This combination effectively improves the efficacy of aerosol drug delivery due to better drug distribution in the peripheral airways. This involves using an in-line handheld nebulizer or a metered dose inhaler, which can be attached to the one-way inlet valve of the device. Repeat this process for four to eight cycles.ĭelivering Aerosol Drugs with PEP TherapyĪerosol drug therapy may be used along with PEP therapy to improve the effectiveness of the treatment.This involves inhaling to full capacity, then exhaling as fast as possible. Finish with 1-2 maximal expiratory efforts through the device.Repeat step 5 and perform up to 10 exhalation maneuvers into the device.Adjust the device to create the most amount of vibrations that can be felt in the lungs.Perform an exhalation against backpressure that is slightly faster than normal.Place the mouthpiece in your mouth and create a tight seal.The flutter valve must be held upright, while the acapella can be used in any position. The steps for using a flutter valve or acapella device are as follows: However, there are some potential hazards that should be considered, such as: Using a flutter valve or acapella device is generally considered to be safe. This is needed to create the oscillations required for effective PEP therapy. PEP therapy is generally not recommended in children 10 to 12 mL/kg of expiratory pressure. Blue model: This model is easier to use and is indicated for patients with an expiratory flow 20 mm Hg.Green model: This model is more difficult and is indicated for patients with an expiratory flow >15 L/min.There are two types of acapella devices to choose from depending on the patient’s ability to generate expiratory flow: This action helps to break up the mucus so it can be cleared more easily. When you exhale into the flutter valve against backpressure, the ball rattles and creates high-frequency oscillations. The device is triangular-shaped with a fluttering steel ball inside. It’s the most common type of oscillatory PEP therapy and is commonly used in patients with cystic fibrosis. What is a Flutter Valve?Ī flutter valve is a small, handheld device that is used to help clear mucus from the lungs. Let’s take a closer look at how each type works. Then they can be cleared by coughing or suctioning.Īs previously mentioned, there are two main types of PEP therapy devices: flutter valves and acapella devices. It requires active expiration into a device against back-pressure, which helps expand the lungs and moves secretions into the larger airways. Positive expiratory pressure (PEP) therapy is commonly used to mobilize secretions, reduce air trapping, and prevent the lungs from collapsing. We’ll also break down the indications, contraindications, and hazards of this type of therapy. In this article, we’ll take a closer look at PEP therapy and how flutter valves and acapella devices work. The two primary types of PEP therapy are flutter valves and acapella breathing devices.īoth have been proven effective in clearing lung secretions, but how do they work? Positive expiratory pressure (PEP) is a type of airway clearance therapy that helps clear mucus from the lungs.
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