The beat goes on ... and up and down

Friday, April 30, 2004

CHATSWORTH, Calif. - Some 20 years after the pulse began to beat for oxygen conservers, the company credited with pioneering the technology has introduced a new family of conserving devices that automatically adjusts the rate of flow between settings for rest and exertion.

Using a built-in motion sensor, CHAD’s Sage oxygen therapeutic device switches from a lower rate of flow to a higher rate when a patient rises from a sitting position. A noise filter distinguishes between an accidental bump or jolt and actual activity whether a patient is carrying the Sage over a shoulder or in a cart.

The device addresses one of the frank realities of oxygen conserver utilization. Doctors usually prescribe a single rate of flow for home oxygen patients. Most home oxygen patients, however, manually self-prescribe more oxygen when they need it, sometimes at the doctor’s suggestion and sometimes because it feels right.
For CHAD, the Sage therapeutic device, which was still awaiting FDA approval at press time, is a logical next step after conservers.

“Conserver devices, when properly applied, can be very clinically effective,” said CHAD Marketing Manager Carla Laureano. “A lot of times they are not because patients are not properly educated on how they need to be switching between settings.”

Clinical effectiveness and scientific proof thereof has become a more urgent issue for manufacturers in recent years as providers demand that vendors who talk the talk also walk the walk. CHAD has conducted a study that shows the benefits of Sage over continuos flow and is awaiting word on publication in a peer review journal.

“The SAGE device was able to maintain adequate SaO2 during both rest and exertion,” the study’s authors write. “While there were transient dips in SaO2 with both devices during rest periods following an exercise period, all saturations returned to the previous resting level and the patients were able to proceed to the next exercise trial without experiencing wide swings in exercise SaO2.”

Many clinicians today believe that ambulation improves the quality of life and outcomes for oxygen patients. But for many, the get-up-and-go gets up and goes the day they start oxygen therapy.

“The common complaint we get is that people don’t go out into the yard now that they are on oxygen,” said David Mills, owner of First Choice in Home Care in Chesapeake, Va.

Some of that disincentive might be traced to desaturation and windedness that comes from a single flow prescription.

At Hytech Home Care in Mentor, Ohio, President Joe Lewarski believes it’s the size of the device, not its performance, that creates the disincentive.

“They are not concerned about desaturating when they ambulate,” said Lewarski. “Most often, we hear that the device is too heavy, or they don’t like the way it looks, or they are embarrassed.”

Nonetheless, the demand for more oxygen during ambulation is high. A survey of 495 home oxygen patients conducted by an independent research organization, Valley Inspired Products, in July 2002 found that 64% used a different setting for walking as compared to rest.