Laboratory investigation into the effect of flow rate on the performance of four oscillating positive expiratory pressure (OPEP) devices: Does mechanism of action matter and considerations for clinical relevance

<bold>INTRODUCTION:</bold> OPEP devices are used therapeutically to aid airway clearance where excess mucus is a challenge. OPEP devices often have differing mechanisms of action. This laboratory study compared four different OPEP devices, each with a distinctly different mechanism of action in producing the OPEP. <bold>Methods:</bold> Aerobika* (TMI), Acapella Choice Blue (ICU Medical), GeloMuc (Pohl Boskamp), and RC Cornet Plus (Cegla) OPEP devices (n=3) were assessed at steady expiratory flows of 10-40L/min using a flow generator (Resmed VPAP III), flow meter (TSI 4000), pressure tap and computer for data analysis. Average positive pressure, pressure pulse amplitude and pulse frequency were determined for each device. RESULTS / DISCUSSION: Each device can be operated at different resistances. The values at a medium resistance are reported in this study as this is typically the recommended starting setting. <fig><object-id>erj;64/suppl_68/PA1368/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig> <bold>Conclusions:</bold> Each OPEP device operates differently mechanically. This may impact device performance and potentially the clinical benefit of the device. In this study the Aerobika* OPEP device performed the best overall. When selecting an OPEP device for a patient, the existence of clinical evidence supporting efficacy, as well as lab data and patient preference, should be considered. All devices will not perform the same.