Breathe Easier. Single-Prong Cannula Represents Important Breakthrough in Oxygen Therapy for COPD Patients

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1 Breathe Easier Single-Prong Cannula Represents Important Breakthrough in Oxygen Therapy for COPD Patients Author: Campbell C. Cauthen, III, BA, BSRRT, Co-founder & Co-inventor, Uni-flo2 Single-Nasal Cannula Uni-flo2 is a registered trademark of UPODS, LLC of DE Copyright 2018 UPODS, LLC US Patents #9,440,039 and 9,925,348

2 Overview Chronic obstructive pulmonary disease (COPD) is an inflammatory lung disease that causes obstructed airflow within the lungs, resulting in shortness of breath with everyday activities. Chronic bronchitis and emphysema are the two most common conditions contributing to COPD. People suffering from lung cancer and heart disease may also develop the symptoms of COPD and may benefit from supplemental oxygen. Not everyone with COPD requires oxygen therapy, but for many patients it is an essential part of their treatment plan. COPD patients may be prescribed oxygen therapy if the physician concludes that supplemental oxygen may address hypoxia -- if the level of oxygen in their bloodstream is below normal -- or improve their health and well-being. Hypoxia is often determined by an arterial blood gas test, or by a pulse oximeter. By increasing the amount of oxygen in the patient s body, oxygen therapy often improves quality of life for people with COPD by decreasing their shortness of breath, fatigue, and potentially improving mental alertness, mood and quality of sleep. The choice of oxygen delivery devices depends on the patient s oxygen requirement, efficacy of the device, reliability, ease of therapeutic application and patient acceptance. Although the oxygen device design plays an important role in selection of these devices, clinical assessment and performance ultimately determine how and which device should be selected. Currently in common use, a two-pronged nasal cannula is an oxygen medical device that delivers oxygen from an oxygen source to two small plastic tubes placed in the nostrils. Oxygen can be administered in a home setting, hospital, treatment center, and when the patient is mobile. In this paper, we examine issues related to the method of delivery of oxygen in supplemental oxygen therapy and explore the advantages of a breakthrough redesign of the nasal cannula delivery system -- a single-prong nasal cannula -- for people living with COPD. With the vast number of COPD patients struggling to breathe and requiring low flow supplemental oxygen, the introduction of the discreet, lightweight Uni-flo 2 Single-nasal Cannula System (Uni-flo 2 ) is a welcome life-changing experience that may optimize oxygen metabolism and improve health.

3 A Look at COPD Chronic Obstructive Pulmonary Disease (COPD) describes lung diseases such as emphysema, chronic bronchitis, and severe asthma. The World Health Organization (WHO) ranks COPD as the third leading cause of death worldwide accounting for approximately three million deaths each year. Avoiding inhaling tobacco smoke, home and workplace air pollutants, and the causes of respiratory infections reduces the risks of COPD. Early detection of COPD may change its course and progress. A simple test, called spirometry, can be used to measure lung function and detect COPD in people with pulmonary problems. Issues with Two-Pronged Nasal Cannulas The nasal cannula is the most common oxygen delivery system in out-patient, hospital, and home therapy settings when low flow (1-6 liters/minute) oxygen is required, and the patient is in a stable state. This low flow supplemental oxygen support allows them to eat, drink and speak while also receiving the supplemental oxygen. The issues presented by the two-pronged cannula are the result of the cannula design and the nature of oxygen gas. Inherently, oxygen is a dry gas which may cause the mucosal membranes in the nasal passages to become hypersensitive and irritated. To compound the problem, the design of the two-pronged cannula may itself irritate the nostrils. To understand the cause of the irritation, it is important to understand how the two-pronged cannula is positioned on the face. Without going into too much detail, the two-pronged cannula placement with the prongs in the nose is supported by resting the base of the nasal prongs on the upper lip and suspending the oxygen tubing over the top of both ears and under the chin in a nooselike configuration. The oxygen tubing over time can become relatively heavy. Daily activity, and as the tubing warms to body temperature, can cause the tubing to lose its original shape, which changes the positioning of the cannula prongs. Patients must frequently adjust the cannula position by tightening or adjusting the noose under their chin, which can cause pressure, friction and irritation to the upper lip, across the cheeks, and over the top of the ears. This interaction of the two-pronged cannula design and the characteristics of the dry oxygen can cause chafing and irritation to the nasal septum, conditions that can lead to sores in the nose, on the upper lip, and on the ears. These pressure sores may become infected and require medical assessment and treatment.

4 A New Standard in Oxygen Delivery Prescribing physicians, respiratory therapists, and caregivers are continually looking for newer devices that use technological advancements to improve the comfort and practice of oxygen therapy for patients with COPD. The Uni-flo 2 single-nasal cannula offers a breakthrough patient-centric solution that ensures continuous oxygen flow equivalent to the low flow dual-pronged cannula with half the skin contact and a reduction in the negative related physical side effects of the dual-pronged cannula. A patient satisfaction survey demonstrated that 98 percent of low flow oxygen patients contacted found the Uni-flo 2 to be more comfortable, stable and secure than a two-prong system. Among the advantages of the Uni-flo 2 most frequently cited by COPD patients are: Greater comfort Freedom of movement Avoidance of facial skin irritation Improved sleep Ease of eating Enhanced ability to smell fragrances and food Enhanced personal appearance With the vast number of COPD patients struggling to breathe and requiring low flow supplemental oxygen, the introduction of the Uni-flo 2 discreet, lightweight single-cannula enables prescribers to provide their patients with a life-changing alternative that may optimize compliance.

5 What is the Uni-flo 2 Single-Nasal Cannula? The Uni-flo 2 single-nasal cannula system has a single-nasal prong attached to one oxygen tube for the delivery of low flow oxygen. The single-oxygen tubing crosses only one side of the face and is supported by a multiple strain relief system. The oxygen tubing goes over the ear, behind and across the neck and is attached by a security clip to the clothing on the chest of the patient. The Uni-flo 2 conforms to facial contours to eliminate chafing, and facial or neck irritation. It is interchangeable to either nostril and is supported for strain-relief, ensuring oxygen flow and reducing oxygen tube tugging or pulling on the patient s nose, nasal septum and ears. The Uni-flo 2 is the first nasal cannula of its kind designed with the user s dignity, comfort and safety in mind. Half the weight, half the skin contact, and twice as discreet, the Uni-flo 2 conforms and ensures continuous low flow oxygen availability and maximizes patient comfort. Testimonial The single-prong nasal cannula of Uni-flo 2 is perfect for my challenge with COPD. I am missing cartilage in my right ear, so I can t use a two-prong cannula without taping it on. Uni-flo 2 Single-Nasal Cannula System gives me the pulse oximetry I need and increased comfort. - Mike M, Wichita Falls, Texas

6 Why the Uni-flo 2 System Works Unique Design Fundamentally, the Uni-flo 2 single-nasal cannula works better than the dual-pronged cannula because of its unique design considering the respiratory system and adapting to the unique physical characteristics of each oxygen dependent patient. There is no need for two nasal prongs and two oxygen tubes across the face to deliver low flow supplemental oxygen; a single-prong with the proper nasal insert design and correct placement may improve oxygen absorption. Uni-flo 2 has a patented nose piece design that has a trumpet oxygen port. The "nasal trumpet" is designed to enhance anatomical positive end-expiratory pressure in the lungs and improve oxygen availability for absorption in the lungs. The nasal trumpet fits comfortably inside the nostril and is easily adjusted; thus, it can be positioned inside the nostril with minimal nasal mucosal contact. The combination of these factors results in a secure comfortable placement in the selected nares. In addition, should nasal mucosal dryness occur in the nasal passages, or if the patient has a deviated septum or other blockage, the nasal trumpet can be switched to the opposite nostril. This simple and effective design allows for placement in either the left or right nostril. The unique design of the Uni-flo 2 does not require support by the upper lip. This design not only eliminates irritation to the nasal septum but may also enhance patient compliance by continued use of oxygen during meals and other activities. In addition to the unique nasal trumpet design, the Uni-flo 2 single-nasal cannula eliminates oxygen tubing over both ears and cheeks and eliminates the restrictive tubing harness under the chin. Because the Uni-flo 2 has a single oxygen tube on one side of the face, it is low profile and less visible. Placement of the soft-design Uni-flo 2 on just one side of the face greatly reduces the opportunity for skin chafing and facial pressure against a pillow with sleep, enhancing comfort during rest or sleep. The single-prong and single tubing of Uni-flo 2, visible from only one side of the face, is found by many patients to be cosmetically more appealing and therefore promotes patient compliance with supplemental oxygen prescriptions.

7 Comfort The device has a memory tube system that allows the Uni-flo 2 nasal cannula to be molded to the individual patient s unique facial contours, which helps secure placement of the memory tubing. The nasal trumpet, which is made of hypoallergenic medical compounds, is inserted into either selected nostril and, supported by the memory tube system across the cheek, placed over the ear and molded comfortably behind the ear. Once in place and affixed to the patient s apparel with the security clip, the patient can move freely during daily activities with comfort and confidence. Works As Well, Or Better, Than Dual Prong Original performance data indicate that the Uni-flo 2 low flow nasal cannula works as well as a dual-prong low flow oxygen cannula, with internal validation studies reporting equivalent or higher POX readings with the single-prong using oxygen cylinders and pulse dose oxygen concentrators. Clinical experience shows effective support of patients using the single-prong approach. The Uni-flo 2 provides a method of delivering oxygen when one nostril is not available, such as when a nasal-gastric tube or feeding tube is in place, when a patient has a deviated septum, or when a patient requires facial surgery. The Uni-flo 2 cannula can be positioned on the opposite side of the face to provide prescribed low flow oxygen support to the patient. The Uni-flo 2 is interchangeable to either the right or left nostril. Clinical experience shows that the ability to alternate sides can reduce the adverse effects of oxygen irritation, sores, ear discomfort, nasal septal irritation and/or pressure ulcers. High Patient Satisfaction Studies show a high level of customer satisfaction which has led many dual-prong users to convert to Uni-flo 2. This conversion is due to increased comfort and dignity, lower profile, less plastic on skin and the elimination of constriction around the neck or throat. In addition, because the Uni-flo 2 uses only one nostril, the sense of smell is enhanced. Patients have commented that they can once again smell aromas, such as food cooking, coffee brewing, flowers in the garden, and smoke from fires. The Uni-flo 2 may also improve one s appetite because the sense of smell greatly impacts the pleasure of eating meals.

8 Optimal Oxygen Delivery The Uni-flo 2 contains a universal female oxygen bushing that fits all standard male connectors (ISO-STD 594). Additionally, internal validation studies show equivalent or higher POX readings with the singleprong using oxygen cylinders and pulse dose oxygen concentrators. The Uni-flo 2 cannula is a low flow (1-6 liters) oxygen cannula. There is no reason to change the prescribed oxygen flow rate provided by the patient s physician while using the Uni-flo 2 nasal cannula. Ease of Use For patients who are bedridden much of the day or have limited ability to raise their head, the Uni-flo 2 can be worn by simply directing the tubing around the ear and to the front of the body, rather than behind the neck, attaching the security clip to the clothing on the opposite side of the body of the nasal trumpet. Wearing the Uni-flo 2 in front of the body is also a recommended option while sleeping. This allows sleeping supine or on the opposite side of the oxygen tubing, with full freedom to sleep comfortably because the user s face is not in direct contact with the oxygen tubing and against the pillow. This eliminates discomfort and tube impressions on the face by the oxygen tubing. Summary Living with COPD may present challenges, but it does not need to define those who have the disease. Many individuals with COPD lead active lives, especially when their disease is diagnosed in its early stages. Innovations designed to make life easier for these individuals are an important way to enhance their dignity and comfort. For those who are dependent on oxygen, the Uni-flo 2, single nasal cannula provides a safe, secure, easy to use, and discreet device. Not only is it more comfortable than dual-pronged cannulas, it also may provide more efficient oxygen delivery and has the potential to reduce oxygen costs over time.

9 Sources 1. COPD.net; COPD Treatment Guidelines; accessed July 10, Kenneth Miller; Oxygen Administration; What is the best choice?; RT Magazine; Oct. 12, 2015; accessed July 10, World Health Organization; Top 10 causes of death; May 24, 2018; news-room/fact-sheets/detail/the-top-10-causes-of-death; accessed July 10, Centers for Disease Control and Prevention; What is COPD? accessed July 10, Nursing Times; When should a nasal cannula be used to deliver oxygen?; Jan. 7, 2011; accessed July 10, 2018.

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