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Positive expiratory pressure (PEP) treatment in children with multiple severe disabilities

Anna-Lena Lagerkvist1, Gunilla Sten, Barbro Westerberg

  • 1Department of Physiotherapy, The Queen Silvia Children's Hospital, Göteborg, Sweden. anna-lena.lagerkvist@vgregion.se

Acta Paediatrica (Oslo, Norway : 1992)
|September 29, 2005
PubMed

Insights

Positive expiratory pressure (PEP) therapy improved blood oxygen levels in severely disabled children with mucus buildup. This chest physiotherapy technique offers immediate benefits for oxygenation in this vulnerable population.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Therapy
  • Rehabilitation Medicine

Background:

  • Severely disabled children often have limited physical activity, impacting ventilatory stimulation.
  • These children frequently experience difficulty clearing airway mucus, increasing risk of respiratory insufficiency.

Purpose of the Study:

  • To evaluate the effectiveness of chest physiotherapy using positive expiratory pressure (PEP) in improving blood oxygen and carbon dioxide levels.
  • To assess PEP therapy's impact on oxygen tension (PO2) and carbon dioxide tension (PCO2) in children with airway mucus accumulation.

Main Methods:

  • Eighteen severely disabled children underwent transcutaneous monitoring of PO2 and PCO2 before and after PEP treatment.
  • Respiratory rate was also recorded, and the treatment's reproducibility was assessed through repeated measurements.

Main Results:

  • A statistically significant increase in mean transcutaneous PO2 (1.0 kPa) was observed immediately post-PEP treatment (p=0.0001).
  • No significant changes in transcutaneous PCO2 or respiratory rate were detected.
  • The positive effect of PEP on PO2 was reproducible across all retests, and children tolerated the treatment well.

Conclusions:

  • Positive expiratory pressure (PEP) therapy provides an immediate improvement in blood oxygen tension for severely disabled children with mucus accumulation.
  • Further research is needed to determine the long-term efficacy of PEP in this patient group.
Abstract

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