PEP Therapy Study Notes

PEP Therapy (Positive Expiratory Pressure)

Purpose

  • Mobilization of Secretions: The primary goal of PEP therapy is to facilitate the mobilization of secretions in the respiratory system.
  • Prevention of Airway Collapse: PEP therapy aims to prevent the collapse of airways during exhalation.

How it Works

  • Mechanism: In PEP therapy, patients exhale against a resistance, which generates positive pressure within the airways. This positive pressure helps to keep the airways open (stenting) and promotes the movement of mucus toward the larger airways for clearance.

Typical Pressure Range

  • Exhalation Pressure: The typical pressure range during exhalation in PEP therapy is between 10 to 20 cm H₂O.

Common PEP Devices

Device Listing

  • Device Name: Acapella (Green/Blue)

    • Type: Oscillating PEP
    • Description / Features: This device uses a counterweighted plug and a magnet to create vibrations during exhalation, which is helpful for mucus clearance. The green device is designed for higher flow patients, while the blue device is meant for lower flow patients.

  • Device Name: Aerobika

    • Type: Flutters Valve
    • Description / Features: This device creates oscillating pressure pulses and airflow vibrations that are effective for mobilizing mucus during exhalation.

  • Device Name: ThAIRapy Vest® / High-Frequency Chest Wall Oscillation (HFCWO)

    • Type: Oscillating PEP
    • Description / Features: This device provides external oscillation to mobilize secretions and is often used in patients with cystic fibrosis.

  • Device Name: Resistex® or PEP Mask System

    • Type: Standard PEP
    • Description / Features: Uses resistors that provide a fixed pressure during exhalation, which can be adjustable via interchangeable orifice sizes to accommodate individual patient needs.

Used For

  • Cystic Fibrosis: A genetic disorder affecting the lungs and digestive system, requiring mucous clearance therapies.
  • COPD with Retained Secretions: Chronic Obstructive Pulmonary Disease (COPD) where mucus buildup requires intervention to improve airflow and lung function.
  • Bronchiectasis: A condition where the airway walls are thickened and damaged, often resulting in excessive mucus production that PEP therapy can help clear.
  • Postoperative Atelectasis Prevention: PEP therapy is utilized post-surgery to prevent atelectasis, a condition characterized by collapsed air sacs in the lungs, which can occur due to shallow breathing or immobility after surgery.