PEP definition etc

• PEP:

  • The PEP system either consists of
  • a fitted facemask with a one-way valve, in which expiratory pressure resistors are inserted
  • or a mouthpiece device with adjustable expiratory resistance
  • A manometer may be incorporated into the system to assess performance

  
• PEP Technique:

  • PEP mask held over the nose and mouth
  • Sit leaning forward with elbows on table
  • Inspire and expire through PEP mask
  • Aim for 10 - 20 cmH2O on mid-expiration
  • 6 - 10 tidal volume breaths
  • Follow with the forced expiration technique
• Effects of PEP:

  • The production of Positive Expiratory Pressure increases end expiratory lung volume therefore reducing airway resistance and small airway closure
  • As a result, channels of collateral ventilation are recruited allowing air to flow behind sputum plugs thus facilitating secretion movement
  • channels of martin = between bronchiole
  • channels of lambert = one alveoli to one bronchiole
  • pores of Kohn = between alveoli
  • remember the above as Martin Luther King
  • alveolar interdependence - where neighbouring alveoli open up, causing other alveoli to open up