Vibratory PEP Device and Hospital Length of Stay for Acute Exacerbation of COPD
Vibratory PEP Device and Hospital Length of Stay for Acute Exacerbation of COPD
This study is evaluating the use of a respiratory device, the Acapella Vibratory Positive
 Expiratory Pressure (PEP) Therapy device, in patients admitted to the hospital with a chronic
 obstructive pulmonary disease (COPD) exacerbation.
The investigators hypothesize that the PEP-FV used as adjunctive therapy in patients
 hospitalized for an acute exacerbation of COPD will result in decreased hospital length of
 stay and improvement of overall COPD-related health outcomes.
Inclusion Criteria:

 -  Admitted with COPD exacerbation as a primary diagnosis

 -  Subjectively produces more than 1 tablespoon (15 ml) / day of sputum

 -  Has the subjective feeling that he/she cannot cough up or clear her secretions

 -  Physical respiratory system exam by the physician with evidence of course ronchi
 suggestive of impacted secretions

 -  > 10 pack-year smoking history

 Exclusion Criteria:

 -  Cannot use the flutter device or unable to follow commands

 -  Altered mental status

 -  Known active malignancy

 -  Known systolic congestive heart failure (CHF) with ejection fraction (EF) < 40% or
 clinically in acute CHF exacerbation as documented by cardiologist or primary
 diagnosis other than COPD

 -  Pregnancy

 -  Patients in severe exacerbation (Intubated, Continuous use of NIPPV, Unable to speak
 full sentences)

 -  Intracranial pressure (ICP) >20 mmHg

 -  Hemodynamic instability (requiring vasopressor support)

 -  Recent facial, oral, or skull surgery or trauma.

 -  Acute sinusitis.

 -  Epistaxis.

 -  Esophageal surgery.

 -  Active Hemoptysis (More than 2 tablespoons of frank blood per day)

 -  Nausea.

 -  Severe earache or discharge from ear. (Known or suspected tympanic membrane rupture or
 other middle ear pathology)

 -  Untreated pneumothorax.