The Oxygen Debate: Liquid or Compressed?

August 30th, 2010 | Author: Katelyn Turner

Holly Julian, from Hugs4Holly, w/her compressed O2. Photo courtesy of husband, Steve Julian.

Say that you’re standing in the middle of a car dealership lot staring at the waves of blue, red, black, white cars, some big, some small, some convertible, some long, some short. And say that you’ve never driven a car before in your life and you’ve got someone forcing you to pick one right now. Isn’t that kind of how it feels to make certain decisions about oxygen?

Well, picking out the best oxygen system doesn’t have to feel the same way. Choosing an oxygen system that works best for you has to be a decision you and your doctor make. And, like a car, it’s something you get used to, accommodate to your needs, and learn to adapt till you become comfortable with it. Just like my Facebook friend Audra says to me about using oxygen, “It becomes part of you, and life is so much better with it than without it.”

I’ve always refer to this great website by Dr. Pete Wilson when it comes to “Oxygen 101.” One of the things many COPDers talk about is about choosing between a compressed and liquid system. And with the help of Drs. Robert Sandhaus from National Jewish Health in Denver, and Dr. Byron Thomashow from Columbia University in New York, we put a little article together about the two oxygen systems.

A compressed system is essentially an aluminum cylinder that comes in different sizes; the smallest is about one pound and the largest (which is usually wheeled in a cart) is about eight pounds. Some folks have a couple containers of different sizes so they can use them for easy travel.

A liquid oxygen system works differently. Because it’s in a liquid rather than gaseous format, it takes up only a tenth (1/10) of the space compressed oxygen takes. The canisters are refilled from reservoirs you keep at home; these reservoirs are cylinders about 29-40 inches tall, and filled, they weigh 100-160 pounds. You can sometimes even connect your cannula tubing to the reservoir directly for continuous flow throughout the night.

According to Pete Wilson’s website, liquid oxygen may be safer than compressed because it has less pressure; there are still dangers with the possibility of “burning” skin if you touch the ports while refilling, since liquid oxygen is amazingly cold.

Bob Campbell from the Alpha-1 Foundation that reminded me that neither liquid nor compressed oxygen are allowed aboard commercial air flights. You can access more information about flying with oxygen at the Airline Oxygen Council website.

Here’s a chart with some of the differences between the two systems outlined:

  Compressed Liquid
Pressure ~2,000 psi Pressure: ~21 psi
Sizes Sizes: Many, from small to quite large Sizes: generally two (small hold 0.7 liters/6lbs; larger hold 1+liters/6-9lbs) plus a large reservoir
Require power source No No
Advantages – Readily available- Cheap(er)

– Wide range of sizes

– No refilling by patient required

– Light and portable- Long lasting

– Can be refilled by patient

Disadvantages – Heavy and clumsy- Need to carry many cylinders with you for long outings

– Potential dangers if dropped

– Need a large reservoir- Filling requires dexterity and some strength

– Potential dangers of burningly cold liquid oxygen

Audra finishes her messages to me by saying, “People who have just been prescribed O2 have to try to keep their heads up and realize that in the end it will keep them ambulatory and feeling better for the most part . . . they just have to give it a chance.” So true.

What are your thoughts about liquid and compresses systems?


  1. […] grocery store and just visit friends. (One tank, when filled, can last up to about 6 hours.) This blog post gives an excellent breakdown of the different types and the pros and cons. Compressed tanks are […]

  2. nancy wingo says:

    glad to find this site. I will call the COPD line as suggested rather than go on about my total confusion. I am newly diagnosed and feel totally insecure about the lack of information from my Pulmonary doctor. The nurse that gave me the results of my test said I had moderate copd and that once I had to use oxygen that I had 2 to 5 years left of life!!! 6 months later I went to see another pulmonary doctor and was told I needed oxygen at night and for excercise…so I thought there was no hope and I would be gone soon! not true…but if not for internet research of my own, I would still be in hopeless mode.
    However, with this research in now have oxygen dealers calling non stop trying to sell me a POC (Inogen, Airsep, etc. etc.
    It is exhausting and no wonder I am so depressed…everyone out for the money only it appears.
    sorry for going on and on! We must all stay positive and help one another. Thanks, Nancy from Knoxville area!

  3. Teddie Kazmierczak says:

    I’m almost 69 and I have been using the concentrator at night and the tanks when I leave the house. They are very heavy and the b’s don’t last at all. Is liquid oxygen covered by Medicare except for the 25,00? I do have High Mark as my extra insurance. How hard is it to fill the liquid and must I have my Dr. order this? Is the liquid oxygen easier to carry? Do these liq tanks make more noise?

    • DD says:

      Concentrators are very noisy and can impact your hearing longterm. There is also a hefty electrical cost with using concentrators, not to mention the heat they produce during the summer months. Liquid Oxygen is covered by Medicare. It is not difficult to fill and, yes, you do need an MD order. The liquid oxygen container is easier to carry than the compressed air and they will provide you with a carrying case. What is most important to know is this: be sure you get the right portable for you!! Some are pulse only. Hope this helps!

  4. becky says:

    mother is in assisted living where they require liquid oxygen in the portable tank; there is a compressor in the room as well. Is it safe to have the large liquid refill tank situated in the room with her? thank you.

  5. Jan Hudson says:

    I am 75 and have COPD/emphazema both now and have had it now going on 16 years. I used to use the compressed air, my husband had to carry my tanks for me as they too heavy for my back. We live 15 miles from town right in the mountains and our power goes off an awfully lot, especially in the winter. Then My husband has to go clear down the basement to get some larger tanks hooked up for me during the night. Sometimes he has to change tanks when they run out. I went on the liquid oxygen a few years ago and love it. Never no worry about the power going off and their small portable tanks I can handle if necessary. I am hoping my medicare will continue helping us out on the costs. I am not sure just how many years I have but I still try to go when I can. I don’t travel long places anymore but maybe once a month to town. We do have a pickup so can take a larger tank with us to refill if necessary. We try to take two little tanks with us for precaution. When I exert myself too much I have to turn it up on 4 then will turn it back on continuous but it will last maybe not quite 3 hours. An all day trip we would have to refill and sometimes the heat makes the tanks run out so we also try to take one dry tank and have used it a few times. Love the liquid though. NO noise, No higher electric bills, and no problem if power goes out.

  6. Mary l. Waitt says:

    Thank you for some good info. I am trying to decide if liquid is the way to go.

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  8. Dan Pirro says:

    Good morning,

    My Mom has chronic COPD which requires the 24/7 use of her medically-prescribed liquid oxygen. I drive Mom back home to Batavia, New York every year, as it’s important for her to spend time with her Grandkids. We’ve always taken along her transportable liquid oxygen tank (it resembles R2D2 from the Starwars movies) that in years past, were able to get refilled in Batavia from a local company in Amherst. We’re staying a little longer this year (10 days), & she said that the company WILL NO LONGER travel to refill her tank! This puts us in a serious dilemma, as the tank will expire well within our 10 days timeframe. Mom’s idea is to travel with an additional liquid oxygen tank, which to me, is unnerving, as the additional size & weight is very cumbersome & even more dangerous in a car.

    Does anyone know of a place in Western New York which will enable us to bring her tank to their facility to get refilled one time during our travels? I’d be more than happy to pay completely out of pocket for the replenishment, if necessary.

    We’re supposed to travel from April 16th until the 28th. Thanks very much, in advance!


    • Cathy says:

      Hi Dan, I have acute end stage COPD and have been on liquid oxygen 24/7 for a few years now and when ever I traveled my oxygen company lent me a concentrator and gas cylinders for the trip. What was the name of the company who had previously come out and filled the tanks for you? Lincare seems to be the only liquid provider in western NY and they are no longer adding new patients because they are going out of the liquid oxygen business because there isn’t enough profit in it for them. They won’t even fix the flange that stops the condensation from running on the floor from my reservoir. I have been looking for another provider but haven’t had any luck as yet, which was why I asked what the name of the Amherst provider was. I think it’s pretty sad when high dollar profit becomes more important than quality of life. If they shut off my liquid I will be pretty much completely house bound because I am on 4 LPM and we all know an E Cylinder won’t even make it through a grocery shopping trip :/ I pray you and your mom find a reasonable solution for your traveling.

      • Trent says:

        Cathy, 4 LPM is the ‘no physical activity’ setting for me, so you certainly have some flexibility. I am 60 years old, and I have a double tank carrier in my car, which can hold two E tanks.

        Now, by MY experience, at 4-5 LPM, one E tank will last 2 hours, so even though I have 4 hours at 4-5 LPM, I still keep several full E tanks in my car. Walking (slowly) runs about 6 LPM and any kind of activity runs me 8 or better, which is only about 20 minutes. I’ve been doing this for 8 years now, and it’s getting harder and harder to motivate me to get out of the house.

        I wish you the best of luck!

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  10. will I get more air from air gas or helios 300 set at 2

  11. lori mcneil says:

    I am using liquid now & its pretty good. No electricity usage, quick easy filling of portable. HOWEVER, with the liquid there is no last minute trips to see family or go out of town. You cannot get the reservoir in your car or truck like a concentrater which plugs in & can refill your canisters. So far I have went anywhere my company will deliver liquid to so its bottles anyway. My company must have 2 weeks notice prior to trip to set you up at new location. If I had my concentrator & bottles back I could put them in the car & go. Seriously considering switching back to canisters.
    Also, I have rented POC’S for 2 vacations. I used the Respironics Evergo. Was easy to pull & manuver but batteries do NOT last long! It took 4 batteries to make 5 hour trip, including charging while in car going to airport & while sitting in airport. I about just as we got to hotel & couldn’t leave hotel room bc I had no batteries. Also takes about 4 hours to charge 2 BATTERIES. So if you fly take extra batteries!

  12. George says:

    For those who have to use a concentrator if you contact the electric company they may have a special rate. I am with SDG&E and they give me a discount.

  13. Marcy says:

    My husband who has Pulmonary Fibrosis AND COPD recently started using liquid oxygen. He is currently on 16 liters of oxygen 24/7. This change was necessary due to the liters necessary for him too breath. We noticed two things immediately after the change….First, there is no heat emanating from the tanks. This is a huge thing for us as we live in the desert. The concentrators produce a lot of heat! Second, they are almost completely silent. As I sit here commenting all I hear is the very slight sound of bubbling water which is caused by the small humidifier cups attached. After two years of the “rumbling” of a concentrator this is wonderful! Next I have to watch our electric bill to see how much it will go down as liquid oxygen does not use electricity. The drawbacks for us are few. My husband is pretty much tethered to the house. We do have a portable liquid oxygen tank but it only carries about 45 minutes of air. We intend to use this for going to his doctors appointments at UCLA…(they can fill it for us as well for the ride home). We have good medical insurance and I think it will cost about $25.00 a month. Hopefully, we will get “the call” from UCLA for my husband’s double lung transplant soon and we won’t have to worry about oxygen any longer.

    • Katelyn Harding says:

      Thanks for stopping by our blog. If you want to chat or if you have more questions about COPD, etc., you can call our COPD Information Line at 866-316-2673.

  14. Donna Campbell says:

    I use a large concentrator at home and have a portable one for travel. I want a light-weight, easy-to-carry system for shopping, in-town visits to friends’ homes b/c the portable system is unwieldy. Which system, liquid or gas, is used in the small, rectangular units I see some people carry?

    • Katelyn Harding says:

      Hi Donna! You should give our C.O.P.D. Information Line a call and talk to them about it! 866-316-2673. They will be sure to help you :)

  15. Denise Lewis says:

    I just turned 49 and have been using oxygen for a few months now and at first I used the concentrator and the tanks. Its been hot and humid lately and the concentrator really, really heats up the room and its loud. The tanks are bulky, heavy and a pain (to me) to tote around but they are quiet. I just switched to the liquid oxygen and for me, the portable unit is easy to fill. Its small and only weighs maybe 3#. Real easy to carry around, but to me its loud, it clicks loudly with every breath I take. And the hot, humid weather makes the liquid portable go fast. For me the liquid is way easier and lighter to use, but the tanks were quieter and seemed to last longer. Still not sure which one I like better. Each one has its positive and negative side.

  16. Neva says:

    I use liquid oxygen. It is so easy. You don’t have to worry about power outages because liquid requires not electric so you don’t have that additional charge. You are not charge per fill up but on a monthly basis. My payment is around $25.00 a month. I have a delivery once a month. I have 2 big tanks that are filled. The helios is light and very easy to carry, about the size of a purse. The downside is you definitely have to plan ahead for travel. I have had no problems though. We have been to the beach and the oxygen was waiting for me when I got there. Just needed to make one phone call to my oxygen provider and they took care of everything. No extra charge. If there is no liquid provider in the area you will have to take tanks. This happened when we went to Key West. Not all providers carry liquid oxygen so you have to call around and some areas simply can’t get it.
    I absolutely love the liquid and wouldn’t change unless I had no other choice.

  17. Bill B says:

    Appreciate information. Seeking VA support for battery Powered unit I can take on plane or off 12 volt car outlet.

    Something about their being subject to a duration of usage seemed to hold up their approval.

    Current use E-bottle at 2 lpm gives me about 2 to 2.5 hrs continuous. Tracy says much longer. Tell me about her conserving regulator please.

    Thanks, Bill B

    • Katelyn Harding says:

      Hi Bill,

      You should give our C.O.P.D. Information Line a call and talk to them about it–866-316-2673.

  18. Bjll Bailey says:

    Got to make a decision compressed or liquid. VA would likely provide, but not very convenient. I am now on E tanks, looking at liquid. I currently use 2 to 4 l/min, and Dr recommends 6. In any case I need a battery powered compactor for air travel.
    Appreciate url, and comments. Bill B

  19. Jim Gibbs says:

    Liquid oxygen in a trailer home is a bad gig. Trailer homes get hotter than the outside and liquid oxygen plus heat don’t mix.

  20. Jim Gibbs says:

    Always the cost effective method is what I look at. Fixed income people haven’t got the money to pay for re-fills on their tanks all the time. A portable unit that produces oxygen and weighs 5 to 6 pounds is out there and, it has rechargeable batteries plus adapters for auto or plane use on trips. Why is it that they always want the bulky stuff for the elderly?

    • cindy says:

      What are those small systems and how do you get them on planes. I would love to hear all about that and agree that they always promote that awful big and clumsy stuff!

      • Katelyn Harding says:

        Hi Cindy–you should call our C.O.P.D. Information Line and ask them about it–866-316-2673. They can help you out!

  21. Nice post. I was checking continuously this blog and I’m impressed! Extremely useful information particularly the last part :) I care for such information much. I was seeking this certain information for a long time. Thank you and best of luck.

  22. Erin says:

    My grandmother is thinking about changing from compressed to liquid and our only concern is how long the liquid tanks last? Do you know?

  23. Tracy says:

    there is several options here,on Liquid you can get a helios marathon,and depending on her liter flow & if she is able to pass a titration test can last for a while( lets say her liter flow is 2lpm & passed a titration test, a person can 11.5 hrs,if someone is continuous then it would 3.5 hrs).on compressed cylinders lets say an E-tank on a conserving regulator a tank will last 18.5 hrs,5 hrs on continuous. there are many option and the patient has the choice. look @ the lifestyle and see how mobile the person is.

  24. Evie says:

    My mom uses a air concentrator at her home and we will take the aluminum canisters with us and we like this method. She prefers it too, we know how long the tanks last so we usually time it for how long we are going to be gone to how many tanks she’ll need. She’s in a physical therapy place now and they use the liquid stuff and she hates it. She can’t lift the thing up to refill it and it has to stay upright. She had an issue in the beginning of her COPD were the liquid oxygen ran out. She felt safer to have more with then to have difficulties. We don’t let her left them, she has severe osteporsis from the prednisone that she’s been on so any really heavy lifting could cause a compression fracture. She currently has 5 of them in her spine just from excessive coughing and the last happened when she fell. She has said that she feels more comfortable with being able to bring more than enough than to run out.

  25. My brother uses a compressed air concentrator at night. My mother was on the same system for years before she passed. It is easy to care for the machine and you replace the tubing and cannula often. All of which are covered by insurance. But I was shocked to find that our electric bill had jumped an extra $80 a month with the use of the concentrator. It sounds to me like the liquid system could be less costly for those on limited income such as us. Thanks for the info something to really look into :)

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