Comparison of effectiveness of two positive expiratory devices in severe COPD patients: Temporary positive expiratory pressure (TPEP) versus oscillatory positive expiratory pressure ( OPEP )

Abstract

Background: recently new tools have been developed to improve airway clearence in patients with Chronic Obstructive Pulmonary Disease (COPD) Aims and objectives: The study aims to evaluate two new tools : Oscillatory Positive Expiration pressure (O-PEP) and to Temporary Positive Expiration Pressure (T-PEP) . T-PEP gives positive pressure only in the first part of the expiration phase. O-PEP combines PEP therapy with airway vibrations . Both therapies apply a low pressure of 1 H 2 O creating oscillations that promote airway secretions9 clearence.We have evaluated their role to reduce exacerbations and to improve pulmonary function tests and patients9 dyspnea ( MMRC scale ) and quality of life scales ( CAT,BCSS) in severe COPD. Methods: We selected 99 severe COPD patients for a randomized, open label 36 weeks study. 34 patients received T-PEP + standard medical therapy (STM) , 33 O-PEP + STM and 32 STM.The primary outcome was the number of exacerbations after 6 months.The secondary outcome changes in pulmonary function tests and dyspnea and quality of life scales Results: Regarding the primary outcome , only TPEP statistically reduced the exacerbations after 6 months (p Conclusion: T-PEP and O-PEP improve equally pulmonary function tests, dyspnea and quality of life scales, but only T-PEP reduces COPD exacerbations.