9+ Best Oxygen Machine Humidifiers & Bottles (2024)


9+ Best Oxygen Machine Humidifiers & Bottles (2024)

Supplemental oxygen, often prescribed for respiratory conditions, can dry out the nasal passages and airways. A device designed to add moisture to this oxygen flow helps alleviate dryness and irritation, improving patient comfort and overall respiratory health. This moisturization is typically achieved by bubbling the oxygen through distilled water.

Maintaining proper humidity levels in supplemental oxygen is crucial for preventing nosebleeds, sinus discomfort, and dry coughs. Historically, simpler methods like placing a water basin near the oxygen source were used, but modern devices offer more precise control and hygienic delivery of moisture. This increased comfort can lead to better patient compliance with prescribed oxygen therapy.

The following sections will explore various aspects of oxygen moisturization, including different types of humidification devices, proper usage and maintenance, potential complications, and best practices for ensuring optimal respiratory comfort and health.

1. Distilled Water Only

Oxygen humidifiers require the exclusive use of distilled water. This stipulation stems from the nature of tap water, which contains minerals and impurities. When tap water is heated and aerosolized within a humidifier, these minerals can accumulate within the device, leading to reduced efficiency and potential blockage. Furthermore, the airborne mineral particles can be inhaled, potentially irritating sensitive airways. In contrast, distilled water, purified through evaporation and condensation, lacks these impurities, ensuring optimal humidifier performance and safeguarding respiratory health. For example, using tap water can lead to a white dust-like deposit on surfaces near the oxygen outlet, a clear indication of mineral buildup. This buildup not only affects the humidifier’s efficiency but also introduces potentially harmful particles into the user’s respiratory system.

This practice is crucial for maintaining the hygiene of the humidification process. The warm, moist environment within a humidifier can be conducive to bacterial growth. While distilled water isn’t sterile, the absence of minerals inhibits the rapid proliferation of microorganisms that might occur with tap water. This minimizes the risk of delivering contaminated moisture into the airways, particularly important for individuals with compromised respiratory systems. Consider a scenario where a patient with a chronic lung condition uses tap water in their humidifier. The mineral buildup could harbor bacteria, increasing their risk of infection.

Adhering to the distilled water requirement is fundamental for the safe and effective operation of oxygen humidifiers. Neglecting this precaution can compromise device longevity, reduce humidification efficiency, and pose health risks to users. The simple act of using distilled water ensures that the delivered oxygen remains free of contaminants, contributing significantly to patient comfort and respiratory well-being. Ultimately, this practice exemplifies a proactive approach to minimizing potential complications and maximizing the therapeutic benefits of supplemental oxygen.

2. Regular Cleaning

Maintaining a sterile environment within an oxygen humidifier is paramount for patient safety and device efficacy. Regular cleaning is essential to prevent the proliferation of microorganisms and ensure the delivery of clean, humidified oxygen. Neglecting this crucial aspect of humidifier maintenance can lead to bacterial contamination, potentially causing respiratory infections and compromising the therapeutic benefits of oxygen therapy.

  • Frequency and Procedure

    Cleaning should occur at manufacturer-recommended intervals, typically every 1 to 3 days, depending on usage frequency and environmental conditions. The procedure usually involves disassembling the humidifier, washing components with mild soap and water, and thoroughly rinsing with distilled water. Specialized cleaning solutions may be recommended for certain devices. Proper drying of all parts before reassembly is crucial to prevent bacterial growth and ensure proper device function. For instance, leaving residual moisture within the humidifier chamber can create a breeding ground for bacteria, negating the benefits of cleaning.

  • Preventing Bacterial Growth

    The warm, moist environment within a humidifier creates ideal conditions for bacterial growth. Regular cleaning disrupts this environment, removing any accumulated biofilm and microorganisms. This preventative measure significantly reduces the risk of patients inhaling contaminated moisture, which could lead to respiratory infections, particularly in individuals with compromised immune systems or pre-existing respiratory conditions. Imagine a scenario where a patient recovering from pneumonia uses a poorly maintained humidifier. The contaminated moisture could re-infect their lungs, hindering recovery and potentially leading to further complications.

  • Maintaining Device Integrity

    Regular cleaning also contributes to the longevity and optimal performance of the oxygen humidifier. Mineral buildup from tap water or accumulated debris can obstruct the device’s components, affecting its ability to effectively humidify the oxygen flow. Thorough cleaning removes these obstructions, ensuring efficient operation and prolonging the device’s lifespan. For example, a clogged diffuser can reduce the amount of moisture delivered to the oxygen, compromising patient comfort and therapeutic effectiveness.

  • Disinfecting vs. Sterilizing

    While regular cleaning with soap and water effectively removes most bacteria and debris, periodic disinfection or sterilization may be necessary. Disinfection involves using a chemical solution to eliminate a wide range of microorganisms, while sterilization aims to eradicate all forms of microbial life, including spores. The specific method depends on the manufacturer’s recommendations and the patient’s individual needs. In certain clinical settings or for immunocompromised patients, sterilization might be the preferred method to ensure maximum protection against infection.

In summary, regular cleaning is an indispensable aspect of oxygen humidifier maintenance. It directly impacts patient safety, device functionality, and the overall effectiveness of oxygen therapy. By adhering to recommended cleaning protocols, healthcare providers and patients can contribute significantly to a safer and more comfortable respiratory care experience.

3. Prevent bacterial growth

Preventing bacterial growth within oxygen humidifiers is critical for patient safety and the efficacy of oxygen therapy. These devices, designed to add moisture to supplemental oxygen, create a warm, humid environment conducive to microbial proliferation. Without proper preventative measures, bacterial contamination can occur, posing significant health risks to users, particularly those with pre-existing respiratory conditions or compromised immune systems.

  • Stagnant Water as a Breeding Ground

    Stagnant water within the humidifier chamber provides an ideal breeding ground for bacteria. The warmth and humidity create optimal conditions for rapid microbial multiplication. For example, if a humidifier is left unused for extended periods with water inside, it can become heavily contaminated, even if initially filled with distilled water. This underscores the importance of regular cleaning and emptying the humidifier when not in use.

  • Biofilm Formation and Persistence

    Bacteria can adhere to surfaces within the humidifier, forming biofilms. These biofilms are resistant to removal by simple rinsing and can harbor a variety of microorganisms. Over time, these biofilms can become a persistent source of contamination, continuously releasing bacteria into the humidified oxygen stream. This poses a risk of inhalation and potential respiratory infection. Regular cleaning and disinfection are essential to disrupt and remove biofilms, preventing their establishment and spread.

  • Impact on Respiratory Health

    Inhaling bacteria-laden aerosol from a contaminated humidifier can have serious consequences for respiratory health. Patients with underlying lung conditions, such as chronic obstructive pulmonary disease (COPD) or asthma, are particularly vulnerable. The introduction of bacteria into their airways can exacerbate existing conditions or trigger new infections, leading to increased hospitalizations and decreased quality of life. In immunocompromised individuals, even seemingly harmless bacteria can cause severe infections.

  • Mitigation Strategies

    Effective strategies for preventing bacterial growth include using only distilled water, regular cleaning and disinfection according to manufacturer guidelines, and proper storage of the device when not in use. Emptying and drying the humidifier between uses significantly reduces the risk of bacterial proliferation. Furthermore, adhering to prescribed replacement schedules for disposable components, such as filters and tubing, ensures optimal hygiene and minimizes the potential for contamination. These practices collectively contribute to a safer and more effective oxygen therapy experience.

The relationship between bacterial growth and oxygen humidifiers highlights the crucial role of hygiene and maintenance in respiratory care. Diligent adherence to preventative measures, including regular cleaning, disinfection, and the exclusive use of distilled water, safeguards patient health and ensures the delivery of clean, humidified oxygen, maximizing the therapeutic benefits and minimizing potential risks.

4. Proper Connection

Proper connection of a humidifier to an oxygen machine is paramount for safe and effective oxygen therapy. A secure, leak-free connection ensures the delivered oxygen flows through the humidifier, receiving the intended humidification. Incorrect or loose connections can lead to several issues, compromising both comfort and therapeutic efficacy.

An improperly connected humidifier can result in oxygen leakage. This leakage reduces the amount of oxygen reaching the patient, potentially diminishing the treatment’s effectiveness. Leaked oxygen also represents a wasted resource and, in certain environments, can pose a fire hazard. For instance, a loose connection between the humidifier bottle and the oxygen tubing can allow oxygen to escape into the surrounding air. In a home setting with a nearby open flame, this leak could create a dangerous situation. Furthermore, leaks can disrupt the pressure within the oxygen delivery system, affecting the accuracy of the prescribed flow rate. A patient relying on a specific oxygen concentration might receive a lower dose than intended due to a leaky connection, compromising their respiratory stability.

Beyond safety concerns, improper connections can also negatively impact patient comfort. If the oxygen bypasses the humidifier due to a faulty connection, it remains dry, potentially irritating the nasal passages and airways. This dryness can lead to discomfort, nosebleeds, and a decreased willingness to adhere to prescribed oxygen therapy. Consider a patient experiencing nasal dryness and discomfort due to a poorly connected humidifier. This discomfort could discourage them from using their oxygen therapy consistently, ultimately hindering their respiratory recovery. Ensuring a proper connection directly contributes to patient comfort and compliance, maximizing the therapeutic benefits of supplemental oxygen.

In summary, the proper connection of a humidifier to an oxygen machine is not merely a technical detail but a critical aspect of safe and effective oxygen therapy. A secure connection ensures the prescribed oxygen flow is humidified and delivered to the patient without leakage, promoting both comfort and therapeutic efficacy. Understanding the potential consequences of improper connections underscores the importance of meticulous attention to this often-overlooked detail. This meticulousness ultimately contributes to improved patient outcomes and a safer respiratory care experience.

5. Compatible Oxygen Source

Compatibility between an oxygen source and a humidifier is essential for effective and safe oxygen therapy. Oxygen concentrators, liquid oxygen systems, and compressed oxygen cylinders operate at different pressures and flow rates. A humidifier must be designed to function within the specific parameters of the chosen oxygen source. Using an incompatible humidifier can lead to inefficient humidification, device malfunction, or even safety hazards. For instance, a humidifier designed for low-flow oxygen from a concentrator might not function correctly or could even be damaged if connected to a high-pressure cylinder. Conversely, a high-flow humidifier attached to a low-flow concentrator may not provide adequate humidification.

Oxygen source compatibility also dictates the type of humidifier suitable for use. Some humidifiers are specifically designed for use with concentrators, while others cater to high-flow systems. Choosing the correct humidifier ensures optimal performance and prevents potential complications. For example, bubble humidifiers are commonly used with oxygen concentrators, providing adequate humidification for low-flow rates. High-flow systems, on the other hand, often require pass-over humidifiers capable of handling larger volumes of oxygen. Practical considerations, such as the intended use environment (home, hospital, portable), also influence humidifier selection. Portable oxygen concentrators typically utilize smaller, lightweight humidifiers designed for mobility.

Understanding the nuances of oxygen source compatibility ensures safe and effective oxygen delivery. Using the correct humidifier not only optimizes humidification but also safeguards against device malfunction and potential harm. This understanding empowers healthcare providers and patients to make informed decisions regarding equipment selection and contributes to a more comfortable and effective respiratory therapy experience. Neglecting compatibility can lead to suboptimal treatment outcomes, emphasizing the practical significance of this knowledge in respiratory care.

6. Appropriate Flow Rate

Appropriate oxygen flow rate is intrinsically linked to the effectiveness of an oxygen humidifier. The flow rate, measured in liters per minute (LPM), directly impacts the humidifier’s ability to add moisture to the oxygen stream. Insufficient flow rates may not generate enough airflow to properly aerosolize the water, leading to inadequate humidification. Conversely, excessively high flow rates can overwhelm the humidifier, reducing its ability to saturate the oxygen with moisture and potentially delivering excess water into the oxygen tubing. Understanding the interplay between flow rate and humidification is crucial for achieving optimal therapeutic benefit and patient comfort.

  • Impact on Humidification Efficiency

    The flow rate significantly influences the efficiency of the humidification process. Lower flow rates allow more time for the oxygen to interact with the water, facilitating greater moisture absorption. Higher flow rates reduce this contact time, potentially resulting in drier oxygen delivery. For example, a flow rate of 2 LPM through a bubble humidifier allows for more thorough humidification than a flow rate of 6 LPM. This highlights the importance of matching the flow rate to the humidifier’s capabilities to ensure adequate moisture output.

  • Condensation and “Rainout”

    Excessive flow rates can lead to a phenomenon known as “rainout,” where excess moisture accumulates in the oxygen tubing. This occurs when the rapid airflow prevents the water vapor from fully integrating into the oxygen stream, causing condensation within the tubing. Rainout can disrupt oxygen delivery, potentially delivering water droplets to the patient and creating a breeding ground for bacteria. Managing flow rate appropriately minimizes the risk of rainout, ensuring consistent oxygen delivery and maintaining hygiene.

  • Prescribed Flow Rates and Humidification Needs

    Oxygen therapy is prescribed at specific flow rates based on individual patient needs. These prescribed rates must be considered when selecting and operating a humidifier. A humidifier should be chosen and adjusted to effectively humidify the prescribed flow rate, ensuring both comfort and therapeutic efficacy. For instance, a patient requiring a high flow rate might need a specialized high-flow humidifier to ensure adequate moisture delivery. Matching the humidifier to the prescribed flow rate is crucial for optimizing treatment outcomes.

  • Humidifier Design and Flow Rate Capacity

    Different humidifier designs have varying flow rate capacities. Bubble humidifiers, commonly used with oxygen concentrators, are typically suited for lower flow rates. Pass-over humidifiers, often employed in hospital settings, are designed to handle higher flow rates. Selecting a humidifier with an appropriate flow rate capacity ensures optimal performance and prevents potential complications. Using a low-flow humidifier with a high-flow oxygen source can lead to inadequate humidification and potential device strain.

The relationship between appropriate flow rate and humidifier effectiveness is a fundamental aspect of oxygen therapy. Matching the flow rate to the humidifier’s capabilities ensures optimal humidification, minimizes the risk of complications like rainout, and ultimately contributes to a more comfortable and effective treatment experience. Understanding this interplay is crucial for healthcare providers and patients alike, empowering informed decision-making and promoting better respiratory care outcomes.

7. Monitor water level

Monitoring the water level in an oxygen humidifier is a fundamental aspect of ensuring consistent humidification and preventing device malfunction. Oxygen humidifiers operate by bubbling oxygen through water, adding moisture to the dry oxygen stream. As oxygen flows, the water level gradually depletes due to evaporation. Failure to replenish the water can lead to several detrimental effects, impacting both patient comfort and the efficacy of oxygen therapy. For instance, allowing the humidifier to run dry interrupts the humidification process, delivering dry oxygen to the patient, which can irritate the nasal passages and airways. This dryness can cause discomfort, nosebleeds, and potentially exacerbate existing respiratory conditions. Furthermore, operating a humidifier without water can damage the device itself, potentially overheating internal components and shortening its lifespan.

Regularly checking the water level prevents these complications and ensures consistent humidification. Most humidifiers have clear reservoirs with marked water level indicators, facilitating easy monitoring. The frequency of checks depends on the humidifier’s capacity and the oxygen flow rate, but generally, checking the water level several times a day or before each use is recommended. For example, a patient using oxygen continuously might need to check and refill the humidifier every few hours, while someone using oxygen only at night might only need to check it once before bedtime. Establishing a routine for monitoring the water level ensures consistent humidification and prevents interruptions in therapy. Practical strategies include integrating water level checks into existing medication routines or setting reminders on a phone or other device.

In summary, monitoring the water level in an oxygen humidifier is not merely a maintenance task but a critical component of effective and safe oxygen therapy. It directly impacts patient comfort, device longevity, and the overall success of treatment. Understanding the implications of neglecting water level monitoring underscores the practical significance of this simple yet essential practice. Consistent vigilance in maintaining the appropriate water level ensures uninterrupted humidification, contributing to improved patient comfort and better respiratory care outcomes.

8. Replace disposable parts

Oxygen humidifiers incorporate disposable components integral to their function and hygiene. These parts, designed for periodic replacement, play a crucial role in maintaining optimal performance and preventing contamination. Ignoring their replacement schedules can compromise the efficacy of the humidifier and pose potential health risks to users.

Canonical examples of disposable parts within oxygen humidifiers include water chambers/bottles, disposable filters, and tubing. These components are frequently exposed to moisture and oxygen, creating an environment conducive to bacterial growth. Water chambers, often made of plastic, can degrade over time, developing microscopic cracks and crevices where bacteria can proliferate. Filters, designed to trap particulate matter, eventually become saturated and lose their effectiveness. Similarly, oxygen tubing can accumulate condensation and harbor microorganisms. Regular replacement of these components mitigates these risks, ensuring the delivery of clean, humidified oxygen. Consider a scenario where a patient uses a humidifier with a cracked water chamber. This crack can harbor bacteria, which are then aerosolized and inhaled by the patient, potentially leading to respiratory infection. Replacing the chamber at the recommended interval prevents this scenario, safeguarding patient health.

The practical significance of replacing disposable parts extends beyond hygiene. Worn-out components can also impact the humidifier’s performance. A clogged filter, for example, restricts airflow, reducing the humidifier’s ability to effectively moisturize the oxygen. A degraded water chamber might not seal properly, leading to leaks and inconsistent humidification. These performance issues can compromise the comfort and therapeutic benefits of oxygen therapy. Adhering to prescribed replacement schedules ensures the humidifier functions optimally, delivering the intended level of humidification and maintaining patient comfort. Furthermore, regular replacement contributes to the longevity of the device itself, preventing premature wear and tear caused by strained components. Ultimately, replacing disposable parts is a proactive measure that safeguards patient health, optimizes humidifier performance, and contributes to a safer and more effective respiratory care experience.

9. Ensure Airtight Seal

Maintaining an airtight seal within an oxygen humidifier system is crucial for both efficient operation and patient safety. A compromised seal can lead to oxygen leaks, reducing the delivered oxygen concentration and potentially creating a fire hazard in oxygen-rich environments. Leaks also disrupt the prescribed flow rate, impacting the therapeutic effectiveness of the oxygen therapy. Furthermore, an airtight seal ensures the humidification process functions as intended. A leak in the system can allow dry, unhumidified oxygen to escape, reducing the overall moisture delivered to the patient and potentially causing discomfort and irritation to the airways. For example, a loose connection between the humidifier bottle and the oxygen tubing can compromise the seal, leading to oxygen leakage and reduced humidification. This can result in the patient receiving a lower-than-prescribed oxygen concentration and experiencing dryness in their nasal passages and airways, potentially exacerbating respiratory issues.

Beyond immediate safety and efficacy concerns, an airtight seal also contributes to the hygiene of the oxygen delivery system. A leak can introduce contaminants into the normally closed system, potentially leading to bacterial growth within the humidifier. This contamination can then be aerosolized and delivered to the patient along with the humidified oxygen, increasing the risk of respiratory infection. Consider a scenario where a crack develops in the humidifier’s water chamber. This breach not only compromises the airtight seal but also creates a pathway for bacteria to enter the system. Maintaining an airtight seal is a preventative measure against such contamination, safeguarding patient health and ensuring the delivery of clean, humidified oxygen.

In conclusion, ensuring an airtight seal within an oxygen humidifier system is not merely a technical consideration but a fundamental aspect of safe and effective oxygen therapy. It directly impacts the delivery of the prescribed oxygen concentration, the efficiency of the humidification process, and the overall hygiene of the system. Diligence in maintaining airtight seals throughout the oxygen delivery pathway, from the oxygen source to the patient interface, safeguards patient well-being and maximizes the therapeutic benefits of supplemental oxygen. Understanding the potential consequences of compromised seals underscores the practical importance of this often overlooked detail in respiratory care.

Frequently Asked Questions

This section addresses common inquiries regarding oxygen humidifiers, providing concise and informative responses to facilitate understanding and promote best practices.

Question 1: Why is using distilled water in an oxygen humidifier essential?

Distilled water is crucial because it lacks the minerals and impurities found in tap water. These impurities can clog the humidifier, reduce its effectiveness, and introduce potentially harmful particles into the airways.

Question 2: How often should an oxygen humidifier be cleaned?

Cleaning frequency depends on the specific device and usage, but generally, cleaning every 1 to 3 days is recommended to prevent bacterial growth and maintain optimal performance. Always consult the manufacturer’s instructions for specific cleaning guidelines.

Question 3: What happens if the humidifier runs out of water during oxygen therapy?

If the humidifier runs dry, the delivered oxygen will be unhumidified, potentially causing dryness and irritation to the nasal passages and airways. It can also damage the humidifier itself. Monitoring the water level regularly is essential.

Question 4: Can any type of humidifier be used with an oxygen concentrator?

No, compatibility between the oxygen source and humidifier is crucial. Using an incompatible humidifier can lead to inefficient humidification, device malfunction, and potential safety hazards. Always consult the oxygen concentrator’s documentation or a healthcare professional for guidance on compatible humidifiers.

Question 5: What are the signs of a leak in the oxygen humidifier system?

Signs of a leak may include a hissing sound, decreased oxygen output, visible moisture around connections, or unusually rapid depletion of water in the humidifier. If a leak is suspected, it’s essential to address it promptly to ensure safe and effective oxygen delivery.

Question 6: How often should disposable parts like filters and tubing be replaced?

Replacement schedules vary depending on the specific product and usage. Consult the manufacturer’s instructions for guidance. Regular replacement prevents bacterial buildup and ensures optimal humidifier performance.

Maintaining a clean, properly functioning oxygen humidifier is crucial for maximizing the benefits and minimizing the risks of oxygen therapy. Adhering to manufacturer guidelines and consulting with healthcare professionals ensures safe and effective treatment.

The following section will discuss troubleshooting common issues encountered with oxygen humidifiers.

Essential Tips for Oxygen Humidifier Use

Optimal use of oxygen humidifiers requires attention to several key aspects. The following tips provide practical guidance for ensuring safe, effective, and comfortable oxygen therapy.

Tip 1: Distilled Water Exclusively
Always use distilled water in oxygen humidifiers. Tap water contains minerals that can clog the device and introduce potentially harmful particles into the airways. Distilled water ensures optimal performance and hygiene.

Tip 2: Regular Cleaning and Disinfection
Regular cleaning, typically every 1 to 3 days, is essential to prevent bacterial growth. Follow manufacturer instructions for cleaning procedures and recommended cleaning solutions. This practice maintains hygiene and ensures efficient operation.

Tip 3: Monitor Water Levels Diligently
Regularly monitor the water level in the humidifier and refill as needed. Allowing the humidifier to run dry interrupts humidification, causing discomfort and potentially damaging the device. Establish a routine for checking water levels, especially during continuous oxygen use.

Tip 4: Secure Connections are Crucial
Ensure all connections between the oxygen source, humidifier, and tubing are secure and airtight. Leaks can reduce oxygen delivery, compromise humidification, and pose safety hazards. Regularly inspect connections for any signs of leakage.

Tip 5: Compatible Components are Essential
Use only compatible humidifiers and tubing with the prescribed oxygen source. Incompatible components can lead to inefficient humidification, device malfunction, and potential safety risks. Consult manufacturer guidelines for compatibility information.

Tip 6: Adhere to Prescribed Flow Rates
Operate the oxygen and humidifier at the prescribed flow rate. Incorrect flow rates can impact humidification efficiency and potentially lead to complications like condensation buildup in the tubing. Maintaining the correct flow rate ensures optimal therapy.

Tip 7: Replace Disposable Parts Regularly
Adhere to manufacturer recommendations for replacing disposable components such as water chambers, filters, and tubing. Regular replacement prevents bacterial buildup and maintains optimal humidifier performance. Refer to the device’s instructions for specific replacement schedules.

Following these tips ensures the safe, effective, and comfortable delivery of humidified oxygen, maximizing the therapeutic benefits and minimizing potential risks.

The concluding section will summarize the key takeaways regarding oxygen humidifier use and maintenance.

Conclusion

Oxygen humidifiers play a vital role in enhancing patient comfort and therapeutic efficacy during supplemental oxygen therapy. Maintaining proper humidification prevents dryness and irritation of the nasal passages and airways, promoting better tolerance of oxygen delivery and improving overall respiratory well-being. This comprehensive exploration has highlighted the importance of several key aspects, including the exclusive use of distilled water, regular cleaning and disinfection, adherence to prescribed flow rates, and the timely replacement of disposable components. Proper connection and compatibility between the oxygen source and humidifier are paramount for safe and efficient operation, while diligent monitoring of water levels ensures consistent humidification. Understanding these elements is crucial for both healthcare providers and patients utilizing supplemental oxygen.

Effective oxygen humidification contributes significantly to positive patient outcomes in respiratory care. Continued adherence to best practices in humidifier usage, maintenance, and component selection ensures optimal therapeutic benefit and promotes respiratory health. Proper utilization of these devices remains a cornerstone of effective and comfortable oxygen therapy.