Oxygen Infusion Help Urgently Needed!!

[torontoCPAPguy]

Well, the Respironics Everflo Q arrived today and I just had a chance to plug it in and experiment with my MAX O2 Oxygen Analyzer.

The gas coming out of the output of the output nipple on the concentrator is 90+% oxygen (forget the exact figure). It does not seem like a very strong flow however, even though the flow control on the front says I have it cranked up to 5L/M. Here's the interesting thing. The air coming through the mask reads 20.8 - 20.9% oxygen as one would expect as it is just room air being blown. I have not put the backflow valve into the line yet as I figure as long as I turn the concentrator off before the CPAP I should be fine. Connecting the oxygen concentrator output into the CPAP air line at about 12 CM H2O pressure and holding the mask up against my face with the oxygen analyzer sampling tube inserted, with the oxygen OFF I get 20.8% and with the oxygen on and set to a full 5L/M I get a 24.9% oxygen content reading. Does that seem normal to you? I was at my endocronologist today (for my diabetes) and mentioned that I would be starting oxygen therapy tonight with 2 or 3L infused into my CPAP line and his comment was "I would just crank it up to 5L/M as I don't think you're going to get much effect at 2/3L". Is this what he was talking about? I realize that we are mixing oxygen with CPAP air for one thing and that we are venting at the same time. But does 24.9% seem like a normal increase in oxygen percentage under these circumstances?

My next experiment is going to be dropping my pressure from 13 - 18cm down to 11 - 16 cm to start. At that point I am going to read my blood oxygen saturation for 5 minutes or until it pretty much settles for a few minutes elapsed time while I am at complete rest using only the CPAP air. I am then going to turn on the oxygen concentrator at a full 5L/M as suggested by several people and see where my SaO2 settles. I am hoping to see an increase in SaO2 that is at least a few percent (say 90% at rest to 94% at rest, maybe I am be overly optimistic). At that point I am going to turn on the recording oximeter and go to sleep for the night, hoping to get a better night of sleep and raising my average or high end baseline SaO2 into the 94-95 % range and holding it there all night.

It is now appearing to me that I may actually need a second 5L/M machine or replace the 5L/M machine with a 10L/M machine so that I have the reserve for effect. I am really surprised at how little pressure there is coming out the end of the 25 foot hose from the oxygen concentrator... I am sure that I seem to recall when wearing the nasal canulas there was noticeably more pressure coming out but I could be wrong as it was a year ago.

My question to you is simply ... does this seem to jive with what you are finding yourself? Does it make sense? (It seems to make sense to me excepting the pressure coming out of the end of that oxygen line from the Everflo Q.

Boy is the Everflo Q ever quiet. GoSouthernMD.com and I have some issues to discuss tomorrow. The machine I ordered and paid for was the Everflo Q with OPI for $729 and some accessory tubing. What I finally got after some pestering was the Everflo WITHOUT the OPI and although only a $50 option and not life endangering.... it is what I ordered and expected. On top of this, the unit that was shipped to me was opened (and obviously so) and was a return from one of their customers. They were apparently in the midst of moving their offices and I empathize with them but not only did I not get the unit I ordered; I got a returned unit from a customer and did not get the rest of my order at all. I am now wondering why the unit was returned.... it was marked simply "return to sender" so it may have been a unit that was ordered somewhere else due to a delay in shipping or something. The good news is that they are not apparently selling the Everflo Q with OPI and a bunch of accessory items for $699 with free shipping... I must mention this to them when speaking with them tomorrow trying to resolve our little problem.

In any event, the ultimate solution to this problem may be my ordering of a SECOND unit... another Everflo Q with OPI. I have a Maxtec MAXO2 Oxygen Analyzer anyway with which I can check my air quality for oxygen content at the mask (most masks have nipples on them for oxygen infusion and testing). Should I be feeding the oxygen into my line at the mask itself?

Please let me know your thoughts as soon as possible.... I find myself in a quandary here.

[Goofproof]

I figure as long as I turn the CPAP off before the concentrator I should be fine. WRONG, Concentrator OFF FIRST!!!!! So no O2 can flow into XPAP. Jim

[Goofproof]

I was supposed to use 2L, I used 4L, because I realize, the O2 stream is going to be badly diluted by the bigger flow of the XPAP.

You say 90% O2 at 3LPM, with XPAP running 20% O2, (ROOM AIR) 35 to 40 LPM, you do the math, the 90% O2, is going to get cut down very fast as a percent of the overall mixture. Jim

For some reason doctors have a hard time with math and science.

[torontoCPAPguy]

Room air = 20.8% oxygen

At CPAP Mask with 5L/M oxygen being infused = 24.8%

Question: Does this sound about right?
Question: Does this match up with YOUR readings?
Question: If you have infused 5L/M O2 into your CPAP air line at 12 cm H2O did you wind up with 24.8% oxygen percentage in your mask? And did it make a significant or at least a noticeable difference in your baseline SaO2?

In any event, that's what I'm going to try tonight; 5L/M infused into my CPAP airline at 12-16 cm H2O with a full face mask for minimal leakage.... and we shall see what happens!

Keep any information or suggestions coming, please! This is brand new for me.

[Goofproof]

I did 6 months at 4L with a pressure of 14.5 cm, with no i'll effects, I told my Dr., he didn't cut my throat. I don't think Doctors get math or physical science classes, they are to busy being in the rat race to become doctors. I don't have any tools to measure O2 levels in a stream. My pump only had a flow setting knob. High Tech! Jim

At the time I was really messed up, and didn't question much, spent my time just trying to live.

[torontoCPAPguy]

Well. APAP only at 12cm H2O = oxygen 20.8% in mask. APAP at 12cm H2O + Oxygen Concentrator at 5L/M into CPAP hose = oxygen 24.8% in mask. I didn't notice a great difference in sleep last night frankly, but my SaO2 at rest before going to sleep was 91% without infused oxygen and 96-97% WITH infused oxygen. Am going to print off the oximetry study for the night and post it. I have no idea at present what it is going to say.

Still looking for others with experiences to share using infused oxygen to maintain SaO2 saturations in the mid 90% range. Anyone?

[M.D.Hosehead]

Here's my stab at the arithmetic. There could well be an error in my thinking.

I don't know how many liters/min your mask is designed to vent. For the following sample calculation I'm using 35 l/m:

Each minute the mask receives 35l of room air + 5l from the concentrator = 40l/m

5l from the concentrator @ 90% O2 = 4.5l of pure O2

35l of room air @ 20% O2 = 7l of pure O2

So, ideally, if there are no other variables, the mask receives 40l of air, containing 11.5l of pure O2, or 29% O2.


I don't know how to account for the discrepancy, but the improvement of SaO2, if consistent, may be all you can expect.

[LoQ]

I figure as long as I turn the CPAP off before the concentrator I should be fine. WRONG, Concentrator OFF FIRST!!!!! So no O2 can flow into XPAP. Jim

I am wondering why it matters if oxygen "flows" into the XPAP machine? Doesn't oxygen get in there, anyway, even without a concentrator? There's apparently a piece of information I'm missing, and maybe you can supply it.

[torontoCPAPguy]

Well, whichever way it flows... my results are astounding with 5L/M flowing infused into the CPAP line!

Last night I ran at pretty much 95% plus all night; this afternoon I took a two hour nap and slept like a log.... oximetry data? 97% SaO2 pretty much the whole time, flat line. It built up as I fell asleep and fell off whe I awoke!

I am going to try and get some graphs posted in the next 24 hours so that folks can see the benefits of O2 infusion.

[M.D.Hosehead]

my results are astounding with 5L/M flowing infused into the CPAP line!

That's good news! I'm sure I'm not the only one here curious about how you feel in a week or a month.

[Madalot]

Well, whichever way it flows... my results are astounding with 5L/M flowing infused into the CPAP line!

Last night I ran at pretty much 95% plus all night; this afternoon I took a two hour nap and slept like a log.... oximetry data? 97% SaO2 pretty much the whole time, flat line. It built up as I fell asleep and fell off whe I awoke!

I am going to try and get some graphs posted in the next 24 hours so that folks can see the benefits of O2 infusion.

I am so glad to see this improvement for you. I know how frustrating this has been for you. This makes me want to bump MY oxygen to the full 5L and see if it makes that big a difference.

Please keep us posted.

[Goofproof]

I figure as long as I turn the CPAP off before the concentrator I should be fine. WRONG, Concentrator OFF FIRST!!!!! So no O2 can flow into XPAP. Jim

I am wondering why it matters if oxygen "flows" into the XPAP machine? Doesn't oxygen get in there, anyway, even without a concentrator? There's apparently a piece of information I'm missing, and maybe you can supply it.

You have bearings in a XPAP, what are they lubed by, Oil or Grease. What happens to oil and grease, or event lint when exposed to high levels of O2, FIRE!!!

IF no fire, rust and corrosion are made worse, just simple rules, that's why the warnings. Jim

The higher level of O2, the more of a chance for a problem. The more O2, the lower the temp needs to be for IGN, even self IGN of the fuel.

[torontoCPAPguy]

Well gang, it's time for a new thread called "RESULTS OF O2 INFUSION INTO APAP LINE" so off we go. Follow this. It is fascinating. Last night was amazing but I find myself groggy this morning and have some aches and pains from laying still so long. But inside I think I am feeling energy building up. Will see what the day goes like. The ultimate tell will be another sleep study with the gear set up in the final configuration with O2 infusion.

[Zeke351]

Is it just me or does this feel like a soap opera cliffhanger? I can't wait to hear more.

Congrats on the results thus far.

Zeke351

[torontoCPAPguy]

Have started new thread entitled:
RESULTS OF O2 INFUSION INTO APAP AIR LINE! Interesting.

viewtopic/t55630/RESULTS-OF-O2-INFUSION ... sting.html

Could not figure out how to change the title of this thread... I'm on a roll here. Going to lower both the infusion rate from 4L/M to 3L/M tonight as well as the APAP pressure range tonight and see what the SaO2 sits at - lower pressures should maintain lower leak rate, etc. Lower infusion rate of 3L should bring me into the 95% range which is where I think I need to be ideally.

Next step is to build a feedback loop style infusion system like gvz did with an oxygen regulator valve; I have everything but the valve on hand at this point.

BTW, going to post this on the other thread too at some point, but I am finding that my one way O2 valve makes a heck of a racket - does that mean it is in backwards?
Or is that just the way it wants to keep closed and vent excess O2?