In OPEP therapy patients are simply instructed to take a deeper breath than normal and exhale through the device with more force than normal. A published study challenges traditional OPEP therapy as a blind technique involving no measures of feedback or effectiveness. The study found that 60% of subjects (25/42) performed either an inadequate inspiratory maneuver or exceeded the recommended inspiratory volume during OPEP therapy. Only 40% of subjects (17/42) were in the recommended range of 51-70% of predicted inspiratory capacity (see chart 2).
The study also found that when resistance was set at the most common “mid-level”, only 43% of subjects (18/42) produced positive expiratory pressures in the effective range of 10 – 20 cmH2O (see chart 3).
The paper concluded, “when coaching patients and changing resistance settings during OPEP therapy, this study has demonstrated the advantage of using adjunct monitoring devices to assure adequate tidal volume and flow, to make sure patients meet therapeutic pressure thresholds.”
Reference: Pursley, D. Analysis of Tidal Volume and Expiratory Pressure during Oscillatory PEP Therapy in Healthy Subjects. Respiratory Therapy Vol. 11 No. 2 n Spring 2016
Abstract presented at AARC and published in the official journal, Respiratory Care, on Respiratory Therapists perceptions that the iPEP may be beneficial to address PPCs (postoperative pulmonary complications), which suggests that evaluating patient preference for postoperative devices and determining clinical benefit of the iPEP are important next steps.