The Science Journal of the American Association for Respiratory Care

2005 OPEN FORUM Abstracts

MOBILITY, REMOTE ACTIVITY & POWER SUPPLY UTILIZATION AMONG OXYGEN DEPENDENT PATIENTS USING A LIGHTWEIGHT PORTABLE OXYGEN CONCENTRATOR SYSTEM

James Stegmaier RRT-NPS, RPFT, CCM, Health Aid of Ohio, Cleveland, Ohio

Background: The standard of practice for ambulatory home oxygen systems is based on recommendations from the 1999 Fifth Consensus for Long Term Oxygen Therapy conference, which suggest that all ambulatory/portable oxygen systems weigh less than 10 lbs. and provide the equivalent of 4 hours of oxygen at 2 liters per minute (lpm). This standard was developed via expert consensus; based around serving ambulatory patient needs within the functional limitations of small compressed gas or liquid oxygen systems, which were the standard ambulatory oxygen systems available in 1999. We hypothesized that a new portable oxygen concentrator (POC) technology, which weighs less than 10 lbs. and operates from numerous power sources, including AC, DC and an internal lithium ion battery (capable of 2-3 hours of remote use) may provide improved ambulation and mobility among active oxygen patients. An effectively employed POC may greatly exceed the suggested standard of 4 hours of remote/ambulatory oxygen use.

Method: Ten active, ambulatory and clinically stable home oxygen therapy patients were selected to participate in the study. All patients had current prescriptions for 24-hour home oxygen therapy (1-3 lpm) and utilized oxygen in their residence > 1 year. We selected the Inogen OneT (Inogen, Inc., Goleta, CA) as the POC because it weighs approximately 9.7 lbs., operates on all required power sources, uses in integrated oxygen conserving device (OCD) and is designed to function as both a stationary and portable oxygen system. All patients were appropriately titrated to the POC-OCD, insuring a SpO2 of ≥ 92 % during all activities. Each patient was instructed to keep a detailed diary of their ambulation and activities outside of the home for a 2-week period. Data recorded in the diary included the patient's specific activity, the device O2 setting, the power supply operating the POC and the length using the power supply. Results: All patients tolerated the POC as their home oxygen system. Data reported in the table below reports the total hours of use during ambulation or travel by power source, along with mean results (SD):

Patient O2 Setting AC Power Use DC Power Use Internal Battery Use
1 2.0 22.50 0.00 1.50
2 2.0 20.25 0.50 0.50
3 3.0 23.00 0.00 0.25
4 2.0 19.75 2.00 2.25
5 1.5 17.25 3.50 1.75
6 2.0 21.50 0.25 2.00
7 2.0 24.00 0.00 0.00
8 2.5 21.25 0.25 1.00
9 1.0 21.75 0.50 1.75
10 2.0 19.50 0.25 1.50
Mean (SD) 21.08 (2) 0.73 (1.1) 1.25 (0.8)

Conclusion: Data from the patient diaries indicated that ambulation and mobility was effectively achieved using all 3 power sources. Despite significant ambulation during the study period (mean = 23.05 hrs), AC power was the primary power supply used (91.4%) followed by internal battery (5.4%). Diary data suggests actual internal battery use occurred multiple times per day with a mean of ~15 min. per use. All patients stated that 2-3 hour battery duration did not prevent participation in any activity and none expressed difficultly finding adequate AC or DC power to operate the POC while in the community. These results suggest a POC capable of operating from various power supplies, including an internal battery, may prove to be an ideal oxygen system for clinically appropriate, active and ambulatory home oxygen patients. Further investigation among a larger cohort may prove beneficial, helping to validate these preliminary findings.

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