Pulmonology & interdicipilinary Medicine

Airway and Therapeutic Devices

Positive airway pressure (PAP) is a mode of respiratory ventilation used in the treatment of sleep apnea. PAP ventilation is also commonly used for those who are critically ill in hospital with respiratory failure, in newborn infants and for the prevention and treatment of atelectasis in patients with difficulty taking deep breaths. In these patients, Positive airway pressure  ventilation can prevent the need for tracheal intubation, or allow earlier extubation. Sometimes patients with neuromuscular diseases use this variety of ventilation as well.A large variety of airway clearance devices are commercially available, the two most recent being the Quake and the Lung Flute. The Quake is a pipe-shaped oscillatory PEP device that bears some resemblance to the more well-known Flutte. A distinguishing feature of the Quake is the small handle that is manually rotated to generate oscillations.This is in contrast to most other PEP devices where oscillations are generated via expiratory effort. The Quake has been reported to generate greater mucus displacement than the Flutter or Acapella devices in tracheal models, however there is little research in the COPD population and it is therefore difficult to define its role in clinical practice.