Positive Expiratory Pressure (PEP) Breathing
Positive Expiratory Pressure (PEP) breathing involves exhaling against a resistance to create back-pressure in the lower airways. This mechanical splinting prevents premature airway collapse, improves gas exchange, and assists in mobilizing retained pulmonary secretions.
- 1Sit upright in a comfortable position with your elbows resting on a table to support your respiratory muscles.
- 2Place the PEP device mouthpiece in your mouth (or use pursed lips if no device is available) and ensure a tight seal.
- 3Take a slow, deep breath in through your nose, filling your lungs slightly more than a normal breath but not to maximum capacity.
- 4Hold your breath for 2 to 3 seconds to allow air to distribute evenly throughout the lungs via collateral channels.
- 5Exhale actively but not forcefully through the mouthpiece (or pursed lips) for 3 to 4 seconds, maintaining steady pressure.
- 6Repeat this cycle for 10 to 15 breaths, then remove the device and perform a 'huff cough' to clear any loosened secretions.
Exhaling against a fixed or variable resistance generates positive pressure within the tracheobronchial tree. This back-pressure splints the airways open during exhalation, preventing the dynamic hyperinflation and premature airway collapse commonly seen in obstructive lung diseases like COPD or asthma. Additionally, the pressure gradient promotes collateral ventilation through the pores of Kohn and canals of Lambert, allowing air to get behind mucus plugs and facilitating the mobilization of secretions toward the larger central airways for expectoration.
Treats Symptoms
Target Metrics
Untreated pneumothorax, recent facial, oral, or skull surgery, active hemoptysis, epistaxis, severe cardiovascular instability, or elevated intracranial pressure.
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