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Impaired airway clearance in lung disease leads to inflammation, recurring lung infections and further destruction of lung tissue. Chest physiotherapy (CPT) and postural drainage (PD) are widely prescribed, traditional methods of airway clearance that are often labor-intensive and time consuming for patients to perform. Positive expiratory pressure (PEP) is an airway clearance therapy that can be used as an alternative, or in adjunct, to standard CPT/PD.
Using a face-mask or mouthpiece, the patient takes in a normal breath and then slowly exhales into a one-way valve against gentle resistance that is preset by the health care provider. The slow breathing maneuver is repeated 10 to 20 times and is followed by a “huff” cough, or forced exhalation, to clear the airways of any secretions that have been mobilized. The device is said to allow pressurized air to go behind secretions moving them toward the larger airways where they can easily be expelled.
Treatments are usually performed for 15-20 minutes, twice a day in patients who are medically stable. The PEP device gives patients with long-term lung disease greater independence as therapy can be easily carried out in a convenient manner without the need for assistance from a caregiver.
In addition to being easy to use, studies suggest that PEP therapy may:1
PEP therapy devices can be purchased online or from a medical supply company. Examples include the AstraPEP, PariPEP and AeroPEP. Compare prices online here.
By Deborah Leader RN, BSN, PHN
 A Hristara-Papadopoulou, J Tsanakas, G Diomou, and O Papadopoulou. Current devices of respiratory physiotherapy. Hippokratia. 2008 Oct-Dec; 12(4): 211–220