title: [Respiratory therapy with Ez-PAP for treatment of dynamic hyperinflation in patients with severe COPD and emphysema].
abstract: BACKGROUND
  Non-pharmacological respiratory physiotherapy in treatment of COPD with severe emphysema is achieving increasing importance. Ez-PAP, a compact CPAP- or flow-PEP system, supports inspiration by using the Coanda effect in addition to a PE(E)P-effect during expiration.
  
  
  METHODS
  30 patients with severe COPD and emphysema and hypercapnic respiratory failure under non-(NIV) (n = 28) and invasive ventilation (n = 2) were treated in ventilator-free intervals with Ez-PAP and analyzed retrospectively. Clinical courses such as ventilator-dependency, dyspnea by visual CR-10 Borg scale, results of six-minute walk tests (6MWT), lung function tests and recordings of transcutaneous CO2 measurements were evaluated where possible.
  
  
  RESULTS
  Analyzed patients showed less ventilator dependancy (n = 9), reported a median decrease of shortness of breath by 3,3 points (n = 10) and improved by 50,4 m in the 6MWT (n = 5). A median increase of vital capacity by 544 ml (n = 5) was shown by spirometry. Combined with manual techniques for reducing air-trapping, treatment success was documented by a median reduction of pCO2 by 7,3 mmHg (n = 6) using transcutaneous pCO2 measurement.
  
  
  CONCLUSIONS
  Ez-PAP is a simple mechanical method to reduce dynamic hyperinflation in severe COPD, thus achieving relief of respiratory muscles and more effective breathing. Prospective studies of this promising method are urgently required.
authors.affiliation: Pneumologie und Beatmungsmedizin, Thoraxklinik, Universitätsklinikum Heidelberg.
authors.forename: G
authors.initials: G
authors.lastname: Iberl
authors.affiliation: Pneumologie und Beatmungsmedizin, Thoraxklinik, Universitätsklinikum Heidelberg.
authors.forename: F
authors.initials: F
authors.lastname: Bornitz
authors.affiliation: Pneumologie und Beatmungsmedizin, Thoraxklinik, Universitätsklinikum Heidelberg.
authors.forename: M
authors.initials: M
authors.lastname: Schellenberg
authors.affiliation: Pneumologie und Beatmungsmedizin, Thoraxklinik, Universitätsklinikum Heidelberg.
authors.forename: M
authors.initials: M
authors.lastname: Wiebel
authors.affiliation: Pneumologie und Beatmungsmedizin, Thoraxklinik, Universitätsklinikum Heidelberg.
authors.forename: F J F
authors.initials: FJ
authors.lastname: Herth
authors.affiliation: Pneumologie und Beatmungsmedizin, Thoraxklinik, Universitätsklinikum Heidelberg.
authors.forename: M
authors.initials: M
authors.lastname: Kreuter
mesh_terms: D000328:Adult; D000368:Aged; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006801:Humans; D008176:Lung Volume Measurements; D008875:Middle Aged; D011175:Positive-Pressure Respiration / Q000295:instrumentation* / Q000379:methods*; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000628:therapy*; D011656:Pulmonary Emphysema / Q000175:diagnosis / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome