normal oxygen levels in the blood usually need an oxygen concentrator to compensate for that oxygen.

The history of oxygen concentrators started back in the 1800s, just a couple of decades after oxygen as an element was discovered. A little reminder, Carl Wilhelm Scheele, a Swedish-German pharmaceutical chemist, discovered oxygen[i] around 1773. He was the first person to describe the properties of oxygen but also participated in the discovery of other elements, including tungsten, molybdenum, hydrogen, barium, chlorine, just to name a few. However, Scheele was slow to publish his discovery which is why English chemist, Joseph Priestly, published his findings three years before Scheele did, even though Priestly discovered oxygen molecules in 1774. The world of science still recognized Scheele's work and contribution, and he is rightfully credited to this day as the first person who learned what oxygen is and described how it works.

Since the discovery of oxygen, it took scientists some time to understand how this element can help patients with certain health conditions. The first-ever use of oxygen for medical purposes was recorded in 1885 on a patient with pneumonia. Two years later, in 1887, the very first device that stored sufficient amounts of oxygen for intermittent usage was invented and sold.

The next breakthrough in the use of oxygen for medical purposes occurred in 1917. Before that point, the nasal catheter was employed to form a connection between the patient and the oxygen. In 1917, however, Scottish physician John Scott Haldane invented a gas mask for the protection and treatment of soldiers who had been exposed to chlorine gasses during WWI. Haldane is today considered the father of oxygen therapy.

Around the 1950s, the first-ever portable medical oxygen therapy was created. These units are used only for emergencies and in ambulances. They weren't lightweight and portable.

The next few decades faced advancements in this field. From the 1970s on, patients could have their own oxygen therapy device at home. These oxygen tanks were a lot larger than the machines used today. From that point, there were efforts to decrease the size of these units and ensure they were portable[ii]. Today, oxygen concentrators can weigh as little as a few pounds.

How does the oxygen concentrator work?

An oxygen concentrator is a safe source of air enriched with oxygen. Also referred to as oxygen generators, these devices work to "drag" room air through filters and thereby remove bacteria, dust, particles, and other impurities.[iii].

The first part of the oxygen concentration process involves forcing the air into one of two cylinders. The cylinders contain semi-permeable membranes or sieve material that serves to absorb nitrogen. This leaves oxygen that is concentrated 90% or higher and a very small amount of other gases present in ambient air. Simultaneously with the absorption of nitrogen in one cylinder, the other cylinder desorbs it and draws it out into the atmosphere.

The second part of the oxygen concentration process revolves around the reversal of cylinder function in a timed cycle to allow for continuous oxygen flow to the patient.

Based on their functionality, we can divide these devices into two categories: low-flow and high-flow oxygen concentrators. The low-flow oxygen concentrators provide oxygen flow of 0.5-5 l.min-1, whereas high-flow units provide oxygen flow of up to 10l.min-1.

In other words, the main job of an oxygen concentrator is to take in air to separate the oxygen. Then, it delivers oxygen through a nasal cannula to the patient. Air consists of 21% of oxygen and 79% of nitrogen. An oxygen concentrator is plugged into the electricity source and works to deliver air that is 90% oxygen or higher[iv], up to 95%.

When is an oxygen concentrator necessary?

External device that supplies pure oxygen alleviates the burden on the lungs in respiratory infections that make oxygen saturation levels go under 90%. However, more severe respiratory illnesses require oxygen, whose purity goes up to 99%. In these instances, an oxygen concentrator may not be a suitable choice.

Both acute and chronic conditions that induce breathing problems may require the use of an oxygen concentrator.

Conditions requiring the usage of oxygen concentrators include:

•     Asthma - a long-term disease indicated by inflammation of the airways in the lungs. About 25 million Americans have asthma which equals to one in three Americans or 7% of children and 8% of adults[v]. Even though various pharmaceuticals can control or manage asthma, an oxygen concentrator pumps high oxygen levels into patient's bloodstreams while they're experiencing an asthma attack or already had one

•     Bronchopulmonary dysplasia - or BPD, is a type of chronic lung disease that primarily affects prematurely born infants. The lungs and bronchi (airways) are damaged in babies with BPD. This damage causes dysplasia or tissue destruction in alveoli

•     Chronic obstructive pulmonary disease (COPD) - a group of diseases that cause blockage of airflow and problems with breathing. COPD affects about 16.4 million people in the US or 6.6% of adults[vi]. When a patient has COPD, they have chronic damage of the lungs. In turn, lungs are unable to absorb enough oxygen, and a patient experiences breathing difficulties. Oxygen concentrator helps provide oxygen and improve breathing

•     Cystic fibrosis - an inherited illness that causes accumulation of sticky mucus in the digestive system and lungs. A patient experiences problems with digestion and develops lung infections

•     Lung cancer - it is estimated 235,760 new cases of lung cancer will be diagnosed[vii] in the US in 2021. Patients with advancing disease usually need oxygen therapy in the form of a cylinder or concentrator

•     Pneumonia - a swelling or inflammation of tissue in one or both lungs. Bacteria infection is the most common culprit for pneumonia. Viruses such as COVID-19 can also cause pneumonia. The infection causes inflammation of alveoli, air sacs in a patient's lungs. These alveoli then fill up with pus or fluid and cause breathing difficulties. Many patients with pneumonia are prescribed oxygen therapy.

•     Respiratory distress syndrome - or RDS for short, a breathing disorder that affects preterm newborns primarily. The condition occurs due to the accumulation of fluid in alveoli. The fluid prevents the lungs from filling with a sufficient amount of air. As a result, oxygen levels that reach the bloodstream are low. Organs don't function properly because they need oxygen to "work." An oxygen concentrator has the potential to pump oxygen into the bloodstream and lungs of a baby and decrease complications linked to RDS.

•     Sleep apnea - a sleeping disorder where breathing stops and starts repeatedly. The most common treatment approach is the use of continuous positive airway pressure (CPAP), physical exercise, and weight loss, but some patients may need oxygen therapy too.

Besides the abovementioned health problems, an oxygen concentrator is also used for patients who develop breathing difficulties due to other illnesses such as COVID-19 or flu.

What is the difference between an oxygen concentrator and an oxygen cylinder?

The main difference between oxygen concentrators and cylinders is in the mechanism of action. You see, a concentrator works to purify the air for patients with a low level of oxygen in the blood and experiencing breathing difficulties. The concentrator needs to be plugged into the source of power to work. Cylinders achieve the same effect, but oxygen is already compressed in the tank. The oxygen supply in the tank gradually decreases until it runs out. Then, it is necessary to refill or replace the tank. While the use of oxygen cylinders is widespread, the costs and logistics are more in favor of concentrators, particularly in developing countries that experience problems with cylinders supplies.[viii].

It is important to mention oxygen cylinders are still the most common delivery method of medical-grade oxygen to patients who need it. Tanks are usually made from aluminum or steel. They store compressed or liquid oxygen. However, concentrators don't store oxygen; they deliver air in an intermittent or continuous flow.

How to shop for an oxygen concentrator?

First things first, an oxygen concentrator is a medical device and can only be used or purchased with a prescription from a doctor. Prescription is necessary to ensure the patient gets a concentrator that suits their needs. The only evidence that describes those needs is the prescription.

When buying the oxygen concentrator, it's important to consider the following:

•     Power consumption - in order to work, the oxygen concentrator needs a power supply. Therefore, it is important to take power consumption into consideration when you're looking to buy this device. Different devices require different amounts of energy. Determine whether power consumption is too high or not. However, you shouldn't go for the machine with the lowest power consumption for the sake of it. The prescription may lead a patient to buy an oxygen concentrator with bigger power consumption.

•     Weight - oxygen concentrators come in different weight options. Heavier devices are suitable for home use, whereas lightweight options are portable. When purchasing an oxygen concentrator, it's useful to think about the intended use and purpose to choose the weight accordingly.

•     Liter flow - most people with oxygen concentrator prescriptions, need to use a device with a two-liter flow or less. That being said, some patients may require higher liter flow. Patients should discuss this subject with their doctors to determine the most suitable liter flow before they purchase this device.

•     Noise level - as mentioned above in this post, oxygen concentrators work by taking in ambient air and purifying it. This process isn't exactly silent. Some concentrators are louder than others. Make sure the noise level is suitable for your needs and the overall ambient.

•     Warranty - like other machines and devices, oxygen concentrators come with a warranty. The warranty policy varies from one manufacturer to another. Before buying an oxygen concentrator, make sure to check the warranty policy and everything it covers

•     Compatibility with humidifiers - in some patients, the oxygen may dry out their nose. When that happens, the patient could benefit from connecting the concentrator to a continuous humidifier. Humidity can add moisture to dry gas, but not every concentrator is compatible with a humidifier, so it's important to check before you buy. Of course, if you don't have these issues, then this factor shouldn't play a role in the decision-making process.

•     Brand - not all brands are the same. Some are better than others or offer concentrators with slightly different features than their counterparts. When shopping for an oxygen concentrator, it can be useful to check out different brands, compare them, and see what's best for you.

•     Budget - just like the brands are different, so are the costs. You shouldn't go for the cheapest option on the market. However, you may want to compare the prices and whether they match the quality of a device.

Where to buy an oxygen concentrator?

Choosing the right supplier of an oxygen concentrator is equally important as other factors in the shopping process. The goal is to purchase the concentrator from a reliable, reputable supplier. That is the best way to buy a high-quality device and be confident in its functionality. There are numerous suppliers around, but one name stands out - Betty Mills Company. Founded in 2002, Betty Mills has become America's favorite medical supplies provider thanks to quality devices as well as fast and friendly service.

What are the best oxygen concentrators to buy?

Betty Mills Company offers several oxygen concentrators made by reputable brands. One of these brands is Invacare, a well-known Ohio-based manufacturer and distributor of medical equipment. Their concentrators include:

•     Platinum 10 Oxygen Concentrator - one of the biggest advantages of this device is quiet operation. Created as an alternative to liquid systems, Platinum 10 delivers continuous oxygen up to 10 LPM (liters per minute). For easy handling, the device features a top handle and bottom recesses. Dimensions of this concentrator are 27" H x 19" W x 15" D, and it weighs 54lbs. Additionally, Platinum 10 is compatible with Invacare HomeFill Oxygen System.

•     Perfecto2 V Oxygen Concentrator - compact, 5-liter concentrator created specifically as an economical option in the series of concentrators made by this brand. The device is quiet and lightweight (40lbs). Like the abovementioned device, Perfecto2 has a top handle for easy portability. It operates with a pressure-based system, which is dubbed superior to the timing-based counterparts. The concentrator comes with self-diagnostic electronics that minimize troubleshooting time. Dimensions of this device are 23"x13"x12," and oxygen purity ranges between 95.7% and 87% at all flow rates.

•     Platinum Mobile Oxygen Concentrator - an easy-to-use device featuring five flow settings and a rugged design. It comes with top loading batteries with hot-swap capability. That means it's easy to replace the batteries on the go without interrupting oxygen flow or having to remove the bag. A carrying bag is versatile and can be transformed into a messenger bag, backpack, or handbag. The oxygen purity of this concentrator is 87% to 95.6%, and it weighs 5lbs only (without a carrying bag). The concentrator is quiet and practical. Batteries run for up to five hours, and their recharge time is two hours and 20 minutes. Besides a single-battery concentrator, there's also the same device with dual batteries.

Other well-known brands of oxygen concentrators available at Betty Mills include DeVilbiss. Their iGo Portable Oxygen Concentrator is designed to help people maintain an active lifestyle. This 3-liter portable oxygen concentrator features two types of operation. One mode is PulseDose delivery, while the second mode is a continuous flow of oxygen. The device comes with a built-in oxygen sensing device that ensures accurate delivery of oxygen and decreases periodic maintenance schedule. Together with the battery, the device weighs less than 20lbs. Batteries charge quite quickly (in 2-4.5 hours, depending on the flow setting). A similar device is made by Drive Medical too.

Shopping for an oxygen concentrator at Betty Mills is easy. There's plenty of info about each device, and it's not that difficult to determine whether a patient could benefit from a specific concentrator. Besides standard info like mode of operation, dimensions, and weight, you can also get informed about warranty, noise level, and other useful characteristics.

Conclusion

Patients with certain health problems may experience difficulty breathing. In these cases, oxygen therapy can be helpful. Oxygen concentrators are safe, easy to operate, and effective means of oxygen therapy. These devices range in weight, and there are plenty of portable, battery-operated options on the market. Oxygen concentrators work by taking air from the room, i.e., ambient, and purifying it so the patient can get air with over 90% of oxygen. All they need is electricity to do their job or batteries. When buying an oxygen concentrator, make sure to check air purity, dimensions, modes of oxygen flow, and noise level. Purchase a device that matches your prescription the most.

References



[i] West JB. (2014). Carl Wilhelm Scheele, the discoverer of oxygen and a very productive chemist. Lung Cellular and Molecular Physiology. 307(11):811-816. https://doi.org/10.1152/ajplung.00223.2014

[ii] Learn about the history of oxygen therapy and oxygen concentrators technology. OxygenConcentrator Store https://www.oxygenconcentratorstore.com/history-of-oxygen-therapy/

[iii] Hardavella, G., Karampinis, I., Frille, A., Sreter, K., & Rousalova, I. (2019). Oxygen devices and delivery systems. Breathe (Sheffield, England)15(3), e108-e116. https://doi.org/10.1183/20734735.0204-2019

[v] Asthma facts. Asthma and Allergy Foundation of America https://www.aafa.org/asthma-facts/

[vii] Key statistics for lung cancer. American Cancer Society. https://www.cancer.org/cancer/lung-cancer/about/key-statistics.html

[viii] Dobson M. B. (2001). Oxygen concentrators and cylinders. The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease5(6), 520-523.