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Obstructive Lung Diseases: COPD Exacerbations |

Comparison of Effectiveness of Two Positive Expiratory Pressure Devices In Severe COPD Patients: Temporary Positive Expirayory Pressure (T-PEP) Versus Oscillatory Positive Expiratory Pressure (O-PEP) FREE TO VIEW

Antonello Nicolini, MD
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Respiratory Diseases Unit, Sestri Levante, Italy


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;149(4_S):A364. doi:10.1016/j.chest.2016.02.379
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SESSION TITLE: COPD Exacerbations

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: In recent years, in order to reduce Chronic Obstructive Pulmonary Disease (COPD) symptoms, new treatment methods have been developed. One of these is the positive expiration pressure (PEP). This can improve the muco.ciliary clearance and prevent airways collapse. Temporary-PEP (T-PEP) uses pressure only in the first part of expiration phase. Oscillatory-PEP (O-PEP) combines the benefits of PEP therapy with airway vibrations. Both therapies apply a low expiratory pressure of 1 H2O creating oscillations that promote the secretions detachment. The study aims to evaluate the efficacy of Lung Flute which use O-PEP compared to T-PEP

METHODS: We have evaluated their efficacy to reduce exacerbations and to improve quality of life, respiratory function parameters in severe COPD patients (FEV1 < 50%). We have enrolled 99 severe COPD patients for a randomized, open label- 48 weeks -trial. 33 patients received T-PEP therapy, 33 the treatment with O-PEP and 33 take part of the control group. Both treatments lasted 30 minutes for 2 session every day for14 days. The primary outcome was the reduction of exacerbations after six months; secondary outcomes improvement of lung function and quality of life parameters (MMRC scale, BCSS scale and CAT)

RESULTS: Regarding the primary endpoint, only TPEP statistically reduced the exacerbations after 6 months. Both the two tools improve dyspnea scale, lung function parameters and quality of life compared to the control group. No significant statistical difference was found between the two techniques in reducing dyspnea and improving the lung function parameters and life quality scores.

CONCLUSIONS: O-PEP is equivalent to T-PEP for COPD treatment but only T-PEP reduces exacerbations.

CLINICAL IMPLICATIONS: Adding tools for airway clearence to medical therapy can help the management of COPD

DISCLOSURE: The following authors have nothing to disclose: Antonello Nicolini

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