Benefits of an Oxygen Reservoir Cannula versus a Conventional Nasal Cannula during Exercise in Hypoxemic COPD Patients: A Crossover Trial

Abstract

Background: The Oxymizer® is a special nasal cannula that provides a higher luminal diameter in combination with an incorporated oxygen (O₂) reservoir. It is assumed that a higher O₂ concentration can be delivered breath by breath in order to increase oxygenation. Objective: We aimed to investigate the effects of the Oxymizer on endurance time in comparison to a conventional nasal cannula (CNC). Methods: Forty-three patients with severe chronic obstructive pulmonary disease (COPD, age 60 ± 9 years, FEV₁ 37 ± 16% pred.) and indications for LTOT were recruited during pulmonary rehabilitation for this cross-over study. After an initial maximal incremental cycle test, all patients performed 4 cycling endurance time tests at 70% of their peak work rate (twice with the Oxymizer and twice with a CNC, in reverse order). Results: The endurance time was significantly higher when patients cycled while using the Oxymizer in comparison to while using the CNC [858 ± 754 vs. 766 ± 652 s; between-group difference 92 s (95% confidence interval 32-152), p < 0.001]. In addition to a longer cycling duration, O₂ saturation at isotime was significantly higher with the Oxymizer (93.5 ± 5.4 vs. 90.4 ± 5.3%; p = 0.027). Furthermore, there was a positive correlation (r = 0.427, p = 0.002) between the O₂ flow rate and improvements in the constant work rate test, showing greater improvements in favor of the Oxymizer in patients with a higher demand for O₂ (≥4 liters/min). Conclusion: We show that O₂ delivery via the Oxymizer is superior to a CNC with regard to endurance capacity and oxygenation during exercise in patients with severe COPD. It seems that patients with a higher demand for O₂ (≥4 liters/min), in particular, may benefit more from the use of the Oxymizer.

Long-Term Oxygen Therapy

“…Manufacturers should make it possible to measure compliance in terms of device use (which is technically possible). In addition, modified delivery systems could increase the efficiency of LTOT during increased oxygen demand (e. g., by using nasal cannulae with larger luminal diameter and an oxygen reservoir) (29).…”

A randomized cross-over trial on the direct effects of oxygen supplementation therapy using different devices on cycle endurance in hypoxemic patients with Interstitial Lung Disease

“…This may lower flow rates and thereby reduce oxygen costs and even more important increase ambulation by making portable system last longer [15–17]. Moreover, supplemental oxygen therapy administered by a Oxymizer improves resting and exercise arterial oxygen tension and saturation when compared to CNC in selected patients with chronic obstructive pulmonary disease (COPD) [16–18] and for a small number of patients with ILD [19]. However, the effect of breathing supplemental oxygen therapy with Oxymizer compared to CNC during exercise has not been studied in patients with ILD.…”

Acute effects of supplemental oxygen therapy using different nasal cannulas on walking capacity in patients with idiopathic pulmonary fibrosis: a randomised crossover trial

“…With CNC, only one reached this MID. Previously published studies of the Oxymizer used cycling exercise and did not reach clinical significance [3,5]. In the Edvardsen study [3], participant pathologies were diverse and not specific to IPF.…”

“…In the Edvardsen study [3], participant pathologies were diverse and not specific to IPF. Further, in the Edvardsen [3] and the Gloeckl [5] study, cycle exercise was used which is not as demanding on oxygenation as walking and therefore could have limited improvements in exercise performance.…”

“…4 Research Office (Biostatistics), Paracelsus Medical University, Salzburg, Austria. 5 Dept of Ophthalmology and Optometry, Paracelsus Medical University, Salzburg, Austria. 6 Research Program Experimental Ophthalmology and Glaucoma Research, Paracelsus Medical University, Salzburg, Austria.…”