Oscillating Positive Expiratory Pressure Device Research Articles

CSP2023: 266 - A prospective study to identify the benefits of using an oscillatory positive expiratory pressure device in the management of bronchiectasis

CSP2023: 266 - A prospective study to identify the benefits of using an oscillatory positive expiratory pressure device in the management of bronchiectasis

Use of the Lung Flute ECO to assist in sputum collection for tuberculosis testing: a randomised crossover trial.

The Lung Flute ECO, a self-powered, low-cost oscillatory positive expiratory pressure device, assisted people with presumptive tuberculosis to produce an adequate sputum volume for diagnostic testing and was well tolerated https://bit.ly/47sDq8W.

The use of oscillatory positive expiratory pressure devices for voice therapy

Over the last three years, a variety of oscillatory positive expiratory pressure (OPEP) devices have been commonly used by voice therapist and trainers (e.g. Acapella Choice, Shaker Deluxe, Shaker Medic Plus, New Shaker), even if they were not originally created for voice-treatment purposes. OPEP are intended to be used by physiotherapists to mobilize secretions from the lower airway when treating excessive sputum or secretion retention. The mechanism of oscillatory OPEP is based on a continuous and rapid shuttering of airflow, which in turn produces modulation of the oral and tracheal air pressure as patients blows into them. People diagnosed with cystic fibrosis and neurogenic diseases are usually recommended using OPEP devices [1, 2]. OPEP devices are different from expiratory/inspiratory muscle strength training devices, which have no oscillatory mechanisms inside.

Effectiveness of the use of an oscillating positive expiratory pressure device in bronchiectasis with frequent exacerbations: a single-arm pilot study.

Impaired airway clearance in patients with non-cystic fibrosis bronchiectasis causes frequent bacterial infection, chronic inflammation, and progressive tissue destruction. We aimed to evaluate whether an oscillating positive expiratory pressure (OPEP) device could allow effective sputum expectoration and prevent acute exacerbations in patients with bronchiectasis who had frequent acute exacerbations. This open-label, single-arm, prospective study included 17 patients who experienced three or more acute exacerbations in the past year. We evaluated the prevention of acute exacerbations, subjective symptom improvement, and change in sputum amount during the use of the Aerobika (Trudell Medical International, London, ON) OPEP device twice daily for 6 months. Of all enrolled patients, only two acute exacerbations occurred during the study period, indicating a significant decrease compared with the number of acute exacerbations before the device use (p < 0.001). Additionally, Bronchiectasis Health Questionnaire score changed from 58.7 to 66.6, showing significant improvement over the treatment period (p < 0.001). The largest sputum volume was observed 3 months after OPEP device use (baseline: 10 ml, 3rd month 25 ml, p = 0.325). There were no major adverse events related to the use of OPEP devices. Twice-daily physiotherapy with OPEP device in patients with bronchiectasis who have frequent exacerbations may facilitate symptomatic improvement and prevention of acute exacerbations without serious adverse events.

Conventional chest physiotherapy compared to other airway clearance techniques for cystic fibrosis.

Conventional chest physiotherapy compared to other airway clearance techniques for cystic fibrosis.

Design and initial testing of a novel disposable oscillating positive expiratory pressure device.

Oscillating positive expiratory pressure (OPEP) devices play a key role in airway clearance, particularly in patients with cystic fibrosis. These devices, however, have the potential to become reservoirs for pathogenic organisms and require daily, or even more frequent, cleaning. This places a large burden on patients and their carers. The objective of this work was to develop a disposable OPEP device, with comparable mechanical performance to commercial devices, that negates the need for cleaning after use thus reducing microbiological risks. 3D printing was used to iterate and develop a prototype disposable device (The University of Limerick OPEP, abbreviated to the UL-OPEP) that was compared with a selection of commercially available devices for mean pressure and oscillation amplitude (cmH2O), as well as oscillation frequency (Hz). All devices were tested using a healthy volunteer at a target expiratory flow of ~ 20 L/min. The target therapeutic range was 10-20 cmH2O at a flow rate of 10-20 L/min as is reported widely in the literature. The prototype disposable device achieved a mean pressure of 14.82 cmH2O at a mean flow rate of 18.82 L/min, and generated an oscillation frequency of 26Hz with an amplitude of 1.28 cmH2O. These characteristics compare favourably with existing, more complex, reusable OPEP devices. The UL-OPEP device is a small, disposable OPEP device, that generates pressure and oscillation amplitudes for clinically effective airway clearance. The device negates the need for cleaning and disinfecting, removing the risk of devices acting as a potential reservoir for pathogenic organisms while maintaining mucus-clearing benefits.

Therapeutic efficacy of oscillating positive expiratory pressure therapy in stable chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airway and the lung to noxious particles or gases. Sputum production is a cardinal feature in COPD. Airway clearance techniques have been the mainstay of management. Oscillating positive expiratory pressure (OPEP) devices are handheld devices that provide a combination of positive expiratory pressure (PEP) with high frequency oscillations which involve exhaling against a resistance that is fluctuating. It encourages airflow within secretions, whereas oscillations induce vibrations within airway wall to displace secretions into airway lumen and help in expectoration. A randomized control trial was conducted at the department of pulmonary medicine, Government Medical College & Hospital, Chandigarh, in which 50 patients with stable COPD were enrolled for one- and- half years. After taking proper history, they were subjected to spirometry, six- minute walk test, and were asked to fill the St. George's Respiratory Questionnaire (SGRQ) and COPD Assessment Test (CAT). These patients were randomized into group A (intervention group) and group B (control group), where group A was prescribed Aerobika OPEP device for daily use for a period of three months. After three months of use of device, the patients were again subjected to assessment parameters and inquired about any exacerbation within the three- month period. At the end of three months were compared with baseline results. The median change in FEV1, FVC, 6MWD from baseline in group A was significantly more as compared to group B (FEV1: P < 0.001; FVC: P < 0.001; 6MWD: P = 0.08), whereas SGRQ score showed a significant improvement in both the intervention and control groups (P < 0.001) and CAT score showed significant improvement in comparison to the control group (P < 0.001). The median change in 6MWD and CAT from baseline in group A was significantly more as compared to group B (SGRQ: P < 0.001; CAT: P < 0.001), whereas it was not significant in case of SGRQ (P = 0.233). There was no significant difference in the incidence of exacerbation in the two groups (P = 0.19). The device did not help in controlling the rate of exacerbation in the present study at three months. Stable COPD patients who were given OPEP therapy as an adjunct to the standard drug therapy showed improvement in the spirometry parameters, exercise capacity and symptom burden in comparison to the drug only group.

An initial evaluation of the safety of a disposable oscillating positive expiratory pressure device in patients with chronic obstructive pulmonary disease: a short-term pilot study

BackgroundHandheld oscillating positive expiratory pressure (OPEP) devices have been a mainstay of treatment for patients with hypersecretory conditions such as cystic fibrosis (CF) and chronic obstructive pulmonary disease (COPD) since the 1970s. Current devices are reusable and require regular cleaning and disinfection to prevent harbouring potentially pathogenic organisms. Adherence to cleaning regimens for respiratory devices is often poor and in response to this, a prototype disposable OPEP device—the ‘UL-OPEP’ (University of Limerick—Oscillating Positive Expiratory Pressure device)—was developed to mitigate the risk of contamination by pathogens. The device was previously evaluated successfully in a group of paediatric CF patients. The aim of the current study was to initially evaluate the safety of the prototype in patients with COPD over a period of 1 month to ensure no adverse events, negative impacts on lung function, exercise tolerance, or quality of life. Data on user experience of the device were also collected during post-study follow-up.MethodsA sample of 50 volunteer participants were recruited from pulmonary rehabilitation clinics within the local hospital network. The patients were clinically stable, productive, and not current or previous users of OPEP devices. Participants were invited to use a prototype disposable OPEP device daily for a period of 1 month. Pre- and post-study lung function was assessed with standard spirometry, and exercise tolerance with the 6-min-walk-test (6MWT). Quality of life was assessed using the St. George’s Respiratory Questionnaire (SGRQ), and user experience of the prototype device evaluated using a post-study questionnaire.Results24 Participants completed the study: 9 were female. Overall median age was 67.5 years, range 53–85 years. Lung function, 6-min walk test, and SGRQ scores showed no significant change post-study. User feedback was positive overall.ConclusionsThe results indicate that the UL-OPEP is safe to use in patients with COPD. No adverse events were recorded during the study or in the follow-up period of 2 weeks. The device did not negatively impact patients’ lung function, exercise tolerance, or quality of life during short term use (1 month), and usability feedback received was generally positive. Larger, longer duration studies will be required to evaluate efficacy.Registration The study was approved as a Clinical Investigation by the Irish Health Products Regulatory Authority (CRN-2209025-CI0085).

A short-term evaluation of a prototype disposable Oscillating Positive Expiratory Pressure (OPEP) device in a cohort of children with cystic fibrosis

BackgroundOscillating Positive Expiratory Pressure (OPEP) devices are important adjuncts to airway clearance therapy in patients with cystic fibrosis (CF). Current devices are typically reusable and require daily, or often more frequent, cleaning to prevent risk of infection by acting as reservoirs of potentially pathogenic organisms. In response, a daily disposable OPEP device, the UL-OPEP, was developed to mitigate the risk of contamination and eliminate the burdensome need for cleaning devices.MethodsA convenience sample of 36 participants, all current OPEP device users, was recruited from a paediatric CF service. For one month, participants replaced their current OPEP device with a novel daily disposable device. Assessment included pre- and post-intervention lung function by spirometry, as well as Lung Clearance Index. Quality of life was assessed using the Cystic Fibrosis Questionnaire – Revised, while user experience was evaluated with a post-study survey.Results31 participants completed the study: 18 males; median age 10 years, range 4–16 years. Lung function (mean difference ± SD, %FEV1 = 1.69 ± 11.93; %FVC = 0.58 ± 10.04; FEV1: FVC = 0.01 ± 0.09), LCI (mean difference ± SD, 0.08 ± 1.13), six-minute walk test, and CFQ-R were unchanged post-intervention. Participant-reported experiences of the device were predominantly positive.ConclusionsThe disposable OPEP device maintained patients’ lung function during short term use (≤ 1 month), and was the subject of positive feedback regarding functionality while reducing the risk of airway contamination associated with ineffective cleaning.RegistrationThe study was approved as a Clinical Investigation by the Irish Health Products Regulatory Authority (CRN-2209025-CI0085).

Impact of Oscillating Positive Expiratory Pressure Device Use on Post-Discharge Hospitalizations: A Retrospective Cohort Study Comparing Patients with COPD or Chronic Bronchitis Using the Aerobika® and Acapella® Devices.

PurposeManaging and preventing disease exacerbations are key goals of COPD care. Oscillating positive expiratory pressure (OPEP) devices have been shown to improve clinical outcomes when added to COPD standard of care. This retrospective database study compared real-world resource use and disease exacerbation among patients with COPD or chronic bronchitis prescribed either of two commonly used OPEP devices.Patients and methodsPatients using the Aerobika® (Trudell Medical International, London, ON, Canada) or Acapella® (Smiths Medical, Wampsville, New York, USA) OPEP device for COPD or chronic bronchitis were identified from hospital claims linked to medical and prescription claims between September 2013 and April 2018; the index date was the first hospital visit with an OPEP device. Severe disease exacerbation, defined as an inpatient visit with a COPD or chronic bronchitis diagnosis, and all-cause healthcare resource utilization over 30 days and 12 months post-discharge were compared in propensity score (PS)-matched Aerobika device and Acapella device users.ResultsIn total, 619 Aerobika device and 1857 Acapella device users remained after PS matching. After discharge from the index visit, Aerobika device users were less likely to have ≥1 severe exacerbation within 30 days (12.0% vs 17.4%, p=0.01) and/or 12 months (39.6% vs 45.3%, p=0.01) and had fewer 12-month severe exacerbations (mean, 0.7 vs 0.9 per patient per year, p=0.01), with significantly longer time to first severe exacerbation than Acapella users (log-rank p=0.01). Aerobika device users were also less likely to have ≥1 all-cause inpatient visit within 30 days (13.9% vs 20.3%, p<0.001) and 12 months (44.9% vs 51.8%, p=0.003) than Acapella users.ConclusionPatients receiving the Aerobika OPEP device, compared to the Acapella device, had lower rates of subsequent severe disease exacerbation and all-cause inpatient admission. This suggests that Aerobika OPEP device may be a beneficial add-on to usual care and that OPEP devices may vary in clinical effectiveness.

Performance Characteristics of Positive Expiratory Pressure Devices.

Positive expiratory pressure (PEP) therapy imposes expiratory flow resistance to increase airway diameter and enhance mucus clearance. PEP is achieved several ways. Oscillatory PEP devices (OPEP) generate repeated occlusions that are known to reduce mucus viscosity. There are many marketed devices, but comparative performance is mostly unreported. The purpose of this study was to evaluate performance characteristics of many PEP/OPEP devices. For OPEP devices, we defined an optimal performance metric by creating an oscillation index that combines the OPEP performance characteristics. PEP devices (TheraPEP, EzPAP, VersaPAP, Resistex, AccuPEP, AccuPAP, and Threshold PEP) and OPEP devices (Acapella DH, Acapella DM, Acapella Choice, ShurClear, Aerobika, VibraPEP, vPEP, and PocketPEP with and without the Oxyjet attachment) were tested by adjusting simulated expiratory flow from 5 L/min to 30 L/min in increments of 5 L/min using a standard flow meter. All devices showed varying performance characteristics. As expiratory flow increased, mean PEP increased for most devices. The TheraPEP showed a mean PEP of 13 cm H2O across all settings. For OPEP devices, there was a major difference between pressure and flow waveforms. The Acapella DH, ShurClear, and Aerobika showed the highest flow amplitude, flow frequency, and oscillation index. PEP devices behaved similarly and as expected, with increased pressure with increased flow (flow resistors) or flow independence (threshold resistors). There was much greater variation in the performance of the OPEP devices. A higher oscillation index indicates better mechanical performance characteristics. Many devices have similar characteristics. However, the devices with the highest oscillation index have the highest flow amplitude and frequency, which may indicate better clinical performance.

Use of oscillatory positive expiratory pressure (OPEP) devices to augment sputum clearance in COPD: a systematic review and meta-analysis

IntroductionOscillating positive expiratory pressure (OPEP) devices are intended to facilitate sputum clearance in chronic obstructive pulmonary disease (COPD), but there is uncertainty as to their place in treatment pathways. We...

PMD12 THE BURDEN OF READMISSIONS IN THE POST-OPERATIVE POPULATION IN THE US: THE INFLUENCE OF MANAGEMENT WITH AN OSCILLATING POSITIVE EXPIRATORY PRESSURE DEVICE

Readmissions in the post-operative setting represent a large financial burden on hospitals. Optimal post-operative respiratory health management is critical to avoid costly and burdensome pulmonary complications. This study estimates the current economic burden of 30-day readmissions in patients undergoing cardiac, upper abdominal or thoracic surgery from the hospital perspective and to estimate the potential impact of an oscillating positive expiratory pressure (OPEP) device versus standard of care (SOC) alone on 30-day readmission rates and costs. Key inputs derived from published real-world evidence (RWE), include 30-day readmission rates for the OPEP device (13.9%) and SOC (22.9%), and the cost per readmission ($27,221). The cost per readmission was estimated via a cost-to-charge ratio from inpatient claims and inflated to 2019 currency. The cost of the OPEP device was $50. Additional scenario analyses tested alternative cost sources and ranges, the robustness of the results in a 500-bed hospital and identified key drivers of readmission burden and potential OPEP device impact. The model estimated 117,556 target patients for OPEP devices in the US. Assuming no target patients use the device, there would be a potential $282 million (38.5%) 30-day readmission cost saving if used in all eligible patients. In a typical 500-bed hospital, a total of 34,693 admissions would be expected per year, with 121 target patients for the OPEP device. A shift from 0% to 100% of an OPEP device use would result in 11 30-day readmissions averted and a cost savings of $290,447 (38.5%). Scenario analyses demonstrated that the device remained cost saving when varying readmission rates and adjusting population size. These findings suggest an OPEP device can potentially reduce 30-day readmission costs in post-operative patients when compared to SOC.

Expiratory Airflow Limitations on Lung Flute Effectiveness in Secretion Clearance: An Observational Cross-sectional Pilot Study

Purpose: The purpose of this observational study was to assess the validity of the Lung Flute® (LF) manufacturer's criterion for effective use of the device. Methods: Peak expiratory flow (PEF) and the ability to activate the oscillatory mechanism in the LF were assessed and compared. The diagnostic accuracy of the manufacturer's PEF threshold value of ≥128.4 L/min was determined, and an optimized threshold was derived. Results: The LF manufacturer's PEF threshold value of ≥128.4 L/min had a sensitivity of 100%, a specificity of 55%, and overall diagnostic accuracy of 83%. Nine (45%) of the twenty subjects that were not capable of activating the oscillatory device had a PEF ≥128.4 L/min. The optimal threshold value, with a sensitivity and specificity of 100%, for our sample was 167.5 L/min. Conclusions: The manufacturer's PEF threshold value of ≥128.4 L/min demonstrated high sensitivity but low specificity for predicting a patient's ability to use the LF device effectively. The optimized threshold value derived from our study was markedly higher. Clinicians should be aware that the LF manufacturer's specifications for the minimum PEF required for effective use of the device may not be evidence-based or accurate and consider this when prescribing this oscillatory positive expiratory pressure device.

Variability in expiratory flow requirements among oscillatory positive expiratory pressure.

IntroductionOscillatory positive expiratory pressure (OPEP) devices facilitate secretion clearance by generating positive end expiratory pressure. However, different device designs may produce different levels of expiratory pressure with the same expiratory flow rate. We bench tested four devices to determine the relationship between expiratory flow and expiratory pressure in each.MethodsA bench model was created to test the gas flow rates required by different OPEP devices to generate target expiratory pressure. Four different devices were tested: Acapella® (DH Green, Smiths Medical), AerobiKa® (Monaghan Medical Corporation), VibraPEP® (Curaplex), and vPEP™ (D R Burton Healthcare). Each OPEP device was tested to determine the expiratory flow needed to generate expiratory pressure thresholds considered appropriate for OPEP therapy.ResultsThe expiratory flow required to generate the same expiratory pressure thresholds varied considerably among devices. Valved OPEP devices such as the VibraPEP required less flow than mechanical devices such as the vPEP, Aerobika, and Acapella.DiscussionIn this bench test of OPEP devices, we found considerable variability in expiratory flow requirements needed to generate an expiratory pressure of >10 cm H2O. Our finding suggests that smaller patients or those with limited expiratory airflow due to diseases such as COPD, obesity, chronic congestive heart failure, and restrictive lung disease may have better results when matched to OPEP devices requiring less expiratory airflow.

Positive expiratory pressure physiotherapy for airway clearance in people with cystic fibrosis.

Positive expiratory pressure physiotherapy for airway clearance in people with cystic fibrosis.

Comparison of 6 Oscillatory Positive Expiratory Pressure Devices During Active Expiratory Flow.

Air-flow oscillations generated by exhaling through oscillatory positive expiratory pressure (OPEP) devices favor airway clearance. Variations in mechanical properties between different devices may influence therapeutic efficacy. The objective of this study was to assess mechanical properties in vitro and to compare the performance of 6 OPEP devices at different resistance levels under active expiratory flow patterns. 4 gravity-dependent OPEP devices (ie, Flutter, Gelomuc, Pari O-PEP, Shaker Medic Plus) and 2 gravity-independent OPEP devices (ie, Acapella Choice and Aerobika) were each tested at low, medium, and high resistance settings. All devices were independently connected to a pulmonary waveform generator that reproduced active exhalation flows. Expiratory flow-volume curves were retrieved from 4 subjects with different stages of obstruction severity and were scaled according to either peak expiratory flow (4, 6, and 8 L/s) or volumes (2, 3 and 4 L), thus amounting to 24 active exhalations. Resulting waveforms were divided into 4 parts and the 2 middle parts were used to extract the following mechanical data: positive expiratory pressure (PEP), maximum expiratory pressure (Ppeak), oscillation frequency, and flow oscillation amplitude. The percentage of tests achieving oscillation frequencies ≥ 12 Hz and PEP ≥ 10 cm H2O was calculated for each device. Mechanistic effects of the Acapella, Aerobika, and Shaker devices were not comparable. The Flutter, Gelomuc, and Pari devices behaved similarly and achieved more tests with optimum oscillation frequency and PEP values than the other devices. These 3 devices also produced the highest oscillation amplitudes at the low-resistance level, whereas the Aerobika elicited higher and consistent oscillation amplitudes at medium and high resistance settings. Operational parameters differed between and within devices, yet the Flutter, Gelomuc, and Pari devices were similar in many aspects. Therapeutic efficacy may depend on the selected OPEP device and set resistance.

Oscillating positive expiratory pressure (OPEP) device therapy in Canadian respiratory disease management: Review, care gaps and suggestion for use

Oscillating positive expiratory pressure (OPEP) devices are a non-pharmacologic therapy that can increase mobilization and elimination of airway mucus hypersecretions. In respiratory diseases such as chronic obstructive pulmonary disease, cystic fibrosis and others, mucus clearance can improve pulmonary mechanics and facilitate gas exchange, reduce breathlessness, prevent recurring infection, reduce exacerbations and hospitalization and improve quality of life. Several OPEP devices are available, although only a few have published evidence of efficacy, cost effectiveness and benefit to patients. We review the evidence and provide suggestions on inclusion of some OPEP devices in mucus clearance therapy regimens.

Cost-Effectiveness of the Aerobika® Oscillating Positive Expiratory Pressure Device in the Management of Chronic Obstructive Pulmonary Disease Exacerbations in Canada.

Background The Aerobika® oscillating positive expiratory pressure (OPEP) device is a hand-held, drug-free medical device that has been shown to improve lung function and improve health-related quality of life in patients with chronic obstructive pulmonary disease (COPD). We estimated the cost-effectiveness of this device among postexacerbation COPD patients in the Canadian healthcare system. Methods We performed a cost-utility analysis using a Markov model to compare both costs and outcome of patients with COPD who had recently experienced an exacerbation between 2 treatment arms: patients who used the Aerobika® device and patients who did not use the Aerobika® device. This cost-utility analysis included costs based on the Alberta healthcare system perspective as these represent Canadian experience. A one-year horizon with 12 monthly cycles was used. Results For a patient after 1 year, the use of the Aerobika® device would save $694 in healthcare costs and produce 0.04 more in quality-adjusted life years (QALYs) in comparison with no positive expiratory pressure (PEP)/OPEP therapy. In other words, the economic outcome of the device was dominant (i.e., more effective and less costly). The probability for this device to be the dominant strategy was 72%. With a willingness to pay (WTP) threshold of $50,000 per QALY gained, the probability for the Aerobika® device to be cost-effective was 77%. Conclusions Given one of the major treatment goals in the GOLD guidelines is to minimize the negative impact of exacerbations and prevent re-exacerbations, the Aerobika® OPEP device should be viewed as a potential component of a treatment strategy to improve symptom control and reduce the risk of re-exacerbations in patients with COPD.

Can Perioperative Oscillating Positive Expiratory Pressure Practice Enhance Recovery in Lung Cancer Patients Undergoing Thorascopic Lobectomy?

背景与目的振动正压呼气（oscillatory positive expiratory pressure, OPEP）训练是一种通过正压呼气装置（acapella）进行的呼吸训练。OPEP在慢性阻塞性肺疾病、支气管扩张症、肺囊肿等疾病的临床价值已经得到广泛探讨，但其在肺癌手术患者围术期的应用价值尚有待探索。本研究旨在探索围术期进行振动正压呼气训练对胸腔镜肺癌患者术后并发症发生率、肺功能、生活质量的影响。方法前瞻性收集2017年9月15日-2018年1月15日四川大学华西医院胸外科单个医疗组行胸腔镜肺叶切除的原发性非小细胞癌患者69例，随机分成实验组（35例）和对照组（34例）。实验组（acapella group, AG）围手术期采用振动正压呼气训练，对照组（control group, CG）进行常规围术期处理。对比分析两组在术后并发症发生率、肺功能、生活质量方面的差异。结果术后肺部并发症和肺不张在AG（2.9%, 0.0%）显著低于CG（20.6%, 14.7%）（P=0.03, P=0.03）；平均住院日和术后住院日在AG（10.86±5.64, 5.09±4.55）d显著短于CG（14.41±4.58, 7.59±3.21）d（P=0.01, P=0.01）；住院药物费用在AG（4, 413.60±1, 772.35）￥显著低于CG（6, 490.35±3, 367.66）￥（P=0.01）。出院当日第1秒用力呼气容积（forced expiratory volume in the first second, FEV1）和呼气峰流速（peak expiratory flow, PEF）在AG[(1.50±0.32) L, (252.06±75.27) L/min]显著高于CG[(1.34±0.19) L, (216.94±49.72) L/min]（P=0.03, P=0.03）。结论肺癌患者围手术期使用振动正压呼气训练有助于降低肺部并发症，同时能够加速患者康复。