Experts guide on why and when to use Oxygen Concentrators

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An oxygen concentrator can be beneficial but definitely not without guidance from a chest physician or internal medicine specialist.

Faced with the increasing demand for oxygen for the Covid-19 patients, the Central Government has specified that import of Oxygen Concentrators for personal use will now come in the exempted list. The oxygen concentrators for personal use, received through post, courier or e-commerce portals, will be in the list of exempted categories, where Customs clearance is sought as ''gifts".

This exemption is valid till July 31, 2021. In a notification issued by Directorate General of Foreign Trade, Ministry of Commerce and Industry yesterday states that Para 2.25 of Foreign Trade Policy, 2015-20 stands revised for the purpose.

Also read: Indo-US Maitree: 318 oxygen concentrators flown in from New York to counter second Covid wave

As the country battles against the second wave of the Covid-19 pandemic, there is a surge of new infections resulting in an alarming increase in the number of active cases. This has led to stress on public health infrastructure giving way to a huge demand for oxygen concentrators.

Here is what one needs to know about oxygen concentrators like when would they be required, how are they to be used or not used?

Importance of oxygen

In order to live, a human being needs a steady supply of oxygen, flowing from the lungs to various cells in the body. The current pandemic, Covid-19 is a respiratory disease which affects lungs and can cause the oxygen level to drop to dangerous levels. This is a critical situation and requires one to undergo what is known as oxygen therapy that is using oxygen for medical treatment, to enhance oxygen levels to clinically acceptable levels.

Oxygen level is measured by oxygen saturation, known briefly as SpO2. This is a measure of the amount of oxygen-carrying haemoglobin in the blood. A healthy individual with normal lungs, will have an arterial oxygen saturation of 95% – 100%.

According to a World Health Organisation training manual on pulse oximetry, if the oxygen saturation is 94% or lower, the patient needs to be treated quickly. A saturation of less than 90% is a clinical emergency.

As per the latest clinical guidance issued by the Ministry of Health and Family Welfare, for management of adult Covid-19 patients, an oxygen concentration less than or equal to 93% on room air requires hospital admission, while that below 90% is classified as a severe disease, requiring admission in ICU.

In the prevalent situation in the wake of the second wave of the Coronavirus, one must do whatever best possible, in order to try and replenish oxygen levels, in the event of delay or inability in getting hospital admission as per the clinical management protocol.

How does an Oxygen Concentrator work?

We know that atmospheric air has roughly 78 per cent nitrogen and 21 per cent oxygen. Oxygen concentrators are simple devices which do precisely what its name promises – they take in ambient air and increase the oxygen concentration, by filtering out and throwing away nitrogen.

These oxygen concentrators work the same way in supplying oxygen needed by the body such as oxygen tanks or cylinders, with the use of a cannula, oxygen masks or nasal tubes. The difference is that, while the cylinders need to be refilled, the oxygen concentrators can work 24x7.

Who can use them and when?

Does this mean that anyone who finds their oxygen level falling below acceptable levels can use a concentrator and help oneself? Absolutely not.

Talking about the appropriate usage of concentrators, Professor and Head of Department Anaesthesia, B. J. Medical College, Pune, Prof. Sanyogita Naik said: “Oxygen concentrators can be used only in moderate cases of COVID-19, when the patient experiences drop in oxygen levels, where the oxygen requirement is a maximum of 5 litres per minute.”

The professor added that oxygen concentrators are also very useful for patients experiencing post Covid complications which necessitate oxygen therapy.

Can we use them on our own?

The answer is a strict no. Speaking at a webinar organized by the Press Information Bureau recently, Dr. Chaitanya H. Balakrishnan, Covid Co-ordinator, St. John’s Medical College Hospital, Bangalore made it abundantly clear that using an oxygen concentrator without medical guidance can be very harmful.

“Patients with moderate pneumonia induced by COVID-19 - with oxygen saturation less than 94 - can benefit from supplemental oxygen given through an oxygen concentrator, but only till they get hospital admission. However, patients using it themselves without suitable medical advice can be harmful.”

Dr. Chaitanya summarised saying, “So, till you get a bed, an oxygen concentrator can be beneficial, but definitely not without guidance from a chest physician or internal medicine specialist. It also depends on patients' pre-existing lung conditions.”

Purchase and usage

Prof. Sanyogita says that both purchase and usage of concentrators is to be done only based on prescription by a medical doctor.  Depending upon the capacity, O2 Concentrators cost upwards of Rs 30,000.

Oxygen Concentrators market in India

India has seen a big spurt in manufacture and sale of oxygen concentrators.  Besides multinational brands, several Indian start-ups, funded under the CAWACH (Centre for Augmenting War with Covid 19 Health Crisis) programme of Department of Science & Technology, have developed efficient and cost effective Oxygen Concentrators.

In view of their usefulness during the second wave of Covid pandemic, one lakh Oxygen Concentrators are being procured through PM CARES fund.

Covid-19 In India