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Nurse-led oscillating positive expiratory pressure (OPEP)

Emma Rickards looks at new forms of airway clearance techniques, and how patients take to them
Showing the effect of bronchiectasis on the bronchus, illustrating the importance of airway clearance

Airway clearance techniques, historically referred to as chest physical therapy, have traditionally consisted of a variety of breathing exercises, manoeuvres, manual percussion and postural drainage. To find a more effective way to promote ‘self-therapy’ and better patient adherence, techniques and devices have rapidly increased.1

Oscillating positive expiratory pressure (OPEP) devices are often used as a form of chest physiotherapy to clear mucus from the lungs of individuals with hypersecretory conditions such as chronic obstructive pulmonary disease (COPD), bronchiectasis and cystic fibrosis . OPEP devices seek to interrupt expiratory airflow by providing resistance during exhalation, causing the airways to vibrate.2
These induced vibrations thin and loosen mucus, allowing the mucus to naturally move to the upper airways where it may be easily coughed out.3 OPEP devices are already available through NHS prescribing and several devices are available. Most commonly seen devices are the Aerobika®, Acapella® and Flutter®.

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