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Idiopathic Pulmonary Fibrosis

Jeremy Feldman, MD

  • What is Idiopathic Pulmonary Fibrosis?
    • Idiopathic Pulmonary Fibrosis Definition
    • Symptoms of Idiopathic Pulmonary Fibrosis
    • Causes of Idiopathic Pulmonary Fibrosis
    • Who Gets Idiopathic Pulmonary Fibrosis
    • Gastro-Esophageal Reflux (GER) and Idiopathic Pulmonary Fibrosis
    • Interstitial Lung Disease vs. Idiopathic Pulmonary Fibrosis
    • Is Pulmonary Fibrosis Hereditary?
    • Research, Life Expectancy and Prognosis for Idiopathic Pulmonary Fibrosis
  • Diagnosing & Monitoring PF
    • Monitoring Progress of IPF
    • Idiopathic Pulmonary Fibrosis Diagnosis
    • Chest X-rays Used in IPF
    • CPET used in IPF
    • HRCT Scans Used to Evaluate IPF
    • Lung Biopsy To Diagnose IPF
    • Pulmonary Function Tests (PFTS)
    • Six Minute Walk Test To Monitor IPF
    • Stages of Idiopathic Pulmonary Fibrosis
    • Complications of Idiopathic Pulmonary Fibrosis
  • PF Treatment Options
    • Esbriet (pirfenidone) Used to Treat IPF
    • OFEV (nintedanib) Used to Treat IPF
    • Pulmonary Rehab for IPF Patients
    • Lung Transplantation for Pulmonary Fibrosis
    • Oxygen Used to Treat IPF
      • Update on Oxygen Use
    • Clinical Trials in Idiopathic Pulmonary Fibrosis
    • IPF & Leg Swelling
    • Pulmonary Hypertension and Idiopathic Pulmonary Fibrosis
    • IPF Exacerbation
  • PF Advocacy & News
  • FAQ’s
    • Respiratory failure, NSIP, diet
    • Leg swelling, lung biopsy, side effects & pets
    • FAQ’s Enzyme Therapy, Progression of IPF & Oxygen
    • FAQ: Diarrhea, Fibrosis Reversal, IPF Symptoms
    • FAQ: Oxygen Flow, Anesthesia & Genetics
    • FAQ: Contagious Cough? Stem Cells, Familial IPF, Flying
    • FAQ: GERD, Fatigue & Environmental Exposure
    • FAQ: How to Travel to Your Doctor’s Office with Oxygen
    • FAQ: Lung Biopsy with Pulmonary Fibrosis
    • FAQ’s: Alcohol, Clinical Trials, Pulmonary Function Testing
    • FAQs: Emphysema, Exercise & Lung Biopsy

Oxygen Used to Treat IPF

Oxygen for pulmonary fibrosis.Idiopathic Pulmonary Fibrosis or IPF is a rare disease characterized by progressive replacement of normal lung tissue with scar tissue. The scarred tissue becomes thick and stiff making it harder for the lungs to exchange oxygen. Supplemental oxygen therapy helps alleviate some of the stress on the heart and other organs caused by pulmonary fibrosis. Oxygen is considered a medication and must be prescribed by a physician. Insurance companies have strict requirements for paying for oxygen and so your physician will have to document your oxygen saturations at rest and with exercise. Below are several different types of oxygen delivery systems that your physician may recommend.

Oxygen Flow Options

Low flow oxygen cannula

This is the most common type of oxygen cannula. They are inexpensive and comfortable. There are different brands that have different characteristics such as the length of the nasal prongs and the softness of the plastic. Low flow cannulas are designed to deliver flow rates of between 0.5 and 3 liters per minute (LPM)

High flow oxygen cannula

This type of cannula is designed to deliver higher oxygen flow rates, typically 4-10 LPM. They differ from low flow cannulas in that they have a larger lumen or internal dimension. This wider configuration allows oxygen to flow more easily with less resistance.

Demand oxygen or flow conserving devices

During continuous flow, much of the oxygen that flows through the nasal cannula is wasted. Patients only actually use oxygen during inspiration. The demand or pulse flow systems allows oxygen to flow only when a valve senses inspiration. This increases the efficiency of the tank by 3-7 fold. For example, a tank that would last 3 hours during continuous flow would last 9 hours or more with a pulse system. The main disadvantage is that patients requiring higher flow rates do not receive enough oxygen flow. For example, patients that typically use 3 LPM continuous flow may need to increase their flow rate to 5 LPM by pulse flow.

Some regulators have the ability to switch between continuous and demand flow. This is optimal for patients that use less oxygen at rest and require higher flows during activity. It allows patients to easily switch back and forth.

Reservoir systems

This type of nasal cannula is designed to improve the amount of oxygen that is inspired. It can also be used to reduce the oxygen flow rate, which may increase the duration that a portable tank can be used. For example, a reservoir cannula set at 2 LPM delivers the equivalent of 4 LPM with a low flow cannula. The only disadvantage of a reservoir cannula is that it is a bit bulkier than low flow cannula and more expensive.

Types of Oxygen Delivery Systems

Oxygen concentrators

There are two types of oxygen concentrators. The most common units are large and require continuous electricity. They are designed to be used at home. They tend to be quite noisy and patients often prefer to place them in an unused room. Oxygen tubing is then used to allow patients to walk around the house. Care must be taken not to trip over the long tubing that runs throughout the house. Typical concentrators can deliver 5-6 LPM of oxygen. Higher quality units can deliver up to 10 LPM.

When using an oxygen concentrator, your electricity bill will increase. In some cases, you may be able to get a reduction in your bill by filling out some forms. Also, everyone who uses an oxygen concentrator at home should have a plan for power outages. First, register with the local energy company so that your power is restored as a priority. Second, you must have backup portable tanks that are available for power outages. The electric company will request your physician sign a form confirming that oxygen has been prescribed for you and is medically necessary.

Portable oxygen concentrators (POC)

These systems have become much more popular in the past five years. They have rechargeable batteries and are lighter in weight than the older type of concentrators. The FAA and TSA now require this type of oxygen delivery system for use during airplane travel.

Key issues with portable concentrators are a trade-off between size, weight and the amount of oxygen the device can deliver. Most units deliver up to 3 LPM with a demand or pulse system. Larger units can deliver 5 LPM pulse flow. Patients should confer with their pulmonary specialists when planning to purchase a portable concentrator. Given their cost, it is important to choose a unit that can deliver an appropriate amount of oxygen now and for the next year or two as your oxygen requirement changes.

Most oxygen companies will provide a POC for patients that are planning air travel. It is important to plan in advance as it can take a few weeks to coordinate.

Compressed oxygen

This is the usual way that portable oxygen is delivered. Tanks of different sizes are available. The size of the tank is determined by the flow rate that patients require. Patients that require higher flow require larger tanks. Oxygen companies deliver tanks periodically. Patients are provided with one or two “regulators” which allows the tank to be accessed and used for oxygen delivery.

Auto fill compressed oxygen

This system uses the patient’s large home concentrator to refill portable oxygen tanks.

Liquid oxygen

The type of oxygen system uses a very large reservoir tank of compressed liquid oxygen in the home. Patients connect their nasal cannula to the tank. When away from home, patients have small tanks that they fill from the larger tank. Liquid oxygen has many advantages for patients. First, no electricity is required. Second, the portable tanks are light weight and can deliver high flow rates easily. The main disadvantage is cost. As a result of higher cost for oxygen companies, most companies are phasing out liquid oxygen.

Transtracheal oxygen

In this system, your physician performs a small surgery to insert a thin oxygen cannula directly through your neck. The main advantage of this system is that lower flow rates efficiently deliver oxygen. Furthermore, patients that are very troubled by the cosmetic aspect of oxygen cannula on the face may find a transtracheal oxygen catheter more acceptable. There are several problems with the system. First, insertion requires a small surgery.   Patients that would benefit most from this system are at high risk for complications from surgery. Second, thick mucous can form on the catheter and result in difficulty breathing. Lastly, some patients have cough from the catheter.

 

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  • What is Idiopathic Pulmonary Fibrosis?
    • Symptoms of Idiopathic Pulmonary Fibrosis
    • Causes of Idiopathic Pulmonary Fibrosis
    • Who Gets Idiopathic Pulmonary Fibrosis
    • Gastro-Esophageal Reflux (GER) and IPF
    • Interstitial Lung Disease vs. Idiopathic Pulmonary Fibrosis
    • Is Pulmonary Fibrosis Hereditary?
    • Research, Life Expectancy & Prognosis for Pulmonary Fibrosis

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  • Idiopathic Pulmonary Fibrosis Diagnosis
    • Chest X-rays Used in IPF
    • CPET used in IPF
    • HRCT Scans Used to Evaluate IPF
    • Lung Biopsy To Diagnose IPF
    • Pulmonary Function Tests (PFTS)
    • Six Minute Walk Test To Monitor IPF
    • Stages of Idiopathic Pulmonary Fibrosis
    • Complications of Idiopathic Pulmonary Fibrosis

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  • Pulmonary Fibrosis Treatment Options
    • Esbriet (pirfenidone) Used to Treat IPF
    • OFEV (nintedanib) Used to Treat IPF
    • Pulmonary Rehab for IPF Patients
    • Lung Transplantation for Pulmonary Fibrosis
    • Oxygen Used to Treat IPF
    • Clinical Trials in Idiopathic Pulmonary Fibrosis
    • IPF & Leg Swelling
    • Pulmonary Hypertension and Idiopathic Pulmonary Fibrosis
    • IPF Exacerbation

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