With Advancements in Technology, Oxygen Therapy Is No Longer Limited to Medical Institutions—Choose the Right Home Oxygen Supply Equipment for You!

Purpose of Long-Term Oxygen Therapy (LTOT)

1. Increase and maintain blood oxygen levels to reduce tissue hypoxia.
2. Reduce the burden on the heart and lungs.
3. Improve quality of life and expand daytime activities and social interactions.
4. Decrease hospitalization rates and improve survival rates.
5. Alleviate nighttime hypoxia and enhance sleep quality.

Who Needs Long-Term Oxygen Therapy?

Patients who meet the following criteria and have been evaluated by a physician may require long-term oxygen therapy. The need for continuous or intermittent oxygen use should be assessed by a doctor.

1. Arterial oxygen pressure (PaO₂) ≤ 55 mmHg or arterial oxygen saturation (SaO₂) ≤ 88% while breathing room air.
2. Patients with specific diseases (such as pulmonary heart disease, congestive heart failure, or polycythemia with hematocrit > 56%) who have PaO₂ between 56–59 mmHg or SaO₂ ≤ 89%.

Types of Home Oxygen Supply Equipment

Doctors determine the best oxygen supply method based on the patient’s oxygen needs, mobility, financial situation, and living environment. The most common types of home oxygen supply equipment include:

1. High-Pressure Oxygen Cylinders:

   • According to the Ministry of Health and Welfare regulations, medical oxygen purity must be ≥99.0%.
   • Oxygen cylinders are typically made of iron or aluminum, with capacities ranging from 600 to 7000 liters.
   • Large cylinders are suitable for home use, while smaller ones can be carried.
   • Disadvantage: Requires frequent refilling or cylinder replacement.

2. Oxygen Concentrators:

   • Also known as oxygen generators, these devices extract nitrogen from the air using molecular sieves to increase oxygen concentration.
   • Different brands offer oxygen flow rates from 1–10 L/min, maintaining 87–96% oxygen concentration.
   • Some models include nebulization therapy functions.
   • Advantage: Easy to operate, suitable for home use.
   • Disadvantage: Cannot be used outdoors and will not function during power outages.

3. Liquid Oxygen:

   • Oxygen exists as a pale blue transparent liquid at -183°C.
   • 1 liter of liquid oxygen converts to approximately 856 liters of gaseous oxygen.
   • Stored in insulated low-temperature containers, it is lighter than gaseous oxygen for the same volume.
   • Advantage: Quiet and noiseless operation.
   • Disadvantage: Requires regular refilling and proper storage to prevent evaporation.

Common Side Effects of Oxygen Therapy

1. Nasal Mucosa Damage:

   • Prolonged inhalation of dry oxygen can cause nasal dryness, congestion, ulceration, nosebleeds, sore throat, and hoarseness.
   • Solution: Use humidification devices to moisten inhaled oxygen.

2. Skin Redness and Damage:

   • Long-term use of oxygen nasal cannulas may cause pressure sores on the cheeks or ears.
   • Some patients may develop allergic reactions to the nasal cannula or mask materials, resulting in redness and skin breakdown.

3. Uncorrected Hypoxemia:

   • Failure to follow medical instructions may lead to improper oxygen delivery, preventing patients from receiving the necessary oxygen levels.

4. Carbon Dioxide Retention:

   • In chronic obstructive pulmonary disease (COPD) patients, prolonged use of high oxygen concentrationscan suppress the respiratory drive, leading to carbon dioxide buildup.
   • Symptoms include headache, drowsiness, confusion, vivid dreams, or lethargy.

5. Oxygen Toxicity:

   • More common in patients receiving high-concentration oxygen (>60%) for extended periods.
   • Symptoms include chest tightness, chest pain, nasal congestion, coughing, shortness of breath, fatigue, and numbness in the hands and feet.
   • Most commercial oxygen concentrators provide mixed oxygen at around 40% concentration when inhaled.

Precautions for Home Oxygen Use

1. Follow Medical Instructions:

   • Do not stop using oxygen therapy or change the oxygen flow rate without a doctor's approval.

2. Ensure Proper Equipment Usage:

   • Check if tubing connections are correct.
   • Confirm if the humidifier bottle is bubbling.
   • Ensure the nasal cannula is delivering oxygen.

3. Equipment Maintenance and Troubleshooting:

   • Choose a professional and responsible supplier for regular equipment maintenance.

4. Keep Away from Fire:

   • Oxygen is highly flammable. Ensure the equipment is at least 3 meters away from flames and electrical sources for safety.

5. Proper Storage Positioning:

   • Oxygen cylinders should be stored upright in a secure location to prevent damage from tipping over.

6. Liquid Oxygen Storage Precautions:

   • Store in a cool, dry, well-ventilated area away from fire sources.
   • If spilled, do not touch—liquid oxygen can cause severe frostbite and tissue damage.

7. Cleaning and Disinfection of Oxygen Delivery Devices:

   • Nasal cannulas are disposable and should be replaced every 1–6 months without requiring additional cleaning.
   • Humidifier bottles should be refilled daily with sterile distilled water or boiled water and washed weekly with neutral detergent.

8. Monitoring Blood Oxygen and Carbon Dioxide Levels:

   • Regularly observe oxygen saturation and watch for symptoms of CO₂ retention.

9. Infection Prevention:

   • Seek medical attention if experiencing fever, chills, shortness of breath, wheezing, changes in sputum color or consistency, or leg swelling.

Reference:

AARC Clinical Practice Guideline, Oxygen Therapy in the Home or Alternate Site Health Care Facility — 2007 Revision & Update