title: An Improvised "Blow Glove" Device Produces Similar PEP Values to a Commercial PEP Device: An Experimental Study.
abstract: BACKGROUND
  Postoperative positive expiratory pressure (PEP) therapy promotes increased lung volume, secretion clearance, and improved oxygenation. Several commercial devices exist that produce recommended PEP values (10-20 cmH2O) when the patient breathes through a fixed orifice resistor. It was hypothesized that an inexpensive, improvised "blow glove" device would produce similar PEP values over a wider range of expiration volumes and flow rates.
  
  
  METHODS
  PEP for different expiration volumes (400-2000 mL) and expiratory flow rates (10-80 L/min) was compared between a commercial PEP device (Resistex, Mercury Medical, Clearwater, FL) and an improvised "blow glove" device, recorded by a Vela ventilator (CareFusion, San Diego, CA). Dynamics in positive end expiratory pressure (PEEP) values were evaluated following five consecutive expirations. The "blow glove" device was evaluated using various glove compositions and sizes.
  
  
  RESULTS
  The improvised "blow glove" device produced a significantly higher rate of PEP values in the recommended range than the Resistex device (88.9% vs. 20%, p<0.0001). No significant difference was observed between small and large glove sizes (88.9% vs. 82.9%, p>0.05), but the powdered latex glove showed a significantly higher rate of PEP values in the recommended range than the powder-free latex glove (88.9% vs. 44.4%, p<0.001).
  
  
  CONCLUSIONS
  A "blow glove" PEP device using a powdered latex glove produces PEP values in the recommended range over a wider spectrum of expiratory flow rates and expiration volumes than a commercial PEP device.
authors.affiliation: Physiotherapy Service.
authors.forename: Yaakov
authors.initials: Y
authors.lastname: Dagan
authors.affiliation: Department of Plastic Surgery, Assaf Harofeh Medical Center, Zerifin (affiliated to Sackler Faculty of Medicine, Tel Aviv University).
authors.forename: Itay
authors.initials: I
authors.lastname: Wiser
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sheba Medical Center (affiliated to Sackler Faculty of Medicine, Tel Aviv University).
authors.forename: Oren
authors.initials: O
authors.lastname: Weissman
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sheba Medical Center (affiliated to Sackler Faculty of Medicine, Tel Aviv University).
authors.forename: Nimrod
authors.initials: N
authors.lastname: Farber
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sheba Medical Center (affiliated to Sackler Faculty of Medicine, Tel Aviv University).
authors.forename: Gabriel
authors.initials: G
authors.lastname: Hundeshagen
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sheba Medical Center (affiliated to Sackler Faculty of Medicine, Tel Aviv University).
authors.forename: Eyal
authors.initials: E
authors.lastname: Winkler
authors.affiliation: Respiratory Equipment Service, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Tamar
authors.initials: T
authors.lastname: Kazula-Halabi
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sheba Medical Center (affiliated to Sackler Faculty of Medicine, Tel Aviv University).
authors.forename: Josef
authors.initials: J
authors.lastname: Haik
keywords: breathing exercises; positive-pressure end expiration pressure; pulmonary atelectasis