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VOLUME 26 , ISSUE 11 ( November, 2022 ) > List of Articles

Original Article

Positive Expiratory Pressure Oxygen Therapy for Respiratory Distress: A Single-arm Feasibility Trial

Nitin Dhochak, Animesh Ray, Manish Soneja, Sushil K Kabra, Rakesh Lodha

Keywords : Acute respiratory distress, Oxygen therapy, Positive end-expiratory pressure valve, Positive expiratory pressure oxygen therapy, Positive expiratory pressure

Citation Information : Dhochak N, Ray A, Soneja M, Kabra SK, Lodha R. Positive Expiratory Pressure Oxygen Therapy for Respiratory Distress: A Single-arm Feasibility Trial. Indian J Crit Care Med 2022; 26 (11):1169-1174.

DOI: 10.5005/jp-journals-10071-24348

License: CC BY-NC 4.0

Published Online: 31-10-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Background: Oxygen delivery devices with positive end-expiratory pressure (PEEP) valves have been described, but high inspiratory flows may lead to poor tolerance in tachypneic patients. Positive expiratory pressure oxygen therapy (PEP-OT) using an occlusive face mask, oxygen reservoir, and PEEP valve has not been evaluated in clinical settings. Materials and methods: In a single-arm intervention trial, patients aged 19–55 years admitted with acute respiratory illness with oxygen support were enrolled. PEP-OT trial was given with PEEP of 5 and 7 cm of water over 45 minutes. Feasibility was assessed as uninterrupted completion of the PEP-OT trial. The effects of PEP-OT on cardiopulmonary physiology and adverse effects of therapy were recorded. Results: Fifteen patients (6 males) were enrolled. Fourteen patients had pneumonia and one patient had pulmonary edema. Twelve patients (80%) completed the PEP-OT trial. There was significant improvement in respiratory rate (RR) and heart rate (HR) at the end of the 45-minute PEP-OT trial (p-values 0.048 and 0.003, respectively). There was a trend toward improved SpO2 and perceived dyspnea. None of the patients developed desaturation, shock, or air leaks. Positive expiratory pressure oxygen therapy is a feasible oxygen therapy in patients with acute hypoxia. Conclusion: Positive expiratory pressure oxygen therapy seems to be safe and has a positive impact on respiratory mechanics in parenchymal respiratory pathology.

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