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Oxygen supplementation at night

Question
Hello, since the end of November I am taking oxygen at night (1.5-2l) and have several questions concerning this topic.

1. Which kind of water should I use? Distilled water or is demineralized water also sufficient? I heard also about tap water with salt and about that I do not need a humidification at all with an amount of 1.5-2 l.

2. How often do I have to change the water in the tank?

3. How do I clean the tank and how often?

4. How often do I have to change the tube?

5. How often do I have to change the tank?

6. Do I get the water reimbursed by the health insurance?

Questions over questions, probably you could help me. Many thanks in advance.

Answer
Dear questioner,

Beforehand several words about the humidification in case of oxygen therapy.
Humidification systems are in general not obligatory necessary in any case, but only in case of complaints with dry nasal mucosa etc. Those complaints do typically occur in case clearly more than 2l/min are used. There are countries, like Switzerland for example, where in hospitals the humidification of oxygen is totally abandonned for hygienic reasons.

In case you still have to humidify the oxygen due to complaints there are in general two possibilities:

1. The usage of sterile waterpacks (single use pack) for humidification of the airways. Such single use packs are not changed daily, as the quality of the water inhibits contamination over a long time. This is the reason, why those systems have displaced practically the systems which have to be filled by the user.

2. Systems, which have to be filled by yourself (your questions aim at this); in this context I would like to answer your questions point by point:

1) For the usage of your device you should use in any case sterile distilled water, in order to avoid the contamination of your device with any environmental germs.

2) The water in the tank should in any case be changed daily.

3)-5) For the next 3 questions (cleaning of the tank, changing of the tube, changing of the tank) you should act according to the instructions of the manufacturer, which can be different for every device.

6) If the health insurance covers the costs for the distilled water, you have to clarify with your insurance directly. As the distilled water is necessary for the therapy, one would think that this should not be a problem. However we have reports from other patients, who did not get the water reimbursed even after a long struggle with the insurance. Therefore one has to clarify it directly with the insurance company.

At the end I would like to point out, that in the usage of inhalation devices it is also very important to do the necessary disinfection of the hands. So please do not forget to disinfect your hands thoroughly with a disinfectant before using your device.

Yours sincerely,
Barbara Kahl, TOF Wagner and D. d’Alquen
21.02.2011