Home Oxygen Therapy is a medical treatment for patients suffering from chronic lung diseases. It involves the use of an oxygen concentrator to deliver oxygen via a nasal cannula or face mask to the patient and some may require being tethered to the machine on a constant basis. COPD is an umbrella term for these conditions and patients have restricted airflow through the lungs and experience coughing, wheezing and shortness of breath. The effect on quality of life can be significant and some are unable to participate in physical activities and require help to move. Home oxygen therapy aims to improve the patient’s freedom, health and quality of life by allowing treatment at home. Patients are encouraged to try and maintain a certain level of activity as research has shown that if exercise and mobility are retained then lung capacity and respiration improves.
However some patients find this difficult as they are tethered to a pressurized oxygen container via tubing and the weight, which is typically 4kg, can make transporting and lifting awkward especially for the more elderly patients. Some patients use a small hand cart to transport their equipment around or use a portable unit which they can carry over their shoulder. Despite the huge benefits of H.O.T it still imposes restrictions on the user’s movements, mobility, ability to participate in certain activities and quality of life.
A Follower Robot has been devised to help improve these patient’s lives. The robot can carry the equipment thereby reducing the physical burden and increasing freedom of movement. It is capable of following the patient’s movements and can follow behind the patient. It is simple to use, low weight, compact and at a low cost.
They have started testing these robots on H.O.T users to see if they are indeed beneficial and can aid them in their daily activities efficiently. Most users have found the robot easy to use and to manoeuvre with. It is hoped that after more trials are completed it can be manufactured and sold commercially for COPD patients. These robots could drastically improve patient’s lives allowing them to easily move around and enjoy more out of life which could have a positive effect on their health also. More importantly, how amazing would it be to have your own robot?!
References: http://www.robomechjournal.com and http://link.springer.com
When the people at iFixit took the new Apple Watch apart they found something strange, there wasn’t the expected optical module you usually find to measure your blood flow rate but there is a pulse-oximeter which can measure your oxygen levels.
It works by shining a light through your skin and it measures changes in your blood flow. As your pulse increases it changes the light transmission through the skin which a sensor measures. Additionally it can test how oxygen levels affect the way your blood interacts with light. The more oxygen in your blood, the brighter the red of the blood and the more infrared light it absorbs.
This component is currently disabled in the Apple Watch for unknown reasons but it looks as if Apple hope in the future to allow their customers to be able to monitor their own blood oxygen levels.
Being able to do this would be incredibly useful for a lot of people. If you’re hiking you can get a better sense of how you’re adapting to high altitudes, an athlete can monitor their performance and those with medical conditions such as asthma can instantly see if their oxygen levels are dropping. For those using oxygen at home you could simultaneously see if the oxygen that you are breathing in is improving your oxygen levels. A record of your data would be stored as your activities alter throughout the day and your doctor could use these results to help improve your treatment.
There is a danger that people may use the device as a self-diagnostic tool with regards to their health. This may be one of the reasons that Apple has left it disabled for now. Also perhaps there are issues with the accuracy of the measurements. It may be that arm hair, sweat and dirt could prevent the infrared light sensors from being accurate enough.
The possibility that very soon in the future we may have yet another helpful device to help monitor our health at home is exciting and good news for many suffering chronic respiratory diseases. It would be a helpful way for many to understand how their disease affects their respiration throughout the day and enable them, with their doctor’s help, to react quickly to changes in their blood oxygen levels to improve their health and quality of life.
References: http://thenextweb.com and http://venturebeat.com
A new study conducted by Jonathan Stamler, a professor of medicine at Case Western Reserve University School of Medicine in Cleveland, OH, and colleagues has shown that the respiratory cycle involves three gases and not just two. He says their findings will transform our understanding of the respiratory cycle and could save lives as it will alter our treatments of various associated diseases linked to the respiratory system and also affect blood banks.
The current understanding is that the respiratory cycle uses blood to transport two gases – oxygen and carbon dioxide. Red blood cells pick up freshly inhaled oxygen from the lungs and carry it to cells in the tissues of the body; and then they bring back carbon dioxide as a waste product to be exhaled from the lungs.
However their study has proven that without the presence of Nitric Oxide it doesn’t matter how high the oxygen level is, the cells cannot accept the oxygen without it. The researchers show how nitric oxide controls the blood flow in small blood vessels inside tissue in a process known as “blood flow auto regulation.” It is the Nitric Oxide that controls the release of oxygen from red blood cells into the tissues that need it. Haemaglobin in the Red Blood Cells needs to be also carrying Nitric Oxide to enable blood vessels to open and to supply the oxygen it is carrying to the tissues.
Prof Stamler says “Within the tissues, the tiny vessels and the red blood cells together make up the critical entity controlling blood flow. Red blood cell dysfunction is likely a hidden contributor to diseases of the heart, lung and blood such as heart attack, heart failure, stroke and ischemic injury to kidneys.”
If you suffer from a condition where there is a lack of oxygen uptake to your cells, it may not be the answer just to increase the oxygen supply, but to also look at whether your Red Blood Cells are functioning correctly and if there is an adequate Nitric Oxide supply. Then if necessary treat the Red Blood Cell problem in conjunction with oxygen therapy.
The study also has implications for blood transfusions. Recent evidence shows that blood transfusions lacking nitric oxide have been linked to higher risk of heart attacks, disease and death. It’s not enough to just increase oxygen content of the blood via a blood transfusion. If the Nitric Oxide mechanism is failing then the oxygen will not be able to make it to its destination. Blood in blood banks are known to be deficient in Nitric Oxide and transfusing this blood may actually make things worse by plugging up blood vessels in tissues and to solve this the nation’s blood should be replenished with Nitric Oxide.
It may be the case that many sufferers on oxygen therapy in the future could be helped and treated even more by investigating their Nitric Oxide levels, as there could be additional failings in their respiratory system that could be investigated and more successfully treated.
References: http://www.medicalnewstoday.com and http://www.sciencedaily.com
Cigarettes on their own are the leading cause of house fires, but add to this the risk of oxygen being stored in the home and the danger dramatically increases.
Over the last few years there have been a staggering number of reports of people on home oxygen therapy being admitted to hospital with facial burns, eyebrows and hair burned off, death, smoke inhalation injuries and fire damage to their homes in the thousands of pounds. These occurred because they or a friend/family member were smoking whilst the patient’s oxygen equipment was in use.
However, do not interpret this to mean that oxygen therapy is something to be afraid of, it just needs to be respected.
General Advice when using oxygen equipment:
• If you’re on oxygen, DO NOT smoke.
• If you live with or visit someone on oxygen, DO NOT smoke around them.
• Stay away from open flames, sparks, and gas (including gas stoves).
• Turn the oxygen off while not in use.
• Avoid petroleum-based products.
• Do not use aerosol sprays nearby.
• Comply with all safety instructions provided by your home medical equipment company.
• Keep your oxygen concentrator in a well-ventilated area.
• Never allow the tubing, cannula, or mask to be covered, as it can result in a build-up of concentrated oxygen.
• Keep the name and number of your home medical equipment provider in a prominent spot for reference.
• Post a sign stating ‘DANGER: No Smoking-Oxygen in Use’ for the benefit of engineers or visitors.
There are also health risks associated with smoking while on oxygen therapy. Smoking is the most common cause of many medical conditions associated with the requirement of oxygen therapy. Smoking got you here therefore it is highly recommended that you put as much effort as possible into trying to give up this harmful addiction, or to at least cut down. Smoking more will just continue to damage your lungs and increase the deterioration of your respiratory capability and make you increasingly more dependent upon supplemental oxygen. Using supplemental oxygen can improve your health and improve your medical condition but if you smoke you are hampering the possible medical benefits of the treatment.
There should be a respectful balance between your own lifestyle choices, your medical needs and the safety of yourself and others around you. Be aware of the dangers and make sure you take all possible safety precautions.
References: http://lambertshc.com and http://scienceblogs.com
Oxygen concentrators work on the principle of ‘rapid pressure swing adsorption’ which is where the Nitrogen is removed from the air using zeolite minerals which adsorb the Nitrogen, leaving the other gases to pass through and leaving oxygen as the primary gas. Once the oxygen is collected the pressure then drops which allows Nitrogen to desorb and be expelled back into the air.
An oxygen concentrator has an air compressor, two cylinders filled with zeolite pellets, a pressure equalizing reservoir and valves and tubes. During the first half-cycle the first cylinder receives air from the compressor, which lasts about 3 seconds. During that time the pressure in the first cylinder rises from atmospheric to a few times normal atmospheric pressure (about 20 psi) and the zeolite becomes saturated with nitrogen. As the first cylinder reaches near pure oxygen (there are small amounts of argon, CO2, water vapour, radon and other minor atmospheric components) a valve opens and the oxygen enriched gas flows to the pressure equalizing reservoir, which connects to the patient’s oxygen hose. At the end of the first half of the cycle, the air from the compressor is directed to the 2nd cylinder. Pressure in the first cylinder drops as the enriched oxygen moves into the reservoir, allowing the nitrogen to be desorbed back into gas. Part way through the second half of the cycle there is another valve position change to vent the gas in the first cylinder back into the ambient atmosphere, keeping the concentration of oxygen in the pressure equalizing reservoir from falling below about 90%. The pressure in the hose delivering oxygen from the equalizing reservoir is kept steady by a pressure reducing valve.
Portable oxygen concentrators
These have been around for decades, but older models were bulky, unreliable, and were not allowed on airplanes. Since 2000, manufacturers have improved their reliability and size and they now produce 1-6 lpm of oxygen. The portable concentrators plug directly into a regular house outlet for charging at home or hotel, but they came with a power adapter that can usually be plugged into a vehicle DC adapter. They are able to operate from the battery power as well for either ambulatory use, or away from a power source, or on an airplane.
Portable oxygen concentrators operate on the same principle as a home domestic concentrator, operating through a series of cycles. Air passes from the miniaturised air compressor and through the molecular sieve of zeolite granules, which adsorb the nitrogen. Some of the oxygen produced is delivered to the patient and some is fed back into the sieves to clear them of the accumulated nitrogen, preparing them for the next cycle. Through this process, the system is capable of producing oxygen of up to 90% consistently. The latest models can be powered from mains electricity supply, 12v DC (car/boat etc.), and battery packs making the patient free from relying on using cylinders & other current solutions that put a restriction on their activities and mobility due to time, weight, and size.
Most of the current portable oxygen concentrator systems provide oxygen on a pulse (on-demand) delivery in order to maximise the purity of the oxygen. The system supplies a high concentration of oxygen and is used with a nasal cannula to channel oxygen from the concentrator to the patient.
References: http://en.wikipedia.org and http://www.inogen.com and http://hme-business.com
There are many stories of patients being misdiagnosed and given treatment for asthma when in fact years later the patient is then diagnosed with COPD.
Pat Crowe was a healthy, active 39 year old but was told he had developed asthma and was given an inhaler. Over the next few years his health deteriorated, he grew dependent upon and overused his inhaler, suffered from side effects and eventually the inhaler wasn’t enough. Being so breathless meant his confidence plummeted, making him almost housebound.
‘I panicked about going outside and crossing busy roads because I was having trouble breathing and couldn’t move quickly.’
During bad spells and prolonged attacks he was also prescribed strong steroid pills, which caused side-effects, including a swollen face and hunger.
‘My wife became my carer, and my family were very scared watching me struggle to breathe,’ he says. ‘I didn’t even want to get out of bed and go down stairs because I was worried about getting back up. My life changed completely.’
It was only then that Pat’s consultant performed a spirometer test which confirmed that he didn’t have asthma after all but suffered from COPD, which explained why he’d found the condition impossible to control.
COPD is incurable and affects 900,000 people in the UK, usually above the age of 35, and an estimated 30,000 people die from it each year. Experts believe there are also more than two million undiagnosed cases.
Specialist advice is crucial when it comes to achieving an accurate diagnosis says Dr Kurukulaaratchy: ‘GPs need better awareness of these conditions. They both rank highly in hospital admissions, but if management is right early on, you can improve quality of life and possibly even life expectancy.’
Nick Hopkinson, honorary chest physician at the Royal Brompton Hospital, London, adds: ‘Asthma patients usually have normal lung function, but when they experience asthma symptoms or an attack their airways go into spasm, becoming narrow and inflamed. Then, after taking medication – usually an inhaler – their lungs return to normal. However, COPD patients have relatively fixed lung disease, so even on a good day they still have symptoms. Most of the damage isn’t reversible and progressively worsens.’
One major consequence of misdiagnosis is that patients could be given the wrong medication.
COPD patients usually start with bronchodilator inhalers to relieve narrowing of the airways and then go through a variety of drugs, starting with shorter-acting medications and moving to longer-acting ones, as the disease worsens, says Dr Kurukulaaratchy.
‘Research has shown steroids can lead to an increased risk of pneumonia (inflammation of lung tissue) in COPD patients, so this is a risk if they are wrongly labelled as having asthma.’
If the condition doesn’t improve, they can end up using a lot of steroids, which have side-effects such as weight gain, mood changes and osteoporosis.
‘If patients are told they have COPD but it’s asthma and they don’t have inhaled steroids, they won’t be able to control the disease – leaving them prone to worsening symptoms and even death from an asthma attack,’ says Dr Hopkinson. ‘We see 1,100 asthma deaths a year in the UK, often because they weren’t on preventer treatments.’
Also oxygen therapy treatment is a major component of COPD treatment which is prescribed by your doctor, so if you are misdiagnosed then you may not be prescribed oxygen as early as you should have been which can affect your health and long-term diagnosis as COPD damage to the lungs is irreversible.
If you have any doubts about your diagnosis then speak to your doctor or get a second opinion, just to be sure as your health is the most important thing.
Oxygen is vitally important to us; not just because we need to breath it but because of how versatile and widely used it is:
• Everyone would get sunburnt as oxygen makes up the ozone and normally helps to block out UV light.
• The sky would get darker during the day if there were fewer oxygen molecules to scatter blue light; the sky would appear less blue and more black.
• All engines that use internal combustion would stop working as oxygen is fundamental for combustion.
• All pieces of untreated metal would suddenly weld to one another, as usually the oxidation layer on the metal prevents this.
• Your inner ear would explode as you would lose 21% of the air pressure in an instant, as if you had been suddenly transported to high altitude.
• Any building made of concrete would crumble as oxygen helps to bind all concrete structures.
• Water is one third oxygen, without it the Hydrogen becomes a free gas and expands, thereby destroying all living cells and evaporating the oceans.
• The earth below us would disappear and we would free fall. The earth’s crust is made up of oxygen, about 45% so without it the majority of the earth’s crust would disappear from beneath our feet.