What is Home Oxygen Therapy?

What is Home Oxygen Therapy?

1. About Home Oxygen Therapy

A. Definition

Clinically, it is common to see some patients with chronic respiratory diseases (such as chronic obstructive pulmonary disease or cor pulmonale) and hospitalized, after treatment, the condition is basically under control, but because of chronic respiratory insufficiency, movement, shortness of breath, cyanosis, quality of life is low.

Such patients need to continue long-term oxygen therapy. In order to save costs and avoid nosocomial infections, oxygen therapy can only be performed at home, so it is called home oxygen therapy.

B. Adapted population

Home oxygen therapy is an important means of treating hypoxemia outside the hospital. It is usually suitable for home treatment of bronchial asthma, chronic bronchitis, emphysema, angina pectoris, respiratory failure and heart failure.

2. Classification

A. Classification according to the usage scenarios in the family

①Long-term oxygen therapy (LTOT): patients with chronic hypoxemia, use ≥15 hours a day;

②Mobile Oxygen Therapy (AOT): Supplemental oxygen is used during exercise or activity during the day, suitable for those who are not statically hypoxic but dynamically hypoxic;

③Night oxygen therapy (NOT): people who do not carry out oxygen therapy during the day and perform oxygen therapy at night;

④Short-term paroxysmal oxygen therapy: simple, intermittent oxygen therapy is needed to prevent hypoxemia in case of occurrence;

⑤ Soothing oxygen therapy (POT): Use oxygen therapy to relieve dyspnea in patients with end-of-life diseases and relieve their possible hypoxemia.

B. According to the classification of household oxygen supply devices

①Oxygen cylinder: There are 10L, 20L, 30L and other different specifications, especially suitable for patients who need large flow and high oxygen demand;

②Oxygen generator based on molecular sieve principle: Through nitrogen and oxygen separation technology, molecular sieve will absorb the air and filter out harmful substances in the air, so as to obtain purified oxygen that meets the medical oxygen standard. ~0.3MPa (ie 2~3kg), there is no danger of high pressure and explosion. 

At present, it is the most stable and widely used, and there are benchtop instruments with different flow rates such as 3L.5L. 8L. 10L. In recent years, the portable molecular sieve oxygen generator (POC) has developed rapidly, with pulse doses of 0.75L, 1L, 1.2L and other specifications (correspondingly equivalent to the continuous oxygen delivery of 3L, 5L, 6L by hand);

③Liquid oxygen tank: small and portable, suitable for going out to supply oxygen, the oxygen supply time is 6~8 hours

④Chemical oxygen production: The principle of producing oxygen by the reaction of two chemical reagents is gradually decreasing at present:

⑤Other ways: Portable oxygen chamber - the market has just started, oxygen bag - temporary emergency use in the family.

3. The role and precautions of home oxygen therapy

A. Function

①Relieve hypoxemia: when Pa0. reaches above 60mmHg Sa0, up to 85%~90%, basically can satisfy the organization metabolic needs;

②Relieve pulmonary hypertension caused by hypoxia, reduce polycythemia, reduce blood viscosity, reduce the burden on the right ventricle, and delay the occurrence and development of pulmonary heart disease;

③ Oxygen inhalation can relieve bronchospasm, relieve dyspnea, and improve ventilation dysfunction;

④Improve the patient's physique, improve sleep and brain function, improve exercise tolerance and quality of life;

⑤ Improve the prognosis and prolong life of patients with COPD;

⑥ Reduce the number of hospitalizations and save medical expenses.

B. Precautions

① Before inhaling oxygen, use a cotton swab dipped in water to clean the nostrils of the oxygen inhaler, and be careful not to drop the cotton swab in the nostrils;

②Be sure to adjust the flow before using it. Those who buy an oxygen concentrator should read the manual carefully before using it.

③ Reasonable selection of oxygen inhalation time: For patients with severe chronic bronchitis and emphysema/with clear lung function abnormality, pay attention to control the oxygen flow rate of 1-2 liters per minute, because high-flow oxygen inhalation will aggravate chronic obstructive pulmonary emphysema The accumulation of carbon dioxide in patients can cause pulmonary encephalopathy; for some patients, there is usually no or only mild hypoxemia, and short-term oxygen supply can relieve the discomfort of "shortness of breath" during activity, tension or fatigue;

④ Pay attention to the safety of oxygen use. When handling oxygen cylinders, it is necessary to avoid dumping and impact to prevent explosions. Therefore, oxygen cylinders should be placed in a cool place, away from fireworks and flammable materials, at least 5 meters away from the stove and 1 meter away from the heater;

⑤ The oxygen in the oxygen cylinder cannot be used up, and generally 1 kPa is required to prevent dust and impurities from entering the cylinder and causing an explosion when re-inflating;

⑥The stuffed nose, face mask, humidification bottle, etc. should be disinfected regularly.