PEP Therapy.txt

• 1. To reduce air trapping in asthma and COPD
• 2. To aid in mobilization of retained secretions (in cystic fibrosis and chronic bronchitis)
• 3. To prevent or reverse atlectasis
• 4. To optimize delivery of bronchodilators in patients receiving bronchial hygiene therapy

• No absolute contraindication
• 1. Inability to tolerate increased work of breathing
• 2. Intracranial pressure (ICP) > 20 mmHg
• 3. Hemodynamic instability
• 4. Recent facial, oral, or skull surgery or trauma
• 5. Acute sinusitis
• 6. Epistaxis (Nose bleed)
• 7. Esophageal surgery
• 8. Active hemoptysis
• 9. Nausea
• 10. Known or suspected tympanic membrane rupture or other middle ear
• 11. Untreated

• 1. Increased work of breathing that may lead to hypoventilation and hypercarbnia
• 2. Increased intracranial pressure
• 3. Cardivascular compromise
• 4. Myocardinal ischemia (reduced blood flow to part of the body)
• 5. Decreased venous return
• 6. Air swallowing with increased likelihood of vomiting and aspiration
• 7. Claustrophobia
• 8. Skin breaks and discomfort from mask
• 9. Pulmonary barotraumas (tear due to back pressure)

• 1. DHD TherapPEP Device
• 2. Acapella
• 3. EzPAP

SVN w/ adapter, SVN w/o adapter, MDI Spacer/holding chamber

10-20 cmH2O

10-20

Acapella (Green, Blue, or Teal)

5 LPM

Closed with cap if no pressure motoring is being done; if measuring then should be open/exposed to ambient air while in use

10-20 breaths 4-6 times