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Are Oxygen Concentrators Solution to India’s Oxygen Crisis?

Are Oxygen Concentrators Solution to India’s Oxygen Crisis?

Healthcare | May, 2021

Amidst the unprecedented spike in critical COVID-19 cases in India borne out of a new mutation in SARS-Cov-2, the unavailability of hospital-grade oxygen and oxygen cylinders has generated a colossal demand for alternate source oxygen concentrators. Shortness of breath due to low oxygen levels is widely observed as a vital symptom indicating the progression of coronavirus to a more advanced stage. In such cases, the patient requires supplemental oxygen, which could be administered through an oxygen concentrator capable of supplying around 5-10 litres of oxygen every minute. Easy to store and low-maintenance oxygen concentrators do not require refilling like oxygen cylinders and only need a power source to provide an uninterrupted supply of oxygen. Given the oxygen crisis in the country, oxygen concentrators make an effective treatment option for patients suffering from mild to moderate symptoms of coronavirus with an oxygen saturation level of 85% and above. Oxygen concentrators are completely safe, reliable and provide great convenience and flexibility for oxygen patients. Setting the oxygen concentrator flow meter, the oxygen delivery rate can be well-adjusted according to the patient’s requirement.

How does oxygen concentrator work?

The oxygen concentrator utilizes surrounding air that generally consists of 78% nitrogen and 21% oxygen to deliver purified oxygen to the patient. When the concentrator draws room air, the series of filters present in the device grasp dust, bacteria, particulates, and other pollutants for further processing. In the first step, the machine compresses air into the first sieve bed or molecular semi-permeable membrane containing a material called Zeolite (six-sided microscopic cube), which absorbs nitrogen and leaves 90-95% concentrated oxygen combined with a small percentage of other gases found in the surroundings. Simultaneously, the other sieve bed desorbs and draws out nitrogen into the atmosphere and moves purified oxygen into the product tank and then to the nasal cannula, employed by patients to inhale oxygen. In the second step, the function of the cylinder is reversed in a timed cycle and the whole cycle starts over again to maintain a continuous supply of oxygen to the patient. Oxygen concentrators can function 24 hours a day, 7 days a week, for up to 5 years or more, depending on the model.


Types of Oxygen Concentrator

Generally, there are two types of oxygen concentrators available in the market, such as stationary and portable.

Stationary (Home) Concentrators

Stationary concentrators are intended to deliver an uninterrupted low-flow oxygen supply with a flow ranging from 0.5 to 10-15 liters every minute to the patient via nasal cannula. With built-in ergonomic handles, the stationary concentrators offer the flexibility of lifting or rolling the device to enhance mobility. The concentrator requires an electricity supply at home to function, and the device comes with a compressed gas cylinder, which can be used as a backup in case of power failure. There are new options of super small home concentrators available in the market, which are lightweight, mobile, and support oxygen flow rates up to 2 liters per minute. Stationary or home concentrated are commonly used by people for long-term oxygen therapy (LTOT) to improve survival in cases of chronic pulmonary disorders.

Portable Concentrators

Portable concentrators are compact, easy-maintain, lightweight, and mobile medical devices that fulfils supplemental oxygen needs for a sufficient duration. These are available in different sizes, oxygen flow settings, range of flow, weight, battery life, and other specifications. Most portable concentrators run on rechargeable batteries and offer great flexibility with power sources. People who desire to use oxygen outside the home, lead an active lifestyle, or are always on-the-go can opt for portable oxygen concentrators for daily oxygen needs and better compliance.

Comparison between Stationary and Portable Oxygen Concentrator

Both stationary and portable oxygen concentrators offer several advantages for those requiring oxygen therapy, some important differences can affect the purchase decision. The differences can be made based on size and weight, oxygen output, power options, and price.

Size and Weight

Portable concentrators have a small size than stationary concentrators, which makes them convenient to carry through crowded hallways, busy shopping aisles, and other tight areas. On the contrary, traveling with a stationary concentrator can be difficult and not advisable due to their relatively bigger size. On average, portable concentrators are one-third lighter than stationary concentrators, so they can be carried in a backpack or shoulder bag. However, wheels attached to the stationary concentrators facilitate mobility from room to room.

Oxygen Output

A conventional stationary concentrator can deliver 5-10 liters of oxygen per minute while a small portable concentrator can provide a maximum oxygen output of 3 liters per minute. The considerable difference between the performance or oxygen output of both the concentrator is due to the size and weight. The smaller the size, the less oxygen concentrator generates and vice versa. People who suffer from serious pulmonary disorders or dependent on oxygen therapy require at least 5-10 liters of oxygen per minute so stationary concentrators are the best solution for them. Opting for a portable concentrator cannot fulfill the oxygen requirement who need consistent delivery all the time.

For small and lightweight design, portable oxygen concentrator uses pulse flow oxygen, which provides a puff of oxygen during the inhale cycle and nothing during the exhale process. On the other hand, a stationary concentrator provides continuous oxygen flow, that runs constantly during inhaling and exhaling. While most patients can do away with pulse oxygen flow, some require high doses of continuous oxygen flow for survival.

Power Options

Most of the stationary oxygen concentrators operate only on AC power sources while portable concentrators can run on DC or AC power sources. However, portable oxygen concentrator offers more flexibility and utility as they can operate from their internal source, so it can be operated from a car, boat, or RV battery. However, a stationary oxygen concentrator consists of a backup gas compressor in case of power failures.

Price

The price of the oxygen concentrator is directly proportional to the size, weight, and performance of the medical device. Since a significant amount of engineering and manufacturing costs are involved in the development of portable concentrators, these are costlier (three to six times) than stationary concentrators. One can buy four stationary concentrators at the price of one good portable concentrator.


How to Choose the Right Oxygen Concentrator for You?

Every model of oxygen concentrator offers different features and benefits, but one should choose the right one as per their needs and requirements. Here are some of the factors that can help one choose the best oxygen concentrator for themselves.

 

Trustworthy Brand

Due to lockdown restrictions and availability issues, people are finding oxygen concentrators on e-commerce sites. Some websites are scamming people by selling equipment like humidifiers and nebulizers in the name of oxygen concentrators and charging high prices. Therefore, users must ensure to purchase the medical device from trustworthy brands like Aspen, Philips, Medtronic, AirSep Corporation, OCM, Yuwell, Equinox, Oxlife, and Inogen. Some websites offering authenticated oxygen concentrators are 1mg, Nightingales India, Healthgenie, and Healthklin. 

 

Flow Rate Capability

One of the most important things to consider while opting for an oxygen concentrator is to check the flow rate capability of the medical device. Depending on the severity of the disease and oxygen requirement of the patient, the doctor advises the flow rate, so it is recommended to discuss the feature beforehand. Different models of oxygen concentrators offer varying flow rates, ranging from as low as 250 millilitres per minute to 10 litres per minute, so make sure to choose one accordingly. 

 

Oxygen Concentration 

Every oxygen concentrator provides a different level of oxygen concentration (purified oxygen that reaches the patient via nasal cannula) depending on the efficacy of its nitrogen-removing sieve system. The oxygen concentration delivered by models can range between 88-99% so it is important to identify this value and compare it between different concentrators. Generally, high-power concentrators provide higher oxygen concentrations whereas low-power or portable concentrators provide relatively low oxygen concentrations. 

 

Portability

If you are always on the go and lead an active lifestyle, then portability is the most important factor to consider while choosing the oxygen concentrator. At-home solutions are bigger and heavier so these cannot be carried everywhere. But portable concentrators weigh between 5 to 10 pounds and are compact, so they are significantly easier to transport. However, portable oxygen concentrators are suitable for people who do not require high oxygen flow rates or oxygen concentration. 

 

Noise 

It is normal for oxygen generators to produce some amount of noise during their functioning. While stationary oxygen concentrators create loud noises due to their high-power consumption and high flow rate, smaller portable concentrators are rather quiet and unobtrusive due to a low rate of oxygen flowing from them. If you easily get annoyed with the noise, consider the amount of noise generated by the oxygen concentrator before purchasing. 

 

Additional features

Many models of oxygen concentrators provide additional features or items such as carrying containers, flow locking settings, easily replaceable filters, oxygen concentrator accessories, etc. The optional items can vary from model to model and influence the functioning of the medical device so consider them as well.

 

Best Oxygen Concentrations of 2021

 

OxLife Independence Portable Oxygen Concentrator

The OxLife Independence Portable Oxygen Concentrator is created from high-quality material and has a compact design, which makes it easy to carry. The medical device features an integrated travel cart with a convenient travel arm and is approved for travel on planes and cruises. The long battery life of the device and quick charging time due to the two-battery configuration in the device prevents the user from spending more time charging and feel limited by the concentrator. The oxygen concentrator has a sleek LCD screen with a colored background to making monitoring easier and effortless. The medical device allows the user to switch between pulse and continuous mode to accommodate varying requirements. The OxLife Independence Portable Oxygen Concentrator is ultra-lightweight (weighs 16.7 pounds), and offers DC run power on all settings. The medical device provides a flow rate of 3 LPM on continuous mode and 4 LPM on pulse mode. 

 

Drive Medical DeVilbiss 10L Oxygen Concentrator

The Drive Medical DeVilbiss 10L Oxygen Concentrator is designed for optimal oxygen delivery for patients who require high oxygen concentrations. The innovative medical device is significantly smaller in size than other high-capacity concentrators available in the market. The device weighs only 42 pounds and comes in the same shell as the 5-liter size. The Drive Medical DeVilbiss 10L Oxygen Concentrator delivers 87%-96% of oxygen purity with a flow rate between 2-10 LPM. The oxygen concentrator is ideal for long-term use and consists of safety alarms to ensure the proper functioning of the device. The recessed humidifier nook and protected cannula port prevent damage and convenient handles facilitate mobility. The easily accessible controls, bright LEDs, and front-located knob facilities enhance the overall experiences of the patient and caregiver while using the device. 

 

Invacare Platinum 10L Oxygen Concentrator

The Invacare Platinum 10L Oxygen Concentrator is based on a pressure-based system, SensO2® Oxygen Sensor that can provide up to 10LPM of oxygen. The light/sound feedback alerts the user of any problem in the medical device that needs to be addressed. The medical device weighs around 54 pounds and delivers oxygen at the flow rate between 2-10 LPM and oxygen concentration between 87-94%. The device comes with a built-in molded top handle to facilitate mobility and easy-to-use controls are clear and visible.

 

Inogen At Home Stationary Oxygen Concentrator

The 5-liter Inogen At Home Stationary Oxygen Concentrator has one of the most lightweight and energy-efficient designs. The oxygen concentrator weighs only 18 pounds and delivers a continuous flow of oxygen in different flow rate settings. The Inogen At Home Stationary Oxygen Concentrator makes a great option for home use and hospital settings as it is extremely quiet. The robust shell of the device ensures its durability by protecting the unit from any accidental damage. The device is exceptionally lightweight, weighing around 18 pounds. The impressive compressor of Inogen At Home Stationary Oxygen Concentrator offers 20,000 hours at the highest setting. 

 

Invacare Perfecto2 5-Litre Oxygen Concentrator

The small, quiet, and energy-efficient Invacare Perfecto2 5-Litre Oxygen Concentrator uses a pressure monitor to maintain a reliable flow of oxygen. The contemporary oxygen concentrator weighs 39 pounds and delivers oxygen at 5-5.5 LPM providing an oxygen concentration between 87-95.6% using three different filters. The concentrator is one of the quietest medical devices, which is sound rated at 43 dBA. The oxygen concentrator can operate at altitudes up to 8,000 feet. 


How are Oxygen Concentrators Different from Oxygen Cylinders?

Oxygen cylinders contain compressed oxygen gas held under high pressure. The size of the oxygen cylinder determines the capacity of the gas in the container. The oxygen cylinder can range from small portable cylinders (430 L oxygen) intended for ambulatory purposes to the large static cylinder (2122 L of oxygen) employed in hospitals. The cylinders need to be moved via a backpack, trolley, or wheel cart, depending on the size and weight of the cylinder. A 400 L of oxygen cylinder can suffice a patient’s oxygen supply for only 2.5 hours, depending on the flow rate. Sometimes compressed gas cylinders are often combined with oxygen concentrators for patients needing continuous delivery of oxygen at home. In hospitals, oxygen cylinders are used when patients undergo diagnostic or therapeutic procedures outside the ICU.


Conclusion

With the country facing a grave shortage of medical oxygen, an oxygen concentrator can prove to be a viable tool that can help India to fight the pandemic. However, the oxygen concentrators cannot be used for patients whose oxygen levels are below 85 as they require very high doses of oxygen per minute. If the patient becomes aware of their symptoms at an early stage, he/she can manage their oxygen levels with the help of oxygen concentrators only, which would reduce the burden on the hospitals, narrow oxygen supply-demand, and decrease mortality rates.

According to TechSci research report on “India Oxygen Concentrators Market By Type (Portable v/s Stationary) By Technology (Pulse Flow v/s Continuous Flow) By Application (Bronchitis, Pneumonia, COVID-19, Lung Cancer, Others) By End Users (Hospitals & Clinics, Ambulatory Care Centres, Home Care) By Region, Competition Forecast & Opportunities, FY2027”, India oxygen concentrators market is set to grow at a significant CAGR during the forecast period. The growth can be attributed to the rising incidences of coronavirus cases in the country and increasing cases of patients suffering from respiratory disorders.

According to another TechSci research report onGlobal Medical Oxygen Market By Form (Liquid Oxygen, Compressed, Oxygen Concentrators), By Purity (96% to 99.5%, 93% to 96%), By Delivery Mode (Aerial Diffusion, Direct Inhalation, Others), By Modality (Portable Medical Oxygen Systems v/s Standalone Medical Oxygen Systems), By Technology (Continuous Flow v/s Pulse Dose), By Application (COPD, Bronchopulmonary, Lung Disorder, Heart Failure, Asthma, Cystic Fibrosis, Others), By End User (Hospitals, Emergency Medical Centres, Ambulatory Centres, Homecare), By Region, Forecast & Opportunities, 2026”, the global medical oxygen market is expected to grow at a formidable CAGR of 7.02% owing to growing prevalence of respiratory disease and increasing geriatric population. 

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