Introduction The EZPAP is a positive pressure hand held device that amplifies an input flow of either air or oxygen approximately four times and so positive pressure is maintained throughout the patients breathing cycle. This augmentation provides a larger flow and volume with less effort than an unsupported inspiration and PEP is provided on expiration. Studies have shown that it is easier to tolerate than Intermittent Positive Pressure Breathing (IPPB) and has greater effect in reversing atelectasis than incentive spirometry. Thus, can be used within physiotherapy to increase lung volume, clear secretions and improve gaseous exchange.
Objectives To measure clinical outcomes of the EZPAP in relation to increasing lung volume, sputum clearance and gaseous exchange.
Method Data were collected from 20 patients identified as suitable for EZPAP interventions and physiological observations pretreatment and posttreatment were recorded, additionally physiotherapists and patients were asked to comment on the treatment session.
Results Patients who demonstrated decreased lung volume showed an 82% increase of air entry on auscultation and a 72% increase in thoracic expansion, whereas audible crepitations on auscultation reduced by 45% and 12% of patients demonstrated a more effective cough to clear secretions. With respect to gas exchange, there was a 33% increase in SaO2 and 12% of patients were weaned from oxygen post intervention. Additionally, this study yielded results to suggest that EZPAP also reduces the work of breathing with a mean decrease of respiratory rate of 3.5 breaths per minute. Both physiotherapists and patients found the device easy to use with a high level of compliance. Improvements in the patients were also rapid with an average of three sessions across 1.2 days.
Conclusions It can be concluded from this study that the EZPAP positive pressure device is an extremely versatile tool for the physiotherapist at a district general hospital in the management of all respiratory problems with a high level of patient compliance, ease of use and rapid clinical improvements.
Recommendations Further randomised control trials need to be undertaken utilising radiological examination and arterial blood gas sampling to avoid bias in physiological observation measurement.
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