Abstract
Background: Positive expiratory pressure (PEP) tubing is an improvised form of PEP therapy, constructed using a length of oxygen tubing, and employed clinically by some physiotherapists in Australia. The recommended pressures for optimal PEP usage are well described. Commercially available manometers are not compatible with PEP tubing, and as a result, pressures generated during their use are unknown.
Objective: To describe the expiratory pressures generated with different PEP tube lengths in an inpatient COPD and healthy population.
Methods: Eight participants were recruited during hospital admission for an acute exacerbation of COPD. Anthropometric data and respiratory function were recorded. Participants performed 3 expiratory efforts through four PEP tubes of varying lengths (5cm, 10cm, 15cm and 10cm+resistance). Expiratory pressures were recorded using a pressure transducer with continuous data recording. The mid and maximum expiratory pressure (EPmid and EPmax) for each effort was compared with that of ten healthy participants.
Results: The COPD and healthy participants were similar in age (mean±SD) (78±6 vs 67±13yrs) and sex (38% vs 50% males). Lung dysfunction in the COPD group was moderate-very severe (GOLD). The 10cm+resistance PEP tube created significantly higher EPmid in both COPD and healthy groups (median±IQR) (21±17 and 16±11cmH2O) when compared to all other lengths (p<0.05). Median EPmid was below 10cmH20 for all other lengths. The EPmax did not exceed 48cmH2O for any effort.
Conclusion: The 10cm+resistance PEP device was the only one to generate sufficient expiratory pressure to meet current therapeutic guidelines. Maximum pressures generated with all lengths appear safe.
- Copyright ©ERS 2015