Portable Oxygen Concentrators: The Chart and the Checklist...

May/June 2014 www.pulmonarypaper.org 11

This issue marks the fourth year

the Pulmonary Paper is publishing

its portable oxygen concentrator

(POC) chart. This year, we’re adding a

checklist of important questions to ask

before purchasing, renting or simply using

a POC.

POCs are seeing even wider acceptance

among oxygen users, home medical equip-

ment dealers and clinicians in the field.

Manufacturers have responded – POC avail-

ability is at an all-time high, with a majority

of current POC models being released within

the last five years. However, throughout

the home respiratory care spectrum there

remain many mis conceptions relating to

the performance capabilities and limitations

of POCs.

Perhaps the most important factor to

consider regarding POCs is that one size

does not fit all. Each POC has limited

oxygen production ability and, generally,

the smaller and lighter the POC is, the

smaller its production capacity is, meaning

it will meet fewer users’ needs than the

larger POCs. Since most oxygen users would

naturally prefer a smaller, lighter device,

manufacturers have made a con scious trade-

off in performance ability that allows for

the POC to be as little and lightweight as

possible while sacrificing oxy gen production

capacity, thereby limiting the total number

of users that could adequately oxygenate

on the device in some or all of their daily

activities.

The smallest available POC weighs

around 3 pounds and produces around

333 mL of oxygen per minute, or 0.33 LPM,

and can only deliver its oxygen in pulse

form while the user is inhaling. It features

no adjustable pulse flow settings, and as the

user breathes faster, the pulse flow volume

delivered actually decreases. Nevertheless,

since this POC is the smallest POC available,

it has clear appeal to a wide range of users,

even though some of them may not know

that the device may not be able to keep them

adequately oxygenated during some or all

of their daily activities.

At the other end of the spectrum, there

are several larger POCs available that can

produce 3000 mL of oxygen per minute, or

3.0 LPM. These units can provide oxygen

at both continuous flow settings and a wide

variety of pulse flow settings, making them

viable options for a wide range of oxygen

users. Yet these POCs can weigh anywhere

from 12 to 20 pounds, and this is before

Portable Oxygen Concentrators:

The Chart and the Checklist

Continued on page 12

Fox

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Fox

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Fran Fox, Main Clinic Supply

2014 Updated,Portable Oxygen Concentrator Review -The Pulmonary Paper's Annual POC Review


This article reprinted courtesy of The Pulmonary Paper

12 www.pulmonarypaper.org Volume 25, Number 3

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Haven’t you suffered long enough?

Ask your doctor about TTO2

For information call:

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adding the weight of the various accessories

that come with the POC. To many users,

that is just too much size and weight to

routinely carry with them no matter how

well the POC can oxygenate them.

Unfortunately, despite the variety of

small- and large-form POCs available, POC

options for oxygen users with high flow

needs is still limited. Users with needs in

the 4 LPM to 6 LPM continuous flow range

may find they can oxygenate well in some

or all of their daily activities on some of

the larger POCs set to their higher pulse

Perhaps the most important

factor to consider

regarding POCs is that

one size does not fit all.

settings. However, those with needs greater

than 6 LPM may not be able to routinely use

any of the POCs currently available, though

there may be some select applications and

scenarios where one of these larger POCs

could be an option for use.

Following is a checklist of questions

anyone considering use of a POC should

take with them when deciding what POC

to buy or use. These questions cover what

we feel are some of the most important

factors to think about when determining

what POCs are options for the user, but this

is not meant to be an exhaustive list. The

more these questions are asked, the more

manufacturers and dealers will need to be

clear on the answers. For now, don’t expect

to get immediate answers to all of them, but

do try and find out as much information as

you can before making a decision.

Continued from page 11


http://store.mainclinicsupply.com/category-s/1832.htm




Q What is the oxygen production capac

ity of the POC?

Oxygen production capacity tells you

how much oxygen the POC is capable

of producing per minute. Smaller POC

units tend to produce less oxygen per

minute than larger units, and will meet

a smaller range of user needs than their

larger counterparts.

Oxygen production is typically given

in milliliters (mL) per minute. 1000 mL/

min = 1 LPM.

Q Is the POC continuous flow capable?

Not all POCs can provide con-

tinuous flow oxygen. Many of the

smaller POCs are pulse-only devices,

meaning that all oxygen volumes are

delivered via pulses as the user breathes

in. Pulse delivery of oxygen has

fundamentally different characteristics

compared to con tinuous flow oxygen

deliv ery, so do not assume pulse settings

have liter flow equivalency (e.g., 2 pulse

setting = 2 LPM). Use of a pulse-only

POC during sleep is not recommended

unless the user has completed an overnight

study with the device showing that

they stayed oxygenated throughout the

night.

Q What is the range of pulse settings

available – and continuous flow

settings if applicable, and what are the

associated pulse volumes at resting and

active breathing rates?

For example, a POC with settings of

1, 2, and 3 may deliver:

1 = 16 mL @ 15 BPM 8 mL @ 30 BPM

2 = 32 mL @ 15 BPM 16 mL @ 30 BPM

3 = 48 mL @ 15 BPM 24 mL @ 30 BPM

Pulse settings on POCs will vary from

device to device – one POC model set

to “2” pulse delivery will not be the

same on another POC model set to “2”.

Additionally, some POCs reduce the pulse

volume deliv ered at a setting as the user’s

breath rate goes up (aka, minute volume

delivery), whereas others keep the pulse

volume the same no matter the rate of

breathing (aka, fixed pulse delivery). Some

units combine both! Know that on minute

volume delivery POCs and some fixed

pulse POCs, you may need to increase

the pulse setting when you are active to

maintain adequate oxygenation.

Q What is the POC’s typical battery life

for each pulse setting at resting and

active breath rates? What are the battery

run times for continuous flow settings, if

available?

Battery life can be dependent on a

variety of factors. For example, a POC

with settings of 1, 2 or 3 may operate from

a full battery charge for:

1 = 4 hrs @ 15 BPM 3 hrs @ 30 BPM

2 = 3.5 hrs @ 15 BPM 2.5 hrs @ 30 BPM

3 = 2.5 hrs @ 15 BPM 1.5 hrs @ 30 BPM

Continuous flow opera tion, when

available, will go through battery power

much faster than a setting in pulse

operation. In pulse delivery, the setting

selection and the user’s breath rate are

significant factors in determining battery

life. Knowing how long each battery will

Continued on page 14




last in the conditions it will be used in can

help to determine how long the user can

be away from a power source or will need

to swap in a freshly charged battery. Per

FAA regulations, traveling with a POC

requires bringing enough battery power

to last the user 1.5 times the duration of

the flight.

Q Is the device limited when being pow

ered by the DC power supply?

Some users find out too late that they

can’t use the device as they normally

would when using DC power. DC power

is provided through fixtures like car

adapters, and most POCs come with a

DC supply for travel purposes.

However, some POCs have limits on

their functionality when operating from

DC power. These limits may include non-

operation at higher flow and pulse settings

and/or the inability to charge the battery

while the device is in use.

Q How much does the POC unit weigh,

with and without all of the included

acces sories?

Manufacturers often will only report

what the unit plus one battery weighs,

which ignores the weight that is added

when toting a wheeled cart, AC/DC pow-

er supplies, extra batteries and other

accessories.

Carrying all of these addi tional pieces

can significantly add to the total weight

of the POC, which can make a difference

to those who may have trouble lifting and

maneuvering the equipment.

Q What is the manufacturer’s warranty

on the POC? If the POC needs repair

(under warranty or not under warranty),

will a substitute POC be supplied while it

is in for service?

If you are buying a POC new, be aware

that the warranty will typically cover the

unit, but not the battery, which will have

its own warranty terms. While the repair

cost may be covered, users who return a

POC for warranty service may be asked

to pay for shipping costs. Some, but not

all, dealers will provide a backup unit

while the defective POC is in for repair. If

a POC is bought used, the manufacturer’s

warranty may not be honored, so check

to see if the seller offers any warranty

guarantees.

The POC comparison chart compiles

information from manufacturer specifica-

tions, device manuals and manufacturer-

supplied material found in the American

Association of Home Respiratory Care’s

A Guide to Portable Oxygen Concen

trators, which can be downloaded for free

at https://www.aarc.org/resources/oxygen_

resources/portable_oxygen_concentrators_

guide.pdf. Please note that some POCs

previously included have been discontinued

and are no longer listed. Every effort has

been made to present the most accurate and

up-to-date infor mation in this comparison

chart – if you no-

tice an error please

contact Ryan

Diesem at rdiesem

@inspiredrc.com.

Continued from page 13




1,000 mL/min(1.0 LPM)

1 to 5

Minute Vol.Delivery: Dose

decreases as rate rises

15 BPM: 66 mL

30 BPM: 33 mL

6 lbs.

2.0 hours

12,000 ft.

333 mL/min(0.33 LPM)

NoneSelectable



15 BPM: 22 mL

30 BPM: 11 mL

3 lbs.

1.5 hours

10,000 ft.

AirSep AirSep AirSep Inogen Focus™ FreeStyle™ 3 FreeStyle™ 5 One G2

PRODUCTION AND DELIVERY

Please consult with your doctor or therapist before deciding to use or purchase any of these devices.

2014 Portable Oxygen ConcentratorsINTERMITTENT FLOW (PULSE ONLY) POCS

Maximum Oxygen

Production (mL/min)

Available Settings

Pulse Delivery

Type

Maximum Delivered Pulse

Volume

Unit & Battery (Approx.)

Approx. Battery Time at Pulse

Setting 2

Max. Altitude

500 mL/min(0.5 LPM)

1 to 3



15 BPM: 33 mL

30 BPM: 17 mL

4 lbs.

2.5 hours

12,000 ft.

1,260 mL/min(1.26 LPM)

1 to 6



15 BPM: 60 mL

30 BPM: 30 mL

7 lbs.

4.0 hours(est.)

10,000 ft.

DOSE VOLUMES PER BREATH***2 LPM Continuous Flow: 15 BPM: 44mL 30 BPM: 22mL

4 LPM Continuous Flow: 15 BPM: 88mL 30 BPM: 44mL


WEIGHT (UNIT + STD. BATTERY); ADD UP TO 5LBS. FOR ACCESSORIES

STANDARD SINGLE BATTERY OPERATION TIMES

ALL UNITS APPROVED FOR FLIGHT BY FAA

High Flow


1 to 5



15 BPM: 56 mL

30 BPM: 28 mL

6 lbs.

2.5 hours

10,000 ft.


Inogen Inova Labs Invacare Oxus One G3 Activox™ XPO2 POC


INTERMITTENT FLOW (PULSE ONLY) POCS


1 to 3



15 BPM: 30 mL

30 BPM: 15 mL

5 lbs.

4.0 hours

10,000 ft.


1 to 5

Fixed Delivery8.5 mL

per setting

43 mL

10 lbs.

3.0 hours

8,000 ft.




Maximum Oxygen

Production (mL/min)

Available Settings

Pulse Delivery

Type


Volume



Setting 2

Max. Altitude


2014 Portable Oxygen Concentrators


1 to 4



15 BPM: 56 mL

30 BPM: 28 mL

5 lbs.

3.0 hours(est.)

10,000 ft.

****Approximate Continuous Flow volumes at 2, 4, and 6 LPM are provided for comparison to maximum volumes delivered by the selected POC.

DOSE VOLUMES PER BREATH***2 LPM Continuous Flow: 15 BPM: 44mL 30 BPM: 22mL



Precision DeVilbiss® Invacare EasyPulse iGo Solo2®


3,000 mL/min(3.0 LPM)

1 to 6Continuous 1 to 3 LPM

Fixed Delivery 14 mL

per setting

84 mL

19 lbs.

4.7 hours(20 BPM)

13,123 ft.





Maximum Oxygen

Production (mL/min)

Available Settings

Pulse Delivery

Type


Volume



Setting 2

Max. Altitude




1 to 5



15 BPM: 52 mL

30 BPM: 26 mL

7 lbs.

3.2 hours(est.)

9,000 ft.

3,000 mL/min(3.0 LPM)

1 to 6Continuous

0.5 to 3 LPM



15 BPM: 133 mL

30 BPM: 66 mL

20 lbs.

3.5 hours

10,000 ft.

INTERMITTENT FLOW (PULSE ONLY) POCS CONTINUOUS FLOW POCS

O2 Concepts Respironics™ SeQual® SeQual® OxLife Independence SimplyGo Eclipse 3/5 eQuinox


2,000 mL/min(2.0 LPM)

Pulse 1 to 6Continuous

0.5 to 2 LPM

Combination Fixed/Minute

Vol. Delivery**

15 BPM: 72 mL

30 BPM: 66 mL

10 lbs.

3.0 hours(20 BPM)

10,000 ft.

3,000 mL/min(3.0 LPM)

Pulse 1 to 6*Continuous

0.5 to 3 LPM

Fixed Delivery16 mL

per setting

96 mL*

19 lbs.

5.1 hours(12 BPM)

13,123 ft.


3,000 mL/min(3.0 LPM)

Pulse 1 to 6*Continuous

0.5 to 3 LPM

Fixed Delivery16 mL

per setting

96 mL*

14 lbs.

2.75 hours(12 BPM)

13,130 ft.

WEIGHT (UNIT + STD. BATTERY); ADD UP TO 10 LBS. FOR ACCESSORIES



Maximum Oxygen

Production (mL/min)

Available Settings

Pulse Delivery

Type


Volume



Setting 2

Max. Altitude

CONTINUOUS FLOW POCS



3,000 mL/min(3.0 LPM)

Pulse 1 to 6Continuous 1 to 3 LPM

Fixed Delivery16 mL

per setting

96 mL

19 lbs.(w/2 batteries)

2.9 hours****(20 BPM)

13,123 ft.

****The Eclipse models also have pulse settings of 128, 160 and 192mL, but have additional breath rate restrictions for use. See Eclipse 3 manual for more information.

****The SimplyGo has two IF delivery modes: Pulse Mode and Night Mode. Shown volumes are for Pulse Mode. Night Mode has Minute Volume Delivery.

****The Independence is packaged with (2) batteries that can be used simultaneously, doubling the reported operating time.

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