• Aerobika* OPEP Device Wins Gold at MEEA 2014!

Overview

Benefits of Aerobika* Oscillating PEP Therapy System

Easier mucus clearance

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Decreased cough frequency

Reduced breathlessness

Increased exercise tolerance

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Improved quality of life

Aerobika* Oscillating Positive Expiratory Pressure Therapy System Moves Mucus Out to make breathing easier
The Aerobika* Oscillating Positive Expiratory Pressure Therapy System (Oscillating PEP) is designed to aid in the loosening and removal of mucus build-up in the lungs.  Some illnesses such as COPD, cystic fibrosis, chronic bronchitis and bronchiectasis produce excess mucus that is difficult to cough out.  When this mucus is stuck in the lungs it can make breathing very difficult and cause other infections.

This video illustrates what is happening in the lungs while using the Aerobika* Oscillating PEP therapy system and why it is helpful.

>> Visit our Aerobika* YouTube Playlist to see more instructional videos

how does oscillating pep work?
With the Aerobika* Oscillating PEP device, pulses of resistance are created using the exhaled breath.  The resistance causes positive pressure to build up in the lungs – helping to hold the airways open.  The pressure gets behind the mucus, helping push it out of the smaller airways.
At the same time, the pulses (or oscillations) create vibrations within the airways helping to thin and shake loose mucus that may be too thick or sticky for the pressure alone to move.  The combination of oscillations and pressure aids in moving mucus into the central airways, where it can be coughed out.

Instructions

Tips
Use Active Exhalation
Active exhalation can best be described as the type of effort required to start blowing up a balloon — but is not as forceful as blowing out candles. Keep your cheeks flat as you exhale.

Try a ' Huff Cough'
A ‘huff cough’ will help move mucus up and out of your lungs. Just like when you use your breath to create fog on a mirror, you would take a short, shallow breath and exhale forcefully with your mouth in an ‘O’ shape. Contact your healthcare professional if you need help with the proper technique.
How to Use your Aerobika* Oscillating PEP Device
The Aerobika* Oscillating PEP device is easy to use.  It is lightweight and comfortable to hold in any position.  These simple steps will help you get the most out of the Aerobika* Oscillating PEP Therapy System:
  1. CLOSE LIPS around mouthpiece
  2. INHALE and HOLD 2–3 seconds
  3. EXHALE — slowly, steady, firmly
  4. REPEAT and cough as needed
Click to watch a short video on how to use the Aerobika* Oscillating PEP device.

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Treatments should be performed at least twice a day and can be done while sitting, standing, laying down or in any position that is comfortable. The device can also be held in any position. If you are bringing up a lot of mucus, you may need to use your Aerobika* Oscillating PEP more often.
How to clean and reassemble the device
Easy to clean and reassemble with only 4 parts.  Click here to watch a detailed video.

NOTE: If at any time during use your device does not oscillate upon exhalation, it can be reset by moving the resistance indicator and returning to its original position. If required, carefully take the device apart as instructed and inspect for damage or foreign objects. Once the device is clear of any issue, reassemble and use as per the operating instructions. Please ensure the cleaning instructions are followed as recommended.

The Importance of Distilled Water
Distilled water is purified water that has gone through a rigorous process to strip it not only of contaminants, but also naturally occurring minerals. Distillation involves boiling the water and then condensing the steam into a clean container. Distilled water is not the same as purified, filtered or bottled water. It is sold at most major retailers at a cost comparable to other bottled waters. Distilled water is recommended because other types of water can contain minerals and calcium. Over time, these minerals can deposit on components within the device causing an adverse effect on device performance.

 How to Use with a nebulizer treatment

The Aerobika* Oscillating PEP device can also be used in combination with your current nebulization treatments.  Click the image to the left to watch a video demonstrating use with the AEROECLIPSE* Breath Actuated Nebulizer.
how to set the resistance indicator
A healthcare professional should set the initial resistance level.  If this is not possible, you can start with the resistance setting in the middle.  Follow the instructions for use as indicated above.
If you are unable to do the treatment for 20 minutes, move the indicator one notch to the right towards the ‘-‘ symbol.  If it feels too easy and after 20 minutes you cannot feel any mucus ready to cough out, then dial it to the left one notch towards the ‘+’ symbol.

 

Aerobika* Oscillating PEP – Instructions for Use
Contains full instructions for use and care of the Aerobika* Oscillating PEP in 14 languages: English, French, Spanish, German, Dutch, Italian, Swedish, Danish, Greek, Turkish, Polish, Portuguese, Chinese and Arabic.

Healthcare Professionals


Meeting an unmet needThe Aerobika* OPEP device helps COPD and Bronchiectasis patients breathe easier and live better by addressing the unmet need of mucus clearance.


Impact of mucus

Chronic cough and sputum production has been linked to premature death and increased occurance of exacerbations1

50% of COPD hospital admissions are associated with bacterial infections2,3

54% of deaths occured in patients exhibiting mucus hypersecretion versus 28% of those without4

Subjects with COPD and mucus hypersecretion are more likely to die from pulmonary infections4


Impact of Aerobika* OPEP

Its unique pressure-oscillation dynamic delivers5:

Easier mucus clearance

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Decreased cough frequency

Reduced breathlessness

Increased exercise tolerance

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Improved quality of life

 

Counselling Tools
Aerobika* Oscillating PEP – Patient Counselling Pad
A quick and easy overview explaining oscillating PEP therapy and how to use the Aerobika* Oscillating PEP device.

Animation of Oscillating PEP therapy within the lungs
A short video using animation of a lung to help explain and understand the function of an oscillatory PEP device.

1 Prescott, E., P. Lange, and J. Vestbo. “Chronic mucus hypersecretion in COPD and death from pulmonary infection.” European Respiratory Journal 8.8 (1995): 1333-1338. 2 Burgel, P. R., and C. Martin. “Mucus hypersecretion in COPD: should we only rely on symptoms?.” European Respiratory Review 19.116 (2010): 94-96. 3 Tesfaigzi, Yohannes, Paula Meek, and Suzanne Lareau. “Exacerbations of chronic obstructive pulmonary disease and chronic mucus hypersecretion.” Clinical and Applied Immunology Reviews 6.1 (2006): 21-36. 4 Groenewegen, Karin H., and Emiel FM Wouters. “Bacterial infections in patients requiring admission for an acute exacerbation of COPD; a 1-year prospective study.” Respiratory medicine 97.7 (2003): 770-777. 5  Svenningsen S, Paulin G, Sheikh K, Pike D, Etemad-Rezai R, Suggett J, McCormack DG and Parraga G. Oscillating Positive Expiratory Pressure Therapy in Chronic Obstructive Pulmonary Disease and Bronchiectasis. Presentation at ERS 2014.

Technical Information

Resistance = frequency
Moving the Resistance Indicator simultaneously adjusts both resistance and frequency of oscillation.  The lowest setting has the lowest resistance and the frequency of the oscillation will be lower.  At the highest setting the resistance will be strong and the frequency of oscillations higher.
Selection of the proper resistance setting will produce the desired inspiratory:expiratory flow ratio of 1:3 or 1:4 for 10–20 minutes without excess fatigue.  It is better to have a long, active exhalation efforts than a high resistance which could lead to fatigue and shorter exhalation efforts.
In a study of patients with bronchiectasis, use of an Oscillating PEP device showed sputum viscosity decreased whether the device was set at low or high pressure, suggesting that there is no need to generate high expiratory pressure to achieve the desired result.2 In addition, they showed that the longer patients maintained expiratory effort, exposing the mucus to constant oscillation, the better the effect.
Clinical Evidence
HYPERPOLARIZED 3HE MAGNETIC RESONANCE IMAGING FOLLOWING OSCILLATORY POSITIVE EXPIRATORY PRESSURE TREATMENT IN GOLD STAGE II & III COPDSvenningsen S, Jobse BN, Hasany A, Kanhere N, Kirby M, Suggett J, McCormack DG, Parraga G.  American Thoracic Society 2013.Conclusions: “In this pilot, proof-of-concept study, self-administered oPEP therapy over 4 weeks variably affected lung volumes, VDP and symptoms in two cases with stable advanced COPD.  One COPD ex-smoker case exhibited clear improvements in Spirometry and plethysmography measurements, mucus clearance and SGRQ, whereas the other case showed no or little change during the treatment period.  Future work will involve careful patient phenotyping using MRI and CT to help stratify subjects to oPEP therapy and to better understand therapy responses.  Results in all subjects are currently being evaluated to determine the effect of 4 weeks oPEP in 14 COPD ex-smokers who completed therapy.  For two COPD ex-smokers, one a self-reported non-responder and the other a self-reported responder to oPEP, there were changes in PFTs, 3HE MRI, SGRQ and ease in bringing up sputum that were in agreement with self-reported response.”
Note:  Helium-3 (3He) is a non-radioactive isotope of helium which when used during an MRI scan helps generate high-resolution images of the respiratory system.  3He MRI was used to produce detailed images of airway function, gas trapping and/or blocked airways and, most importantly, to understand how and where gas exchange was improving for patients after use of the Aerobika* Oscillating PEP.  3He MRI is a unique imaging tool for patients with COPD.

COMBINING OSCILLATING POSITIVE EXPIRATORY PRESSURE THERAPY WITH INHALATION OF BRONCHODILATOR VIA A BREATH-ACTUATED NEBULIZER: INITIAL EVALUATION OF IN VITRO DATA TO DETERMINE NEBULIZER PERFORMANCESchmidt J, Nagel M, Schneider H, Avvakoumova V, Doyle C, Wang V, Ali R, Meyer A, Kopala R, Mitchell JP.  Respiratory Drug Delivery 2013.Conclusions:  “The delivery of medication as fine particles from the AEROECLIPSE* II BAN [Breath Actuated Nebulizer] is comparable by combining the BAN with the Aerobika* OPEP [Oscillating Positive Expiratory Pressure] device, offering the patient the opportunity for combined aerosol/OPEP therapy.  Substitution by OPEP devices that do not allow incoming aerosol to be transported directly to the patient, are likely to result in substantial loss of aerosol from this nebulizer that may be clinically significant.”

OSCILLATING POSITIVE EXPIRATORY PRESSURE FOR EFFECTIVE AIRWAY CLEARANCE Oscillations create short bursts of increased expiratory resistance to thin, dislodge and move mucus to the upper airways where it can be coughed out.
  • Aids in lung hygiene and helps prevent infections1
  • Improves gas transfer and lowers air trapping2
  • Oscillations start at the beginning of each exhalation and continue through the end for maximum effect (see graph below)
Benefits of Oscillating Positive Expiratory Pressure Therapy1,2
  • May help prevent lung infections
  • Easy to learn for independent use
  • Inexpensive and portable device
  • Little interruption to daily living
  • At least as effective as manual chest physiotherapy2
EFFECTIVE AEROSOL DELIVERY WHEN COMBINED WITH NEBULIZER TREATMENTSAerobika* Oscillating PEP may be used in combination with a small volume nebulizer with a standard 22mm adapter, and has been purposely designed to ensure the aerosol flow path delivers a respirable dose comparable to that of the nebulizer alone.  In bench testing, the Aerobika* Oscillating PEP device performed significantly better than the competitive device.3
TECHNICAL INFORMATION
VISUAL AID
An overview of the key features of the Aerobika* Oscillating PEP Therapy System.
CLINICAL WHITE PAPER
Studies supporting use of PEP and oscillatory PEP within clinical and in vitro environments.
CLINICAL STUDY OF THE AEROBIKA* OSCILLATING PEP THERAPY SYSTEM
A study conducted at Robarts Imaging at the University of Western Ontario using the Aerobika* Oscillating PEP device with Stage II and III COPD patients.




Source: 1 McCool FD, Rosen MJ. Nonpharmacologic Airway Clearance Therapies: ACCP Evidence-Based Clinical Practice Guidelines. Chest 2006;129(1):250S-259S. 2 Marks HJ. Airway Clearance Devices in Cystic Fibrosis. Paediatric Respiratory Reviews 2007;8:17-23.  3  TMI Aerosol Lab, Data on File: 4.0 mL Ipratropium bromide @ 15 L/min ± 5%; continuous delivery with an AEROECLIPSE* II Breath Actuated Nebulizer (BAN).

Where to Buy


Contact InformationPlease use the following contact information to get more information about where  Aerobika* Oscillating Positive Expiratory Pressure Therapy System can be purchased in your area.
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