Difference Between Ambulatory Oxygen and Home Oxygen
Ambulatory oxygen is specifically designed for use during physical activity outside the home, while home oxygen (LTOT) is primarily intended for stationary use within the home environment, with ambulatory oxygen being a supplementary component for mobile patients.
Key Differences
Purpose and Usage
Home Oxygen (Long-Term Oxygen Therapy - LTOT):
Ambulatory Oxygen:
- Specifically designed for use during physical activity outside the home
- Portable systems that allow patient mobility
- Used when patients leave their residence or move around within it
- Should be considered for patients who are active outside the home, following an ambulatory oxygen assessment 1
Equipment Types
Home Oxygen Equipment:
- Oxygen concentrators (primary device for home use)
- Stationary systems connected to electrical outlets
- Provides consistent, long-term oxygen supply
- Recommended for flow rates of 4 L/min or less 1
Ambulatory Oxygen Equipment:
- Portable oxygen cylinders/tanks
- Portable liquid oxygen systems
- Portable oxygen concentrators (POCs)
- Lightweight systems designed for mobility
- Often equipped with oxygen-conserving devices to extend duration 1
Selection Criteria
The British Thoracic Society recommends that portable oxygen should be delivered by whatever mode best suits the individual patient's needs to increase daily oxygen usage and activity levels in mobile patients 1. This selection should consider:
- Patient's mobility profile and activity level 3
- Required flow rate (some portable systems have limited flow capabilities) 4
- Duration of time spent outside the home
- Physical ability to carry/transport the equipment
- Patient preference and comfort
Clinical Considerations
Assessment for Ambulatory Oxygen
- An ambulatory oxygen assessment should be performed before prescribing portable devices 1
- Oxygen-conserving devices should be considered for patients who are active outside the home 1
- Patients may need time to learn how to use ambulatory oxygen effectively 5
Equipment Burden
- All portable device types can be burdensome to patients 4
- Gas tanks are often reported as most burdensome (51% of users report high burden) 4
- Even with POCs (considered least burdensome), 29% of users still report high associated burden 4
- Many patients use POCs despite them not fully meeting oxygen needs due to advantages over alternative equipment 4
Practical Considerations
- Trolleys, wheeled carts, or backpacks should be offered to less able patients if assessment shows they improve ambulation and quality of life 1
- When transporting oxygen in cars, cylinders should be secured with a seat belt or in the foot-well/car boot 1
- Liquid oxygen should always be transported in an upright position 1
Common Pitfalls and Caveats
Inadequate Assessment: Failing to properly assess a patient's mobility needs before prescribing ambulatory oxygen can lead to poor adherence and wasted resources.
Flow Rate Limitations: Many portable oxygen concentrators have limited flow capabilities, which may not meet all patients' oxygen requirements during exercise 4.
Oxygen Conservation Devices: These devices vary in their ability to maintain oxygen saturation levels during exercise, and some patients (particularly mouth breathers) may struggle to trigger them 1.
Patient Education: Patients need adequate time and training to learn how to effectively use ambulatory oxygen systems 5.
Safety Concerns: Patients should receive formal education on the safe use of oxygen, particularly regarding fire hazards and transportation 1, 2.
By understanding these differences, clinicians can better match patients with the appropriate oxygen delivery systems to optimize mobility, quality of life, and adherence to therapy.