Oxygen Therapy for COPD: Types, Benefits and How to Use O2

Oxygen therapy for COPD is a treatment used to increase the oxygen (O2) in your lungs and bloodstream. Research suggests that people with chronic obstructive pulmonary disease (COPD) who use oxygen may have improved life expectancy and quality of life when they understand and comply with their treatment.

COPD, a lung disease, makes breathing difficult because the airways become inflamed and thickened, affecting airflow in and out of the lungs. The tissue needed to exchange oxygen is damaged, too. Your healthcare provider may recommend oxygen therapy for COPD and help you learn how oxygen equipment is used.

Why COPD May Require Oxygen

Air follows a pathway into your lungs to ensure your body has its vital oxygen supply. When you breathe air into your lungs through your trachea (windpipe):

• The air enters into bronchi, with one of these two passages on each side of your airway.
• The bronchi branch out into smaller air passages known as bronchioles.
• The bronchioles connect air flow to the small air sacs in the lungs called alveoli, equipped with small blood vessels (capillaries).
• When the oxygen reaches the capillaries, it can then enter the bloodstream.

Carbon dioxide is exchanged through the same system and exhaled when you breathe. Healthy lungs have elasticized air sacs that deflate and inflate to make the process go smoothly. In a person with COPD, though, the airflow in and out of the lungs becomes strained and shallow.

If they're not getting enough oxygen to cells in their body, they may need supplemental oxygen.

Oxygen Therapy Benefits 

Oxygen therapy is supplemental oxygen introduced into the body. A person with COPD who uses oxygen therapy might use it at different times or in different ways that can help them to:

• Perform daily tasks with less breathing difficulty
• Participate in activities such as exercise without experiencing trouble breathing
• Protect the organs in their body from further damage that can be caused by oxygen deprivation
• Improve their sleep (which helps them feel more alert during the day)
• Increase their life expectancy

Portable oxygen also gives people with COPD more freedom to travel without having to worry about experiencing symptoms. Keep in mind that your oxygen needs may change, such as with a higher altitude environment, so talk with your healthcare provider about your plans.

Types of O2 Therapy for COPD 

There are many forms of oxygen therapy designed for different uses. These forms of oxygen therapy are administered to people with COPD using a tube-like device that connects to the source. It is inserted into the nostrils (nasal cannula), a face mask, or a tube surgically placed into the windpipe.

Three types that can be used at and outside the home include:

• Compressed oxygen cylinders: These metal cylinders are filled with oxygen in a gas form. They are portable and offer a continuous but time-limited flow of oxygen if you are away from home. They cannot be used on airplanes.
• Liquid oxygen: Some cylinders contain oxygen in liquid form, which expands the time they can be used and the shelf life. A liter of liquid oxygen can be transformed into 860 liters of gas oxygen. They can be used to refill portable devices and may be especially helpful when higher levels of O2 are prescribed or when traveling with O2. They cannot be used on airplanes.
• Oxygen concentrators: These devices draw air from the environment, either in a unit at home or a portable option that is approved by the Federal Aviation Administration. Miniature units with lower weights make mobile use easier.

Oxygen therapy options have different benefits and drawbacks. A concentrator requires continuous power, for example, with cylinders used as a backup. Liquid oxygen canisters extend the time of use and are lighter weight than compressed oxygen, but cost can be a concern.

Using O2 Equipment

Experts recommend specific steps to ensure proper use of your equipment. Studies also show that people confident about their oxygen therapy and how to use it are more likely to experience its health and quality-of-life benefits by complying with their treatment.

Talk with your healthcare provider about the following steps:

1. Wash your hands to avoid contamination of your gear.
2. Turn on the system according to the instructions you've received.
3. Check the gauge to be sure you know how much oxygen you have and how long it will last.
4. Ensure that a humidifier bottle, if needed, is properly cleaned and filled with distilled water.
5. Attach the tubing to the source. Be careful it's not blocked or kinked.
6. Set the flow rate that's been prescribed. Usually, it will stay the same unless your healthcare provider changes it.
7. Place the cannula or mask properly on your face, or attach your tracheal tube.

If you are not able to feel oxygen flow, put the cannula in a glass of water. If there are bubbles in the water, it means that the oxygen is flowing and the cannula is working as it should.

Cleaning Your Equipment

Avoiding infection is important for people using oxygen therapy for COPD. Each piece of equipment that is part of your oxygen therapy needs to be cleaned regularly to keep it safe for you to use.

Here is an overview of how often you need to clean or replace each part:

• Your cannula and tubing need to be replaced once every week or two. Any foam wraps that you use to protect your skin should be replaced at the same time.
• The humidifier bottle should be washed with soap and warm water every time that you refill it. Disinfect it once a week, using a vinegar solution. Get a new bottle each month.
• An air filter should be cleaned every week and replaced each month, and the tubing should be replaced every two months.
• Your concentrator needs to be serviced by your oxygen supply company once a year.

If you use canisters, keep them in an upright position and wipe the outside down once a week.

Affordability and Insurance 

Medicare typically covers 80% of the costs of home oxygen if you are enrolled in Part B, pay your deductibles, and have gone through the required tests with a written order from your healthcare provider. Check the details to ensure your Medicare or other insurance coverage.

Costs also will depend on the type of oxygen therapy used. A 2020 study put the cost of metal oxygen cylinders in the United States at typically between $50 and $100, with additional supplies still needed. Liquid is about four times higher primarily due to storage and service requirements and insurance may not fully cover the cost.

Some people purchase equipment. You can buy a portable concentrator for $2,000 to $4,000.

Summary

COPD is an incurable disease that gets worse over time. The chronic nature of the disease means that people with COPD often face an increased mortality rate. Oxygen therapy can help to manage their condition and improve their quality of life.

Your healthcare provider can prescribe oxygen and the specific devices, levels, and times when it's needed. Keep in mind that additional medications and treatments often are needed.