Physiotherapy Department, The Prince Charles Hospital, Queensland, Australia.
School of Allied Health Sciences, Griffith University, Queensland, Australia.
Respir Care. 2019 Apr;64(4):434-444. doi: 10.4187/respcare.06410. Epub 2019 Jan 22.
Positive expiratory pressure (PEP) devices are widely used in clinical settings, yet the performance characteristics of these devices remain relatively unknown. This study compared the performance characteristics of 6 airway clearance devices by varying resistance and flow.
Mean PEP, peak PEP, oscillation frequency, and amplitude PEP of the Flutter, Pari PEP S, Acapella Choice, Acapella DM, Acapella DH, and Aerobika devices were obtained across flows of 5, 10, 15, 20, 25 and 30 L/min and at low, medium, and high resistance using an experimental apparatus custom-built for this bench study.
Performance characteristics of the devices differed across flows and resistance settings (device × flow/resistance interaction; < .001). At a fixed resistance, increasing flows increased mean PEP produced by the Acapella Choice, Acapella DH, Aerobika, and Pari PEP S. Increasing flow resulted in minimal change in mean PEP produced by the Flutter and Acapella DM. Increasing flow increased peak PEP and amplitude PEP produced by all devices except the Acapella DH and Acapella Choice. Increasing flow maintained or increased oscillation frequency for all devices except the Flutter. At a fixed flow, increasing resistance increased mean PEP produced by all devices except the Acapella Choice. Increasing resistance increased peak PEP produced by the Acapella DM, Aerobika, and Pari PEP S but resulted in minimal change in peak PEP for the Flutter and Acapella Choice. Increasing resistance either maintained or increased oscillation frequency for all devices. Amplitude PEP was either maintained or increased during oscillations when increasing resistance for all devices except the Flutter.
PEP devices produced small but statistically significant variations in performance characteristics across a range of flows and resistance settings. There appear to be flow-dependent and non-flow-dependent devices. Varying flow or resistance typically maintained or increased the production of mean, peak, and amplitude PEP and oscillation frequency.
呼气正压（PEP）设备在临床环境中被广泛使用，但这些设备的性能特征仍相对未知。本研究通过改变阻力和流量来比较 6 种气道清除设备的性能特征。
使用专门为此台架研究设计的实验设备，在低、中、高阻力下，在 5、10、15、20、25 和 30 L/min 的流量下，获得 Flutter、Pari PEP S、Acapella Choice、Acapella DM、Acapella DH 和 Aerobika 设备的平均 PEP、峰值 PEP、振荡频率和振幅 PEP。
设备的性能特征在流量和阻力设置方面存在差异（设备×流量/阻力交互；<0.001）。在固定阻力下，增加流量会增加 Acapella Choice、Acapella DH、Aerobika 和 Pari PEP S 产生的平均 PEP。增加流量会使 Flutter 和 Acapella DM 产生的平均 PEP 变化最小。增加流量会增加所有设备产生的峰值 PEP 和振幅 PEP，但除 Acapella DH 和 Acapella Choice 外，振幅 PEP 变化最小。增加流量会使除 Flutter 外的所有设备的振荡频率保持或增加。在固定流量下，增加阻力会增加除 Acapella Choice 外的所有设备产生的平均 PEP。增加阻力会增加 Acapella DM、Aerobika 和 Pari PEP S 产生的峰值 PEP，但会使 Flutter 和 Acapella Choice 产生的峰值 PEP 变化最小。增加阻力会使除 Flutter 外的所有设备的振荡频率保持或增加。除 Flutter 外，当增加所有设备的阻力时，振幅 PEP 在振荡过程中保持或增加。
PEP 设备在一系列流量和阻力设置下产生了小但具有统计学意义的性能特征变化。似乎存在流量相关和非流量相关的设备。改变流量或阻力通常会维持或增加平均、峰值和振幅 PEP 和振荡频率的产生。
