BACKGROUND: In recent years, interest has been focused on devices designed to minimize the volume of oxygen wasted during administration in order to decrease costs and increase the time that the ambulatory patient can be away from his major oxygen source. MATERIALS & METHOD: We compared the effects on oxygenation of breathing oxygen (1) supplied at 4 flowrates from a continuous-flow device (CLD) and from a Syncoxy breath-synchronized valve (SBSV) equipped with 3 different reservoirs in 12 healthy volunteers and in 24 patients with chronic obstructive pulmonary disease; (2) from a CLD, an Oxymizer Pendant, an Oxymizer Mustache, and a SBSV, at various flows, in 12 healthy volunteers; (3) from the breath-synchronized Oxymatic and a SBSV in 8 healthy volunteers; and we measured (4) the oxygen concentrations obtained at various outflows with the SBSV attached to a 2 L/min pressure-swing-adsorption oxygen concentrator. RESULTS: When compared to a conventional continuous-flow cannula, the SBSV afforded higher levels of oxygenation at equivalent flowrates or equivalent levels of oxygenation at flowrates reduced 30% or more. In addition, higher transcutaneous oxygen partial pressures were seen when the effect of SBSV on oxygenation was compared to the effects of other reservoir devices at the same flowrate. The addition of the SBSV to the concentrator allowed delivery of higher oxygen concentrations at higher flowrates. CONCLUSION: The SBSV can provide equivalent levels of oxygenation with less total oxygen usage—thus allowing greater patient mobility.