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Introduction

Clinical studies have demonstrated that many COPD patients using supplemental oxygen with oxygen conserving devices (OCD) do not maintain their S_pO₂ at acceptable levels (>90%) during exercise. The causes of desaturation are multifactoral and frequently due to the selection of an OCD that is unable to meet the patient’s oxygenation needs. For this reason, many pulmonary rehab centers have standard protocols which put all patients on continuous flow oxygen during rehab, which often does not match their ‘real world’ conditions.

Problem Statement

There are many OCDs in the marketplace and performance characteristics such as sensitivity, oxygen dose volume, and timing of dose delivery vary widely. A common characteristic of traditional conservers is that during activity, and as respiratory rate increases and inspiratory time decreases, the percentage of oxygen (F_iO₂) being delivered to the airway decreases. This means that during the times of highest oxygen need, traditional OCDs are frequently unable to meet that need resulting in continuing oxygen desaturation which has the potential to increase breathlessness, limit activity levels, reduce quality of life, and even shorten life expectancy.

Previous Options

Until now, clinicians have been lacking a portable oxygen solution that provided for patients' ever changing oxygen needs during activity. With decreasing cost as a primary driver, OCD’s performance has suffered, especially in O₂ delivery and in triggering sensitivity. Oxygen doses are smaller and tend to decrease as patients are active.  In many cases, patients can not or do not trigger the units consistently and therefore, don’t signal the unit to deliver oxygen. In other cases, the oxygen is delivered too late during inhalation or even during exhalation

The Inspired Technologies Solution

Inspired Technologies has developed SmartDose (patent pending), a revolutionary new technology which adjusts itself to deliver the right amount of oxygen based on the patient’s needs. SmartDose monitors a patient’s breathing patterns and automatically increases the oxygen dose as breath rate and I:E ratios change during activity. This allows the patient to receive an increasing amount of oxygen during the times when they need it most, preventing desaturation, decreasing breathlessness, and even increasing the patient’s ability to maintain activity.

Because we feel so strongly about the effectiveness of the SmartDose technology, we created the Clinical Oxygen Dose Recorder (CODR). This small recorder connects to the patient and any portable oxygen source, or no oxygen source (room air) and allows clinicians to monitor oxygen saturation, pulse, respiratory rate, I:E ratio, and OCD dosing data. Data can be viewed in real time, breath by breath by wireless transmission to your computer or retrospectively, looking at trended data.

Recently, SmartDose was used on patients at the Cheboygen Memorial Hospital – Cardio-Pulmonary Rehab . Two patients were tested on their current oxygen equipment, or on continuous flow, and then on the SmartDose system. Both were monitored with the CODR.

Note that each patient was tested with their own equipment or continuous flow first, then allowed to rest, and tested with SmartDose second to ensure that fatigue was not a factor in any favorable outcomes with SmartDose.