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Erschienen in: Irish Journal of Medical Science (1971 -) 5/2023

23.11.2022 | Original Article

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

verfasst von: Kevin J. O’Sullivan, Colum P. Dunne, Barry Linnane, Deirdre McGrath, Leonard O’Sullivan

Erschienen in: Irish Journal of Medical Science (1971 -) | Ausgabe 5/2023

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Abstract

Background

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.

Aims

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.

Methods

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.

Results

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 26 Hz with an amplitude of 1.28 cmH2O. These characteristics compare favourably with existing, more complex, reusable OPEP devices.

Conclusions

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.
Literatur
1.
2.
Zurück zum Zitat Hauber H-P, Foley SC, Hamid Q (2006) Mucin overproduction in chronic inflammatory lung disease. Canadian respiratory journal 13 Hauber H-P, Foley SC, Hamid Q (2006) Mucin overproduction in chronic inflammatory lung disease. Canadian respiratory journal 13
3.
Zurück zum Zitat Flume PA, Robinson KA, O’Sullivan BP et al (2009) Cystic fibrosis pulmonary guidelines: airway clearance therapies. Respir Care 54:522–537PubMed Flume PA, Robinson KA, O’Sullivan BP et al (2009) Cystic fibrosis pulmonary guidelines: airway clearance therapies. Respir Care 54:522–537PubMed
4.
Zurück zum Zitat Rajan S, Saiman L (2002) Pulmonary infections in patients with cystic fibrosis. In: Seminars in respiratory infections 1:47–56 Rajan S, Saiman L (2002) Pulmonary infections in patients with cystic fibrosis. In: Seminars in respiratory infections 1:47–56
6.
Zurück zum Zitat Yang I, Brown J, George J et al (2018) The COPD-X plan: Australian and New Zealand guidelines for the management of chronic obstructive pulmonary disease 2018, version 2.53. Lung Foundation Australia Yang I, Brown J, George J et al (2018) The COPD-X plan: Australian and New Zealand guidelines for the management of chronic obstructive pulmonary disease 2018, version 2.53. Lung Foundation Australia
7.
Zurück zum Zitat Ewart W (1901) The treatment of bronchiectasis and of chronic bronchial affections by posture and by respiratory exercises. The Lancet 158:70–72CrossRef Ewart W (1901) The treatment of bronchiectasis and of chronic bronchial affections by posture and by respiratory exercises. The Lancet 158:70–72CrossRef
9.
Zurück zum Zitat Myers TR (2007) Positive expiratory pressure and oscillatory positive expiratory pressure therapies. Respir Care 52:1308–1327PubMed Myers TR (2007) Positive expiratory pressure and oscillatory positive expiratory pressure therapies. Respir Care 52:1308–1327PubMed
10.
Zurück zum Zitat Hess DR, MacIntyre NR, Galvin WF, Mishoe SC (2007) Airway clearance: physiology, pharmacology, techniques, and practice. Respir Care 52:1392–1396PubMed Hess DR, MacIntyre NR, Galvin WF, Mishoe SC (2007) Airway clearance: physiology, pharmacology, techniques, and practice. Respir Care 52:1392–1396PubMed
11.
Zurück zum Zitat McIlwaine PM, Wong LT, Peacock D, Davidson AGF (2001) Long-term comparative trial of positive expiratory pressure versus oscillating positive expiratory pressure (flutter) physiotherapy in the treatment of cystic fibrosis. The Journal of Pediatrics w138:845–850. https://doi.org/10.1067/mpd.2001.114017 McIlwaine PM, Wong LT, Peacock D, Davidson AGF (2001) Long-term comparative trial of positive expiratory pressure versus oscillating positive expiratory pressure (flutter) physiotherapy in the treatment of cystic fibrosis. The Journal of Pediatrics w138:845–850. https://​doi.​org/​10.​1067/​mpd.​2001.​114017
12.
Zurück zum Zitat McIlwaine PM, Wong LT, Peacock D et al (1997) Long-term comparative trial of conventional postural drainage and percussion versus positive expiratory pressure physiotherapy in the treatment of cystic fibrosis. J Pediatr 131:570–574CrossRefPubMed McIlwaine PM, Wong LT, Peacock D et al (1997) Long-term comparative trial of conventional postural drainage and percussion versus positive expiratory pressure physiotherapy in the treatment of cystic fibrosis. J Pediatr 131:570–574CrossRefPubMed
13.
Zurück zum Zitat App EM, Kieselmann R, Reinhardt D et al (1998) Sputum rheology changes in cystic fibrosis lung disease following two different types of physiotherapy: flutter vs autogenic drainage. Chest 114:171–177CrossRefPubMed App EM, Kieselmann R, Reinhardt D et al (1998) Sputum rheology changes in cystic fibrosis lung disease following two different types of physiotherapy: flutter vs autogenic drainage. Chest 114:171–177CrossRefPubMed
14.
Zurück zum Zitat Franks LJ, Walsh JR, Hall K et al (2019) Comparing the performance characteristics of different positive expiratory pressure devices. Respir Care 64:434–444CrossRefPubMed Franks LJ, Walsh JR, Hall K et al (2019) Comparing the performance characteristics of different positive expiratory pressure devices. Respir Care 64:434–444CrossRefPubMed
16.
Zurück zum Zitat Shabari V, Alaparthi GK, Vaishali V (2011) Comparison of acapella and rc-cornet for airway clearance in bronchiectasis-a pilot study. International Journal of Current Research and Review 3:138 Shabari V, Alaparthi GK, Vaishali V (2011) Comparison of acapella and rc-cornet for airway clearance in bronchiectasis-a pilot study. International Journal of Current Research and Review 3:138
17.
Zurück zum Zitat Volsko TA, DiFiore JM, Chatburn RL (2003) Performance comparison of two oscillating positive expiratory pressure devices: Acapella versus Flutter. Respir Care 48:124–130PubMed Volsko TA, DiFiore JM, Chatburn RL (2003) Performance comparison of two oscillating positive expiratory pressure devices: Acapella versus Flutter. Respir Care 48:124–130PubMed
20.
Zurück zum Zitat Denton M, Rajgopal A, Mooney L et al (2003) Stenotrophomonas maltophilia contamination of nebulizers used to deliver aerosolized therapy to inpatients with cystic fibrosis. J Hosp Infect 55:180–183CrossRefPubMed Denton M, Rajgopal A, Mooney L et al (2003) Stenotrophomonas maltophilia contamination of nebulizers used to deliver aerosolized therapy to inpatients with cystic fibrosis. J Hosp Infect 55:180–183CrossRefPubMed
21.
Zurück zum Zitat O’Malley CA (2009) Infection control in cystic fibrosis: cohorting, cross-contamination, and the respiratory therapist. Respir Care 54:641–657CrossRefPubMed O’Malley CA (2009) Infection control in cystic fibrosis: cohorting, cross-contamination, and the respiratory therapist. Respir Care 54:641–657CrossRefPubMed
22.
Zurück zum Zitat Van Fleet H, Dunn DK, McNinch NL, Volsko TA (2017) Evaluation of functional characteristics of 4 oscillatory positive pressure devices in a simulated cystic fibrosis model. Respir Care 62:451–458CrossRefPubMed Van Fleet H, Dunn DK, McNinch NL, Volsko TA (2017) Evaluation of functional characteristics of 4 oscillatory positive pressure devices in a simulated cystic fibrosis model. Respir Care 62:451–458CrossRefPubMed
23.
Zurück zum Zitat Steen H, Redmond A, O’NEILL D, Beattie F (1991) Evaluation of the PEP mask in cystic fibrosis. Acta Paediatr 80:51–56CrossRef Steen H, Redmond A, O’NEILL D, Beattie F (1991) Evaluation of the PEP mask in cystic fibrosis. Acta Paediatr 80:51–56CrossRef
24.
Zurück zum Zitat McIlwaine M (2006) Physiotherapy and airway clearance techniques and devices. Paediatr Respir Rev 7:S220–S222CrossRefPubMed McIlwaine M (2006) Physiotherapy and airway clearance techniques and devices. Paediatr Respir Rev 7:S220–S222CrossRefPubMed
25.
Zurück zum Zitat Placidi G, Cornacchia M, Polese G et al (2006) Chest physiotherapy with positive airway pressure: a pilot study of short-term effects on sputum clearance in patients with cystic fibrosis and severe airway obstruction. Respir Care 51:1145–1153PubMed Placidi G, Cornacchia M, Polese G et al (2006) Chest physiotherapy with positive airway pressure: a pilot study of short-term effects on sputum clearance in patients with cystic fibrosis and severe airway obstruction. Respir Care 51:1145–1153PubMed
26.
Zurück zum Zitat Hristara-Papadopoulou A, Tsanakas J, Diomou G, Papadopoulou O (2008) Current devices of respiratory physiotherapy. Hippokratia 12:211PubMedPubMedCentral Hristara-Papadopoulou A, Tsanakas J, Diomou G, Papadopoulou O (2008) Current devices of respiratory physiotherapy. Hippokratia 12:211PubMedPubMedCentral
27.
Zurück zum Zitat McIlwaine M, Agnew J, Black C (2008) Use Of airway clearance techniques incystic fibrosis clinics in Canada. Pediatr Pulmonol 43:392–393 McIlwaine M, Agnew J, Black C (2008) Use Of airway clearance techniques incystic fibrosis clinics in Canada. Pediatr Pulmonol 43:392–393
29.
Zurück zum Zitat Neely AN (2000) A survey of gram-negative bacteria survival on hospital fabrics and plastics. J Burn Care Rehabil 21:523–527CrossRefPubMed Neely AN (2000) A survey of gram-negative bacteria survival on hospital fabrics and plastics. J Burn Care Rehabil 21:523–527CrossRefPubMed
30.
Zurück zum Zitat Manor E, Gur M, Geffen Y, Bentur L (2017) Cleaning and infection control of airway clearance devices used by CF patients. Chron Respir Dis 14:370–376CrossRefPubMedPubMedCentral Manor E, Gur M, Geffen Y, Bentur L (2017) Cleaning and infection control of airway clearance devices used by CF patients. Chron Respir Dis 14:370–376CrossRefPubMedPubMedCentral
31.
Zurück zum Zitat Reychler G, Aarab K, Van Ossel C et al (2005) In vitro evaluation of efficacy of 5 methods of disinfection on mouthpieces and facemasks contaminated by strains of cystic fibrosis patients. J Cyst Fibros 4:183–187CrossRefPubMed Reychler G, Aarab K, Van Ossel C et al (2005) In vitro evaluation of efficacy of 5 methods of disinfection on mouthpieces and facemasks contaminated by strains of cystic fibrosis patients. J Cyst Fibros 4:183–187CrossRefPubMed
32.
Zurück zum Zitat Saiman L, Siegel JD, LiPuma JJ et al (2014) Infection prevention and control guideline for cystic fibrosis: 2013 update. Infect Control Hosp Epidemiol 35:1–67CrossRefPubMed Saiman L, Siegel JD, LiPuma JJ et al (2014) Infection prevention and control guideline for cystic fibrosis: 2013 update. Infect Control Hosp Epidemiol 35:1–67CrossRefPubMed
35.
Zurück zum Zitat Santos MD, Milross MA, Alison JA (2016) Therapist-made bubble-positive expiratory pressure: a survey of physiotherapists in Australia. Cardiopulmonary Physical Therapy Journal 27:3–10CrossRef Santos MD, Milross MA, Alison JA (2016) Therapist-made bubble-positive expiratory pressure: a survey of physiotherapists in Australia. Cardiopulmonary Physical Therapy Journal 27:3–10CrossRef
36.
Zurück zum Zitat Ngan CG, O’Connell CD, Blanchard R et al (2019) Optimising the biocompatibility of 3D printed photopolymer constructs in vitro and in vivo. Biomed Mater 14:035007CrossRefPubMed Ngan CG, O’Connell CD, Blanchard R et al (2019) Optimising the biocompatibility of 3D printed photopolymer constructs in vitro and in vivo. Biomed Mater 14:035007CrossRefPubMed
40.
Zurück zum Zitat Bradley JM, Moran FM, Elborn JS (2006) Evidence for physical therapies (airway clearance and physical training) in cystic fibrosis: an overview of five Cochrane systematic reviews. Respir Med 100:191–201CrossRefPubMed Bradley JM, Moran FM, Elborn JS (2006) Evidence for physical therapies (airway clearance and physical training) in cystic fibrosis: an overview of five Cochrane systematic reviews. Respir Med 100:191–201CrossRefPubMed
41.
Zurück zum Zitat Macintyre NR, Galvin WF (2015) Respiratory care: principles and practice. Jones & Bartlett Publishers Macintyre NR, Galvin WF (2015) Respiratory care: principles and practice. Jones & Bartlett Publishers
42.
Zurück zum Zitat Mestriner RG, Fernandes RO, Steffen LC, Donadio MVF (2009) Optimum design parameters for a therapist-constructed positive-expiratory-pressure therapy bottle device. Respir Care 54:504–508PubMed Mestriner RG, Fernandes RO, Steffen LC, Donadio MVF (2009) Optimum design parameters for a therapist-constructed positive-expiratory-pressure therapy bottle device. Respir Care 54:504–508PubMed
43.
Zurück zum Zitat Mueller G, Bersch-Porada I, Koch-Borner S et al (2014) Laboratory evaluation of four different devices for secretion mobilization: acapella choice, green and blue versus water bottle. Respir Care 59:673–677CrossRefPubMed Mueller G, Bersch-Porada I, Koch-Borner S et al (2014) Laboratory evaluation of four different devices for secretion mobilization: acapella choice, green and blue versus water bottle. Respir Care 59:673–677CrossRefPubMed
Metadaten
Titel
Design and initial testing of a novel disposable oscillating positive expiratory pressure device
verfasst von
Kevin J. O’Sullivan
Colum P. Dunne
Barry Linnane
Deirdre McGrath
Leonard O’Sullivan
Publikationsdatum
23.11.2022
Verlag
Springer International Publishing
Erschienen in
Irish Journal of Medical Science (1971 -) / Ausgabe 5/2023
Print ISSN: 0021-1265
Elektronische ISSN: 1863-4362
DOI
https://doi.org/10.1007/s11845-022-03225-1

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